{ "schema_version": 1, "kind": "condition", "id": "cervical-spondylosis", "name": "Cervical Spondylosis", "category": "chronic", "sources": "NICE Clinical Knowledge Summaries: Cervical radiculopathy 2021 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Tizanidine hydrochloride tablets US prescribing information (DailyMed, Dr. Reddy's) · Alzain 75 mg Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 1762)", "review_status": "reviewed", "verified_against": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Tizanidine hydrochloride tablets US prescribing information (DailyMed, Dr. Reddy's) · Alzain 75 mg Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 1762) · Cervical Spondylosis - disease-level clinical article (cervical-spondylosis-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 384, "generic": "Ibuprofen", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "400 mg orally three times daily with or after food", "adult_duration": "Short-term use only; consult a doctor if required for more than 10 days", "dose_source": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)", "rationale": "Non-selective NSAID used first-line to control the inflammatory and mechanical pain of cervical spondylosis by blocking prostaglandin synthesis.", "cautions": [ "Use the lowest effective dose for the shortest duration necessary to minimize gastrointestinal, renal, and cardiovascular risks.", "Contraindicated in active peptic ulcer disease, severe heart failure, advanced renal impairment, or third trimester of pregnancy.", "Co-prescribe a proton pump inhibitor (e.g. omeprazole) in elderly patients (>65 years) or those with gastrointestinal risk factors." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Cervical spondylosis is a chronic degenerative spine disease of adults; pediatric spinal pathology requires specialist pediatric orthopedic evaluation.", "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": "cervical-spondylosis" }, { "id": 387, "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": "Cervical Spondylosis - disease-level clinical article (cervical-spondylosis-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "The red flags requiring urgent evaluation are severe or rapidly progressing neurological deficits, bowel or bladder dysfunction, and unexplained weight loss." ], "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": "cervical-spondylosis" }, { "id": 386, "generic": "Pregabalin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 75.0, "adult_dose": "150 mg/day to start, given as 75 mg twice daily. If response and tolerability allow, increase to 300 mg/day (150 mg twice daily) after an interval of 3 to 7 days, and if needed to the maximum 600 mg/day (300 mg twice daily) after a further 7 days. Reduce the dose in renal impairment.", "adult_duration": "Ongoing evaluation", "dose_source": "Alzain 75 mg Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 1762)", "rationale": "Second-line agent used when cervical spondylosis produces neuropathic arm pain from nerve root compression (cervical radiculopathy); it dampens abnormal nerve signalling rather than treating the underlying joint disease.", "cautions": [ "Indicated as second-line therapy when cervical spondylosis is accompanied by neuropathic arm pain (cervical radiculopathy).", "May cause significant dizziness, somnolence, peripheral edema, gait disturbance, and weight gain; counsel on driving impairment.", "Requires gradual dose reduction over at least 1 week when discontinuing to avoid withdrawal symptoms; reduce dose in renal impairment.", "NG59's instruction not to offer gabapentinoids is about sciatica and low back pain - the lumbar spine. It does not cover the cervical spine, and pregabalin here rests on CG173 for neuropathic pain instead. Worth knowing, because the sciatica entry does not offer pregabalin on that NG59 recommendation, and the two entries look inconsistent until you know the scopes differ.", "The label opens by telling you to agree an exit plan with the patient BEFORE the first dose: pregabalin causes dependence, addiction and a withdrawal syndrome, and treatment should be given for the shortest possible duration (Alzain SmPC sections 4.2 and 4.4)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not indicated for degenerative neck pain in pediatric patients.", "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": "FORPREGAB 75 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GRAND PHARMA > PARKVILLE", "price_egp": 45.0, "pack_count": 30, "unit_price": 1.5, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SNAPGAB 75 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE > TA PHARMA", "price_egp": 49.5, "pack_count": 30, "unit_price": 1.65, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LYRIBALIN 75MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 18.0, "pack_count": 10, "unit_price": 1.8, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEURAGABALIN 75 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA GRAND PHARMA", "price_egp": 23.0, "pack_count": 10, "unit_price": 2.3, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NERVATYCA 75 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 48.75, "pack_count": 20, "unit_price": 2.44, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "QUEENLEPT 75 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > ASPIN PHARMACEUTICAL", "price_egp": 93.0, "pack_count": 30, "unit_price": 3.1, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LYRICA 75MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 232.0, "pack_count": 20, "unit_price": 11.6, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREGABEDIUM 75 MG 20 H.G. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SABAA > ACTIVA THERAPEUTICS", "price_egp": 56.66, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCIKASWAB 100MG/5ML 20 UNIDOSE ORAL SOLN.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNISWAB > VODACHEM", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "AVEROPREG 100MG/5ML SYRUP 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA-EGYPT", "price_egp": 55.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "cervical-spondylosis" }, { "id": 385, "generic": "Paracetamol", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500-1000 mg orally three or four times a day PRN for neck pain (max 4000 mg/day)", "adult_duration": "PRN during painful flares", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "Adjunct analgesic added to NSAID therapy for extra pain control in cervical spondylosis; works centrally rather than through an anti-inflammatory action and does not replace the NSAID.", "cautions": [ "Do not exceed 4000 mg per day total paracetamol from all combined medications to avoid severe hepatotoxicity.", "Use caution in chronic alcohol dependency, malnutrition, or severe hepatic impairment." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Degenerative condition of adults; not applicable in pediatric populations.", "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": "cervical-spondylosis" } ] }