{
  "schema_version": 1,
  "kind": "condition",
  "id": "mastalgia",
  "name": "Mastalgia (Breast pain)",
  "category": "chronic",
  "sources": "RCOG Guidelines on Management of Breast Pain 2018 · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)",
  "review_status": "reviewed",
  "verified_against": "MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Mastalgia - disease-level clinical article (mastalgia-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1119,
      "generic": "Paracetamol",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 500.0,
      "adult_dose": "1 g 3 or 4 times daily (max. 4 g daily)",
      "adult_duration": "as needed during painful symptomatic days",
      "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)",
      "rationale": "Simple analgesic offered first when reassurance and a properly fitted support bra alone do not control cyclical or non-cyclical breast pain.",
      "cautions": [
        "Reassurance and proper fitting support bra benefit up to 80% of cyclical mastalgia.",
        "Examine for focal breast mass, skin changes, or nipple discharge.",
        "Refer to specialist breast clinic if discrete mass or bloody nipple discharge is present."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily)",
      "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": "FEBRIMOL 500 MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO",
          "price_egp": 3.5,
          "pack_count": 20,
          "unit_price": 0.17,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CETAMOL 500 MG 20 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 8.0,
          "pack_count": 20,
          "unit_price": 0.4,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MUP",
          "price_egp": 13.0,
          "pack_count": 20,
          "unit_price": 0.65,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CETAL 500 MG 20 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "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
        },
        {
          "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "UTOPIA",
          "price_egp": 42.0,
          "pack_count": 30,
          "unit_price": 1.4,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "PARAMOL 500MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR",
          "price_egp": 38.0,
          "pack_count": 20,
          "unit_price": 1.9,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ADOL 500MG 24 CAPLETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "JULPHAR",
          "price_egp": 32.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AUG PHARMA",
          "price_egp": 50.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FEBRIMOL ORAL DROPS 20 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO",
          "price_egp": 4.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHAROPHARMA",
          "price_egp": 5.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 3200.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "mastalgia"
    },
    {
      "id": 1121,
      "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": "Mastalgia - disease-level clinical article (mastalgia-clinical.txt)",
      "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.",
      "cautions": [
        "RED FLAG - The physical exam red flags that mean the pain needs evaluation for malignancy rather than symptomatic analgesia are a lump, skin changes, nipple retraction or discharge, and ulceration."
      ],
      "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": "mastalgia"
    },
    {
      "id": 1120,
      "generic": "Ibuprofen",
      "line": 2,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 400.0,
      "adult_dose": "400 mg 3 times daily after food",
      "adult_duration": null,
      "dose_source": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)",
      "rationale": "NSAID stepped up to when paracetamol alone does not control breast pain, targeting the inflammatory component of mastalgia.",
      "cautions": [
        "Topical NSAID gel applied to painful areas has fewer GI side effects than oral NSAIDs.",
        "Evaluate relationship to menstrual cycle (cyclical vs non-cyclical).",
        "Exclude musculoskeletal chest wall pain (Tietze syndrome).",
        "Consult a doctor if symptoms persist or worsen, or if required for more than 10 days."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Adolescents >=12 years: 200-400 mg 3 times daily after food",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": [
        {
          "label": "12 years and over",
          "age_min_months": 144,
          "age_max_months": 216,
          "dose_text": "200-400 mg three times daily after food"
        }
      ],
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "DAJUANOFEN 400 MG 20 F.C. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "COPAD PHARMA",
          "price_egp": 5.0,
          "pack_count": 20,
          "unit_price": 0.25,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FLABU 400MG 10 F.C.TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "DELTA PHARMA",
          "price_egp": 3.75,
          "pack_count": 10,
          "unit_price": 0.38,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SANOFI",
          "price_egp": 12.75,
          "pack_count": 30,
          "unit_price": 0.42,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "IBUPROFEN 400 MG 10 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SEDICO",
          "price_egp": 6.0,
          "pack_count": 10,
          "unit_price": 0.6,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "MAFO 400 MG  30 F.C.TABS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 42.0,
          "pack_count": 30,
          "unit_price": 1.4,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BRUFEN 400 MG 30 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KAHIRA > ABBOTT LABORATORIES",
          "price_egp": 78.0,
          "pack_count": 30,
          "unit_price": 2.6,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "PROFUSOL 400MG 20 S.G CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.",
          "price_egp": 31.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ANALGIPROF 400 MG 25 SACHETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EVA PHARMA",
          "price_egp": 37.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 400.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "NOVA-PROFEN  100MG/5ML ORAL SUSP. 100ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SANOFI",
          "price_egp": 2.25,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 100.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BRUFEMOL-N SUSP. 60 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ARAB DRUG COMPANY (ADCO)",
          "price_egp": 4.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "mastalgia"
    }
  ]
}