{
  "schema_version": 1,
  "kind": "condition",
  "id": "calcaneal-spur",
  "name": "Calcaneal spur",
  "category": "acute",
  "sources": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral)",
  "review_status": "reviewed",
  "verified_against": "MSF Essential Drugs 2024 - paracetamol (oral) · SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 339,
      "generic": "Paracetamol",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 500.0,
      "adult_dose": "1 g three or four times daily, maximum 4 g in 24 hours",
      "adult_duration": "As needed for pain or fever",
      "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)",
      "rationale": "Standard analgesic dosing regardless of the cause of the heel pain.",
      "cautions": [
        "Pain persisting despite conservative treatment, or signs suggesting infection or a different cause of heel pain — warrants referral.",
        "Simple first-line analgesic for heel pain.",
        "Do not exceed 4 g in 24 hours.",
        "Persistent pain despite conservative treatment, or signs of infection, warrants referral.",
        "Administer with caution to patients with hepatic impairment."
      ],
      "peds_mgkg_low": 15.0,
      "peds_mgkg_high": 15.0,
      "peds_max_mg": 500.0,
      "peds_basis": "dose",
      "peds_unit": "mg",
      "peds_note": "Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.",
      "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": [
        {
          "weight_kg": 10,
          "low_mg": 150,
          "high_mg": 150,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 300,
          "high_mg": 300,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 450,
          "high_mg": 450,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 500,
          "high_mg": 500,
          "capped": true
        }
      ],
      "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": "calcaneal-spur"
    },
    {
      "id": 340,
      "generic": "Ibuprofen",
      "line": 2,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 400.0,
      "adult_dose": "200-400 mg PO Q6-8H PRN, max 1200 mg/day.",
      "adult_duration": null,
      "dose_source": "SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc",
      "rationale": "Standard NSAID analgesic dose for heel pain; the much higher pericarditis anti-inflammatory regimen is unnecessary here.",
      "cautions": [
        "Use alongside stretching, footwear changes, and a heel cushion/orthotic, which remain the mainstay of treatment.",
        "Avoid in NSAID-exacerbated asthma, active peptic ulcer disease, or renal impairment.",
        "Take with or after food.",
        "Severe hepatic failure, renal failure and heart failure (NYHA Class IV) (see section 4.4, Special warnings and precautions for use).",
        "Last trimester of pregnancy (see section 4.6 Pregnancy and lactation)."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Age 3m+: 20-30 mg/kg/day divided Q6-8H PRN. (Dosed by age bands on liquid suspension labels).",
      "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": "calcaneal-spur"
    }
  ]
}