{ "schema_version": 1, "kind": "condition", "id": "polycystic-ovary-syndrome", "name": "Polycystic ovary syndrome (PCOS primary management)", "category": "chronic", "sources": "Egyptian National Drug Formulary - Endocrine System 2024 · International Evidence-based Guideline for PCOS 2023", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Endocrine System 2024 · International Evidence-based Guideline for PCOS 2023", "verified_date": "2026-08", "treatments": [ { "id": 1426, "generic": "Ethinyl estradiol + Cyproterone", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "1 tablet daily for 21 days starting on day 1 of cycle, followed by 7 pill-free days", "adult_duration": "long-term (review after 3-4 cycles)", "dose_source": "International Evidence-based Guideline for PCOS 2023", "rationale": "Diane-35 is not registered by the Egyptian Drug Authority (imported only). Registered COC alternatives with alternative progestogens (e.g. Drospirenone) are widely available and may be preferred for VTE risk profile.", "cautions": [ "This is first-line for hyperandrogenism (hirsutism, acne) and menstrual irregularity.", "VTE risk is higher than standard COCs; contraindications include history of VTE, severe HTN, focal migraine, smoking >35yo.", "Continue long-term for symptom control; hyperandrogenism recurs upon discontinuation." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable in pediatric care; specialist adolescent gynecology referral", "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": "DIANE 35 - 21 TABLETS (ILLEGAL IMPORT)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BAYER HEALTHCARE >", "price_egp": 43.0, "pack_count": 21, "unit_price": 2.05, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "polycystic-ovary-syndrome" }, { "id": 1427, "generic": "Metformin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg orally once daily with meal, titrate weekly up to 500-850 mg twice daily", "adult_duration": "long-term", "dose_source": "Egyptian National Drug Formulary - Endocrine System 2024 (metformin monograph), Adult dosing, immediate release: \"Initial: Oral: 500 mg once or twice daily\", \"may increase gradually by 500mg increments every 7 days\", \"Usual maintenance dosage: Oral: 1 g twice daily or 850 mg twice daily\". Note: the only metformin indication in this formulary is type 2 diabetes, so these are its general adult titration figures, not a PCOS-specific regimen; the International Evidence-based Guideline for PCOS 2023 is not held in this corpus.", "rationale": "Metformin improves insulin sensitivity and reduces hepatic glucose output; in PCOS it is used to address the underlying insulin resistance and cardiometabolic risk that drive the syndrome.", "cautions": [ "Metformin is first-line for cardiometabolic management and insulin resistance in PCOS.", "Monitor renal function before starting and annually.", "GI adverse effects are minimized by gradual titration with meals." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric endocrine referral for adolescents", "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": "METFORMIN-EL NASR 500MG 200 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 26.0, "pack_count": 200, "unit_price": 0.13, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIAPHAGE 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.0, "pack_count": 20, "unit_price": 0.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMOPHAGE 500MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 10.5, "pack_count": 30, "unit_price": 0.35, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIDOPHAGE 500 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GLUCOPHAGE 500 MG 50 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > MERCK SANTE-FRANCE", "price_egp": 60.0, "pack_count": 50, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KELVAMET MR 500 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOMED", "price_egp": 54.0, "pack_count": 30, "unit_price": 1.8, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANDOGLYCEMIC XR 500MG 30 EXT. REL. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 24.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METIANORMIN 500 MG 30 EXT. REL. F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WADI ELNEEL BENTA", "price_egp": 54.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "polycystic-ovary-syndrome" } ] }