{ "schema_version": 1, "kind": "condition", "id": "erythema-nodosum", "name": "Erythema nodosum", "category": "chronic", "sources": "Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) · No dose - assessment step, no medicine given", "review_status": "reviewed", "verified_against": "Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) · No dose - assessment step, no medicine given · Erythema nodosum - disease-level clinical article (erythema-nodosum-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 680, "generic": "No drug therapy in primary care (Assess first)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Erythema nodosum is a reaction pattern, not a diagnosis. The lumps settle by themselves over weeks; the work is finding what set them off. In Egypt, exclude tuberculosis actively - chest x-ray and a tuberculin or interferon-gamma test. Then look for streptococcal throat infection (ASO titre), sarcoidosis (the same chest x-ray), inflammatory bowel disease, pregnancy, and drugs, especially the combined pill and sulfonamides.", "adult_duration": "Assess, then decide", "dose_source": "No dose - assessment step, no medicine given", "rationale": "Treating the pain without looking for the cause is how a first presentation of tuberculosis, sarcoidosis or Crohn's disease gets missed. The skin has done the diagnostic work; the job is to follow it.", "cautions": [ "Bed rest and leg elevation genuinely help, and compression stockings help the aching once the acute tenderness has settled.", "Ulcerating lesions, lesions that scar, or lumps still present after 8 weeks are not straightforward erythema nodosum - biopsy and refer.", "Systemic corticosteroids should not be started until infection, and tuberculosis in particular, has been excluded." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "In a child, erythema nodosum is most often post-streptococcal. Take a throat swab and an ASO titre, and still do the chest x-ray.", "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": "erythema-nodosum" }, { "id": 681, "generic": "Naproxen", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg twice daily with food", "adult_duration": "Until the nodules settle, usually 2-6 weeks; review rather than continue indefinitely", "dose_source": "Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639)", "rationale": "An NSAID controls the pain in the lumps and the accompanying joint aching while the reaction burns itself out. It is symptomatic treatment - the condition resolves on its own.", "cautions": [ "The naproxen label does not list erythema nodosum by name. The dose here is the standard adult naproxen dose from that label; using it for erythema nodosum is accepted practice rather than a licensed indication.", "Do not give an NSAID with active peptic ulcer disease, significant renal impairment, heart failure, or in the third trimester of pregnancy - and erythema nodosum is itself common in pregnancy.", "Take it with food, and consider gastric protection in anyone over 65 or on an antiplatelet.", "A topical corticosteroid is deliberately not offered. The inflammation is in the subcutaneous fat, far below anything a cream reaches." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not recommended for use in any other indication in children under 16 years of age.", "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": "ORGOPROXEN 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANOPHARMA > ORGANO", "price_egp": 16.0, "pack_count": 20, "unit_price": 0.8, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPROSYN 500 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > F.HOFFMAN LA ROCHE", "price_egp": 8.05, "pack_count": 10, "unit_price": 0.81, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPROFEN 500MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPROFEN 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "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 } ], "condition_id": "erythema-nodosum" }, { "id": 682, "generic": "Colchicine", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": null, "adult_dose": "1 to 2 mg/day", "adult_duration": "until symptoms improve", "dose_source": "Erythema nodosum - disease-level clinical article (erythema-nodosum-clinical.txt)", "rationale": "Second-line anti-inflammatory option for persistent or symptomatic erythema nodosum.", "cautions": [ "GIVE IT WITH THE ANTI-INFLAMMATORY, NOT INSTEAD OF IT." ], "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": "COLCHICINE 500 MCG 100 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 190.0, "pack_count": 100, "unit_price": 1.9, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLMEDITEN 0.5 MG 100 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 190.0, "pack_count": 100, "unit_price": 1.9, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GOURYST 0.5 MG 100 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 190.0, "pack_count": 100, "unit_price": 1.9, "strength_mg": 0.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLCHIOPO 0.6 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG PHARMACEUTICAL INDUSTRIES", "price_egp": 61.5, "pack_count": 30, "unit_price": 2.05, "strength_mg": 0.6, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLCHIOPO 1 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG PHARMACEUTICAL INDUSTRIES", "price_egp": 61.0, "pack_count": 20, "unit_price": 3.05, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "erythema-nodosum" } ] }