Dawaa Reference

acute

Intermenstrual pain (Mittelschmerz / ovulation pain)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Brott NR, Le JK. Mittelschmerz. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2023 May 1. Bookshelf ID: NBK549822; PMID: 31747229.

Verified against3 documents
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)
  • Brott NR, Le JK. Mittelschmerz. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2023 May 1. Bookshelf ID: NBK549822; PMID: 31747229.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

  • It does not come every month, and women may not connect it to ovulation at all
  • Pain sits in either iliac fossa, usually the side of the growing follicle
  • It normally stops within three to twelve hours
  • After ovarian surgery it can instead drag on until the period begins
  • A mild backache may go with it [back pain]
  • It falls at the luteinising hormone peak, so it marks the most fertile days

Signs — what you find (1)

  • Gynaecological disease and appendicitis alike can give Rovsing sign, guarding, a raised white count and fever [abdominal pain · fever · guarding · right lower quadrant pain]

Tests (1)

  • Working up acute abdominal pain in this group means weighing gynaecological causes

If not this — what else fits (1)

  • In women of reproductive age this is readily mistaken for acute appendicitis

SourceStatPearls "Mittelschmerz" - disease-level clinical article

Presentation findings are traced to the source above.

1

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever

Paediatric dose

15 mg/kg/dose [child max 500 mg]

(Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.)

Dose by weight
3kg45 mg/dose
4kg60 mg/dose
5kg75 mg/dose
6kg90 mg/dose
7kg105 mg/dose
8kg120 mg/dose
9kg135 mg/dose
10kg150 mg/dose
11kg165 mg/dose
12kg180 mg/dose
13kg195 mg/dose
14kg210 mg/dose
15kg225 mg/dose
16kg240 mg/dose
17kg255 mg/dose
18kg270 mg/dose
19kg285 mg/dose
20kg300 mg/dose
21kg315 mg/dose
22kg330 mg/dose
23kg345 mg/dose
24kg360 mg/dose
25kg375 mg/dose
26kg390 mg/dose
27kg405 mg/dose
28kg420 mg/dose
29kg435 mg/dose
30kg450 mg/dose
31kg465 mg/dose
32kg480 mg/dose
33kg495 mg/dose
34kg500 mg/dose (capped)
35kg500 mg/dose (capped)
36kg500 mg/dose (capped)
37kg500 mg/dose (capped)
38kg500 mg/dose (capped)
39kg500 mg/dose (capped)
40kg500 mg/dose (capped)
41kg500 mg/dose (capped)
42kg500 mg/dose (capped)
43kg500 mg/dose (capped)
44kg500 mg/dose (capped)
45kg500 mg/dose (capped)
46kg500 mg/dose (capped)
47kg500 mg/dose (capped)
48kg500 mg/dose (capped)
49kg500 mg/dose (capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Symptomatic relief only; it does not treat the cause. The dose is MSF's, under its mild-pain indication: an adult takes 1 g either 3 or 4 times a day, with a daily ceiling of 4 g. The dose claim holds and the indication claim does not, because no disease-level document here recommends an analgesic for mittelschmerz.

Cautions
  • NO DOCUMENT HELD HERE RECOMMENDS AN ANALGESIC FOR THIS CONDITION. The card's own cited article (StatPearls, Mittelschmerz, NBK549822) was opened and read in full: it has no management section, names no analgesic, and the single treatment sentence in it points at an oral contraceptive, not at a painkiller. This dose is a general analgesic dose for mild pain, offered because the pain is real, not because a source recommends this drug for this diagnosis.
  • The article's own view of the course: the pain usually settles inside three to twelve hours. The exception is the woman who has had ovarian surgery, in whom it can carry on until her period starts. A short analgesic course is all that should be needed.
  • Relief only - it does not treat what is causing the pain or fever.
  • Check every other product the patient is taking for paracetamol; combination cold and flu preparations are the usual route to an accidental overdose.
  • Reduce the dose in significant liver disease, chronic alcohol use, or low body weight.
  • RED FLAG - Pain lasting well beyond the usual day or two, or fever or abnormal vaginal bleeding accompanying the pain (consider ectopic pregnancy or pelvic infection instead).
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP
2

IBUPROFEN

add-on - not a substitute

Strength400 mg

Formoral.solid

Adult dose and duration

200 to 400 mg up to three times a day, at least 4 hours between doses, maximum 1200 mg in 24 hours - Short-term use only; the shortest effective course

Paediatric dose

(Label verbatim: "For pain and fever 20 mg/kg/day in divided doses (including OTC use)." The label's age bands for the 100 mg/5 ml suspension are 3-6 months 2.5 ml three times daily, 6-12 months 2.5 ml three to four times daily, 1-4 years 5 ml three times daily, 4-7 years 7.5 ml three times daily, 7-12 years 10 ml three times daily. Not to be given under 3 months.)

Dose by age
3 to 5 months:2.5 mL of the 100 mg/5 ml suspension three times daily. Not under 3 months.
6 to 11 months:2.5 mL three to four times daily
1 to 3 years:5 ml three times daily
4 to 6 years:7.5 ml three times daily
7 to 11 years:10 ml three times daily
Dose source

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)

Why

An anti-inflammatory analgesic for the pain. The row once read 200 to 400 mg by mouth every 6 to 8 hours as needed, which permits four doses a day, where the label it cites permits three. The label's own figures are 200 mg to 400 mg - 10 to 20 ml - up to three times daily as required, at least four hours apart, and never more than 1200 mg or 60 ml within any 24 hour period. The daily maximum was already right. The citation was also rewritten from a bare URL to the label's name, which is the same document under the form docs/SOURCES.md asks for.

Cautions
  • NO DOCUMENT HELD HERE RECOMMENDS AN ANALGESIC FOR THIS CONDITION. The card's own cited article (StatPearls, Mittelschmerz, NBK549822) was opened and read in full: it has no management section, names no analgesic, and the single treatment sentence in it points at an oral contraceptive, not at a painkiller. This dose is a general analgesic dose for mild pain, offered because the pain is real, not because a source recommends this drug for this diagnosis.
  • The label's own indication is symptomatic - it is licensed for mild to moderate muscle pain, for fever following immunisation, for headache and earache, for dental pain, and for backache. It does not name this condition.
  • Relief only - it does not treat what is causing the pain.
  • Take with or after food, and give gastroprotection if it is needed for more than a short course or the patient is over 65.
  • Avoid in dehydration and in anyone not drinking - the kidney risk is highest there.
Egyptian brands
Egyptian brandManufacturerIndicative price
DAJUANOFEN 400 MG 20 F.C. TABS.COPAD PHARMA5.00 EGP (0.25/unit)
FLABU 400MG 10 F.C.TAB.DELTA PHARMA3.75 EGP (0.38/unit)
NOVA-PROFEN 400MG 30 F.C. TABLETSSANOFI12.75 EGP (0.42/unit)
IBUPROFEN 400 MG 10 TAB.SEDICO6.00 EGP (0.60/unit)
MAFO 400 MG 30 F.C.TABSEIPICO42.00 EGP (1.40/unit)
BRUFEN 400 MG 30 TABS.KAHIRA > ABBOTT LABORATORIES78.00 EGP (2.60/unit)
PROFUSOL 400MG 20 S.G CAPS.EUROPEAN EGYPTIAN PHARM. IND.31.00 EGP
ANALGIPROF 400 MG 25 SACHETSEVA PHARMA37.50 EGP
NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML? strength differs? different route - not oral solidSANOFI2.25 EGP
BRUFEMOL-N SUSP. 60 ML? strength differs? different route - not oral solidARAB DRUG COMPANY (ADCO)4.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.