{ "schema_version": 1, "kind": "condition", "id": "biliary-colic", "name": "Biliary Colic (symptomatic gallstones)", "category": "chronic", "sources": "Egyptian National Drug Formulary (ENDF) 2026 · Egyptian National Drug Formulary 2026 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Ibuprofen 400 mg film-coated tablets (POM) SmPC section 4.2 (eMC product 7020) · MSF Essential Drugs 2024 - paracetamol (oral) · NICE Guideline CG188: Gallstone disease: diagnosis and management 2014 · Diclofenac sodium 50 mg delayed-release (gastro-resistant) tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID a57b897e-0cbe-4ac3-969f-b00357a0cfa8) for the oral dose; the intramuscular dose is from Voltarol Ampoules (diclofenac sodium 75 mg in 3 ml solution for injection) SmPC section 4.2 (eMC product 1043): \"One ampoule once (or in severe cases twice) daily intramuscularly by deep intragluteal injection into the upper outer quadrant\"", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary 2026 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Ibuprofen 400 mg film-coated tablets (POM) SmPC section 4.2 (eMC product 7020) · MSF Essential Drugs 2024 - paracetamol (oral) · Diclofenac sodium 50 mg delayed-release (gastro-resistant) tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID a57b897e-0cbe-4ac3-969f-b00357a0cfa8) for the oral dose; the intramuscular dose is from Voltarol Ampoules (diclofenac sodium 75 mg in 3 ml solution for injection) SmPC section 4.2 (eMC product 1043): \"One ampoule once (or in severe cases twice) daily intramuscularly by deep intragluteal injection into the upper outer quadrant\" · Gallstones (Cholelithiasis) - disease-level clinical article (biliary-colic-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 275, "generic": "Diclofenac", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "50 mg two to three times daily with or after food (or 75 mg IM deep intragluteal injection single dose for severe acute pain)", "adult_duration": "1-3 days PRN during acute pain episode", "dose_source": "Diclofenac sodium 50 mg delayed-release (gastro-resistant) tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID a57b897e-0cbe-4ac3-969f-b00357a0cfa8) for the oral dose; the intramuscular dose is from Voltarol Ampoules (diclofenac sodium 75 mg in 3 ml solution for injection) SmPC section 4.2 (eMC product 1043): \"One ampoule once (or in severe cases twice) daily intramuscularly by deep intragluteal injection into the upper outer quadrant\"", "rationale": "NSAID that blocks prostaglandin synthesis; because prostaglandins drive gallbladder wall contraction against the obstructed cystic duct, blocking them is what relieves the pain of biliary colic, and it is why NSAIDs are first-line here.", "cautions": [ "First-line analgesia for biliary colic because NSAIDs inhibit prostaglandin-mediated gallbladder wall contraction.", "Contraindicated in active gastrointestinal ulceration, severe heart failure, established ischemic heart disease, or severe renal impairment.", "Refer urgently if pain persists >6 hours, accompanied by fever/chills (acute cholecystitis) or jaundice/dark urine (choledocholithiasis/cholangitis)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Pediatric biliary colic is rare and requires urgent pediatric surgical / gastroenterology referral", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DECLOFENAC 50MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 12.0, "pack_count": 20, "unit_price": 0.6, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RHEUMARENE 50MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 13.5, "pack_count": 20, "unit_price": 0.68, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DICLORAPID 50MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SPIMACO MISR", "price_egp": 37.5, "pack_count": 30, "unit_price": 1.25, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITOXANAL 50 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB CAPS > SUECAL PHARMA", "price_egp": 69.0, "pack_count": 30, "unit_price": 2.3, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RHUMAQUICK 50 MG 20 DISP. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OFLAM 50 MG 20 QUICKETAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > ACINO", "price_egp": 48.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DECLOPHEN FAST 50MG GR. FOR ORAL SUSP. 30 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 102.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACTIFAST 50 MG 30 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > OCTOBER PHARMA", "price_egp": 105.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CATAFLAM 15MG/ML ORAL DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 15.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "DOLPHIN K 15MG/ML ORAL DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 11.25, "pack_count": null, "unit_price": null, "strength_mg": 15.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "biliary-colic" }, { "id": 276, "generic": "Ibuprofen", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "400 mg three to four times daily with or after food PRN during acute pain episodes (maximum 2400 mg/day)", "adult_duration": "1-3 days PRN", "dose_source": "Ibuprofen 400 mg film-coated tablets (POM) SmPC section 4.2 (eMC product 7020)", "rationale": "NSAID with the same prostaglandin-blocking mechanism as diclofenac, used as an alternative first-line analgesic for biliary colic during acute pain episodes.", "cautions": [ "Take with or after food to reduce gastric mucosal irritation.", "Avoid in severe renal impairment, active peptic ulcer disease, or severe asthma triggered by NSAIDs.", "Refer to general surgery for elective laparoscopic cholecystectomy for recurrent symptomatic gallstones.", "Above 1200 mg a day is prescription territory, not the over-the-counter suspension. The tablet label allows up to 2400 mg in three or four divided doses, but only as a temporary increase in an acute severe episode, and no single dose above 800 mg." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric evaluation required for gallstone symptoms.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "biliary-colic" }, { "id": 279, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Gallstones (Cholelithiasis) - disease-level clinical article (biliary-colic-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Urgent hospital admission is needed for fever, sepsis, acute cholangitis, or cholecystitis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "biliary-colic" }, { "id": 277, "generic": "Paracetamol", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500-1000 mg three or four times a day PRN when NSAIDs are contraindicated (maximum 4000 mg/24 hours)", "adult_duration": "1-3 days PRN", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "Alternative non-opioid analgesic when NSAIDs are contraindicated due to peptic ulcer disease, asthma, or renal impairment.", "cautions": [ "Do not exceed 4000 mg total daily dose to prevent severe liver injury.", "Check co-formulated analgesics or cold remedies to avoid inadvertent paracetamol double-dosing." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Pediatric evaluation required for suspected biliary pain.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARAMOL 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOL 500MG 24 CAPLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "biliary-colic" }, { "id": 278, "generic": "Hyoscine butylbromide", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10-20 mg three to four times daily PRN for acute visceral spasm", "adult_duration": "1-3 days PRN", "dose_source": "Egyptian National Drug Formulary 2026", "rationale": "Antispasmodic targeting smooth muscle spasm of the biliary tract; widely used as an adjunct to NSAIDs in Egyptian primary care.", "cautions": [ "Use with caution in prostatic enlargement, urinary retention, narrow-angle glaucoma, or tachycardia." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children (6 to 12 years): Oral: 10 mg three times daily.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "6 to 12 years", "age_min_months": 72, "age_max_months": 155, "dose_text": "10 mg by mouth three times daily" } ], "peds_doses": null, "brands": [ { "trade_name": "NU-SPASM 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 4.0, "pack_count": 20, "unit_price": 0.2, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BUTACID 10MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 20.0, "pack_count": 20, "unit_price": 1.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPASMOCIN 10MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BUSCOPAN 10 MG 20 SUGAR C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SERVIER > Opella Healthcare", "price_egp": 56.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPASMOCIN 100MG/100ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 3.85, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "FARCORELAXIN 1MG/ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "biliary-colic" } ] }