# Herpes zoster (shingles) - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph) · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683) · Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (famciclovir monograph) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph) - MSF Essential Drugs 2024 - paracetamol (oral) - Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) - Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683) - Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph) - Herpes Zoster - disease-level clinical article (herpes-zoster-full.txt) ## Treatment metadata - Acyclovir — 800 mg — oral.solid - Valacyclovir — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) - Famciclovir — 500 mg — oral.solid - Paracetamol — 500 mg — oral.solid - Ibuprofen — 400 mg — oral.solid - Amitriptyline — 25 mg — oral.solid - Gabapentin — 300 mg — oral.solid ## Complete treatment card ```text HERPES ZOSTER (SHINGLES) Sources: Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph) · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683) · Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (famciclovir monograph) Review status: REVIEWED against Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph), MSF Essential Drugs 2024 - paracetamol (oral), Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560), Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683), Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph), Herpes Zoster - disease-level clinical article (herpes-zoster-full.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (7) - Zoster begins with a prodrome of fever, malaise, and severe burning pain before any rash appears [burning pain · fever · malaise · rash] - Abnormal skin sensations or pain in the affected area can start at least 48 hours before any lesion is visible - Headache, general malaise, and light sensitivity can accompany the pre-rash phase [headache · malaise · photophobia · rash] - Pain during the blistering phase is often severe and does not respond well to standard pain medication - Pain persisting beyond 4 weeks marks chronic infection, with tingling and shock-like sensations that can last a year or more [shock · tingling] - Spread from the facial nerve to the inner-ear nerve causes hearing loss and vertigo in Ramsay Hunt syndrome [hearing loss · vertigo] - Radicular pain along a dermatome with no rash at all defines zoster sine herpete SIGNS - what you find (8) - Lesions stay confined to one side, within a single dermatome - The thoracic, cervical, trigeminal, and lumbosacral dermatomes are most often involved, in that order - Lesions start as closely grouped red bumps that quickly turn into blisters on a red, swollen base [blisters] - Vesicles on the tip or side of the nose flag involvement of the nerve branch that also supplies the eye [blisters · vesicles] - Eye involvement occurs in roughly 10 to 25 percent of cases, with keratitis, uveitis, or optic nerve palsy [paralysis] - More than 20 skin lesions outside the original area define disseminated zoster, which can also affect other organs and turn lethal [skin lesions] - Pain persisting 3 months after the rash defines post-herpetic neuralgia, most often when the eye-nerve branch is involved in older adults [neuralgia · rash] - Risk factors for lasting nerve pain include older age, severe early or acute pain, a severe rash, and a weakened immune system [neuralgia · rash] TESTS (6) - Diagnosis rests on the burning pain plus the characteristic look and spread of the rash - A red background on dermatoscopy is seen in essentially all cases of zoster - Dermatoscopy can diagnose zoster about 1.6 days earlier than clinical examination alone - A halo sign on dermatoscopy comes from the contrast between crusted vesicle centres and the surrounding redness - A Tzanck smear of vesicle fluid shows multinucleated giant cells but is less sensitive and specific than PCR or antibody testing - Newer real-time PCR is faster and less prone to contamination than the older nested PCR or viral culture IF NOT THIS - what else fits (12) - Pain before any rash can mimic gallbladder disease or biliary colic - Pre-rash pain can also be mistaken for renal colic, trigeminal neuralgia, or a dental infection - Prodromal pain is often mistaken for a toothache, leading to unnecessary dental treatment - Zoster in the mouth involves only one side, unlike other blistering oral conditions - Herpes zoster skin lesions must be differentiated from chickenpox - Herpes zoster skin lesions must be differentiated from herpes simplex - Herpes zoster skin lesions must be differentiated from cellulitis - Herpes zoster skin lesions must be differentiated from erysipelas - Herpes zoster skin lesions must be differentiated from folliculitis - Herpes zoster skin lesions must be differentiated from irritant contact dermatitis - Herpes zoster skin lesions must be differentiated from insect bites - Herpes zoster skin lesions must be differentiated from mucosal candidiasis Source StatPearls "Herpes Zoster" - disease-level clinical article Status traced to the source above Rx: Antiviral | Main treatment | Antiviral - for acyclovir-resistant zoster | Pain - first step | Pain - add if not enough | Nerve pain ANTIVIRAL - choose one 1. ACYCLOVIR [1st line] Adult 800 mg orally 5 times daily (every 4 hours while awake) x 7 days Peds 20 mg/kg/dose [child max 800 mg] (20 mg/kg 4 times daily (max 800 mg/dose) for children 1 mo–11 yrs; 800 mg 5 times daily for adolescents ≥12 yrs) 3kg -> 60 mg/dose 4kg -> 80 mg/dose 5kg -> 100 mg/dose 6kg -> 120 mg/dose 7kg -> 140 mg/dose 8kg -> 160 mg/dose 9kg -> 180 mg/dose 10kg -> 200 mg/dose 11kg -> 220 mg/dose 12kg -> 240 mg/dose 13kg -> 260 mg/dose 14kg -> 280 mg/dose 15kg -> 300 mg/dose 16kg -> 320 mg/dose 17kg -> 340 mg/dose 18kg -> 360 mg/dose 19kg -> 380 mg/dose 20kg -> 400 mg/dose 21kg -> 420 mg/dose 22kg -> 440 mg/dose 23kg -> 460 mg/dose 24kg -> 480 mg/dose 25kg -> 500 mg/dose 26kg -> 520 mg/dose 27kg -> 540 mg/dose 28kg -> 560 mg/dose 29kg -> 580 mg/dose 30kg -> 600 mg/dose 31kg -> 620 mg/dose 32kg -> 640 mg/dose 33kg -> 660 mg/dose 34kg -> 680 mg/dose 35kg -> 700 mg/dose 36kg -> 720 mg/dose 37kg -> 740 mg/dose 38kg -> 760 mg/dose 39kg -> 780 mg/dose 40kg -> 800 mg/dose 41kg -> 800 mg/dose (capped) 42kg -> 800 mg/dose (capped) 43kg -> 800 mg/dose (capped) 44kg -> 800 mg/dose (capped) 45kg -> 800 mg/dose (capped) 46kg -> 800 mg/dose (capped) 47kg -> 800 mg/dose (capped) 48kg -> 800 mg/dose (capped) 49kg -> 800 mg/dose (capped) 50kg -> 800 mg/dose (capped) Source Egyptian National Drug Formulary - Antimicrobial 2023 Why Nucleoside analogue antiviral that inhibits viral DNA polymerase to limit replication of varicella-zoster virus; started early after the shingles rash appears, before extensive viral replication, to reduce the severity of the episode. Caution Initiate within 72 hours of rash onset for optimal efficacy. Maintain high fluid intake to prevent renal crystallization. Dose adjustment is required in renal impairment. Egypt VIRUSTAT 800MG 35 TAB. PHAROPHARMA 266.00 EGP (7.60/unit) ACIVIRAX 800MG 20 TABS. MASH PREMIERE 154.00 EGP (7.70/unit) LOVIR 800 MG 35 ORAL DISP. TABS. SUN PHARMA EG... 300.00 EGP BORGAVIRAX 200MG/5ML SUSP. 125 ML BORG 61.00 EGP -> ? strength differs, ? different route - not oral solid VIRUSTAT 200MG/5ML SUSP. 120 ML PHAROPHARMA 61.00 EGP -> ? strength differs, ? different route - not oral solid 2. VALACYCLOVIR [1st line] Adult 1000 mg three times daily x 7 days Peds The formulary gives no paediatric herpes zoster dose for valacyclovir - its paediatric doses are for herpes labialis and genital herpes. Use the aciclovir row in a child. Choice Alternatives. Three doses a day against aciclovir's five. Shingles is painful and its patients are old; a five-times-a-day schedule is the one that gets missed. Source Egyptian National Drug Formulary - Antimicrobial 2023 (valacyclovir monograph) Why Three doses a day against aciclovir's five. Shingles is painful, patients are elderly, and a five-times-a-day schedule is the one they miss. The formulary carries the drug and the herpes zoster dose, and it is on the Egyptian Essential Medicine List. Caution An alternative to the aciclovir above, not an addition. Give one antiviral. Start within 72 hours of the rash appearing - the formulary states efficacy is not established beyond that, and preferably within 48 hours. Reduce the dose in renal impairment: 1 g every 12 hours if creatinine clearance is 30-49, every 24 hours if 10-29, and 500 mg every 24 hours below 10. Keep fluid intake up. Confusion and hallucination occur in the elderly and in renal impairment, and are usually a sign the dose is too high. Egypt VIROCLEAR 500 MG 10 TAB. ALFACURE PHAR... 50.00 EGP (5.00/unit) VALTREX 500 MG 42 TAB. GLAXO SMITHKLINE 789.00 EGP (18.79/unit) HERPACUT 500 MG 10 SCORED F.C. TABS. INTERNATIONAL DRUG AGENCY (IDI) 50.00 EGP VALYSERNEX 500MG 20 F.C. CAPLET EVA PHARMA 154.00 EGP MAIN TREATMENT 3. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Herpes Zoster - disease-level clinical article (herpes-zoster-full.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Prompt ophthalmology referral is needed when eye involvement is present. ANTIVIRAL - FOR ACYCLOVIR-RESISTANT ZOSTER 4. FAMCICLOVIR [1st line] Adult 500 mg every 8 hours x 7 days Peds The formulary gives no paediatric dose for herpes zoster in immunocompetent children; its paediatric famciclovir doses are for genital herpes and for HIV-positive adolescents. Source Egyptian National Drug Formulary - Antimicrobial 2023 (famciclovir monograph) - verbatim: "Herpes zoster (shingles): Oral: Note: Initiate therapy as soon as possible after diagnosis and within 1 week of rash onset or any time before full crusting of lesions. Immunocompetent patients: 500 mg every 8 hours for 7 days." Why The card carries acyclovir and valacyclovir and stops there. Famciclovir is the third oral antiviral licensed for shingles, the formulary gives it a zoster heading of its own, and the article names it for the patient whose virus is acyclovir-resistant. Caution Start it within the first week of the rash, or at least before the lesions have fully crusted - after that an antiviral has little left to offer. Reduce the dose in renal impairment; the formulary steps it down as creatinine clearance falls, and again for dialysis patients. This dose is for the immunocompetent patient - shingles in someone immunosuppressed needs a different plan and usually a specialist. It does not prevent post-herpetic neuralgia on its own; the pain rows on the card still apply. Egypt EACLOVIR 500MG 7 F.C. TABS. MEDIZEN PHARM... 85.00 EGP (12.14/unit) PROPENCIVIR 500MG 7 F.C. TAB. BIORIGINAL IN... 175.50 EGP (25.07/unit) PAIN - FIRST STEP - give alongside 5. PARACETAMOL [add-on - not a substitute] Adult 1000 mg three or four times daily, maximum 4000 mg in 24 hours - while the rash is painful, usually 2-4 weeks Peds 15 mg/kg/dose [child max 500 mg] (15 mg/kg 3 or 4 times daily, maximum 60 mg/kg daily. Under 1 month: 10 mg/kg 3 or 4 times daily, maximum 40 mg/kg/day (MSF Essential Drugs 2024).) 3kg -> 45 mg/dose 4kg -> 60 mg/dose 5kg -> 75 mg/dose 6kg -> 90 mg/dose 7kg -> 105 mg/dose 8kg -> 120 mg/dose 9kg -> 135 mg/dose 10kg -> 150 mg/dose 11kg -> 165 mg/dose 12kg -> 180 mg/dose 13kg -> 195 mg/dose 14kg -> 210 mg/dose 15kg -> 225 mg/dose 16kg -> 240 mg/dose 17kg -> 255 mg/dose 18kg -> 270 mg/dose 19kg -> 285 mg/dose 20kg -> 300 mg/dose 21kg -> 315 mg/dose 22kg -> 330 mg/dose 23kg -> 345 mg/dose 24kg -> 360 mg/dose 25kg -> 375 mg/dose 26kg -> 390 mg/dose 27kg -> 405 mg/dose 28kg -> 420 mg/dose 29kg -> 435 mg/dose 30kg -> 450 mg/dose 31kg -> 465 mg/dose 32kg -> 480 mg/dose 33kg -> 495 mg/dose 34kg -> 500 mg/dose (capped) 35kg -> 500 mg/dose (capped) 36kg -> 500 mg/dose (capped) 37kg -> 500 mg/dose (capped) 38kg -> 500 mg/dose (capped) 39kg -> 500 mg/dose (capped) 40kg -> 500 mg/dose (capped) 41kg -> 500 mg/dose (capped) 42kg -> 500 mg/dose (capped) 43kg -> 500 mg/dose (capped) 44kg -> 500 mg/dose (capped) 45kg -> 500 mg/dose (capped) 46kg -> 500 mg/dose (capped) 47kg -> 500 mg/dose (capped) 48kg -> 500 mg/dose (capped) 49kg -> 500 mg/dose (capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why The pain is what the patient came with. The antiviral shortens the rash; it does very little for today's pain. Uncontrolled acute zoster pain is also the strongest predictor of post-herpetic neuralgia, so treating it is not just comfort. Caution Regular, not as-needed. Zoster pain is constant for the first week or two and PRN dosing under-treats it. Check every other product for paracetamol - cold and flu sachets are the usual route to an accidental overdose. Reduce the maximum to 3000 mg/day if the patient is under 50 kg, malnourished, or has liver disease. If paracetamol and an NSAID together are not holding the pain, that is the point to add a nerve-pain drug, not to keep escalating the analgesic. 500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid PAIN - ADD IF NOT ENOUGH - give alongside 6. IBUPROFEN [add-on - not a substitute] Adult 400 mg up to three times daily with or after food, maximum 1200 mg in 24 hours - while the rash is painful, usually 2-4 weeks Peds 20 mg/kg/day [child max 1200 mg] (20 mg/kg/day in divided doses, with food. Not under 3 months. Shingles in a child is uncommon and warrants a look for immunosuppression.) 3kg -> 60 mg/day 4kg -> 80 mg/day 5kg -> 100 mg/day 6kg -> 120 mg/day 7kg -> 140 mg/day 8kg -> 160 mg/day 9kg -> 180 mg/day 10kg -> 200 mg/day 11kg -> 220 mg/day 12kg -> 240 mg/day 13kg -> 260 mg/day 14kg -> 280 mg/day 15kg -> 300 mg/day 16kg -> 320 mg/day 17kg -> 340 mg/day 18kg -> 360 mg/day 19kg -> 380 mg/day 20kg -> 400 mg/day 21kg -> 420 mg/day 22kg -> 440 mg/day 23kg -> 460 mg/day 24kg -> 480 mg/day 25kg -> 500 mg/day 26kg -> 520 mg/day 27kg -> 540 mg/day 28kg -> 560 mg/day 29kg -> 580 mg/day 30kg -> 600 mg/day 31kg -> 620 mg/day 32kg -> 640 mg/day 33kg -> 660 mg/day 34kg -> 680 mg/day 35kg -> 700 mg/day 36kg -> 720 mg/day 37kg -> 740 mg/day 38kg -> 760 mg/day 39kg -> 780 mg/day 40kg -> 800 mg/day 41kg -> 820 mg/day 42kg -> 840 mg/day 43kg -> 860 mg/day 44kg -> 880 mg/day 45kg -> 900 mg/day 46kg -> 920 mg/day 47kg -> 940 mg/day 48kg -> 960 mg/day 49kg -> 980 mg/day 50kg -> 1000 mg/day Source Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) Why Can be given with the paracetamol when that alone is not enough. AAFP names NSAIDs alongside acetaminophen for the acute pain. Caution SHINGLES IS NOT CHICKENPOX. The rule against NSAIDs in varicella is about primary chickenpox and the risk of necrotising soft tissue infection; AAFP names NSAIDs for zoster in adults. If the diagnosis is actually primary varicella, do not give this. Avoid in asthma, active peptic ulcer, significant renal impairment, heart failure, and the third trimester. Most zoster patients are elderly - check the eGFR and check whether they are already on an ACE inhibitor or a diuretic before adding an NSAID. With food, short course, and not on top of another NSAID. Egypt DAJUANOFEN 400 MG 20 F.C. TABS. COPAD PHARMA 5.00 EGP (0.25/unit) FLABU 400MG 10 F.C.TAB. DELTA PHARMA 3.75 EGP (0.38/unit) NOVA-PROFEN 400MG 30 F.C. TABLETS SANOFI 12.75 EGP (0.42/unit) IBUPROFEN 400 MG 10 TAB. SEDICO 6.00 EGP (0.60/unit) MAFO 400 MG 30 F.C.TABS EIPICO 42.00 EGP (1.40/unit) BRUFEN 400 MG 30 TABS. KAHIRA > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid NERVE PAIN - give alongside 7. AMITRIPTYLINE [add-on - not a substitute] Adult 10-25 mg in the evening to start, increased by 10-25 mg every 3-7 days as tolerated; usual range 25-75 mg at night - reviewed at 4-6 weeks; continue while it is helping, then taper Peds The label states amitriptyline should not be used in children and adolescents under 18 years, as safety and efficacy have not been established. Choice Alternatives. NICE CG173 offers a free choice of four drugs for neuropathic pain; amitriptyline is the cheapest to start and the most familiar in primary care. Source Amitriptyline Hydrochloride 25 mg Film-Coated Tablets SmPC sections 4.1 and 4.2 (eMC product 13683) Why Post-herpetic neuralgia is neuropathic pain and NICE CG173 offers a choice of four drugs for it. Amitriptyline is the cheapest of the four in Egypt and is licensed for the indication. This is the drug the patient needs when the rash has healed and the pain has not. Caution Dry mouth, constipation, urinary retention, postural dizziness and falls are all dose- related. Alternative to the gabapentin below, not an addition. NICE offers a choice of one. Take it in the evening; the sedation is useful when the pain is worst at night. Avoid after a recent myocardial infarction, in arrhythmia, and in untreated closed-angle glaucoma. It takes 2-4 weeks at an adequate dose to work. Stopping at day 5 because 'it did nothing' is the commonest way this fails. Do not stop abruptly after a long course - taper. Avoid in elderly patients, and in severe cardiovascular disease or arrhythmias. Amitriptyline - StatPearls - NCBI Bookshelf (NBK537225) puts amitriptyline on the American Geriatrics Society's Beers list, to be avoided in the elderly because its anticholinergic effect is so strong. Egypt TRYPTIZOL 25 MG 30 TABS. KAHIRA 33.00 EGP (1.10/unit) GRANITYLLIN 25MG/5ML SYP. 120 ML GRAND PHARMA ... 5.00 EGP -> ? strength differs, ? different route - not oral solid ZINOTRAVAL 25MG/5ML SYP. 120 ML DEBEIKY > PHA... 10.00 EGP -> ? strength differs, ? different route - not oral solid 8. GABAPENTIN [add-on - not a substitute] Adult 300 mg on day 1, 300 mg twice daily on day 2, 300 mg three times daily on day 3, then increased in 300 mg/day steps every 2-3 days to a usual 1800 mg/day in three divided doses - titrated over 1-3 weeks; reviewed at 4-6 weeks and continued while it is helping Peds The paediatric mg/kg dose in the formulary is for partial-onset seizures from 3 years, not for neuropathic pain. The neuropathic pain indication is adults only, and the dose is a step-up schedule rather than a single mg/kg rule. Source Egyptian National Drug Formulary - Nervous system disorders 2025 (gabapentin monograph) Why The formulary names post-herpetic neuralgia in the indication line, with its own titration schedule. NICE CG173 offers it as one of four initial choices for neuropathic pain. Caution Alternative to the amitriptyline above, not an addition. NICE offers a choice of one. It must be titrated. A patient started straight on 300 mg three times daily will be too drowsy to continue. Reduce the dose in renal impairment - gabapentin is cleared by the kidney and accumulates. Drowsiness, dizziness and unsteadiness are common early and matter in an elderly patient who may fall. Divide into three doses with no more than 12 hours between them. Do not stop abruptly - taper over at least a week. Egypt EZAPENTIN 300MG 10 CAPS. MULTI-APEX 11.00 EGP (1.10/unit) PENTALIPSY 300MG 10 CAPS. SAFE PHARMA 14.40 EGP (1.44/unit) OCTOCONVAL 300 MG 30 CAPS. OCTOBER PHARMA 72.00 EGP (2.40/unit) NEUROGLOPENTIN 300 MG 30 CAPS. GLOBAL NAPI P... 111.00 EGP (3.70/unit) SHALGATEN 300MG 30 CAPS. EGPI > MASH P... 126.00 EGP (4.20/unit) GABALEPSY 300MG 30 CAPS. EL-OBOUR 135.00 EGP (4.50/unit) GABAVERONA 300 MG 30 H.G. CAPS. AVERROES PHARMA 126.00 EGP SAJALIPSY 300 MG 30 H.G. CAPS. SAJA PHARMACE... 126.00 EGP STABLENTIN 6MG/120ML SYRUP MEPACO 21.60 EGP -> ? strength differs, ? different route - not oral solid ADAPTAN 250MG/5ML ORAL SOLUTION 100 ML EUROPEAN EGYPTIAN PHARM. IND. 37.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)