{ "schema_version": 1, "kind": "condition", "id": "epistaxis", "name": "Epistaxis (anterior nosebleed, primary care)", "category": "chronic", "sources": "AAO-HNS Clinical Practice Guideline: Epistaxis 2020 · Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG-MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg-nl-2022.txt): \"Afrin 0,5 mg/ml neusspray, oplossing\" and \"Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride\", which is the 0.05% strength. · Epistaxis - disease-level clinical article (StatPearls, NCBI Bookshelf NBK435997) · Iliadin Nose Drops / Nose Spray 0.05% Professional Information - South African Health Products Regulatory Authority (English cross-check) · NICE CKS Epistaxis 2021", "review_status": "reviewed", "verified_against": "Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG-MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg-nl-2022.txt): \"Afrin 0,5 mg/ml neusspray, oplossing\" and \"Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride\", which is the 0.05% strength. · Epistaxis - disease-level clinical article (StatPearls, NCBI Bookshelf NBK435997) · Iliadin Nose Drops / Nose Spray 0.05% Professional Information - South African Health Products Regulatory Authority (English cross-check)", "verified_date": "2026-08", "treatments": [ { "id": 672, "generic": "Oxymetazoline", "line": 1, "is_adjunct": false, "form": "nasal", "strength_mg": null, "adult_dose": "Instill 1-2 sprays into bleeding nostril after blowing out clots", "adult_duration": "single application for acute bleeding", "dose_source": "Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG-MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg-nl-2022.txt): \"Afrin 0,5 mg/ml neusspray, oplossing\" and \"Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride\", which is the 0.05% strength.", "rationale": "Topical nasal decongestant that constricts the nasal mucosal blood vessels, helping control an ongoing anterior nosebleed; used alongside, not instead of, firm nasal compression, which remains the first step. The indication is the condition's own disease article - \"Vasoconstrictors such as oxymetazoline or thrombogenic foams or gels can be employed if that is ineffective\" - while the spray quantity and the age floor are the regulator SmPC's; neither SmPC licenses the drug for epistaxis, so the two claims are cited separately.", "cautions": [ "The first-line step is firm bilateral nasal alar compression for 10-15 minutes leaning forward.", "Avoid prolonged use (>3-5 days) to prevent rhinitis medicamentosa.", "Refer urgently to ENT if bleeding persists >20 minutes despite compression.", "Licensed from 6 years at the 0.05% strength. Afrin SmPC 4.1 verbatim: \"Afrin is geïndiceerd voor volwassenen en kinderen van 6 jaar en ouder.\" (indicated for adults and children of 6 years and older), and 4.3: \"Afrin mag niet worden gebruikt bij kinderen jonger dan 6 jaar.\" Under 6, use a 0.025% paediatric preparation instead.", "Not with coronary heart disease, not in angle-closure glaucoma, and not within two weeks of an MAOI." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Licensed from 6 years at this 0.05% strength - not from 12. The old 12-year line came from a UK patient leaflet, which is a general-sales restriction and not a fact about the drug; both regulator SmPCs license the strength from 6. Children 6-10 years: 1 spray, not 2. Under 6 years the 0.05% strength is contraindicated - Egypt registers separate 0.025% paediatric preparations (Iliadin paediatric, Afrin pediatric, Oxymet paed); dose those from their own carton. Compression remains the first step at every age.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": 72.0, "peds_age_max_months": null, "peds_age_bands": [ { "label": "6 to 10 years", "age_min_months": 72, "age_max_months": 131, "dose_text": "1 spray of the 0.05% strength, not 2. Under 6 years this strength is contraindicated. Compression remains the first step at every age." } ], "peds_doses": null, "brands": [ { "trade_name": "NASOPHARM 0.05% SPRAY", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > EGYPTIAN PHARMACISTS COMPANY", "price_egp": 2.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ILIADIN 0.05 % ADULT NASAL SPRAY", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN > MERCK KGAA F.R.GERMANY", "price_egp": 4.3, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NORMIFRIN 0.5MG/ML NASAL SPRAY 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 26.0, "pack_count": null, "unit_price": null, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ILIADIN 0.025 % PAED. NASAL SOL. 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN > MERCK KGAA F.R.GERMANY", "price_egp": 3.2, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ILIADIN 0.05 % ADULT NASAL SOLUTION 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN > MERCK KGAA F.R.GERMANY", "price_egp": 3.35, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OXYMET 0.025% PAED.NASAL DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OXYMET 0.05% ADULT NASAL DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOFRINAZ 0.05% NASAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "epistaxis" } ] }