{ "schema_version": 1, "kind": "condition", "id": "primary-dysmenorrhoea", "name": "Primary dysmenorrhoea", "category": "chronic", "sources": "ACOG Committee Opinion No. 760 (2018) · Mefenamic Acid 500 mg film-coated Tablets SmPC sections 4.2 and 4.3 (eMC product 12503) · Dysmenorrhea - StatPearls - NCBI Bookshelf - disease-level clinical article (primary-dysmenorrhoea-full.txt) · Microgynon 30 tablets SmPC section 4.2 (eMC product 1130)", "review_status": "reviewed", "verified_against": "Mefenamic Acid 500 mg film-coated Tablets SmPC sections 4.2 and 4.3 (eMC product 12503) · ACOG Committee Opinion No. 760 (2018) · Paracetamol 500mg Tablets SmPC (eMC product 5164) · Dysmenorrhea - StatPearls - NCBI Bookshelf - disease-level clinical article (primary-dysmenorrhoea-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1485, "generic": "Mefenamic acid", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg TID with meals starting at onset of menses", "adult_duration": "2-3 days during menses", "dose_source": "Mefenamic Acid 500 mg film-coated Tablets SmPC sections 4.2 and 4.3 (eMC product 12503)", "rationale": "NSAID with dual action: COX inhibition and prostaglandin receptor antagonism", "cautions": [ "Discontinue immediately if diarrhea develops (unique to mefenamic acid); CONTRAINDICATED in active inflammatory bowel disease.", "Take with or after food to minimize gastric irritation.", "CONTRAINDICATED in active peptic ulcer disease or NSAID-induced asthma.", "Caution in renal impairment or bleeding disorders.", "CONTRAINDICATED in inflammatory bowel disease, in active or recurrent peptic ulcer or GI haemorrhage, and in severe renal failure. Maximum 1500 mg a day.", "Opioids and tramadol should not be used routinely for period pain.", "All NSAIDs carry black box warnings for serious adverse events, which must be heeded whichever agent is chosen.", "Period pain that does not respond to NSAIDs is a warning sign for endometriosis - up to 35% of NSAID non-responders have it, against up to 29% of women with dysmenorrhoea overall.", "In primary dysmenorrhoea the pain starts within a few hours of menses and typically resolves within 72 hours; pain lying outside that pattern should raise suspicion of a secondary cause.", "Onset of menstrual pain in a woman older than 25 points towards a secondary cause rather than primary dysmenorrhoea.", "Perform a pelvic examination when the history of onset and duration suggests a secondary cause, or when the pain is not responding to medical treatment.", "A pelvic examination is not required in an adolescent who is not sexually active and has a typical presentation without additional symptoms.", "If the pain persists despite treatment, investigate for a secondary cause rather than escalating analgesia." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Licensed for dysmenorrhoea in adolescents over 12 years: 500 mg TID", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "Over 12 years", "age_min_months": 144, "age_max_months": 216, "dose_text": "500 mg three times daily" } ], "peds_doses": null, "brands": [ { "trade_name": "PONAGIC FORTE 500MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 3.0, "pack_count": 10, "unit_price": 0.3, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEFRONIL 500 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 14.25, "pack_count": 30, "unit_price": 0.47, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FAROSTAN FORTE 500MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": 10, "unit_price": 0.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFEPAIN 500MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SPIMACO > EIMC", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEFENAM 500MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 14.0, "pack_count": 20, "unit_price": 0.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PONSTAN FORTE 500MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 14.0, "pack_count": 20, "unit_price": 0.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PONOFORTE 500MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA", "price_egp": 30.0, "pack_count": 20, "unit_price": 1.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "primary-dysmenorrhoea" }, { "id": 1486, "generic": "Ibuprofen", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "400 mg TID with food starting 1-2 days before or at menses onset", "adult_duration": "2-3 days during menses", "dose_source": "ACOG Committee Opinion No. 760 (2018)", "rationale": "Widely available first-line NSAID for dysmenorrhoea relief", "cautions": [ "Take with food or milk.", "Avoid in active GI ulceration, severe renal impairment, or late pregnancy.", "May cause dyspepsia or mild fluid retention." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Adolescents >12 yrs: 200-400 mg TID with food during menses", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "13 years and over", "age_min_months": 156, "age_max_months": 216, "dose_text": "200 to 400 mg three times daily with food during menses" } ], "peds_doses": null, "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": "primary-dysmenorrhoea" }, { "id": 1487, "generic": "Paracetamol", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "500-1000 mg (1-2 tablets) every 4-6 hours as required (max 4000 mg/day)", "adult_duration": null, "dose_source": "Paracetamol 500mg Tablets SmPC (eMC product 5164)", "rationale": "Non-NSAID analgesic alternative for dysmenorrhea pain when NSAIDs are contraindicated.", "cautions": [ "Do not exceed 4000 mg (8 tablets) in 24 hours to prevent hepatotoxicity.", "Avoid concurrent use with other paracetamol-containing products." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child 1 month and over: 15 mg/kg 3 or 4 times daily (max 60 mg/kg daily). Child under 1 month: 10 mg/kg 3 or 4 times daily (max 40 mg/kg daily).", "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": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PYRAL 500MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 28.0, "pack_count": 20, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TEMPORAL 1000 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 40.0, "pack_count": 20, "unit_price": 2.0, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 250 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 30.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STOPADOL JOINT 650 MG 30 EXT. REL. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 75.0, "pack_count": null, "unit_price": null, "strength_mg": 650.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 1000 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 80.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "primary-dysmenorrhoea" }, { "id": 1488, "generic": "Ethinyl estradiol + Levonorgestrel", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "A 21-day pack, one tablet each day at about the same time, begun on day 1 of the period, then 7 days with no tablet before the next pack", "adult_duration": "Continued cycle after cycle for as long as contraception is wanted; judge the effect on the pain over a few cycles", "dose_source": "Microgynon 30 tablets SmPC section 4.2 (eMC product 1130) - verbatim: \"First treatment cycle: 1 tablet daily for 21 days, starting on the first day of the menstrual cycle. Contraceptive protection begins immediately\"", "rationale": "A combined pill thins the endometrium and blocks ovulation, so less prostaglandin is made and the cramps ease. The article limits it to patients who also want contraception, which is the right way to offer it - it is not a painkiller for someone who does not.", "cautions": [ "Do not prescribe it to anyone with a current or past venous thromboembolism, or a known clotting predisposition.", "Migraine with aura is an absolute contraindication - ask about it directly, because patients volunteer the headache and not the visual symptoms.", "Avoid it in smokers over 35, in severe hypertension, in diabetes with vascular complications, and in current or past breast cancer or severe liver disease.", "Vomiting or diarrhoea within a few hours of a tablet, or a tablet more than 12 hours late, means contraceptive cover is lost - additional precautions are needed for the next 7 days.", "If the pain does not settle over a few cycles, look again for a secondary cause such as endometriosis or adenomyosis rather than escalating the hormone." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Used from menarche onwards in adolescents who want contraception; the same one-tablet-daily regimen applies, and the contraindications below matter just as much in a teenager as in an older woman.", "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": true, "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": true, "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": true, "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": true, "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": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "primary-dysmenorrhoea" } ] }