{ "schema_version": 1, "kind": "condition", "id": "urticaria", "name": "Acute urticaria (hives)", "category": "chronic", "sources": "EAACI/GA2LEN/EDF/WAO Urticaria Guideline 2021 · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph) · Egyptian National Drug Formulary - Respiratory System 2026 (loratadine monograph) · Egyptian National Drug Formulary - Respiratory 2026 (fexofenadine monograph) · Levocetirizine dihydrochloride tablets US prescribing information, sections 1 and 2 Dosage and Administration (DailyMed SetID 8274ca80-e7d3-4f4f-9901-cc5c589b4fef)", "review_status": "reviewed", "verified_against": "EAACI/GA2LEN/EDF/WAO Urticaria Guideline 2021 · Egyptian National Drug Formulary - Respiratory System 2026 (loratadine monograph) · Egyptian National Drug Formulary - Endocrine System 2024 (prednisolone monograph) · Egyptian National Drug Formulary - Respiratory 2026 (fexofenadine monograph) · Levocetirizine dihydrochloride tablets US prescribing information, sections 1 and 2 Dosage and Administration (DailyMed SetID 8274ca80-e7d3-4f4f-9901-cc5c589b4fef) · Acute urticaria (hives) - disease-level clinical article (urticaria-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1825, "generic": "Cetirizine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10 mg once daily (may increase up to 40 mg daily in 2-4 divided doses under specialist care for severe urticaria)", "adult_duration": "1-2 weeks", "dose_source": "EAACI/GA2LEN/EDF/WAO Urticaria Guideline 2021", "rationale": "Second-generation non-sedating antihistamine that blocks H1 receptors to relieve the itch, wheal, and flare of acute urticaria; first-line symptomatic treatment, with escalation available under specialist care for severe cases.", "cautions": [ "Non-sedating antihistamine, but mild somnolence can occur at standard or off-label high doses.", "Dose reduction is required in renal impairment (eGFR < 50 mL/min)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child 2-5 years: 2.5 mg twice daily (or 5 mg once daily); 6-11 years: 5 mg twice daily (or 10 mg once daily); >=12 years: 10 mg once daily", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 to under 6 years", "age_min_months": 24, "age_max_months": 71, "dose_text": "2.5 mg twice daily (or 5 mg once daily)" }, { "label": "6 to under 12 years", "age_min_months": 72, "age_max_months": 143, "dose_text": "5 mg twice daily (or 10 mg once daily)" }, { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "10 mg once daily" } ], "peds_doses": null, "brands": [ { "trade_name": "EPIRIZINE 10 MG 10 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 15.5, "pack_count": 10, "unit_price": 1.55, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETRITIN 10MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 42.0, "pack_count": 20, "unit_price": 2.1, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TOMAZINE 10MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 63.0, "pack_count": 30, "unit_price": 2.1, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETRAK 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 68.0, "pack_count": 20, "unit_price": 3.4, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HISTAZINE-1 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 68.0, "pack_count": 20, "unit_price": 3.4, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZYRTEC 10 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 100.0, "pack_count": 20, "unit_price": 5.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETRICHEW 10MG 20 CHEWABLE F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HISTA CHEW 10 MG 20 CHEWABLE TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB CAPS > ADVOCURE", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LERGFREE 5MG/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEBEIKY", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "EPIRIZINE 5MG/ML SYRUP 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 19.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "urticaria" }, { "id": 1826, "generic": "Loratadine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10 mg once daily", "adult_duration": "1-2 weeks", "dose_source": "Egyptian National Drug Formulary - Respiratory System 2026 (loratadine monograph)", "rationale": "Second-generation non-sedating H1-antihistamine, an alternative to cetirizine for symptomatic relief of acute urticaria.", "cautions": [ "Caution in severe hepatic impairment (start with 10 mg every other day)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child 2-11 years (<30 kg): 5 mg once daily; (>30 kg): 10 mg once daily", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 to under 12 years", "age_min_months": 24, "age_max_months": 143, "dose_text": "5 mg once daily at 30 kg or less; 10 mg once daily over 30 kg" } ], "peds_doses": null, "brands": [ { "trade_name": "HISTALONG 10 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 17.0, "pack_count": 20, "unit_price": 0.85, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "UNILORATADINE 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 17.0, "pack_count": 20, "unit_price": 0.85, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEDCLARIT 10MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 19.5, "pack_count": 20, "unit_price": 0.97, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LORATADINE 10MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 25.5, "pack_count": 10, "unit_price": 2.55, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ONY 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA", "price_egp": 51.0, "pack_count": 20, "unit_price": 2.55, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALLERGETONE 10 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI) > SPLENDID PHARMA", "price_egp": 66.0, "pack_count": 20, "unit_price": 3.3, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLARITINE 10MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO > BAYER HEALTHCARE", "price_egp": 110.0, "pack_count": 20, "unit_price": 5.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALLERGIRAZ 10MG 30 DISINTEGRATING TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS > ELRAZY PHARMACEUTICALS-EGYPT", "price_egp": 31.5, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LORANO 5MG/5ML SYRUP 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "UNILORATADINE 5MG/5ML SYRUP 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "urticaria" }, { "id": 1828, "generic": "Fexofenadine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 180.0, "adult_dose": "180 mg once daily when required (adults and children 12 years and over)", "adult_duration": "While the urticaria is active; if it persists beyond 6 weeks it is chronic urticaria and needs reassessment rather than a repeat prescription", "dose_source": "Egyptian National Drug Formulary - Respiratory 2026 (fexofenadine monograph)", "rationale": "40 live products. The formulary lists relief of symptoms of urticaria, including chronic idiopathic urticaria, with a dedicated 180 mg once-daily dose. Unlike the cetirizine already listed it does not cross the blood-brain barrier appreciably, which matters for a driver or a machine operator.", "cautions": [ "Use one non-sedating antihistamine - fexofenadine replaces the cetirizine or loratadine here, it does not add to them.", "Absorption falls with aluminium- or magnesium-containing antacids and with fruit juice. Fexofenadine 180mg film coated tablets SmPC section 4.5 (eMC product 14744) says \"It is advisable to leave 2 hours between administration of fexofenadine hydrochloride and aluminium and magnesium hydroxide containing antacids\". Allegra Hives 24HR (fexofenadine hydrochloride) 180 mg tablets, US OTC Drug Facts label (DailyMed SetID 490b4c5f-448b-4563-928b-837117b59b9f) says \"do not take with fruit juices\" and directs that the 180 mg tablet be taken \"with water\".", "Renal impairment: 60 mg every 12-24 hours at eGFR 10-49, and 60 mg every 24 hours below eGFR 10 or on dialysis", "Urticaria lasting more than 6 weeks is chronic - look for a cause, check thyroid function, and consider referral rather than escalating the dose indefinitely.", "Angioedema of the lips, tongue or throat is not simple urticaria - treat as the angioedema condition." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Urticaria is licensed from 6 months. Children 6-23 months: 15 mg (2.5 mL of suspension) twice daily. Children 2-11 years: 30 mg (5 mL) twice daily. 12 years and over: 180 mg once daily. Any degree of kidney impairment: 15 mg once daily under 2 years, 30 mg once daily at 2-11 years, 60 mg once daily at 12 years and over.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "6 to under 24 months", "age_min_months": 6, "age_max_months": 23, "dose_text": "15 mg (2.5 mL of suspension) twice daily" }, { "label": "2 to under 12 years", "age_min_months": 24, "age_max_months": 143, "dose_text": "30 mg (5 mL) twice daily" }, { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "180 mg once daily" } ], "peds_doses": null, "brands": [ { "trade_name": "ORGOFEXADINE 180MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANOPHARMA > ORGANO", "price_egp": 8.0, "pack_count": 10, "unit_price": 0.8, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RAPIDO 180MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FASTOFEN 180 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 28.5, "pack_count": 20, "unit_price": 1.43, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEXODINE 180MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 15.6, "pack_count": 10, "unit_price": 1.56, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEXOSTADINE 180 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 70.0, "pack_count": 20, "unit_price": 3.5, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FASTEL 180 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 84.0, "pack_count": 20, "unit_price": 4.2, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TELFAST 180MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 160.0, "pack_count": 20, "unit_price": 8.0, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LINOFENADINE 180MG 10 SCORED F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > HEALTH LINE INTERNATIONAL", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 180.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALERTAM 30MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": 30.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "FEXODINE 30MG/5ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 30.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "urticaria" }, { "id": 1830, "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": "Acute urticaria (hives) - disease-level clinical article (urticaria-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - The signs of anaphylaxis requiring immediate medical attention are throat or facial swelling, difficulty breathing, dizziness, and hypotension." ], "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": "urticaria" }, { "id": 1829, "generic": "Levocetirizine", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5 mg once daily in the evening", "adult_duration": "While symptoms persist; review at 4-6 weeks", "dose_source": "Levocetirizine dihydrochloride tablets US prescribing information, sections 1 and 2 Dosage and Administration (DailyMed SetID 8274ca80-e7d3-4f4f-9901-cc5c589b4fef)", "rationale": "The active enantiomer of cetirizine, and the one licensed specifically for chronic idiopathic urticaria. 30 live Egyptian products from 3.25 EGP. An alternative to the cetirizine above, not an addition - they are the same molecule.", "cautions": [ "Do NOT give with cetirizine. Levocetirizine IS cetirizine's active half, so the two together are one drug at double the dose.", "Evening dosing is on the label, and it matters: urticaria itch is worst at night and this is the sedating end of the second-generation antihistamines.", "Reduce to 2.5 mg in mild renal impairment (creatinine clearance 50-80 mL/min) - a lower threshold than most drugs, and easy to miss in the elderly.", "Guidelines allow up-titration above the licensed dose in resistant chronic urticaria; that is a specialist decision and off-label, not a routine step." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "6-11 years: 2.5 mg once daily - half of the scored 5 mg tablet. The label gives no dose below 6 years for the tablet.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "6 to 11 years", "age_min_months": 72, "age_max_months": 143, "dose_text": "2.5 mg once daily - half of the scored 5 mg tablet. The tablet has no dose below 6 years." } ], "peds_doses": null, "brands": [ { "trade_name": "ZALKEVOR 5 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > REPHARMA", "price_egp": 5.5, "pack_count": 10, "unit_price": 0.55, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RHIPGIC 5 MG 30 F.C. 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CO. FOR PHARMACEUTICALS > ARAX PHARM. 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