{ "schema_version": 1, "kind": "condition", "id": "nocturnal-enuresis", "name": "Nocturnal Enuresis (Bedwetting)", "category": "chronic", "sources": "NICE Guideline CG111 Nocturnal Enuresis in Children 2010 · Oxybutynin Hydrochloride 5 mg Tablets SmPC section 4.2 (eMC product 11470) · Egyptian National Drug Formulary, endocrine 2024, desmopressin acetate monograph, primary nocturnal enuresis (printed pp. 242-243)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary, endocrine 2024, desmopressin acetate monograph, primary nocturnal enuresis (printed pp. 242-243) · Oxybutynin Hydrochloride 5 mg Tablets SmPC section 4.2 (eMC product 11470)", "verified_date": "2026-08", "treatments": [ { "id": 1221, "generic": "Desmopressin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 0.1, "adult_dose": "Initially: 120 mcg at bedtime. If no sufficient effectiveness, the dose may be increased up to 240 mcg.", "adult_duration": "3 months (then 1 week trial withdrawal)", "dose_source": "Egyptian National Drug Formulary, endocrine 2024, desmopressin acetate monograph, primary nocturnal enuresis (printed pp. 242-243)", "rationale": "Synthetic vasopressin analogue that reduces nighttime urine output by increasing renal water reabsorption; first-line when rapid control of bedwetting is needed or an alarm device is unsuitable.", "cautions": [ "FLUID RESTRICTION MANDATORY: Restrict fluid 1 hour before and 8 hours after the dose.", "There is a risk of severe hyponatraemic convulsions if fluid restriction is ignored.", "Desmopressin is first line for children >= 5 years when rapid control is needed or an alarm is unsuitable.", "The melt and the tablet are not interchangeable milligram for milligram: 120 mcg of the sublingual melt is roughly 200 mcg of the swallowed tablet. Egypt sells the 0.1 mg tablet, so this dose is two of them." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children (from 5 years of age): Initially: 120 mcg at bedtime. If no sufficient effectiveness, the dose may be increased up to 240 mcg.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "5 years and over", "age_min_months": 60, "age_max_months": 216, "dose_text": "120 micrograms at bedtime; may be raised to 240 micrograms if not effective" } ], "peds_doses": null, "brands": [ { "trade_name": "DESMODJUST 0.1 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 210.0, "pack_count": 30, "unit_price": 7.0, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEGAPRESS 0.1 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > OMEGA PHARMA OPCI", "price_egp": 288.0, "pack_count": 30, "unit_price": 9.6, "strength_mg": 0.1, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "nocturnal-enuresis" }, { "id": 1222, "generic": "Oxybutynin", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5 mg 2-3 times daily, max 20 mg daily", "adult_duration": null, "dose_source": "Oxybutynin Hydrochloride 5 mg Tablets SmPC section 4.2 (eMC product 11470)", "rationale": "Antimuscarinic that reduces detrusor overactivity, added to desmopressin rather than replacing it, for children with daytime urgency or enuresis that persists on desmopressin alone.", "cautions": [ "Used for daytime urgency or enuresis resistant to desmopressin monotherapy.", "Anticholinergic side effects include dry mouth, constipation, and blurred vision.", "Rule out urinary tract infection, diabetes mellitus, or spinal pathology.", "In the elderly the half-life is longer: start 2.5 mg twice daily, more so if the patient is frail, and go no higher than 5 mg twice daily unless it is tolerated. Oxybutynin is strongly anticholinergic - confusion, dry mouth, constipation and falls." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children 5 years of age and over: 2.5 mg twice a day, may be increased to 5 mg two or three times daily (last dose before bedtime)", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "5 years and over", "age_min_months": 60, "age_max_months": 216, "dose_text": "2.5 mg twice daily initially, may increase to 5 mg two or three times daily (last dose before bedtime)" } ], "peds_doses": null, "brands": [ { "trade_name": "DRY TROPAN 5MG MR 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DETRONIN 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 26.0, "pack_count": 20, "unit_price": 1.3, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OXYBIN 5 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 26.0, "pack_count": 20, "unit_price": 1.3, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "URIPAN 5 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 54.0, "pack_count": 30, "unit_price": 1.8, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OXURATE 1MG/ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 6.5, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "DRY TROPAN 2.5MG/5ML ELIXIR 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 7.0, "pack_count": null, "unit_price": null, "strength_mg": 2.5, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "nocturnal-enuresis" } ] }