{ "schema_version": 1, "kind": "condition", "id": "bronchial-asthma", "name": "Bronchial asthma", "category": "chronic", "sources": "GINA Asthma Strategy 2023 · Egyptian National Drug Formulary - Respiratory System 2026 (montelukast monograph) · Symbicort Turbohaler 200/6 SmPC section 4.2 (eMC product 1327) · SIGN 158 / BTS British guideline on the management of asthma (2019), section 9.3.3 · SIGN 158 / BTS British guideline on the management of asthma (2019), section 9.8.4 · Goldin J, Cataletto ME. Asthma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: May 3, 2024.", "review_status": "reviewed", "verified_against": "GINA Asthma Strategy 2023 · Egyptian National Drug Formulary - Respiratory System 2026 (montelukast monograph) · Symbicort Turbohaler 200/6 SmPC section 4.2 (eMC product 1327) · SIGN 158 / BTS British guideline on the management of asthma (2019), section 9.3.3 · SIGN 158 / BTS British guideline on the management of asthma (2019), section 9.8.4", "verified_date": "2026-08", "treatments": [ { "id": 306, "generic": "Salbutamol", "line": 1, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 0.1, "adult_dose": "100-200 mcg (1-2 puffs of 100 mcg/puff) as needed for acute symptom relief", "adult_duration": "as-needed", "dose_source": "GINA Asthma Strategy 2023", "rationale": "Short-acting beta-agonist that relaxes bronchial smooth muscle for quick relief of acute asthma symptoms; a reliever only, and never to be used without a concomitant inhaled corticosteroid, since reliever-only treatment is what leads to fatal exacerbations.", "cautions": [ "Never on its own. NICE NG245 1.6.3 is a flat prohibition: do not prescribe a short-acting beta 2 agonist, at any age, to a person with asthma unless an ICS is prescribed with it. Reliever-only treatment is what kills asthmatics.", "Overuse (>2 canisters/year) indicates poor asthma control.", "May cause tremor and tachycardia at high doses.", "Use with spacer device in young children." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "100-200 mcg as needed via spacer in children", "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": "AEROLIN 100MCG/DOSE INHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO > 3M HEALTH CARE-U.K.", "price_egp": 7.3, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BUTALIN 100MCG/ACTUATION 200 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VENTAL INHALER 100 MCG/DOSE 200 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 72.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIASALMOL 100MCG 200 ACTUATION INHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MDI PHARMA", "price_egp": 72.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VENTOLIN EVOHALER 100MCG/ACTUATION INHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 86.0, "pack_count": null, "unit_price": null, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OPICHESTAL SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 2.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "SALBUTAMOL 2MG/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 3.5, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "bronchial-asthma" }, { "id": 307, "generic": "Budesonide", "line": 1, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 0.2, "adult_dose": "200-400 mcg (1-2 puffs of 200 mcg/puff) BID regular maintenance", "adult_duration": "long-term", "dose_source": "GINA Asthma Strategy 2023", "rationale": "Inhaled corticosteroid that reduces the chronic airway inflammation underlying asthma; a regular controller taken to prevent symptoms rather than to relieve an acute attack.", "cautions": [ "Rinse mouth after inhalation to prevent candidiasis.", "Counsel on daily compliance even when asymptomatic.", "Budesonide is not for acute relief of bronchospasm." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "100-200 mcg BID maintenance in children", "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": "BUDECORT 200MCG/DOSE INHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 55.0, "pack_count": null, "unit_price": null, "strength_mg": 0.2, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PULMICORT 200MCG/DOSE TURBOHALER", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ASTRA ZENECA", "price_egp": 110.0, "pack_count": null, "unit_price": null, "strength_mg": 0.2, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "bronchial-asthma" }, { "id": 310, "generic": "Budesonide + formoterol", "line": 1, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 0.2, "adult_dose": "200/6 mcg per inhalation. As-needed AIR: 1 inhalation whenever symptoms occur, no regular dose. As MART: 1 inhalation morning and evening plus 1 extra whenever symptoms occur; not more than 6 on any single occasion and not normally more than 8 in a day", "adult_duration": "long-term", "dose_source": "Symbicort Turbohaler 200/6 SmPC section 4.2 (eMC product 1327)", "rationale": "NG245 makes a low-dose ICS/formoterol inhaler the first thing written for newly diagnosed asthma in anyone 12 and over. The condition currently starts with a plain salbutamol reliever, which the same guideline says must never be prescribed without an inhaled steroid. This is the single biggest gap in the asthma card.", "cautions": [ "The whole point of this inhaler is that the steroid travels with the reliever. If the patient is given a separate salbutamol as well, they will use that instead and the steroid stops being taken.", "AIR and MART are two different prescriptions. AIR is as-needed only. MART is one puff twice a day plus as-needed. Write which one you mean on the Roschetta.", "Rinse the mouth after every inhalation to prevent oral thrush.", "Using more than 8 inhalations a day means the asthma is not controlled - review, do not just refill.", "Formoterol is a long-acting beta agonist. Never combine this with a separate LABA inhaler." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The AIR and MART recommendations apply from 12 years. The SmPC states reliever therapy with this product is not recommended under 12 years; a younger child needs the paediatric pathway and a separate ICS.", "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": "MDICORVAL 200MCG/6MCG 120 METERED ACTUATIONS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MDI PHARMA", "price_egp": 198.0, "pack_count": null, "unit_price": null, "strength_mg": 0.2, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "bronchial-asthma" }, { "id": 308, "generic": "Salmeterol + Fluticasone", "line": 2, "is_adjunct": false, "form": "oral.inhalation", "strength_mg": 0.25, "adult_dose": "1 puff (50/250 mcg per puff) BID", "adult_duration": "long-term", "dose_source": "GINA Asthma Strategy 2023", "rationale": "Combination long-acting beta-agonist and inhaled corticosteroid used as a step-up controller when inhaled corticosteroid alone does not achieve control; the long-acting bronchodilator is not for acute relief and is always paired here with the steroid component.", "cautions": [ "Do not use for acute symptom relief.", "Rinse mouth after each dose to avoid oral thrush.", "Step down therapy once controlled for 3 months." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist referral for ICS-LABA in children under 12", "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": "SEROFLO 100/50MCG PD. FOR INH. 30 BLISTERS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 52.5, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEROFLO 250/50MCG PD. FOR INH. 30 BLISTERS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEROFLO 500/50MCG PD. FOR INH. 30 BLISTERS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY", "price_egp": 77.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METRICASON 125/25 MCG 120 METERED ACTUATIONS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MDI PHARMA", "price_egp": 121.0, "pack_count": null, "unit_price": null, "strength_mg": 0.025, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE EVOHALER 50/25MCG 120 METERED ACTUATIONS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 198.0, "pack_count": null, "unit_price": null, "strength_mg": 0.025, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE DISKUS 100/50MCG 60 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 244.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE DISKUS 250/50MCG 60 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 335.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERETIDE DISKUS 500/50MCG 60 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > MODERN PHARMA", "price_egp": 411.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "bronchial-asthma" }, { "id": 309, "generic": "Montelukast", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10 mg once daily in the evening", "adult_duration": "long-term", "dose_source": "Egyptian National Drug Formulary - Respiratory System 2026 (montelukast monograph)", "rationale": "Leukotriene receptor antagonist used as an add-on or alternative oral controller when inhaled corticosteroid therapy needs to be stepped up; less effective than inhaled corticosteroids as monotherapy, as the cautions note.", "cautions": [ "Monitor for mood and behavior changes.", "Montelukast carries an FDA warning for neuropsychiatric events.", "Montelukast is less effective than ICS as monotherapy." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "4 mg (6 mos-5 yrs) or 5 mg (6-14 yrs) or 10 mg (15-17 yrs) once daily in evening", "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 months to 5 years", "age_min_months": 6, "age_max_months": 71, "dose_text": "4 mg once daily in the evening" }, { "label": "6 to 14 years", "age_min_months": 72, "age_max_months": 179, "dose_text": "5 mg once daily in the evening" }, { "label": "15 to 17 years", "age_min_months": 180, "age_max_months": 215, "dose_text": "10 mg once daily in the evening" } ], "peds_doses": null, "brands": [ { "trade_name": "PIRONTAGONIST 10MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ADVANCE PHARMA", "price_egp": 60.0, "pack_count": 20, "unit_price": 3.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASMALAIR 10MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 40.0, "pack_count": 10, "unit_price": 4.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MONTEKAL 10MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 40.0, "pack_count": 10, "unit_price": 4.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "INLETAIR 10 MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANOPHARMA", "price_egp": 47.0, "pack_count": 10, "unit_price": 4.7, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MONTELOSAB 10 MG 14 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "P&C > VERCURE", "price_egp": 82.0, "pack_count": 14, "unit_price": 5.86, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LELIPEL 10 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > GLOBE INTERNATIONAL PHARMACEUTICALS", "price_egp": 120.0, "pack_count": 20, "unit_price": 6.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OPIKAST 10 MG 14 SCORED F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 22.2, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STATUKAST 10 MG 10 SCORED F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 41.5, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "bronchial-asthma" }, { "id": 311, "generic": "Prednisolone", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "40-50 mg once daily in the morning", "adult_duration": "until recovery, minimum 5 days, then stop without tapering", "dose_source": "SIGN 158 / BTS British guideline on the management of asthma (2019), section 9.8.4", "rationale": "The asthmatic who walks in wheezing needs a steroid course as well as the inhalers, and the condition had nothing for the attack. NG245 deliberately does not cover acute attacks, so the dose comes from the BTS/SIGN guideline that does.", "cautions": [ "Give it early - the guideline states the earlier steroids are given in the attack the better the outcome.", "Do not stop the inhaled corticosteroid while the tablets are running.", "No taper after a short course, provided the patient is on an inhaled steroid.", "A patient needing repeated courses has uncontrolled asthma and needs the maintenance treatment stepped up, not more prednisolone.", "Raises blood glucose - warn the diabetic patient." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Fixed doses by age band, not mg/kg: 10 mg under 2 years, 20 mg for 2-5 years, 30-40 mg over 5 years, once daily. Larger doses give no advantage and the course does not need tapering.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "Under 2 years", "age_min_months": 0, "age_max_months": 23, "dose_text": "10 mg once daily" }, { "label": "2 to 5 years", "age_min_months": 24, "age_max_months": 71, "dose_text": "20 mg once daily" }, { "label": "Over 5 years", "age_min_months": 72, "age_max_months": 216, "dose_text": "30 to 40 mg once daily. Larger doses give no advantage and the course does not need tapering." } ], "peds_doses": null, "brands": [ { "trade_name": "HOSTACORTIN H 5MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.0, "pack_count": 30, "unit_price": 0.4, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNISOLONE 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDILONE 5MG 10 TAB. (25 STRIPS PACK)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 250.0, "pack_count": 10, "unit_price": 25.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPICOPRED 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 69.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNISOLONE-EVA 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 79.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISPRELONE-OD 5 MG 30 ORODISPERSABLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SOLUPRED ORO 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI WINTHROP > SANOFI", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACETASEE 1% EYE DROPS (SUSP.) 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNIS 5MG/5ML SYRUP 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 9.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "bronchial-asthma" } ] }