{
  "schema_version": 1,
  "kind": "condition",
  "id": "old-myocardial-infarction",
  "name": "Old myocardial infarction",
  "category": "acute",
  "sources": "Egyptian National Drug Formulary - cardiovascular.pdf, Atorvastatin monograph (chapter PDF p207) · Ojha N, Dhamoon AS. Myocardial Infarction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2023 Aug 8. Bookshelf ID: NBK537076.",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - cardiovascular.pdf, Atorvastatin monograph (chapter PDF p207)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1240,
      "generic": "Atorvastatin",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "80 mg once daily (secondary-prevention statin dose after myocardial infarction).",
      "adult_duration": "Long-term / indefinite.",
      "dose_source": "Egyptian National Drug Formulary - cardiovascular.pdf, Atorvastatin monograph (chapter PDF p207)",
      "rationale": "High-intensity statin therapy is standard lifelong secondary prevention after a myocardial infarction, regardless of baseline cholesterol level.",
      "cautions": [
        "Recurrent chest pain, new breathlessness or oedema suggesting heart failure, palpitations suggesting arrhythmia.",
        "Check liver function and creatine kinase before starting and if muscle symptoms develop.",
        "Watch for myopathy, especially with interacting drugs (e.g. clarithromycin, fibrates).",
        "Counsel on the need for lifelong adherence even though the patient feels well.",
        "Contraindicated in acute liver failure or decompensated cirrhosis, and during pregnancy or lactation."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Not applicable - this is an adult condition; paediatric statin dosing (from age 10, for familial hypercholesterolaemia only) is specialist-set and is not reproduced here.",
      "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": "PREVENVAST 10 MG 10 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 6.5,
          "pack_count": 10,
          "unit_price": 0.65,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ANTICHOL 10 MG 10 F.C. TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS",
          "price_egp": 8.5,
          "pack_count": 10,
          "unit_price": 0.85,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "LIPOVAST 10MG 7 F.C.TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR",
          "price_egp": 9.25,
          "pack_count": 7,
          "unit_price": 1.32,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "LIRIMAR 80 MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RIVA PHARMA S.A.E.",
          "price_egp": 29.0,
          "pack_count": 10,
          "unit_price": 2.9,
          "strength_mg": 80.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "LIPINORM 10 MG 7 F.C.TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MUP",
          "price_egp": 28.0,
          "pack_count": 7,
          "unit_price": 4.0,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ATOR 40 MG 10 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 106.0,
          "pack_count": 10,
          "unit_price": 10.6,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "HIPOLIXAVAST 10 MG 30 CHEW. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EGPI",
          "price_egp": 114.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "HIPOLIXAVAST 20 MG 30 CHEW. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EGPI",
          "price_egp": 127.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 20.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "old-myocardial-infarction"
    }
  ]
}