{ "schema_version": 1, "kind": "condition", "id": "constipation", "name": "Constipation (acute and chronic)", "category": "chronic", "sources": "NICE Guideline ES35 (2017) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (bisacodyl monograph) · Glycerin Suppositories BP 4 g Adult SmPC sections 4.2-4.3 (eMC product 4897)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (bisacodyl monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (polyethylene glycol 3350 (macrogol) monograph, ATC A06AD65) · Glycerin Suppositories BP 4 g Adult SmPC sections 4.2-4.3 (eMC product 4897) · Constipation - disease-level clinical article (constipation-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 480, "generic": "Lactulose", "line": 1, "is_adjunct": false, "form": "oral.liquid", "strength_mg": null, "adult_dose": "15-30 mL daily in 1-2 divided doses, adjust to produce soft stool", "adult_duration": "Short-term or chronic under supervision", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph)", "rationale": "Safe first-line osmotic laxative suitable for all age groups", "cautions": [ "Takes 48 hours to act; advise patient not to exceed recommended dose prematurely.", "Caution in lactose intolerance or galactosemia.", "Maintain adequate hydration.", "Gastrointestinal obstruction.", "Digestive-perforation or risk of digestive perforation." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Infant under 1 year: up to 5 mL daily. Child 1-6 years: 5-10 mL daily. Child 7-14 years: start 15 mL daily, maintenance 10-15 mL daily. Adjust to produce a soft stool without diarrhoea.", "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 1 year", "age_min_months": 0, "age_max_months": 11, "dose_text": "Up to 5 mL daily" }, { "label": "1 to 6 years", "age_min_months": 12, "age_max_months": 83, "dose_text": "5 to 10 mL daily" }, { "label": "7 to 14 years", "age_min_months": 84, "age_max_months": 179, "dose_text": "15 mL daily to start, then 10 to 15 mL daily. Adjust to produce a soft stool without diarrhoea." } ], "peds_doses": null, "brands": [ { "trade_name": "FARCOLAC 667GM/L SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 667000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LACTOLINE 50% SYRUP 200ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 9.25, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAEVOLAC 67GM/100ML SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > FRESENIUS KABI", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 67000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEDALAC 3.35GM/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 20.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAXOLAC 3.35GM/5ML SYRUP 300ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAXOLAC 3.35GM/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUPHALAC 667GM/L SYRUP 200ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ABBOTT LABORATORIES", "price_egp": 143.0, "pack_count": null, "unit_price": null, "strength_mg": 667000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LACTULOSE-AUG PHARMA 3.35GM/5ML SYRUP 320ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 170.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VILLAPURG 67% SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "VILLAPURG 67% SYRUP 200 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 17.75, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "constipation" }, { "id": 483, "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": "Constipation - disease-level clinical article (constipation-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Look for alarm features and concerning historical features in the evaluation of constipation." ], "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": "constipation" }, { "id": 484, "generic": "Macrogol 3350", "line": 1, "is_adjunct": false, "form": "oral.liquid", "strength_mg": null, "adult_dose": "1-3 sachets daily in divided doses, adjusted up or down as required to produce regular soft stools (maximum 4 sachets a day) - the 13.125 g adult sachet", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (polyethylene glycol 3350 (macrogol) monograph, ATC A06AD65)", "rationale": "First-line osmotic laxative recommended for maintenance treatment and disimpaction in chronic constipation.", "cautions": [ "Not recommended in children under 2 years of age for chronic constipation.", "Ensure adequate hydration during treatment.", "The sachet sizes are not interchangeable, and the doses above are counted in sachets. ENDF verbatim: \"Products containing 6.563 grams per sachet: 1. For the treatment of chronic constipation in children 2 to 11 years of age\" and \"Products containing 13.125 grams per sachet: 4. Treatment of chronic constipation in adults\". MOVICOL PAEDIATRIC is the 6.563 g sachet; MOVICOL is the 13.125 g one. Handing an adult pack to a child dosed at 1 sachet daily doubles it.", "NOT the colonoscopy preparation, which is the same drug at eight times the pouch. ENDF verbatim: \"Products containing 100 grams per pouch: 5. Osmotic laxative indicated for cleansing of the colon in preparation for colonoscopy in adults\". MOVIPREP and PREPAWEST are that product, and they are deliberately not among the Egyptian brands listed below." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child 2-6 yrs: starting dose 1 sachet daily; Child 7-11 yrs: 2 sachets daily - the 6.563 g paediatric sachet, not the adult one. Adjust to produce regular soft stools.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 to 6 years", "age_min_months": 24, "age_max_months": 83, "dose_text": "1 sachet daily to start - the 6.563 g paediatric sachet, not the adult one" }, { "label": "7 to 11 years", "age_min_months": 84, "age_max_months": 143, "dose_text": "2 sachets daily - the 6.563 g paediatric sachet, not the adult one" } ], "peds_doses": null, "brands": [ { "trade_name": "MOVICOL PAEDIATRIC 30 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NORGINE LIMITED > ACINO", "price_egp": 221.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "potassium chloride, sodium chloride, sodium hydrogen carbonate" }, { "trade_name": "MOVICOL 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NORGINE LIMITED > ACINO", "price_egp": 273.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "potassium chloride, sodium bicarbonate, sodium chloride" } ], "condition_id": "constipation" }, { "id": 481, "generic": "Bisacodyl", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5-10 mg once daily at bedtime (acts in 6-12 hours)", "adult_duration": "Up to 5 days without medical advice", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (bisacodyl monograph)", "rationale": "Stimulant laxative for short-term relief of acute constipation", "cautions": [ "CONTRAINDICATED in intestinal obstruction or acute surgical abdomen.", "Do not take within 1 hour of antacids or milk (dissolves enteric coating).", "Avoid prolonged continuous use due to risk of intestinal atony and electrolyte loss.", "Acute inflammatory bowel diseases.", "Patients with severe dehydration." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children over 12 years: 5 - 10 mg once daily before bedtime.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "Over 12 years", "age_min_months": 144, "age_max_months": 216, "dose_text": "5 to 10 mg once daily before bedtime" } ], "peds_doses": null, "brands": [ { "trade_name": "CONSTACODYL 5 MG 10 ENTERIC COATED TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DULCOLAX 5MG 20 SUGAR COATED TAB..", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID > SANOFI", "price_egp": 3.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ABILAXINE 5 MG 20 COATED TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BISADYL 5 MG 30 E.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 28.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BISADYL 10MG/37ML ENEMA", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 6.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "constipation" }, { "id": 482, "generic": "Glycerin", "line": 2, "is_adjunct": false, "form": "rectal", "strength_mg": null, "adult_dose": "1 suppository (4 g adult size) inserted rectally as required", "adult_duration": "Single use / as required", "dose_source": "Glycerin Suppositories BP 4 g Adult SmPC sections 4.2-4.3 (eMC product 4897)", "rationale": "Fast-acting rectal lubricant/stimulant laxative (acts in 15-30 minutes)", "cautions": [ "Moisten suppository with water before insertion.", "Avoid in presence of anal fissures or severe proctitis.", "Dip the suppository in water before inserting it - dry glycerol drags and stings.", "The three sizes are separate products, not fractions of each other: 4 g adult, 2 g child, 1 g infant. The adult suppository is explicitly not for a child.", "Glycerin is for short-term rectal evacuation only." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children: One suppository (1.4 gm) rectally as needed. Infants: One suppository (0.7 gm) rectally as needed.", "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": "GLYCERIN ADULT 6 SUPP. (EL-NILE)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 11.0, "pack_count": 6, "unit_price": 1.83, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GLYCERIN INFANTILE 10 SUPP. (GLAXO)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 19.0, "pack_count": 10, "unit_price": 1.9, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GLYCERIN ADULT 10 SUPP. (GLAXO)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SMITHKLINE BEECHAM > GLAXO SMITHKLINE", "price_egp": 22.0, "pack_count": 10, "unit_price": 2.2, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GLYCERIN INFANTILE 6 SUPP. (EL-NILE)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 14.0, "pack_count": 6, "unit_price": 2.33, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "constipation" } ] }