{
  "schema_version": 1,
  "kind": "condition",
  "id": "restless-legs-syndrome",
  "name": "Restless Legs Syndrome (Willis-Ekbom disease)",
  "category": "chronic",
  "sources": "IRLSSG Consensus Guidelines on Restless Legs Syndrome 2016 · Egyptian National Drug Formulary, nervous system 2025, pramipexole monograph, restless legs syndrome (printed p. 88) · Ropinirole tablets, film coated (Bionpharma Inc.) US prescribing information, section 1.2 Restless Legs Syndrome, section 2.3 Dosing for Restless Legs Syndrome and section 5 Warnings and Precautions (DailyMed SetID 4e6b070c-50a6-4742-af3c-59b45c45735e) · NEUPRO (rotigotine) transdermal system US prescribing information, section 1.2 Restless Legs Syndrome, section 2.2 Dosage in Restless Legs Syndrome and section 5 Warnings and Precautions (DailyMed SetID 939e28c5-f3a9-42c0-9a2d-8d471d82a6e0) · Restless Legs Syndrome - StatPearls - NCBI Bookshelf (NBK430878) - the article states the dose for this use",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary, nervous system 2025, pramipexole monograph, restless legs syndrome (printed p. 88) · IRLSSG Consensus Guidelines on Restless Legs Syndrome 2016 · Restless Legs Syndrome - disease-level clinical article (restless-legs-syndrome-full.txt) · Ropinirole tablets, film coated (Bionpharma Inc.) US prescribing information, section 1.2 Restless Legs Syndrome, section 2.3 Dosing for Restless Legs Syndrome and section 5 Warnings and Precautions (DailyMed SetID 4e6b070c-50a6-4742-af3c-59b45c45735e) · NEUPRO (rotigotine) transdermal system US prescribing information, section 1.2 Restless Legs Syndrome, section 2.2 Dosage in Restless Legs Syndrome and section 5 Warnings and Precautions (DailyMed SetID 939e28c5-f3a9-42c0-9a2d-8d471d82a6e0)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1546,
      "generic": "Pramipexol",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 0.18,
      "adult_dose": "0.088-0.18 mg once daily 2-3 hours before bedtime",
      "adult_duration": "long-term",
      "dose_source": "Egyptian National Drug Formulary, nervous system 2025, pramipexole monograph, restless legs syndrome (printed p. 88)",
      "rationale": "Pramipexole is a dopamine agonist that corrects the dopaminergic dysfunction thought to underlie restless legs syndrome, easing the urge to move the legs and the associated discomfort, particularly in the evening.",
      "cautions": [
        "Doses are expressed as free base (0.088 mg base = 0.125 mg salt).",
        "There is a risk of impulse control disorders (gambling, hypersexuality, binge eating).",
        "Titration, if 0.088 mg is not enough: step up every 4-7 days through 0.18, then 0.35, then 0.54 mg once daily. 0.54 mg is the ceiling for restless legs - do not carry on to Parkinson's doses.",
        "Review at three months whether it is still needed. If it is stopped for more than a few days, titrate again from the start rather than resuming the old dose. Below 0.54 mg a day it can be stopped outright.",
        "No renal adjustment above a clearance of 20 mL/min; below that, and on dialysis, it has not been studied.",
        "There is a risk of symptom augmentation with prolonged high-dose use."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Specialist paediatric neurology consultation required",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": 216.0,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "SIFROL 0.18MG 30 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "BOEHRINGER INGELHEIM",
          "price_egp": 150.0,
          "pack_count": 30,
          "unit_price": 5.0,
          "strength_mg": 0.18,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "restless-legs-syndrome"
    },
    {
      "id": 1548,
      "generic": "Referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": null,
      "adult_duration": null,
      "dose_source": "Restless Legs Syndrome - disease-level clinical article (restless-legs-syndrome-full.txt)",
      "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.",
      "cautions": [
        "RED FLAG - Augmentation (symptoms worsening/spreading with earlier onset) is a recognized complication of prolonged dopamine agonist use, including the pramipexole listed here, and should prompt reassessment rather than simple continuation."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": null,
      "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": [],
      "condition_id": "restless-legs-syndrome"
    },
    {
      "id": 1549,
      "generic": "Ropinirole",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "Started very low and titrated weekly, taken before bed. US label verbatim: \"The recommended adult starting dose for RLS is 0.25 mg once daily 1 to 3 hours before bedtime. After 2 days, if necessary, the dose can be increased to 0.5 mg once daily, and to 1 mg once daily at the end of the first week of dosing, then as shown in Table 2 as needed to achieve efficacy. Titration should be based on individual patient therapeutic response and tolerability, up to a maximum recommended dose of 4 mg daily. For RLS, the safety and effectiveness of doses greater than 4 mg once daily have not been established.\" The label's own schedule is 0.25 mg on days 1 to 2, 0.5 mg on days 3 to 7, then 1 mg, 1.5 mg, 2 mg, 2.5 mg, 3 mg and 4 mg at weeks 2 to 7. On dialysis it starts at 0.25 mg once daily with a 3 mg daily ceiling.",
      "adult_duration": "Continued while it helps and reviewed for augmentation, then withdrawn slowly. US label verbatim: \"When discontinuing ropinirole in patients with RLS, gradual reduction of the daily dose is recommended.\"",
      "dose_source": "Ropinirole tablets, film coated (Bionpharma Inc.) US prescribing information, section 1.2 Restless Legs Syndrome, section 2.3 Dosing for Restless Legs Syndrome and section 5 Warnings and Precautions (DailyMed SetID 4e6b070c-50a6-4742-af3c-59b45c45735e)",
      "rationale": "The disease article names the drug inside the class it recommends, verbatim: \"Dopamine agonists, including pramipexole, ropinirole, rotigotine, and cabergoline, have reduced symptoms and improved sleep quality and quality of life.\" and adds the honest caveat that belongs beside it - \"Pramipexole and ropinirole have adverse effects, including gambling addiction and extreme weight gain.\" The US label's indication section names the disease, verbatim: \"Ropinirole tablets are indicated for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS).\" The card carried pramipexole alone, and the article's own meta-analysis sentence compares the two directly, so a patient who cannot tolerate one had nothing to move to. Ropinirole is cheap in Egypt - ROPINIROLE 0.25 mg tablets are on the register at 5.5 EGP - which matters for a drug taken every night.",
      "cautions": [
        "The characteristic failure of this drug class is that it makes the disease worse over time. Ropinirole label verbatim: \"Augmentation is a phenomenon in which dopaminergic medication causes a worsening of symptom severity above and beyond the level at the time the medication was started. The symptoms of augmentation may include the earlier onset of symptoms in the evening (or even the afternoon), increase in symptoms, and spread of symptoms to involve other extremities.\" and \"If augmentation or early-morning rebound occurs, the use of ropinirole should be reviewed and dosage adjustment or discontinuation of treatment should be considered.\" A patient whose legs now trouble them in the afternoon is not under-treated - escalating the dose is the wrong move.",
        "RED FLAG - sudden sleep attacks while driving. US label section 5.1 is titled \"Falling Asleep during Activities of Daily Living and Somnolence\". Ask directly about drowsiness at follow-up; the label's own point is that patients may not report it unless asked.",
        "Impulse control disorders are a named class effect and patients do not volunteer them. The disease article puts it plainly: ropinirole has \"adverse effects, including gambling addiction and extreme weight gain.\" Ask about gambling, spending, eating and sexual behaviour at every review, and ask the family too.",
        "Postural hypotension and syncope during titration - the label carries separate warnings for both. Take a lying and standing blood pressure at the start and at each dose step, especially in an older patient.",
        "Hallucinations and psychotic-like behaviour are listed warnings. New confusion or visual hallucinations after a dose increase is the drug until proved otherwise.",
        "Correct the iron first. The article's own list of things that alleviate symptoms begins with \"iron replacement\", and the ferrous fumarate row on this card exists for that reason. Starting a dopamine agonist over an untreated iron deficiency treats the symptom and leaves the cause."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Not a paediatric prescription. US label verbatim: \"Safety and effectiveness in pediatric patients have not been established.\" Restless legs in a child is usually iron deficiency until proven otherwise, and the ferrous fumarate row on this card is the relevant one.",
      "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": "ROPINIROLE 0.25 MG 10 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EPCI",
          "price_egp": 5.5,
          "pack_count": 10,
          "unit_price": 0.55,
          "strength_mg": 0.25,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ROPINIROLE 0.5 MG 30 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EPCI",
          "price_egp": 27.0,
          "pack_count": 30,
          "unit_price": 0.9,
          "strength_mg": 0.5,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "TREMODECT 1 MG 30 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EVA PHARMA",
          "price_egp": 31.5,
          "pack_count": 30,
          "unit_price": 1.05,
          "strength_mg": 1.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ROPINIROLE 2 MG 10 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EPCI",
          "price_egp": 12.0,
          "pack_count": 10,
          "unit_price": 1.2,
          "strength_mg": 2.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "TREMODECT 4 MG 30 F.C. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EVA PHARMA",
          "price_egp": 52.5,
          "pack_count": 30,
          "unit_price": 1.75,
          "strength_mg": 4.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "restless-legs-syndrome"
    },
    {
      "id": 1550,
      "generic": "Rotigotine",
      "line": 2,
      "is_adjunct": false,
      "form": "topical",
      "strength_mg": null,
      "adult_dose": "One patch a day, titrated weekly. US label verbatim: \"In patients with Restless Legs Syndrome, the recommended starting dose for NEUPRO is 1 mg/24 hours. Based upon individual patient clinical response and tolerability, NEUPRO dosage may be increased weekly by 1 mg/24 hours if additional therapeutic effect is needed. The lowest effective dose is 1 mg/24 hours. The maximum recommended dose is 3 mg/24 hours.\"",
      "adult_duration": "Continued while it helps, and stepped down rather than stopped. US label verbatim: \"For discontinuation of NEUPRO in patients with Restless Legs Syndrome, reduce the daily dose by 1 mg every 24 hours preferably every other day, until complete withdrawal of NEUPRO is achieved.\"",
      "dose_source": "NEUPRO (rotigotine) transdermal system US prescribing information, section 1.2 Restless Legs Syndrome, section 2.2 Dosage in Restless Legs Syndrome and section 5 Warnings and Precautions (DailyMed SetID 939e28c5-f3a9-42c0-9a2d-8d471d82a6e0)",
      "rationale": "The disease article names the drug twice, once in the class and once as a formulation, verbatim: \"Dopamine agonists, including pramipexole, ropinirole, rotigotine, and cabergoline, have reduced symptoms and improved sleep quality and quality of life.\" and \"The rotigotine transdermal patch can also be used. It is well tolerated and has a relatively low risk of clinically significant augmentation of RLS.\" The US label's indication section names the disease, verbatim: \"NEUPRO is indicated for the treatment of moderate-to-severe primary Restless Legs Syndrome.\" It earns a separate row from the oral agonists because the article's reason for it is a property of the patch rather than of the molecule - steady 24-hour delivery, and less augmentation. Egypt registers no rotigotine product, so no brand and no price can be shown.",
      "cautions": [
        "RED FLAG - sudden sleep attacks while driving. US label verbatim: \"Patients with early- and advanced-stage Parkinson's disease and with Restless Legs Syndrome treated with NEUPRO have reported falling asleep while engaged in activities of daily living, including the operation of motor vehicles, which sometimes resulted in accidents. Although many of these patients reported somnolence while on NEUPRO, some did not perceive warning signs, such as excessive drowsiness, and believed that they were alert immediately prior to the event. Some of these events have been reported as late as one year after initiation of treatment.\" At the maximum 3 mg/24 hours dose, 2% of restless-legs patients reported sleep attacks against 0% on placebo.",
        "It moves the blood pressure in both directions. US label verbatim: \"An increased risk for decreases in systolic and diastolic blood pressure were observed when supine, standing, and changing from supine to standing position in patients treated with NEUPRO.\" and, separately, \"In patients with Restless Legs Syndrome, this increased risk for diastolic blood pressure greater than 105 mm Hg was 8% for NEUPRO and 4% for placebo.\"",
        "New or worsening psychiatric symptoms. US label verbatim: \"Post-marketing reports indicate that patients with Parkinson's disease or RLS may experience new or worsening mental status and behavioral changes, which may be severe, including psychotic behavior during NEUPRO treatment or after starting or increasing the dose of NEUPRO.\"",
        "Augmentation is less likely with the patch but is not excluded. The disease article's wording is careful - it has \"a relatively low risk of clinically significant augmentation\", not none. Evening-shifted or spreading symptoms are still a reason to review rather than to increase.",
        "Somnolence is common enough to be part of the conversation. US label verbatim: \"Somnolence is a common occurrence in patients receiving NEUPRO.\" For restless legs at the maximum dose it was 10% against 4% on placebo.",
        "No Egyptian product exists, so the patch cannot be filled at a pharmacy in Cairo. It is printed so that one brought in from abroad can be recognised, dosed and withdrawn correctly rather than guessed at."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Not a paediatric prescription; the label establishes no paediatric use in this indication.",
      "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": [],
      "condition_id": "restless-legs-syndrome"
    },
    {
      "id": 1547,
      "generic": "Ferrous fumarate",
      "line": 2,
      "is_adjunct": true,
      "form": "oral.solid",
      "strength_mg": 200.0,
      "adult_dose": "200 mg 1-2 times daily if serum ferritin <= 75 mcg/L",
      "adult_duration": "3 months",
      "dose_source": "IRLSSG Consensus Guidelines on Restless Legs Syndrome 2016",
      "rationale": "Iron replacement is disease-modifying in restless legs when ferritin is low, not just supportive. Egypt sells ferrous fumarate rather than the sulphate the guideline names; match the elemental iron, not the tablet weight.",
      "cautions": [
        "Check serum ferritin in all RLS patients; supplement if ferritin <= 75 mcg/L.",
        "Iron deficiency in central nervous system exacerbates RLS symptoms.",
        "Take on an empty stomach with Vitamin C for optimal absorption.",
        "Most iron tablets in Egypt come with folic acid in them, though not all - check the pack. Folate corrects the blood picture of B12 deficiency while the neurological damage carries on - check B12 before starting if the anaemia is macrocytic, mixed, or unexplained.",
        "The guideline says ferrous sulphate. The Egyptian formulary has no ferrous sulphate monograph; its oral iron is ferrous fumarate, 200 mg tablet = 65.57 mg elemental. Substitute on elemental iron, not on tablet weight.",
        "The pack a pharmacy hands over is a combination rather than plain iron - besides folic acid, many Egyptian iron products add vitamin C, and some add zinc or B vitamins. A combination is an acceptable way to give oral iron: the formulary's ferrous fumarate monograph lists the dosage forms as a 200 mg tablet and a 140 mg/5 mL syrup, then adds combination products to that list, and states the adult dose in elemental iron (100 to 200 mg elemental iron daily). The vitamin C is wanted rather than merely tolerated - 200 to 500 mg alongside oral iron is recommended to enhance its absorption. Dose by the elemental iron the pack states, not by tablet weight and not by the other ingredients. The Egyptian register does not record elemental iron content for most of these products, so the carton has to be read."
      ],
      "peds_mgkg_low": 3.0,
      "peds_mgkg_high": 6.0,
      "peds_max_mg": 180.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": "Divided into 2 doses daily; elemental iron basis. Ceiling of 180 mg is the formulary maximum for a child: 20 mL/day of the 140 mg/5 mL syrup, which is 45 mg elemental iron per 5 mL. This is deliberately above the 130 mg an adult gets here: a growing child needs more elemental iron per kilogram, and modern adult practice is lower and less frequent dosing than the formulary allows. It is not an inversion to correct.",
      "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": [
        {
          "weight_kg": 10,
          "low_mg": 30,
          "high_mg": 60,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 60,
          "high_mg": 120,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 90,
          "high_mg": 180,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 120,
          "high_mg": 180,
          "capped": true
        }
      ],
      "brands": [
        {
          "trade_name": "FERROL 10 F.C. TABLET",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AMOUN",
          "price_egp": 2.0,
          "pack_count": 10,
          "unit_price": 0.2,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "folic acid"
        },
        {
          "trade_name": "FOLIFER 30 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR",
          "price_egp": 7.2,
          "pack_count": 30,
          "unit_price": 0.24,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "folic acid"
        },
        {
          "trade_name": "FERROZINC-C 24 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SAFE PHARMA > PHARCO",
          "price_egp": 7.5,
          "pack_count": 24,
          "unit_price": 0.31,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "vitamin c, zinc"
        },
        {
          "trade_name": "IROFOL 30 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MULTICARE",
          "price_egp": 40.5,
          "pack_count": 30,
          "unit_price": 1.35,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "copper, folic acid, pyridoxine, vitamin b12, zinc"
        },
        {
          "trade_name": "HAEMACTIN 30 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "DELTA GRAND PHARMA > NOBEL PHARM. INDUSTRIES",
          "price_egp": 150.0,
          "pack_count": 30,
          "unit_price": 5.0,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "folic acid, vitamin b12"
        },
        {
          "trade_name": "TESLAGLOBIN 20 CAP",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "DAWA EGYPT INTERNATIONAL > TESLA",
          "price_egp": 140.0,
          "pack_count": 20,
          "unit_price": 7.0,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "b12, b6, copper, folic acid, zinc"
        },
        {
          "trade_name": "CHEMARED CAPSULE",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARMA ZAD > CHEMA HERB",
          "price_egp": 195.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "calcium, methyl cobolamine, pyridoxine"
        },
        {
          "trade_name": "FERRONIL 125MG/5ML SYRUP 120 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EL NILE.",
          "price_egp": 4.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 125.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "restless-legs-syndrome"
    },
    {
      "id": 1551,
      "generic": "Ascorbic acid",
      "line": 2,
      "is_adjunct": true,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "250 mg taken at the same time as the iron tablet",
      "adult_duration": null,
      "dose_source": "Restless Legs Syndrome - StatPearls - NCBI Bookshelf (NBK430878) - the article states the dose for this use",
      "rationale": "The card already replaces iron but says nothing about how to make it work. The article pairs the iron tablet with vitamin C on an empty stomach, which is the difference between replacement and no replacement.",
      "cautions": [
        "Give it with the iron on an empty stomach and eat nothing for an hour afterwards, or the absorption gain is lost.",
        "This is an absorption aid, not a treatment for restless legs on its own."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "No paediatric dose in the sources opened.",
      "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": "C-VITON 500 MG 20 TABS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KAHIRA",
          "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": "CEVAROL 500MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 12.0,
          "pack_count": 20,
          "unit_price": 0.6,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "C-SAFE 500 MG 36 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SAFE PHARMA",
          "price_egp": 35.0,
          "pack_count": 36,
          "unit_price": 0.97,
          "strength_mg": 500.0,
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