{ "schema_version": 1, "kind": "condition", "id": "peripheral-neuropathy", "name": "Painful peripheral neuropathy", "category": "chronic", "sources": "Egyptian National Drug Formulary - Nervous System Disorders 2025 · Amitriptyline 25 mg Film-Coated Tablets SmPC section 4.2 (eMC product 13683) · Duloxetine Dr. Reddy's 60 mg Gastro-Resistant Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 6966) · Bodman MA, Dreyer MA, Varacallo MA. Diabetic Peripheral Neuropathy. [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK442009; PMID: 28723038. · Alzain 75 mg Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 1762)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Nervous System Disorders 2025 · Amitriptyline 25 mg Film-Coated Tablets SmPC section 4.2 (eMC product 13683) · Duloxetine Dr. Reddy's 60 mg Gastro-Resistant Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 6966) · Bodman MA, Dreyer MA, Varacallo MA. Diabetic Peripheral Neuropathy. [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK442009; PMID: 28723038. · Alzain 75 mg Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 1762)", "verified_date": "2026-08", "treatments": [ { "id": 1391, "generic": "Duloxetine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 60.0, "adult_dose": "60 mg once daily with or without food; max 120 mg daily in divided doses", "adult_duration": "long-term", "dose_source": "Duloxetine Dr. Reddy's 60 mg Gastro-Resistant Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 6966)", "rationale": "Duloxetine is an SNRI that boosts serotonin and norepinephrine in the descending pain-modulating pathways, offering an alternative mechanism to pregabalin for painful peripheral neuropathy. The condition's cited article puts it on the first line of its drug therapy, alongside the gabapentinoids - pregabalin, gabapentin.", "cautions": [ "Avoid in end-stage renal disease (CrCl < 30 mL/min) or severe hepatic impairment.", "Monitor blood pressure periodically (risk of dose-dependent hypertension).", "There is a risk of serotonin syndrome when combined with other serotonergic agents." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not indicated for neuropathic pain in children", "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": "DULOPRESSIVE 60 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > TA PHARMA", "price_egp": 174.0, "pack_count": 30, "unit_price": 5.8, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPRETREVE 60MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > ANDALOUS PHARMA", "price_egp": 148.0, "pack_count": 20, "unit_price": 7.4, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DULOXEPRIN 60 MG 28 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > UTOPIA", "price_egp": 214.0, "pack_count": 28, "unit_price": 7.64, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CYMBATEX 60 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 295.5, "pack_count": 30, "unit_price": 9.85, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUCANDES 60 MG 28 CAPSULES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE > INCANDESCE", "price_egp": 280.0, "pack_count": 28, "unit_price": 10.0, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CYMBALTA 60 MG 28 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ELI LILLY", "price_egp": 544.0, "pack_count": 28, "unit_price": 19.43, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUXNORZET 60 MG 30 DEL. REL. H.G. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ZETA PHARMA", "price_egp": 231.0, "pack_count": null, "unit_price": null, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WADILOXTIN 60 MG 28 DEL. REL. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WADI ELNEEL BENTA", "price_egp": 280.0, "pack_count": null, "unit_price": null, "strength_mg": 60.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "peripheral-neuropathy" }, { "id": 1392, "generic": "Pregabalin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 75.0, "adult_dose": "150 mg per day in two or three divided doses (75 mg twice daily); may increase to 300 mg per day after an interval of 3 to 7 days and, if needed, to a maximum of 600 mg per day after an additional 7 days", "adult_duration": null, "dose_source": "Alzain 75 mg Capsules, Hard SmPC section 4.2 Posology and method of administration (eMC product 1762)", "rationale": "Pregabalin binds the alpha-2-delta subunit of voltage-gated calcium channels on nerve terminals, reducing excitatory neurotransmitter release; this condition's cited article names gabapentinoids a first-line agent for painful diabetic peripheral neuropathy.", "cautions": [ "Treatment should be given for the shortest possible duration; agree a plan for stopping before starting, to minimise the risk of dependence, addiction and withdrawal.", "Dizziness and somnolence are common; caution when driving or operating machinery.", "Reduce dose in renal impairment based on creatinine clearance.", "Do not discontinue abruptly; taper over at least 1 week to avoid withdrawal symptoms.", "There is potential for misuse and dependence." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Safety and efficacy have not been established in children below 12 years or in adolescents 12-17 years of age.", "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": "FORPREGAB 75 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GRAND PHARMA > PARKVILLE", "price_egp": 45.0, "pack_count": 30, "unit_price": 1.5, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SNAPGAB 75 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE > TA PHARMA", "price_egp": 49.5, "pack_count": 30, "unit_price": 1.65, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LYRIBALIN 75MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 18.0, "pack_count": 10, "unit_price": 1.8, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEURAGABALIN 75 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA GRAND PHARMA", "price_egp": 23.0, "pack_count": 10, "unit_price": 2.3, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NERVATYCA 75 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 48.75, "pack_count": 20, "unit_price": 2.44, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "QUEENLEPT 75 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > ASPIN PHARMACEUTICAL", "price_egp": 93.0, "pack_count": 30, "unit_price": 3.1, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LYRICA 75MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 232.0, "pack_count": 20, "unit_price": 11.6, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREGABEDIUM 75 MG 20 H.G. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SABAA > ACTIVA THERAPEUTICS", "price_egp": 56.66, "pack_count": null, "unit_price": null, "strength_mg": 75.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LOCIKASWAB 100MG/5ML 20 UNIDOSE ORAL SOLN.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNISWAB > VODACHEM", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "AVEROPREG 100MG/5ML SYRUP 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AVERROES PHARMA-EGYPT", "price_egp": 55.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "peripheral-neuropathy" }, { "id": 1390, "generic": "Amitriptyline", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 25.0, "adult_dose": "10-25 mg at bedtime initially, titrate by 10-25 mg weekly to 50-75 mg nightly (usual maximum 75 mg nightly)", "adult_duration": "long-term", "dose_source": "Amitriptyline 25 mg Film-Coated Tablets SmPC section 4.2 (eMC product 13683)", "rationale": "Second-line agent for painful peripheral neuropathy. The condition's own cited article places the tricyclic antidepressants, amitriptyline among them, on its second line, behind the gabapentinoids and duloxetine. It stays on the card because it is cheap and widely prescribed in Egypt, but it is no longer the printed first choice.", "cautions": [ "Contraindicated in recent myocardial infarction and heart block.", "Amitriptyline has strong anticholinergic side effects (dry mouth, urinary retention, constipation, blurred vision).", "Avoid in elderly patients, and in severe cardiovascular disease or arrhythmias. Amitriptyline - StatPearls - NCBI Bookshelf (NBK537225) puts amitriptyline on the American Geriatrics Society's Beers list, to be avoided in the elderly because its anticholinergic effect is so strong.", "The label puts the usual range at 25-75 mg nightly and says doses above 100 mg should be used with caution." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Amitriptyline should not be used in children and adolescents aged less than 18 years, as safety and efficacy have not been established.", "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": "TRYPTIZOL 25 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 33.0, "pack_count": 30, "unit_price": 1.1, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GRANITYLLIN 25MG/5ML SYP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GRAND PHARMA > DELTA GRAND PHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ZINOTRAVAL 25MG/5ML SYP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY > PHARMACHEMIC", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "peripheral-neuropathy" } ] }