{ "schema_version": 1, "kind": "condition", "id": "gerd", "name": "Gastro-oesophageal reflux disease (GERD)", "category": "chronic", "sources": "ACG Management of GERD 2022 for the indication, with the dose from Baclofen 10 mg Tablets SmPC section 4.2 (eMC product 102514), which titrates \"5mg three times a day for three days\", then \"10mg three times a day for three days\", then \"15mg three times a day for three days\", then \"20mg three times a day for three days\". The SmPC's only indication is spasticity, so use in reflux is off-label and rests on the ACG guideline, which is not held in this corpus. · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 · ACG Management of GERD 2022 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (famotidine monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (esomeprazole monograph) · Gaviscon Double Action Aniseed Oral Suspension SmPC section 4.2 (eMC product 685) · Sucralfate 1 g tablets US prescribing information, Dosage and Administration (DailyMed, Amneal Pharmaceuticals NY LLC)", "review_status": "reviewed", "verified_against": "ACG Management of GERD 2022 for the indication, with the dose from Baclofen 10 mg Tablets SmPC section 4.2 (eMC product 102514), which titrates \"5mg three times a day for three days\", then \"10mg three times a day for three days\", then \"15mg three times a day for three days\", then \"20mg three times a day for three days\". The SmPC's only indication is spasticity, so use in reflux is off-label and rests on the ACG guideline, which is not held in this corpus. · ACG Management of GERD 2022 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (famotidine monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (esomeprazole monograph) · Gaviscon Double Action Aniseed Oral Suspension SmPC section 4.2 (eMC product 685) · Sucralfate 1 g tablets US prescribing information, Dosage and Administration (DailyMed, Amneal Pharmaceuticals NY LLC) · Gastro-oesophageal reflux disease (GERD) - disease-level clinical article (gerd-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 783, "generic": "Omeprazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 20.0, "adult_dose": "20 mg once daily 30-60 min before breakfast", "adult_duration": "4-8 weeks", "dose_source": "ACG Management of GERD 2022", "rationale": "Proton pump inhibitor that suppresses gastric acid production to allow oesophageal mucosal healing and relieve reflux symptoms; first-line pharmacological therapy for GERD.", "cautions": [ "Long-term use (>1 yr) is associated with hypomagnesaemia and fracture risk.", "Re-evaluate need for continued therapy at 8 weeks.", "There is an increased risk of Clostridioides difficile diarrhoea." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Licensed in children over 1 yr: 10-20 mg daily under specialist care", "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 1 year", "age_min_months": 13, "age_max_months": 216, "dose_text": "10-20 mg daily under specialist care" } ], "peds_doses": null, "brands": [ { "trade_name": "OMEGASTAZOLE 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 18.0, "pack_count": 14, "unit_price": 1.29, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEPRAL 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 32.0, "pack_count": 14, "unit_price": 2.29, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RISEK 20 MG 28 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 75.0, "pack_count": 28, "unit_price": 2.68, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMISEC 20MG 14CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "THE UNITED PHARMACEUTICALS CO LTD-JORDAN > MODERN PHARMA", "price_egp": 42.0, "pack_count": 14, "unit_price": 3.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPIRAZOLE 20MG 14CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 44.0, "pack_count": 14, "unit_price": 3.14, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEPAK 20 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 50.0, "pack_count": 14, "unit_price": 3.57, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RISEK 20 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 57.0, "pack_count": 14, "unit_price": 4.07, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPIZOLE 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 62.0, "pack_count": 14, "unit_price": 4.43, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "gerd" }, { "id": 784, "generic": "Pantoprazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 40.0, "adult_dose": "40 mg once daily before breakfast", "adult_duration": "4-8 weeks", "dose_source": "ACG Management of GERD 2022", "rationale": "Alternative proton pump inhibitor with the same acid-suppressing mechanism as omeprazole, offered as a second PPI option for patients who need a change of agent or have specific tolerability or interaction concerns.", "cautions": [ "Swallow tablet whole - do not crush or chew.", "Caution in severe hepatic impairment (max 20 mg/day).", "Long-term PPI cautions apply." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist use only in children", "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": "PEPTOLOC 40MG 14 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > MULTIPHARMA", "price_egp": 35.0, "pack_count": 14, "unit_price": 2.5, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PEPTOLOC 40MG 7 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > MULTIPHARMA", "price_egp": 21.0, "pack_count": 7, "unit_price": 3.0, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PERLOC 40MG 14 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 75.0, "pack_count": 14, "unit_price": 5.36, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PANTOLOC 40MG 14 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 102.0, "pack_count": 14, "unit_price": 7.29, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DELPANTO 40MG 14 E.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PANTAZOL 40MG 14 ENTERIC COATED TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SOVALUE PHARMA", "price_egp": 104.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZURCAL 40 MG 28 GASTRO-RESISTANT TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 192.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PANTOMEDRA 40 MG 28 E.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ROWAD PHARMACEUTICAL INDUSTRIAL CO. > BIOMED PHARMACEUTICALS", "price_egp": 208.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "gerd" }, { "id": 786, "generic": "Esomeprazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 20.0, "adult_dose": "20 mg once daily for symptomatic GERD without oesophagitis; 40 mg once daily for erosive reflux oesophagitis; 20 mg once daily for long-term maintenance after healing", "adult_duration": "4 weeks, extended by a further 4 weeks if not healed; maintenance 20 mg daily thereafter", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (esomeprazole monograph)", "rationale": "74 live Egyptian products - the single largest orphan on the list. The formulary's first listed indication for esomeprazole is GERD, with separate doses for symptomatic disease, erosive oesophagitis and maintenance.", "cautions": [ "Re-assess the need for continued PPI therapy at 8 weeks and step down to the lowest effective dose.", "Long-term use is associated with hypomagnesaemia, vitamin B12 malabsorption and fracture risk.", "Increases the risk of Clostridioides difficile diarrhoea.", "Reduces absorption of atazanavir, erlotinib and rilpivirine - check the drug list before adding.", "Take 30-60 minutes before breakfast; swallow gastro-resistant tablets whole." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Licensed from 1 month as granules or powder for oral suspension. Children 1-11 years: 10 mg once daily if 10-20 kg; 10 mg or 20 mg once daily if 20 kg or more; up to 8 weeks. Doses above 1 mg/kg/day have not been studied. Adolescents 12 years and over use the adult dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "1 to 11 years", "age_min_months": 12, "age_max_months": 143, "dose_text": "10 mg once daily at 10 to 20 kg; 10 mg or 20 mg once daily at 20 kg or more; up to 8 weeks. Doses above 1 mg/kg/day have not been studied." }, { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "The adult dose." } ], "peds_doses": null, "brands": [ { "trade_name": "ESMOPROTON 20 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WADI EL-NEEL BENTA", "price_egp": 42.0, "pack_count": 20, "unit_price": 2.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ORGIXIUM 20 MG DR 21 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ORIGIN IN PHARMA", "price_egp": 49.5, "pack_count": 21, "unit_price": 2.36, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIORAZO 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOPHARM EGYPT > SAJA PHARMA", "price_egp": 42.0, "pack_count": 14, "unit_price": 3.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ATMIPRAZOLE 20 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 75.0, "pack_count": 20, "unit_price": 3.75, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ESOVAXOLE 20 MG 28 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOMED", "price_egp": 152.0, "pack_count": 28, "unit_price": 5.43, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ESMATAC 20 MG 14 D.R. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 55.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EZOGAST 20MG 14 DELA. REL. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "OCTOBER PHARMA > COPAD PHARMA", "price_egp": 122.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ESMOPUMP 20 MG 14 E.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANOPHARMA > ORGANO", "price_egp": 162.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "gerd" }, { "id": 790, "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": "Gastro-oesophageal reflux disease (GERD) - disease-level clinical article (gerd-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Alarm symptoms (dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, anorexia) require prompt diagnostic evaluation rather than empiric therapy." ], "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": "gerd" }, { "id": 785, "generic": "Famotidine", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 20.0, "adult_dose": "20 mg BID (up to 40 mg BID for severe reflux)", "adult_duration": "4-8 weeks", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (famotidine monograph)", "rationale": "Histamine H2-receptor antagonist that reduces gastric acid secretion by a different mechanism than the PPIs above; offered as a second-line or step-down option for GERD, though tolerance can develop with continued use.", "cautions": [ "Tachyphylaxis (tolerance) can develop within 2 weeks of use.", "Reduce dose in renal impairment.", "CNS side effects (confusion, headache) are more common in the elderly." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist use in pediatric reflux", "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": "FAMOTAK 20MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 28.0, "pack_count": 20, "unit_price": 1.4, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GASTRODOMINA 20MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > ALMIRALL PRODES-SPAIN", "price_egp": 28.0, "pack_count": 20, "unit_price": 1.4, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANTODINE 20 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 60.0, "pack_count": 30, "unit_price": 2.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FAMOTIN 20MG 20TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 40.0, "pack_count": 20, "unit_price": 2.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RANI-F 20MG 6 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 42.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "gerd" }, { "id": 788, "generic": "Sucralfate", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 1000.0, "adult_dose": "1 g four times daily on an empty stomach", "adult_duration": "while symptoms persist in pregnancy", "dose_source": "Sucralfate 1 g tablets US prescribing information, Dosage and Administration (DailyMed, Amneal Pharmaceuticals NY LLC)", "rationale": "ACG 2022 lists sucralfate with antacids and alginates as first-line for reflux in pregnancy when lifestyle change fails, and says plainly that outside pregnancy there is little to recommend it. Reflux in pregnancy is a weekly consultation. The dose is the label's duodenal-ulcer dose - the label carries no GERD indication.", "cautions": [ "Off-label here. The label carries one indication - active duodenal ulcer - and GERD is not on it. It is used in pregnancy because it is not absorbed, which is a good reason, but it is not a licensed one.", "This option is for pregnancy. ACG says there is little to recommend sucralfate in GERD outside pregnancy - do not use it as a general alternative to a PPI.", "The label's licensed indication is duodenal ulcer; GERD use rests on the ACG guideline, not on the label.", "It is largely unabsorbed and has no systemic toxicity, which is the point in pregnancy.", "It binds other drugs - separate it by 2 hours from quinolones, tetracyclines, levothyroxine, phenytoin and digoxin.", "Four times daily on an empty stomach is a hard regimen to keep to; say so when you write it." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Safety and effectiveness in children have not been established on the label.", "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": "GASTROFAIT 1 GM 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 70.0, "pack_count": 20, "unit_price": 3.5, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SUCROFILMPAN 1GM/5ML ORAL SUSP. 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PANAX PHARMA", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "gerd" }, { "id": 787, "generic": "Sodium alginate + Sodium bicarbonate + Calcium carbonate", "line": 1, "is_adjunct": true, "form": "oral.liquid", "strength_mg": 500.0, "adult_dose": "10-20 mL after meals and at bedtime, up to four times a day", "adult_duration": "as-needed, alongside or after a PPI course", "dose_source": "Gaviscon Double Action Aniseed Oral Suspension SmPC section 4.2 (eMC product 685)", "rationale": "The ACG 2022 GERD guideline places antacids and alginates as the on-demand symptom-relief layer, and specifically credits an alginic acid preparation with efficacy in symptom relief. A PPI takes days; this is what the patient takes tonight, and what covers breakthrough symptoms once the PPI is stepped down. Strength is quoted as sodium alginate per 10 mL dose.", "cautions": [ "On-demand relief only - it does not heal oesophagitis and does not replace a PPI in erosive disease.", "High sodium content; take care in a patient on a strict salt restriction or in renal insufficiency.", "Contains calcium carbonate - caution in hypercalcaemia, nephrocalcinosis and recurrent calcium renal stones.", "Leave 2 hours between this and tetracyclines, fluoroquinolones, iron salts, thyroid hormones and chloroquine." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "12 years and over use the adult dose. Under 12 years only on medical advice - the label gives no paediatric dose.", "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": "GAVISCON DOUBLE ACTION SUSP 150 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RECKITT BENCKISER HEALTHCARE > UNITED PARTNERS", "price_egp": 144.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GAVISCON DOUBLE ACTION 24 SACHETS*10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RECKITT BENCKISER HEALTHCARE > UNITED PARTNERS", "price_egp": 288.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GAVISCON LIQUID 24 SACHETS*10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RECKITT BENCKISER HEALTHCARE > UNITED PARTNERS", "price_egp": 288.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "gerd" }, { "id": 789, "generic": "Baclofen", "line": 3, "is_adjunct": true, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "5-20 mg three times a day", "adult_duration": "a time-limited trial, reviewed for benefit", "dose_source": "ACG Management of GERD 2022 for the indication, with the dose from Baclofen 10 mg Tablets SmPC section 4.2 (eMC product 102514), which titrates \"5mg three times a day for three days\", then \"10mg three times a day for three days\", then \"15mg three times a day for three days\", then \"20mg three times a day for three days\". The SmPC's only indication is spasticity, so use in reflux is off-label and rests on the ACG guideline, which is not held in this corpus.", "rationale": "ACG 2022 states that a trial of baclofen at 5-20 mg three times a day can be considered where reflux is objectively documented to continue despite optimal PPI therapy. It is a 'consider' rather than a recommendation, and it is a post-investigation drug, not a primary-care first move.", "cautions": [ "Only after objective documentation of continued reflux on optimal PPI therapy - not for a patient whose symptoms simply have not settled.", "ACG notes a randomised trial found no significant benefit over placebo at 1 year, though it was underpowered.", "Limited by dizziness, somnolence and constipation.", "Do not stop abruptly after prolonged use." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not a paediatric GERD drug. The ACG recommendation is for adults with objectively documented refractory reflux.", "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": "MYLOBAC 10MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 28.0, "pack_count": 20, "unit_price": 1.4, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BACLOFEN 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > AL DELTA PHARMACEUTICALS TRADING CO.", "price_egp": 30.0, "pack_count": 20, "unit_price": 1.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPINOBAC 5MG/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SAJA PHARMACEUTICALS > CLAVITA PHARMA", "price_egp": 39.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "SPINOBAC 5MG/5ML SYRUP 300ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SAJA PHARMACEUTICALS > CLAVITA PHARMA", "price_egp": 73.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "gerd" } ] }