chronic

Polycythaemia (Erythrocytosis Investigation & Referral)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources1 source

BSH Guideline for the Diagnosis and Management of Polycythemia Vera 2019

Verified against2 documents

BSH Guideline for the Diagnosis and Management of Polycythemia Vera 2019
Polycythaemia (Erythrocytosis Investigation & Referral) - disease-level clinical article (polycythemia-referral-clinical.txt)

Verified date2026-08

Presentation reference

Reference only, to read alongside your own examination.

Symptoms from hyperviscosity include fatigue, headache, dizziness, tinnitus, visual change, claudication, itching, and early fullness after eating. [claudication · dizziness · fatigue · headache · itching · tinnitus]
Itching triggered by a hot shower, aquagenic pruritus, affects about 40% of patients. [itching]
Erythromelalgia causes burning hand and foot pain with redness or pallor of the skin. [foot pain · pallor · redness]
Bleeding and clotting complications each occur in roughly 1% of patients. [bleeding]
Feeling full quickly after eating results from an enlarged spleen crowding the stomach. [early satiety · splenomegaly]

Exam may show facial and palm flushing, red conjunctivae, scratch marks from itching, and an enlarged spleen or liver. [itching · splenomegaly]

WHO major criteria include hemoglobin above 16.5 g/dL in men (16 in women), or hematocrit above 49%/48%, or red cell mass over 25% above predicted.
Bone marrow biopsy shows age-inappropriate hypercellularity with growth in all three cell lines and pleomorphic megakaryocytes.
A JAK2 V617F or exon 12 mutation is required as a major diagnostic criterion.
A low serum erythropoietin level below the normal reference range is the minor diagnostic criterion.
The diagnostic criteria are applied only once secondary causes of polycythemia have been excluded.

Because it's driven by hypoxia or smoking, secondary polycythemia occurs far more often than primary PV and must always be ruled out first.
A rare EPO-receptor mutation mimics PV's raised red cell mass and low EPO, but works through an over-sensitive receptor rather than EPO-independent growth.
An isolated high white count can be from infection or a leukemoid reaction, and isolated high platelets from bleeding or iron deficiency.
Other diagnoses named to distinguish include essential thrombocythemia, chronic myelogenous leukemia, and primary myelofibrosis.

SourceStatPearls "Polycythemia Vera" - disease-level clinical article

Presentation findings are traced to the source above.

1st line

Strength75 mg

Formoral.solid

Adult dose and duration

75-100 mg once daily with food - long-term under haematologist monitoring

Paediatric dose

CONTRAINDICATED in children under 16 years due to Reye's syndrome risk

Dose source

BSH Guideline for the Diagnosis and Management of Polycythemia Vera 2019

Why

Low-dose aspirin reduces arterial and venous thrombotic events in polycythemia vera

Cautions

SPECIALIST HAEMATOLOGY REFERRAL IS MANDATORY for hematocrit >0.52 in men or >0.48 in women.
Primary treatment for polycythemia vera is therapeutic venesection (target hematocrit <0.45) under haematology guidance.
Differentiate primary polycythemia vera (JAK2 mutation) from secondary erythrocytosis (chronic hypoxia, smoking, OSA, renal tumors).
Take aspirin with food to reduce GI bleeding risk.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
AGGREX 75MG 60 TABS.	RAMEDA	33.00 EGP (0.55/unit)
ASPOCID 75MG 20 TAB.	CID	22.00 EGP (1.10/unit)
ASPOCID 75MG 30 TAB.	CID	33.00 EGP (1.10/unit)
ASPIRIN-CHEMIPHARM 75 MG 30 CHEW.TABS.	CHEMIPHARM	12.00 EGP
RIVO 75 MG 30 CHEW. TABS.	ARAB DRUG COMPANY (ADCO)	21.00 EGP
ASPOCID PAEDIATRIC 75MG 30 CHEW. TABS.	CID	35.00 EGP
EZACARD 75 MG 30 E.C. TABS.	MULTI-APEX	51.00 EGP

1st line

Dose source

Polycythaemia (Erythrocytosis Investigation & Referral) - disease-level clinical article (polycythemia-referral-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions

RED FLAG - Aspirin is contraindicated in patients with extreme thrombocytosis (platelets >1 million/microliter) due to acquired von Willebrand disease.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.