{ "schema_version": 1, "kind": "condition", "id": "polymenorrhea", "name": "Polymenorrhea (Frequent Periods)", "category": "acute", "sources": "Egyptian National Drug Formulary - Endocrine System Drugs 2024, norethisterone (norethindrone) monograph (endocrine.pdf page index 125, printed p112) · Microgynon 30 (ethinylestradiol 30 mcg + levonorgestrel 150 mcg) SmPC sections 4.2-4.4 (eMC product 1130) · SmPC sections 4.1 and 4.2, https://www.medicines.org.uk/emc/product/1130/smpc · Tranexamic Acid 500 mg Tablets SmPC section 4.2 (eMC product 14622) · Mikes BA, Vadakekut ES, Sparzak PB. Abnormal Uterine Bleeding. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2025 Feb 21. Bookshelf ID: NBK532913; PMID: 30422508.", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Endocrine System Drugs 2024, norethisterone (norethindrone) monograph (endocrine.pdf page index 125, printed p112) · SmPC section 4.2, https://www.medicines.org.uk/emc/product/14622/smpc · SmPC sections 4.1 and 4.2, https://www.medicines.org.uk/emc/product/1130/smpc · Mikes BA, Vadakekut ES, Sparzak PB. Abnormal Uterine Bleeding. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2025 Feb 21. Bookshelf ID: NBK532913; PMID: 30422508.", "verified_date": "2026-08", "treatments": [ { "id": 1425, "generic": "Norethisterone", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "Acute bleed: 20 mg by mouth three times daily for 7 days (StatPearls, Abnormal Uterine Bleeding NBK532913, acute AUB progestin-only option). The Egyptian National Drug Formulary gives 5 mg by mouth three times daily for 10 days for the same indication, with bleeding usually stopping within 48 hours. Then, to prevent recurrence: 5 mg by mouth twice daily from day 19 to day 26 of each of the next two cycles (Egyptian National Drug Formulary).", "adult_duration": "7 days for the acute course (StatPearls) or 10 days (Egyptian formulary), then the day 19 to day 26 course in each of the two following cycles", "dose_source": "StatPearls, Abnormal Uterine Bleeding (NBK532913), acute AUB progestin-only option (lead); Egyptian National Drug Formulary - Endocrine System Drugs 2024, norethisterone (norethindrone) monograph (endocrine.pdf page index 125, printed p112)", "rationale": "Cyclical progestogen imposes a normal-length cycle on frequent periods; a standard alternative when the combined pill is unsuitable.", "cautions": [ "The two sources disagree four-fold on the acute dose: StatPearls gives 20 mg three times daily for 7 days, the Egyptian formulary 5 mg three times daily for 10 days. The international figure leads here per the app's source policy; both are printed.", "Evaluate abnormal bleeding that persists or is severe before repeating courses.", "Contraindicated in pregnancy, in current or past deep vein thrombosis or pulmonary embolism, in hepatic impairment or disease, and in undiagnosed abnormal genital bleeding.", "Alternative when a combined pill is contraindicated or contraception is not wanted; this cyclical regimen is NOT reliably contraceptive.", "Never combine with tranexamic acid - listed as a contraindicated (Risk X) combination in the Egyptian formulary.", "Side effects include bloating, weight gain, mood change, and breast tenderness.", "Refer to gynaecology if the cycle has not regularised after 3 cycles, or if intermenstrual/postcoital/postmenopausal bleeding appears." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The formulary gives adult dosing only; no paediatric or adolescent dose is stated in this monograph.", "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": "CIDOLUT NOR 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 36.0, "pack_count": 20, "unit_price": 1.8, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIDOLUT NOR 5 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 57.0, "pack_count": 30, "unit_price": 1.9, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STERONATE 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 56.0, "pack_count": 20, "unit_price": 2.8, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "polymenorrhea" }, { "id": 1426, "generic": "Tranexamic acid", "line": 3, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1000 mg (2 tabs) PO TID during menstruation (max 4 g/day, up to 4 days).", "adult_duration": "up to 4 days per cycle; continue cycle-to-cycle for as long as it remains beneficial", "dose_source": "SmPC section 4.2, https://www.medicines.org.uk/emc/product/14622/smpc", "rationale": "Reduces blood loss if the frequent cycles are also heavy; does not lengthen the cycle interval itself.", "cautions": [ "Only needed if the frequent cycles are also heavy - it does not lengthen the cycle interval, only reduces blood loss during a bleed.", "Contraindicated in active or past venous/arterial thromboembolism.", "Any postmenopausal bleeding needs urgent referral, not this drug.", "Check a full blood count if bleeding is heavy or prolonged; treat confirmed iron deficiency separately." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "This should be calculated according to body weight at 25 mg /kg per 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": null, "brands": [ { "trade_name": "TREXAM 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRANEX 500 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ABBOTT", "price_egp": 117.0, "pack_count": 30, "unit_price": 3.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KAPRON 500 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 110.0, "pack_count": 20, "unit_price": 5.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SAVIBLEED 500 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 110.0, "pack_count": 20, "unit_price": 5.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "polymenorrhea" } ] }