{ "schema_version": 1, "kind": "condition", "id": "tinea-capitis", "name": "Tinea capitis (scalp ringworm)", "category": "infectious", "sources": "Egyptian National Drug Formulary, antimicrobial 2023, griseofulvin monograph (printed p. 43) · Griseofulvin 125 mg Tablets SmPC sections 4.2-4.6 (eMC product 12894) · Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510) · Tinea Capitis - disease-level clinical article (tinea-capitis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary, antimicrobial 2023, griseofulvin monograph (printed p. 43) · Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510) · Tinea Capitis - disease-level clinical article (tinea-capitis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph)", "verified_date": "2026-08", "treatments": [ { "id": 1720, "generic": "Griseofulvin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "Microsize: 500 mg/day in single or divided doses; for more widespread lesions initial doses of 750 to 1,000 mg/day in single or divided doses may be needed", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary, antimicrobial 2023, griseofulvin monograph (printed p. 43)", "rationale": "The only route that reaches the fungus. Tinea capitis lives inside the hair shaft and down in the follicle, where no cream can follow it - oral treatment is not an escalation here, it is the treatment.", "cautions": [ "Microsize and ultramicrosize are NOT the same dose. The formulary's 20-25 mg/kg is microsize; ultramicrosize runs about a third lower, and the UK label for its tablets gives 10 mg/kg. Two Egyptian brands are called ULTRAFULVIN and ULTRAGRISEOFULVIN. Read which one is in your hand before you calculate, because guessing here either poisons a child or wastes six weeks.", "The label's paediatric figure is 10 mg/kg/day and the Egyptian formulary's is 20-25. The higher one is used here because it is the tinea-capitis-specific dose; 10 mg/kg is the general minimum for any griseofulvin indication. Scalp infection needs the higher figure.", "After food, and fatty food - whole milk, ice cream, peanut butter. On an empty stomach barely any of it is absorbed, and a failed course is usually a food problem rather than a resistant fungus. Shake the suspension.", "Not in pregnancy, and not in a woman who might conceive within a month of finishing. Men must not father a child for six months after the course.", "It weakens oral contraceptives. Additional precautions throughout and for a month afterwards.", "It photosensitises - keep off intense sun. Monitor liver function; jaundice or rising enzymes can be serious and means stop. Rarely leukopenia: stop if granulocytes fall.", "Watch warfarin and ciclosporin levels alongside it.", "Breastfeeding is not recommended during treatment.", "Contraindicated in hypersensitivity, hepatic failure, porphyria, and pregnancy. Use with caution in lupus erythematosus (risk of exacerbation)." ], "peds_mgkg_low": 20.0, "peds_mgkg_high": 25.0, "peds_max_mg": 1000.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Children >2 years and Adolescents: Microsize: Oral: 20 to 25 mg/kg/day in single or 2 divided doses; maximum daily dose: 1,000 mg/day", "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": 200, "high_mg": 250, "capped": false }, { "weight_kg": 20, "low_mg": 400, "high_mg": 500, "capped": false }, { "weight_kg": 30, "low_mg": 600, "high_mg": 750, "capped": false }, { "weight_kg": 40, "low_mg": 800, "high_mg": 1000, "capped": false } ], "brands": [ { "trade_name": "ULTRAFULVIN 125MG 25 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 5.0, "pack_count": 25, "unit_price": 0.2, "strength_mg": 125.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ULTRAGRISEOFULVIN 125 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 5.5, "pack_count": 20, "unit_price": 0.28, "strength_mg": 125.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ULTRAGRISEOFULVIN 2.5% SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 6.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "GRISEOVIN 2.5% SUSP. 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 7.25, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "tinea-capitis" }, { "id": 1722, "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": "Tinea Capitis - disease-level clinical article (tinea-capitis-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Monitor liver enzymes before, during, and after oral antifungal therapy." ], "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": "tinea-capitis" }, { "id": 1723, "generic": "Fluconazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 150.0, "adult_dose": "150 to 300 mg once weekly", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Fluconazole is named by the article as an alternative oral antifungal for tinea capitis; the formulary gives a general tinea dose of 150 to 300 mg once weekly. No duration is stated in the formulary for this dosing entry.", "cautions": [ "Hypersensitivity to fluconazole or any component of the formulation", "Cases of QTc prolongation and torsade de pointes are associated with fluconazole use." ], "peds_mgkg_low": 3.0, "peds_mgkg_high": 12.0, "peds_max_mg": null, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Children: initial 6 to 12 mg/kg/dose, then 3 to 12 mg/kg/dose once daily (general dosing; no specific paediatric tinea dose in the monograph; limiting dose 600 mg/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": [ { "weight_kg": 10, "low_mg": 30, "high_mg": 120, "capped": false }, { "weight_kg": 20, "low_mg": 60, "high_mg": 240, "capped": false }, { "weight_kg": 30, "low_mg": 90, "high_mg": 360, "capped": false }, { "weight_kg": 40, "low_mg": 120, "high_mg": 480, "capped": false } ], "brands": [ { "trade_name": "JENFUNGA 150 MG 1 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > JENIKO MEDICINE PHARMACEUTICALS", "price_egp": 4.5, "pack_count": 1, "unit_price": 4.5, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMRIFLUCAN 150 MG 2 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 11.0, "pack_count": 2, "unit_price": 5.5, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUDCONRIZOLE 150 MG 1 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 6.0, "pack_count": 1, "unit_price": 6.0, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUCORAL 150 MG 4 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 60.0, "pack_count": 4, "unit_price": 15.0, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRICONAL 150 MG 1 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "T3A PHARMA > PAXAL", "price_egp": 26.5, "pack_count": 1, "unit_price": 26.5, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAVILUCA 150 MG 2 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > ROTABIOGEN", "price_egp": 69.0, "pack_count": 2, "unit_price": 34.5, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAZOWELL 150 MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > HEALTH WELL", "price_egp": 108.0, "pack_count": 3, "unit_price": 36.0, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIFLUCAN 150 MG 1 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 111.0, "pack_count": 1, "unit_price": 111.0, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIFLUNAZOLE 25MG/5ML SYRUP 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 28.8, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "FLUCAZONIL 25MG/5ML SYRUP 70 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 28.8, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "tinea-capitis" }, { "id": 1721, "generic": "Ketoconazole", "line": 1, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "2% shampoo twice weekly, left on 3-5 minutes before rinsing, alongside the oral treatment", "adult_duration": "The first 2-4 weeks, while the oral drug works", "dose_source": "Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510)", "rationale": "Cuts the spores shed onto pillows, combs and other children. It shortens nobody's infection - it limits who catches it next.", "cautions": [ "Off-label. The shampoo is licensed for dandruff, seborrhoeic dermatitis and tinea versicolor - not for tinea capitis. It is used here to cut spore shedding and reduce spread, which is a real benefit, but it is not what the label covers.", "This is an adjunct and nothing more. A shampoo cannot cure tinea capitis - the fungus is inside the hair shaft, below where anything topical reaches. Treating scalp ringworm with shampoo alone is how it runs for months and scars.", "Check the rest of the household, and the combs, hats and pillowcases. Reinfection from home is the usual reason a proper course seems to fail.", "A boggy, pustular, tender swelling is a kerion - an inflammatory reaction, not a bacterial abscess. It should not be incised. It still needs the oral antifungal, and it is the presentation that scars if it is treated as a boil." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Ketoconazole shampoo 2% is for use in adolescents and adults:", "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": "KONAZOLE 2% SHAMPOO 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KETODERM 2% GEL SHAMPOO 60 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 18.0, "pack_count": null, "unit_price": null, "strength_mg": 60000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KENZO 2% SHAMPOO 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 27.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CURAZOLE 2% TOPICAL CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 7.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZAKAN 2% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 7.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NIZODERM 2% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZAKAN 2GM/100ML SHAMPOO 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 18.3, "pack_count": null, "unit_price": null, "strength_mg": 2000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NIZAPEX 20MG/GM SHAMPOO 80 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "APEX PHARMA", "price_egp": 68.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "tinea-capitis" }, { "id": 1724, "generic": "Prednisolone", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5 to 60 mg/day as a single daily dose or in 2 to 4 divided doses, tapered", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph)", "rationale": "Added to - never instead of - the oral antifungal, for a kerion, to reduce inflammation and the risk of permanent scarring alopecia.", "cautions": [ "Adjunct only - the oral antifungal remains the treatment; a steroid alone does not clear the infection.", "Abrupt withdrawal is not recommended, particularly with doses of 40 mg or more or 3 weeks of treatment or more.", "The dose should be gradually decreased to the lowest dose that maintains an adequate clinical response.", "No paediatric dose is stated in the ENDF for this use, and this is a predominantly paediatric condition - refer rather than extrapolate." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The ENDF prednisolone monograph gives no paediatric figure for this indication, so none is stated here. Tinea capitis is mainly a childhood disease, so this row's adult range should not be applied to a child without a paediatric source.", "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": "HOSTACORTIN H 5MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.0, "pack_count": 30, "unit_price": 0.4, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNISOLONE 5 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDILONE 5MG 10 TAB. (25 STRIPS PACK)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 250.0, "pack_count": 10, "unit_price": 25.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPICOPRED 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 69.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNISOLONE-EVA 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 79.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISPRELONE-OD 5 MG 30 ORODISPERSABLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SOLUPRED ORO 5 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI WINTHROP > SANOFI", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ACETASEE 1% EYE DROPS (SUSP.) 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNIS 5MG/5ML SYRUP 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 9.5, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "tinea-capitis" } ] }