{ "schema_version": 1, "kind": "condition", "id": "ovarian-cyst", "name": "Ovarian Cyst (Simple, Primary Care)", "category": "chronic", "sources": "RCOG Green-top Guideline No. 62: Management of Suspected Ovarian Cysts in Premenopausal Women 2011 · RCOG Green-top Guideline No. 34: Management of Ovarian Cysts in Postmenopausal Women 2016 · NICE CKS: Ovarian cyst 2022 · RCOG Green-top Guideline No. 62: Management of Suspected Ovarian Masses in Premenopausal Women, section 6.1 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Microgynon 30 (ethinylestradiol 30 mcg + levonorgestrel 150 mcg) SmPC sections 4.2-4.4 (eMC product 1130) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299)", "review_status": "reviewed", "verified_against": "RCOG Green-top Guideline No. 62: Management of Suspected Ovarian Masses in Premenopausal Women, section 6.1 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Microgynon 30 (ethinylestradiol 30 mcg + levonorgestrel 150 mcg) SmPC sections 4.2-4.4 (eMC product 1130) · Ovarian Cyst - disease-level clinical article (ovarian-cyst-full.txt) · MSF Essential Drugs 2024 (ibuprofen oral monograph)", "verified_date": "2026-08", "treatments": [ { "id": 1289, "generic": "Conservative Management & Pelvic Ultrasound Monitoring (Primary Care Strategy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Simple cyst under 50 mm in a premenopausal woman: no follow-up needed - these usually resolve over 2-3 cycles on their own. 50 to 70 mm: yearly ultrasound. Above 70 mm: further imaging or surgical assessment, because a cyst that size is hard to characterise on ultrasound alone. No drug therapy is needed to make a simple cyst resolve - it does that on its own. The entries below are for the pain while it does, and, where functional cysts keep forming, for preventing the next one.", "adult_duration": "no routine follow-up under 50 mm; yearly from 50 to 70 mm", "dose_source": "RCOG Green-top Guideline No. 62: Management of Suspected Ovarian Masses in Premenopausal Women, section 6.1", "rationale": "Simple physiological cysts (follicular or corpus luteum) < 5 cm in premenopausal women routinely resolve spontaneously without pharmacological intervention.", "cautions": [ "Rescanning a simple cyst under 50 mm is not recommended. It finds nothing, and it keeps a well woman in the system for months.", "Urgent referral to emergency gynecology if acute severe pelvic pain, vomiting, or peritoneal signs occur (suspected cyst rupture or ovarian torsion).", "Check CA-125 level and calculate Risk of Malignancy Index (RMI) in postmenopausal women or premenopausal women with complex/solid features.", "Refer to gynecology if cyst is > 5 cm, persistent > 3 months, complex/multilocular on ultrasound, or symptomatic." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Adolescent simple cysts < 5 cm: observe with pelvic ultrasound over 2-3 cycles under pediatric gynecology consultation.", "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": "ovarian-cyst" }, { "id": 1292, "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": "Ovarian Cyst - disease-level clinical article (ovarian-cyst-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Sudden onset of unilateral, moderate-to-severe sharp lower abdominal pain (with or without nausea/vomiting), especially after strenuous activity or intercourse, is a red flag for rupture/hemorrhage or torsion and needs prompt evaluation regardless of cyst size.", "RED FLAG - Surgical referral is indicated for suspected ovarian torsion, persistent adnexal mass, acute abdominal pain, or suspected malignancy - independent of the size-based follow-up thresholds." ], "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": "ovarian-cyst" }, { "id": 1291, "generic": "Ethinyl estradiol + Levonorgestrel", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 0.03, "adult_dose": "1 tablet (30 mcg ethinylestradiol / 150 mcg levonorgestrel) once daily for 21 days followed by 7 pill-free days for prevention of new functional cyst formation", "adult_duration": "3-6 cycles", "dose_source": "Microgynon 30 (ethinylestradiol 30 mcg + levonorgestrel 150 mcg) SmPC sections 4.2-4.4 (eMC product 1130)", "rationale": "Combined oral contraceptives do not hasten the resolution of existing functional ovarian cysts but prevent new cyst formation in women with recurrent functional cysts.", "cautions": [ "Does not treat existing cysts; acts by suppressing ovulation to prevent recurrent functional cysts.", "Contraindicated in women with history of venous thromboembolism, ischemic heart disease, migraine with aura, severe hypertension, or age > 35 and smoking.", "The clot risk is highest in the first year on it - and it resets, so restarting after a break of four weeks or more carries that first-year risk again, not the lower steady-state one." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Adolescents post-menarche: 1 tablet daily for cycle regulation/prevention under gynecology supervision.", "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": "MICROCEPT 21 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 0.76, "pack_count": 21, "unit_price": 0.04, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICRODETTE 3* 21 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 7.5, "pack_count": 21, "unit_price": 0.36, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NORDETTE 5*21 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE. > PFIZER", "price_egp": 15.0, "pack_count": 21, "unit_price": 0.71, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICROGENEST 30/150 MCG 21 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ACDIMA INTERNATIONAL TRADING", "price_egp": 23.0, "pack_count": 21, "unit_price": 1.1, "strength_mg": 0.15, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIOCEPT 21 TAB. X 6 STRIP (TRIPHASIC)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 120.0, "pack_count": 21, "unit_price": 5.71, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "ovarian-cyst" }, { "id": 1290, "generic": "Ibuprofen", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "400 mg three times daily PRN with food for mild to moderate pelvic pain associated with functional ovarian cyst", "adult_duration": "3-5 days PRN", "dose_source": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) for the adult dose: \"The recommended dose is 200 mg-400 mg (10-20 ml), up to three times a day as required... do not take more than 1200 mg (60 ml) in any 24 hour period\". That label's paediatric section gives weight bands and a 20 mg/kg/day pain-and-fever ceiling but states no mg/kg per dose, so the paediatric 5 to 10 mg/kg per dose is from MSF Essential Drugs 2024 (ibuprofen oral monograph): \"Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily (max. 30 mg/kg daily)\".", "rationale": "Ibuprofen is an NSAID added on top of expectant management of the functional ovarian cyst to control the pelvic pain while the cyst is left to resolve on its own; it does not treat the cyst itself.", "cautions": [ "Symptomatic relief of mild to moderate pelvic discomfort during cyst regression.", "Take with food or milk to minimize gastrointestinal upset.", "Do not mask severe acute pain; re-evaluate for torsion or rupture if pain worsens.", "The 400 mg per-dose ceiling comes from the reference literature, not from the suspension label - that label's largest paediatric single dose is 200 mg. Below about 40 kg the weight calculation binds first and the ceiling never comes into it." ], "peds_mgkg_low": 5.0, "peds_mgkg_high": 10.0, "peds_max_mg": 400.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "5-10 mg/kg per dose every 8 hours as needed, with food. Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily, maximum 30 mg/kg daily. The suspension's own label caps pain-and-fever use lower still, at 20 mg/kg/day. Never exceed 400 mg in a single dose.", "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": [ { "weight_kg": 10, "low_mg": 50, "high_mg": 100, "capped": false }, { "weight_kg": 20, "low_mg": 100, "high_mg": 200, "capped": false }, { "weight_kg": 30, "low_mg": 150, "high_mg": 300, "capped": false }, { "weight_kg": 40, "low_mg": 200, "high_mg": 400, "capped": false } ], "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": "ovarian-cyst" } ] }