{ "schema_version": 1, "kind": "condition", "id": "cerebrovascular-disease", "name": "Cerebrovascular Disease", "category": "chronic", "sources": "Cerebrovascular Disease - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK430927/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class ND70 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Egyptian National Drug Formulary - Cardiovascular 2024 (acetylsalicylic acid monograph, management of cardiovascular diseases) · Cerebrovascular Disease - disease-level clinical article (cerebrovascular-disease-full.txt)", "review_status": "reviewed", "verified_against": "No dose - referral pathway, no medicine given in primary care · Egyptian National Drug Formulary - Cardiovascular · Cerebrovascular Disease - disease-level clinical article (cerebrovascular-disease-clinical.txt) · Egyptian National Drug Formulary - Cardiovascular 2024 (acetylsalicylic acid monograph, management of cardiovascular diseases) · Cerebrovascular Disease - disease-level clinical article (cerebrovascular-disease-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 370, "generic": "No drug therapy in primary care (Referral & Advice)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Covers a prior transient ischaemic attack, stroke, or investigation-confirmed cerebrovascular disease; a GP manages long-term secondary prevention with an antiplatelet, statin, and blood pressure control, while any new acute event needs emergency referral.", "adult_duration": "Refer, with advice", "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Covers a prior transient ischaemic attack, stroke, or investigation-confirmed cerebrovascular disease; a GP manages long-term secondary prevention with an antiplatelet, statin, and blood pressure control, while any new acute event needs emergency referral.", "cautions": [ "No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.", "RED FLAG - Use the ACT FAST acronym for recognizing early stroke symptoms: face droop, arm weakness, speech difficulty, time to call emergency.", "RED FLAG - Sudden new focal weakness, speech disturbance or facial droop is an acute stroke and an emergency. Recurrent transient neurological symptoms (crescendo TIA), or severe headache with neurological signs (possible haemorrhage), need urgent referral." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.", "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": "cerebrovascular-disease" }, { "id": 371, "generic": "Clopidogrel", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "75 mg once daily", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Cardiovascular", "rationale": "Oral antiplatelet agent for secondary prevention of ischemic stroke and transient ischemic attack.", "cautions": [ "Increases bleeding risk - caution with other antiplatelets/anticoagulants and before surgery.", "Avoid in active pathological bleeding (e.g. peptic ulcer, intracranial haemorrhage).", "Effectiveness is reduced by strong CYP2C19 inhibitors such as omeprazole - use pantoprazole instead if a PPI is needed.", "If combined with aspirin, bleeding risk is higher - confirm indication and planned duration of dual therapy.", "The disease article recommends the aspirin-plus-clopidogrel combination be started within 24 hours of a minor stroke or high-risk TIA and continued for 21 days to prevent early recurrence; the ENDF states no duration for dual therapy, so the length of the dual phase follows the treating stroke service." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose is stated in the sources held for this drug.", "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": "BLOTAGRIL 75MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES", "price_egp": 33.0, "pack_count": 30, "unit_price": 1.1, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ITOLAVIX 75 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > INTERNATIONAL TRADING OFFICE", "price_egp": 54.0, "pack_count": 30, "unit_price": 1.8, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BORGAVIX 75MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 66.0, "pack_count": 30, "unit_price": 2.2, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SIGAGREL 75MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLOPACIRC 75 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 117.0, "pack_count": 30, "unit_price": 3.9, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IDIAVIX 75MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG AGENCY (IDI)", "price_egp": 48.0, "pack_count": 10, "unit_price": 4.8, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PLAVIX 75 MG 28 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI WINTHROP > SANOFI", "price_egp": 311.0, "pack_count": 28, "unit_price": 11.11, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PLAVIX 300 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI WINTHROP > SANOFI", "price_egp": 704.0, "pack_count": 30, "unit_price": 23.47, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cerebrovascular-disease" }, { "id": 372, "generic": "Acetylsalicylic acid", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 75.0, "adult_dose": "75 to 150 mg once daily; higher doses up to 300 mg may be needed in acute cases for a short time", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Cardiovascular 2024 (acetylsalicylic acid monograph, management of cardiovascular diseases)", "rationale": "The card carried clopidogrel alone. The disease article's 2019 update strongly recommends dual antiplatelet therapy - aspirin AND clopidogrel - within 24 hours of a minor stroke or high-risk TIA, continued for 21 days, so the card named one half of a two-drug regimen. The ENDF's aspirin indications name ischemic stroke and transient ischemic attack explicitly. The article's 21-day limit on the DUAL phase is a decision for the treating stroke service and is stated in the cautions rather than written into this row's duration field, because the ENDF states no duration for it.", "cautions": [ "Hypersensitivity to NSAIDS", "Patients with asthma, rhinitis, and nasal polyps", "Active peptic ulceration", "Use in children or teenagers for viral infections, with or without fever.", "The disease article recommends the aspirin-plus-clopidogrel combination be started within 24 hours and continued for 21 days to prevent early recurrence; the ENDF states no duration for dual therapy, so the length of the dual phase follows the treating stroke service." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable - an adult cerebrovascular condition. The ENDF's paediatric aspirin figures are for thromboprophylaxis after cardiac surgery and for Kawasaki disease, not for this indication.", "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": "AGGREX 75MG 60 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 33.0, "pack_count": 60, "unit_price": 0.55, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASPOCID 75MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 22.0, "pack_count": 20, "unit_price": 1.1, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASPOCID 75MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 33.0, "pack_count": 30, "unit_price": 1.1, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASPIRIN-CHEMIPHARM 75 MG 30 CHEW.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RIVO 75 MG 30 CHEW. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ASPOCID PAEDIATRIC 75MG 30 CHEW. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 35.0, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EZACARD 75 MG 30 E.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 51.0, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cerebrovascular-disease" } ] }