Index:

Analgesics, antipyrtics and muscle relaxants

Angina, hypertension and hypotension

BILIARY COLIC

breast

Cholestrol lowering drugs

Colics

Constipation

Cough

Dementia

Diarrhea

Diabetes

Diabetic neuropathy

Eye and Ear

Fatigue

ED

Endocrine drugs

ENT

Epilepsy

Fatigue

GERD, H pylori PUD

Infection

Insomnia, anxiety and depression

Liver disease

Mouth preparation in Egypt

Osteoprosis

Prostate

Parkinson

Skin and soft tissue, hemorrhoids all creams

smoking

Vaginal

Vascular insuffiency

Vitamin and minerals defiecny

vomiting

Urologic

Weight

ANALGESICS AND ANTI-INFLAMMATORY MEDICATIONS IN EGYPT

By: Maged Taman

NSAID?s: Aceclofenac

Amoflam, bristaflam, fenac all 100 mg one tab daily bristaflam more expensive about 1.4 LE per one tab

NSAID: Acemetacin

OST map 60 mg one cap about 0.5 LE

NSAID: Diclofenac Sodium

Diclfenac, voltaren, declophen, dolphin, olfen, epifenac, rheumafen, rheumarene all cheap most have 50, 100 mg pills usually given twice a day. Voltaren has cheap ampoules, SR pill one a day, voltaren suppository and cream.

NSAID: Diclofenac Potassium

Adwiflam, antiflam, cataflam, dolphin K, oflam, potfen, rapidus all have 25, 50 mg pills dose is twice a day less GI upset than diclofenac sodium. All cheap cataflam has 75 mg suppository and ampoules.

NSAID: Diflusinal

Doloban 250, dolozal 500

NSAID: Dexibuprofen

Dexa ibufen 400, extragesic 400 one tab three times daily as needed for pain. Both cheap 1 LE per on tab

NSAID: Ibuprofen

Brufen, profinal, ultrafen, all 200, 400, 600 mg, ibuprofen 400 mg all cheap average dose is 400 mg every 6 hour as needed. Brufen 100 mg/5ml 5-12 years old 10ml/q6h as needed for pain or fever, 1-5 years old 5 ml every 6 h PRN. Infant 20-40 mg/kg per dose.

NSAID: Fenoprofen

Fenoprofen 200, 300, 600 mg cheap

NSAID: loxoprofen

Loujain, roxonin and roxogesic all 60 mg all cheap

NSAID: Ibuprofen + paracetamol

Parofen 400/500 mg tab q 6 h prn, contafever 100/162.5/5ml both cheap.

NSAID: Indomethacin

Indomethacin 25, 50m g tab also indomethacin, indocid, indocin 100 mg suppository. All cheap.

NSAID: Ketoprofen

Alcofan, ketofan, ketoglin all 25 and 50 mg ketoprof, ketogesic, kupan SR 200, all cheap.

NSAID: Ketorolac

Adolor, fam, ketolac 30 mg initial dose 30-60 mg IM can repeat 30 mg IM every 6 hours as needed for 2 doses than follow by oral fam or ketolac 10 mg bid prn maximum 5 days.

NSAID: Naproxen

Naprofen, naprogesic 500 mg 1 tab bid prn cheap

NSAID: Piroxicam

Brexin, feldene, inflacam, piroxiden piroxifar, feldoral all 20 mg once daily, feldene has also 20 mg amp and 20 mg suppository all are cheap.

NSAID: Tenoxicam

Anoxicam, epicotil, soral, tenocam all 20 mg all are cheap once daily as needed for pain.

NSAID: Tolmetin

Rumatol 200 and 400, Tolmet DS 400 1 tab bid prn pain on cap about 2 LE.

NSAID: Mefenamic acid

Mefenam, pono, ponstan all 250 mg 2 tab to start then 1 tab Q 6 h prn pain, all cheap

Cyclo-oxygenase blocker or cox 2 inhibitors: Dexketoprofen

Dexketo care 25 and dextrafast 25 one tab 0.5 LE

Cox 2 inhibitors: Celecoxib

Arythrex, celebrex, celoxib, eurocox all 200 mg daily as needed Celecox about 1 LE per cap while celebrex is 5 LE per capsule

COX2 inhibiors: Lornoxicam

Lornoxicam, Rheuxicam, toprano, xefo, zeficam all 4 and 8 mg tab and all cheap dose 4-8 mg twice daily as needed.

COX 2 inhibitors: Meloxicam

Anti- cox II, medexaflam, melocam, meloxicam, mexicam, mobic, mobitil all 7.5 and 15 mg all cheap mobic most expensive about 2 LE per pill mobic has 15 mg IM ampoules.

COX 2 inhibitors: Nimesulide

Mesulid, nilsid, nimalox and sulide all 100 mg tab and nimalx 200 mg suppository dose is 100 mg 1-2 tab bid PRN or one supp bid prn.

Asprin either coated or buffered:

Asprotec 100 mg, bufferin 325 mg daily. Alexoprin 75 mg, Alexoprin forte 300 mg, all cheap all once daily with food.

Primrose plus 1000 mg Q PM for premenstrual pains, also atopic eczyma and aging.

Glucosamine/chondroitin:

Move free, shark cartilage

MSM:

MSM, nitora, both 1000 mg twice daily.

Tramadol

50 mg q 6 h prn pain, also amadol, and tramal, tramadol also come as 100 mg amp all cheap

For joint injections or muscles:

Kenacort A 40mg or depotmedrol 40 mg

COMMON ANALGESICS AND ANTIPYRTICS IN EGYPT:

Abimol, panadol, paramol, paracetamol, pyral ( paracetamol) 500 mg

Excedrin 20 tab 9 LE ASA/Paracetamol/caffeine 1 tab bid prn headache

Ponstan, farostan, mefenam 500 mg (mefenamic acid) cheap 1 tab q 8 h prn pain, fever

Novalgin (dipyrone or Metamizole) 500 mg bid PRN pain OR headache, however very rarely cause aganeulocytosis that can be fatal. Not used in many countries now.

Nabutone or rheumon (Nabumetone) 500 tab po 2tab with supper and 1 tab with breakfast

COMMONLY USED MUSCELE RELAXANTS IN EGYPT

Baclofen 10 and 25, Liorsal 10 and 25, mylobac 10 and 20mg (baclofen) start slowly 5 mg bid increase gradually maximum dose 80 mg per day divided tid to qid, baclofen is the cheapest of the three.

Multi-relax? 5 or 10 1 tab Qhs prn msucles spasticity, rigidity, spasms, cramps, adjuvant in insomnia. 20 tab of 5 mg 14 EP

Dimara (Methocarbamol ?500 mg + diclofenac? 50 mg? 1 tab bid prn pain/muscle spasm??? 10 tab 9.5 EP

Noreflex (orphenadrine) 100 mg? bid prn muscle spasms 20 tab 2.4 EP

Noregesic, orphamol? (orphenadrine 30 mg with paracetamol 450 mg) 1 tab tid PRN pain

COMMONLY USED DRUGS TO TREAT HYPERTENSION AND ANGINA IN EGYPT:

Atenolol, ateno, blokium, Tenormin, tenotens ( all atenolol) all 50, 100 mg tabs all around 1/2 LE per one tab.

Labipress 100 or 200 mg tab (labetolol) about 1/2 LE per one tab

bisobeta, bisocard, bistol, concor, egypro, soprol ( all bisprolol) most has 5 and 10 mg tab 5 mg daily is ususally the standard dose maximum 20 mg daily. one tab about ½ LE

Bistol plus 2.5/6.25 or 5/6.25 or 5/12.5, concor plus 5/12.5 and 10/25, lodoz 5/6.25, 5/12.5/10/6.25 (all are bisprolol + HCTZ) price about average concor cheapest.

Betaloc, low press (both are metoprolol) and both comes on 100 mg about 1/2 LE per one tab.

Nebilet, nevilob, Symbian, ( all are nebivolole) all are 5 mg tab. Nebilet is about 2.5 LE per one tab while the other two 2 LE per one tab

Betacor 80, sotaloc 160 ( both are sotalol) 1/2 to 1 LE per one tab.

Cardilol, carlol, carvena, carvid, carvipress, dilatrend, dilator, karvex (all Carvedilol) all cheap except dilatrend. karvex is cheap and have all doses 6.25, 12.5 and 25 mg

Amlodipine, Norvasc, alkapress, vasonorm, myodura, windipine. ( all amlodipine) most come 5 and 10 mg, 5mg about 1/2 LE while 10 mg about 1 LE Norvasc is very expensive. myodura appears the cheapest.

Felocor, plendil, plentopine (all are Feldopine) all are expensive, plentopine is about 1-2 LE per tab the cheapest.

Lacidac, lacipil, lodipine (all Lacidipine) all 2 and 4 mg once a day, lodipine is 7.25 and 10 LE respectively.

Angina:

Corconit 20,40, dinitra 10,20, isomack 10,20, isordil 5, 10(all Isosorbide Dinitrate) all cheap

Angised 0.5 mg SL (glyceryl trinitrate)PRN chest pain.

Effox 20,40 and 25, 50 for long acting, imdur 60, monomack 20,40 (all Isosorbid mononitrate) all cheap.

Adancor 10, Randil 20 (both Nicorandil) 10 mg bid to 60 mg bid about 1 LE per one tab

Angiopress, Captopril, capoten, hypopress, lotensine (all capoten) all cheap

Zapritens 1,2.5 and 5 mg (Cilazepril) ACE inhibitor about 2 LE for one tab, about 2.5 to 5 mg daily.

Acapril, enalapril, ezapril, lotrial, presslight ( all Enalapril) most have 5,10 and 20 mg and dose is 10-20 mg daily or bid

All cheap except lotrial

Monopril (fosinopril) 10, 20 mg about 1 and 2 LE per one tab 10-40 mg daily

Lisinopril, maxipril, sinopril, zestril (all lisniopril) all cheap 5-40 mg daily.

Primox (Moexpril) 7.5 and 15 mg daily

Corpril, Ramipril, tritace, (All are ramipril or altace in America) 1.25, 2.5 and 5 mg tritace is more expensive.

Atacand, candalkan, candeblock, candesar, candesartan (all are Candesartan) all cheap except atacand 4-16 mg daily most has 8 and 16 mg and all are tablets.

Irbesartan 75m 150 and 300 mg in America diovan. Also irbedrin, kenasartan and x-tension all about 1 to 2 LE per one tab.

Losartan ( in America cozaar) cozaar is very expensive others amosar, kanzar, lozapress. Most 50 and 100 mg tabs

Angiosartan, erastapex, normesar (all Olmesartan in America benicar.) all 20m, 40 mg dose about 1-2 LE per one tab, dose10-40 mg about daily

Angiosartan plus or erastapex plus 20/12.5, 20/25 40/12.5 and 40/25 ( all Olmesartan + HCTZ) about 1.5- 1.8 LE per one tab.

Biocardis, 40, chartoreg 80, micardis 40 and 80 mg (all are Telmisartan)micardis expensive about 3 LE for one tab.

Valscard 80 (Valsartan) cheap 30 tab 16 LE, others are disartan, lasaromep, tareg.

Aldomet (methyldopa) 250 mg tid max 3 gram/day others epidopa, alphadopa methyl dopa all are 250 mg all cheap.

Rogitine (Phentolamine)

Blokium diu 100/25, tenedone 50/25 and 100/25, tenoretic 50/12.5 and 100/12.5 all are atenolol + chlorthalidone) all are cheap

Atenoretic and hypers-D (both are atenolol 50, amiloride 2.5 and thiazide 25. Both cheap

Cibadrex 10/12.5 and 20 /25 (benzapril + HCTZ) one tab 3 LE

Capozide, farcopril plus, capojed H, hypopress-D ( all are captopril + HCTZ) all are cheap. All 50/25 mg

Combipress 20/12.5, enalazide 10/12.5 , ezapril-co 20/12.5, thiazopril 20/12.5 (all enalapril + HCTZ) all are cheap

Monozide 10/12.5 and 20/12.5 (Fosinoopril + HCTZ) 1.5-2.5 LE per one tab.

Lisitens, sinopril CO, zestoretic (all lisinopril + HCTZ) all 20/12.5 zestoretic more expensive about 2 LE per one tab

Tritace comp 2.5/12.5, 5/25/10/12.5 and 10/25 mg

Atacand plus, 16/12.5m sarcozide 16/12.5 (Candasartan + HCTZ)

Ibredrin diu 150/12.5 and 300/12.5, kansartan 150/12.5 and 300,12.5 x-tension plus 150/12.5 and 300/12.5 (all irbesartan + HCTZ) all average about 1.5-2 LE per one tab

Losazide 50/12.5 (Losartan + HCTZ) about 1.2 LE per one tab.

Alkapress plus 5/160, blokatens 5/160, 10/160, exforge 5/160, 10/160, exforge hctz 10/160/25 (all amlodipine + valsartan) all expensive about 5 LE per tab blokatens about 3 per tab amlobenzmir 2.5/10, 5/10, 5/20, 10/20 (amlodipine/benzapril) cheap one cap about 1 LE

Amlosterolen 5/20, 10/20, caduet 5/10, 10/10, lipclear 5/20, 10/10, 10/20, 20/40 (amlodipine + atrovastatin) caduet is expensive, others about 2 LE per one tab.

Logimax 5/50 mg (fledopine + metoprolol)

Brinerdin, hypoten ( both are combo of reserpine 0.1, clopamide 5, dihydroergocrisitne 0.5)

Hybisc, master hibiscus ( both karakda or hibiscus) about 1 LE per one cap.

COMMONLY USED DRUGS IN HYPOTENSION IN EGYPT:

Corasore 150 tablets or 150 /ml drops, hepta 150, heptaminol 150, respirin 150 (all are Heptaminol) and all very cheap.

Effortil 5 mg tab and 7.5mg /ml drops, vascon 5 mg tab or 10 mg/ml drops (all are Etilfrine) all cheap 1-2 tab tid or 10 drops tid

Astonin h 0.1 mg, cortilon 0.1 mg (Both are fludrocortisone) both very cheap. Start ½ tab q am and advance slowly.

Guttron 2.5 mg tab or 1 % drops, Midodrine 25 mg tablets and 10 mg/ml drops, morepress 25 mg tab (all are midodrine) all are very cheap.

COMMONLY USED DRUGS FOR BREAST ISSUES IN EGYPT:

Improve lactation:

Herbana, lacto-oil, lactoflow, lactomax, Lacto G, Lacto Ton, Siwa laco oil (all are contain fenugreek) about 20-30 capsule cost 20 to 30 dollars most of them lactoflow packs 10 pack is 3 LE.

TREATMENT OF BILLIARY COLIC IN EGYPT:

Rowachol or bilichol both are volatile oils in gall stones colics not obstruction or inflammation very cheap 12 capsules 1 tid

Urosodiol 250 mg one bid or tid in gall stones, 250 mg qid in primary biliary cirrhosis. (other ursodeoxycholic acid are biliver 450m egyresolve 250, egyurso 500, livagoal 450, ursofalk 250, ursochol 250, ursogall 450. All are capsules cheapist is urosodiol 30 capsules is 9 LE.

Cholicynar ( contain cynara and choline) sachets has diuretic, choleretic effects as well used for high cholestrol.

COMMONLY USED CHOLESTEROL AND LIPID LOWERING DRUGS IN EGYPT:

By: Maged Taman

Fibrates: mainly lower triglycerides and increase HDL

Bezalip-retard 400 mg (benzofibrate) about 0.3 LE per one tab

Lipo-Merz 500 mg (etofibrate) About 1.2 LE per one capsule

Lopid 600, regulip 300,600 (both are gemfibrozile) about 1 LE per capsule for regulip and 2 per tab for lopid

Finorate 100, fenorate retard 250, fenolip 100,300, lipanthyl 300, lipolex 200, 300 (all are fenofibrates). Fenorate and fenolip cheaper.

Statins: Mainly reduces LDL, usualy first drug of choice in high cholestrol patients given reduction of cardiovascular disease morbidity and mortality

Atrovastatin:

Ator 10,20,40, lipitor, atrostat 10,20,40, lipona, lipicole, lipiless, lipinorm all three 10,20, torstatin and trovast 20 and 40 mg, average pill 2-4 LE per one pill.

Fluvastatin

Lescol XL 80 mg (fluvastatin)

Paravastatin:

Cholilysis, low chol 10,20,40 (lovastatin) all about 1-3 LE per pill

Lipostat 10,20,40 about 3-4 LE per one pill

Rosuvastatin

Crestor, crestolip rosuvast all 5,10,20 all about 3-4 LE per pill, pentastatin 5 and 20 about 1.1 LE per one pill (all )

Simvistatin

Alkor 10,20,40, amristatin 20,80, simvacor 20,40,80, simvastat 20, zocor 20,40 (all are) all about 3-4 LE per pill.

Drug blocking cholestrol absorption in intesine Ezetimibe alone or in combinations:Mainly to help reach goal of LDL if statin alone does not do it or patients do not tolerate statin or increase dose of statin

Ezetimibe 10 mg ( ezetimibe) about 1.2 LE per 1 pill.

Atoreza 10/10, ezastatin 10/40 (both are atrovastatin + ezetimibe) about 4.5 LE per one pill

Alkor plus or zetalip 10/20,10/40, cazet, ingey, lipitrin, simvastimibe all 10/10,10/20,10/40, (all ezetimibe with simvistatin) all about 4 LE per pill.

Questrans: Cholestyramine maily lower LDL, likely to increase triglyceride

Cholestran 4gm per pack or questran 4 gm/pack about 1 LE per pack one pack twice a day. Welchol is not available yet in Egypt better tolerated than cholestyramine.

Nicotinic acid: extended relase niacin the best to increase HDL.

in Egypt Nicotipan 750 mg 1-2 tab daily.1 tab about 2 LE.

         

             TREATMENT OF COLICS IN EGYPT

Hyoscine:

Spasmocin 10 mg oral, 15 mg suppository and 20mg IM injection for colics very cheap. Buscopan 10 mg po, 20 mg IM TID prn for colics. Spazaway 0.125 mg sublingual q 6 h prn.  All cheap

Dicycolamine:

Spasomrest 10 or 20 mg tablets tid prn very cheap also for colics.

Tiemonium:

Spasmofree 25 mg tab po, 5m/2ml amp, visecralgine 50 mg po, 20 mg supp or 5mg/amp IM

Drotaverine more stronger than papverine and less toxic.

Spasmocure  60 mg oral, 40 mg amp, Do-spa 40 mg oral and 40 mg amp

Pipoxolane:

Rowapraxin 10 and mg tab, 10 mg supp tid prn

For patient who is pregnant, BPH or glaucoma rowapraxin (pipoxolane)

Camylofin + analgin:

Spasompyralgin po, amp or supp

Pediatric and newborn carminative antispasmodics:

All dose 1 / 4 to 1 dropper and 2.5 to 5 ml tid prn according to age

Aqua baby, aqua cid, aquacure, baby moon, baby drink, baby rest, calma baby, calm mix, ema calm, free baby, spasmotal, spasm away

Baby tea sachets:

Baby calm, baby drink

Drugs for Spastic colon:

Itropide:

Alkapride, ganaton, garopride, gastrorelif, itopride, movigit all 50 mg tid before meals daily all ok about 1 LE per pill or less

Mebeverine:

Colo relax, colospasmin, coloverin, mepacolon, spasmotalin, colona all tid 1 / 2 hour before meals. Colona has as well sulpiride 25 mg. all cheap

Pinaverine

Spasmopinaver 50 and 100 mg bid

Trimebutine:

Debridat 200, gast-reg 100,200 gast-reg 100 mg supp, tribudat 100, tritone 100, 200 tab one tid.

Clidinium + chlordiazpoxide:

Cidiaspasm, cloxide, dibrex and librax all 5 + 2.5 mg bid all cheap

Phenobarbitone + belladonna:

Bellacid

Otilonium bromide:

Spasmomen 40 mg

Pappermint oil:

Colomint 1  cap tid aftrer meals.

Natural fibers:

Bran 1-2 tab or bran mepaco daily

Oils:

Anisol, colostop, gestin, gesto, GIT forte, master-gest, regest, u-gest, ginger, all are tablets 1 hour before meals tid.

IBD meds:

Pentasa 500 mg tab, 1000 mg enema salofalk, salazine, salazopyrin all 500 mg tab. Dose 2 tab tid.

Cortisone containing enema:

Enemacort in UC.

Indigestion and antiflutalent preparations:

Digestant preparations:

After meals, amarase, digenorm, digestin, easy meal postine, spasmocanulase D, Zymogen forte, spasmodigestin,

Anti-flatulant preparations:

Disflatyl, flatidyl,  simethicone, digestix (herbals)

A good combo for spastic colon:

Acute spasm one of the IM spasmolyitcs like , visecralgine  20 mg supp or 5mg/amp IM x 1

Chronic milder spasms, colona 1 tab tid + spasmocanulase D 1 tab or digestix tid PRN gases

Constipation: COMMONLY USED LAXATIVES IN EGYPT:

Laxative safe in pregnancy:

Laxeol, normalax, picolax, skilax all drops (sodium picosulfate) 7.5 mg/ml 10-15 drops daily PRN constipation. All cheap

Bisacodyl also safe in pregnancy abilaxine, Bisadyl both 5mg tab, 5 and 10 mg suppository. 2 tab or 1 supp daily prn constipation. All cheap

Laxatives:

Evak, evaculax both calcium polycarbophil 625 mg 2 tab tid prn for acute and chronic constipation. 20 tab 19 EP

Enema, enmaz, phosphate enema all has phosphate daily prn all cheap

Bisadyl enema

Glycerin supp adult or pediatric very cheap daily prn.

Lactulose, lexolac, duphalac all lactulose syrup 30 ml bid prn constipation, in hepatic encephalopathy about 30 ml qid all 6-10 EP

Adcostigmine and ubretid both are distigmine ?for postop ileus and bladder atony 0.5 mgIM or 5 mg po both are cheap

Amostigmine, prostigmine both 0.5 mg SQ or IM cheap for post-op ileus

Some of common Cough medicines (Egypt)

For Dry Cough:

Cough cut and sinecod both 7.5 mg/5ml 15 ml po q 8h prn ( both butamirate) both are cheap and has some bronchospasmolytic effect.

Notussil (clopersatine) for dry cough and antihistaminc 20mg/5ml 5 ml q8h prn cheap

Silomat 20 mg syrup and 40 mg tab both 40 mg q 8h prn

(colbutinol hcl) cheap

Rhinotus avoid for now for question of respiratory depression

Oxeladine 10 mg/5ml syrup, paxeladine 2% syrup or 40 mg tablets. (all oxeladine) all cheap and for dry cough

Selgon 20 mg tab q 8h prn cough (pipazthate), cheap

For dry cough also cabella, colfin, pectipro, tussapine

For wet cough:

Ambroxol 20 mg tab, bronchopro ret 75 mg caps, muco 15 mg/5ml syrup and 15 mg tablets, mucobroxol sr 75 mg, mucopect 15 mg/5ml and 15 mg tab, mucosin 15 mg/5 ml syrup, 15 mg lozenges (all are ambroxol) All cheap all q 8h prn except for the 75 mg is daily prn.

Mucomyst 200 sachets q 8h prn after meals (acetylcysteine). cheap

Bisolvon, bromhexine, muclear, mucolyte, solvin all 8mg tab, 4 mg/5ml (all Bromohexine hcl) all one tab or 10 mg q 8h prn. All cheap

Avichest, mucosol, solvex all caps or syrup (all carbocysteine) all for wet cough all cheap

Mucotec 150, 300 (erdosteine) 300 mg bid prn for wet cough, cheap

Combined cough medications:

avipect, bronchistal, brochofree, coldal, bronchicum (herbal), expectyl, isilin, pulmocare N, tussivan N, ultrasolv

Flu symptoms: night and day N one white tab q am and one yellow tab q pm for 5 days.

Aldol sinus tab (like tyleonl sinus in America one tid.

                              Dementia

Co-dergocrine cheap

Hydergine 1.5 mg tab one tab tid, 0.3 mg ampoules

Meclfenoxate cheap

Lucidril250, 500 mg 1 tab tid and 1000 mg amp

Nicergoline cheap

Dinacer 5mg bid

Piracetam: cheap

Cerebro 200 mg/ml syrup, cerebro forte 800 mg , nootropil and stimulan 400, 800 mg 400 to 800 mg tid.

Pyritinol cheap

Encephabol 80 mg/5ml

Ebcephabol forte 200 mg 200 mg tid

Glutamic: cheap

Glutamic acid 500 mg 3 x 3 tab cheap

Vincamine: cheap

 Brain ox 30 , depotvinc 30 , oxybral, 30, vincebral SR 30 all caps all cheap 1 cap bid

Vinburnine: cheap

Cerebrine  20 mg cap one tid after meals

Vinpocetine: cheap

Cavalpha, angiovan, cavestine, cavinil, veinpo, vinporal all 5 mg all 1 tab tid after meals.

Donepezil:

Alzimer, alzepizil,, donepezil 5 and 10 mg 5 mg daily up to 10 mg daily after one month. Avdomontace,  donezil, donepezil and donhimer 5 mg tab one pill about 7 LE, alzepizil cheaper.

Galantamine:

Reminyl PR 8 and 16 mg or oral solution 4 mg/ml. 8 mg with food for 4 weeks then 8 mg bid. One pill about 12 LE

Rivastigmine:

Exlon 1.5, 4.5 pills and 4.5 and 9.5 patches very expensive.

Memantine:

Alzmenda, condomania, dementexa, ebiax, mantine, memexa, ravemantine, all 10 mg Ebixa expensive 8 LE per one pill, condmania cheap 1 pill less than 2 LE  5 mg daily x 1 week then 5 mg bid x 1 week then 10 mg and 5 mg daily x 1 week then 10 mg bid

                    CNS Stimulants

Ethamivan: stimulate respiration

Alertin 20 mg cheap

Doxpram:

Dopram 100 mg amp expensive.

Methylphenidate:

Ritaline 10 mg amp cheap, anexnil 10 mg amp expensive

Riluzole for ALS

Rilutek 50 mg  very expensive

Modafinil:

Provigil 100 mg expensive 30 tab 1104 LE

Anti-Diarrheal and anthelmintic 

Streptophenicol capsules or susp 2-4 capsules every 6 h

Anti-peristalsis: Loperamide

Immodium 2 mg or sedomid 2 mg tid prn

Anti-peristalsis: Dophenoxylate + atropine

Lomotil 2.5/0.025 mg bid prn diarrhea

Anti-Ameba: Diloxanide + metronidazole

Dilozole, dimetrol, furazol farcozol all tab or suspension. Also tabs only farcozol plus, flagimide, furamebe forte, amoebyl. Doses 1-2 tab or  1-2 tsp q 8h for 7-10 days.

Absorb pathogens: Diosmecite

Disamect, diomacte, smecta all sachets one tid

Probiotic: Lactobacillus 

Lacteol fort one tab or sachet tid.

Absorb enterotoxines: Kaolin + pectin

Kapect susp 5-10 ml tid

All above cheap

Anti-ameba/anti-bacterial: metronidazole

Amrizole, flagyl, flagicure all 250 or 500 mg  flagyl has susp, also IV infusion both flagyl and metonidazole  500 mg. All cheap except IV  one vial 17 and 10 LE respectively.

Metronidazole-like: Ornidazole

Ornidaz and tibezole 1 tab bid both about 2 LE per one pill

Gut Anti-bacterial: Nifuroxazide: safe during pregnancy, lactation and infancy

Antinal, diax, diafuryl, nifunal, Nifuroxazide all caps or susp 1cap tid or 2-5-5 ml tid.

Anti-crypto and anti-gardia: Nitazoxanide

Nanazoxid, nit clean, protostop 1 tab bid for 3 days.

GI antibiotic: Rifaximin

Gastrobiotic 200 mg 1 tab tid for 3 days.

Chronic intestinal ameba (cystic form): Secnidazole

Cipazole, eurazole, fladazole, senidal all 500 mg, amebazole 1000 mg dose is 2 gram daily for 3 days. Average one tab about 3 LE.

Chronic intestinal ameba (cystic form): tinidazole

Fasigyn , protozole both 500 mg  cheap

Other antidiarrheals:

Entocid, intetrix, colisitn,  all cheap

Anthelmintic: Praziquantel

Biltricide, distocide, praziquantel all 600 mg,  all cheap, dose 20-40 mg /kg split in two doses for one day only for intestinal flukes

Anthelmintic: Albendazole

Alzental, bendax, vermizole all 200 mg dose is 400 mg single dose for entrob, ascaris, trich, trichostrong, hookworm and for 3 days for strong

Anthelmintic: Comiphora mukul

Loserol 100, mirazid 300 mg for cystodes,

 Anthelmintic: Flubendazole:

Flub, fluvermal, fluver, verm all 100 mg for all dose is one tab or one tea spoon every 12 h for 3 days.

Anthelmintic: levamisole

Katrex 47 mg tab, wormine  40 mg susp dose 3 tab x 1 repeat after 2 & 4 weeks.

 Anthelmintic: Mebendazole

Anthelmin, antiver, pentalmin, all 100 mg dose is 1 tab q 12 h for 3 day

 repeat after 2 & 4 weeks.

 Anthelmintic: Niclosamide

Niclosan and yomesan both 500 mg first day chew 4 tab then 2 tab daily for one week.

Anthelmintic: local ammoniated mercury

Ammoniate mercury, white precipitate apply to anal area bid for entrob.

All meds in this chapter cheap.

Anti-Diabetics

Insulin:

Insulin R vial 100 iu/ml 10 ml vial 10 LE

Insulin R caridge 5 x 3ml  80 LE

Insulin actrapid 100 iu/ ml 10 ml vial 31 LE

Insulin Actrapid penfill 5 penfills 95 LE

Apidera Solostar 5 x 3ml 250 LE

Insulin N 100 100 iu/ml 10 ml 14 LE

Insulin N 100  5 x 3ml cartidage 80 LE

Insulin mix 100 70/30 10 ml vial 27 LE

Insulin Lantus solostar: 5 x 3ml 5 pens 450 LE

Insulin novorapid flexpen 100 units 5 x 3ml cartidge 250 LE

Sulphonylurea: Glibenclamide = glyburide

Doanil , diaben, euglumide, glibenase 5mg 1/  2 to 1 tab on am and 1 tab pm daily

All cheap

Sulphonylurea: Glibenclamide = glyburide + metformin

Glucovance, diavance, glimet fort, euglumide plus, metclamide all 2.5/500 mg and 5/500 mg  dose 1 tab qam to 2 of 5/500 bid. All cheap  

Sulphonylurea:   Gliclazide

Diabetron 40 and 80 mg, diabyl, dianormal, gliclazide, glipicrone all 80 mg, diamicron 80 and 30 mg,  unocron 30 and 60 mg all cheap dose is 80-240 mg on 2-3 doses per day.

Sulphonylurea:   Glimepiride

Amaryl, conida, dolcyl, glimadel, glimaryl, glimitoid, glucoryl all 2 and 4 mg all cheap.

Sulphonylurea:   Glimepiride + metformin cheap

Amaryl M 2/500 mg 1 tab bid

Sulphonylurea:   Glimepiride + pioglitazone

Glimepiride plus: 4/30 mg half to one tab daily cheap

Sulphonylurea:   Glipizide

Glupizide 5 mg half tab q am to 2 tab daily, cheap

Sulphonylurea:   Glimepiride + metformin

Engilor 2.5/500 and 5/500 2.5/500 mg q am to 2 tab of 5/500 bid, cheap

Sulphonylurea: Gliquidone

Glurenor 30 mg daily cheap

Sulphonylurea: Tolbutamide

Diamol 500 mg 1 tab bid cheap

Repaglinide

Diarol, novonorm and repaglid all 0.5, 1 and 2mg tab, repaglinid 1 and repandin 1 and 2 mg. one tab 2 mg about 1 LE except for repaglid 0.6 LE

Pioglitazone:

actozone and glustazon 30 and 45, diabetin ensudyne, glustin and hi glitazon all 15 and 30 mg Actos 15 and 30 mg very expensive, most 3 LE per pill but glustazon 1 LE for one tab.

Pioglitazone + metfomrin

Pioglumet and glustacomb 15/850 mg 1-2 tab bid cheap about 1.2 LE per one tab

Acarbose:

Glucobay 50 and 100 mg up to 100 mg tid

Nateglinide:

Starelidine 60 and 120 mg

Sitaglipitin:

Januvia 100 mg tab daily, janumet 50/1000 mg bid januvia 1 tab 7 LE, janumet 1 tab 4 LE

Vildaglipitin + metformin

Galvus met 50/1000 mg 1 tab bid one tab about 3 LE.

Metfomrin:

Cidophage 500, retard 850 and retard 1000 mg glucophage 500 and 1000 mg diaphage 500, 850 and SR 1000 mg

Hypoglycemia:

Glucagon 1 mg sq or IM or IV 71 LE per one vial, Glucose chew tab cheap 

             Diabetic neuropathy:

Neurobion, neuroton, neurovit, tri b one tab bid or one IM twice weekly.

Alpha lipoic 600 mg q hs and milga 2 tab q am.

Eye and Ear drops

Eye antibiotics drops:

 Cirpo, ciloxan, ciprocin, 0.3% eye drops one tid

Gentamycin eye oint 0.3% tid

Vigamox  0.5% one bid

Levoxin one bid

Ofloxin 0.3% one bid

Tobrex 0.3% one tid

Tobradex drops or oint bid

Maxitrol oint bid

Eye anti-inflammatory drops

Pred forte 1% tid

For eye allergy:

Naphcon A or visine or patanol 0.1% or citrizine 1% bid

Dry eyes:

Refresh tears bid

Ear wax:

Ear wax or remowax drops 2 tid for 3 days

Otitis externa:

Ciprocort 2 drops bid

                    Drugs for Erectile Dysfunction ED in Egypt:

PDE 5 inhibitors:

first drugs of choice in America viagra 25-100 mg, levitra 10-20 mg daily as needed 1 1/2 hour before sex or cialis 10-20 mg every 72 hours as needed start 1 1/2 hour before sex.

Viagra in Egypt expesive cheaper equivalent: erec, erecton, faroviga, phragra, silagra, viavag. virecta, cheapest appear to be sildava 100 mg 4 tab 9 LE.

Non-PDE 5 inhibitors

Can be added to PDE 5 inhibitors. Cream can be added to all meds as well

Argi gel cream apply bid + and pre-sex both sexes Argi B3 can be also tried.

One of the below medications can be added to the above.

Isophro 20 cap 20 Ep one tab bid gisneing and ginko biloba for dementia and ED

Tongati Ali 10 caps 46 LE one tab 2 hours before sex: has korean ginseng and eurycoma

Yohimbex 20 tablets 8 EP one tablet bid has yohimbine 5.4 mg

or patients with low or low normal testestrone:

Testenon 250 mg IM q 2h cheapest and most predictable.

For patients with low testetrone due to prolactinoma treat as such.

For patients suspected of having ED due to vascular cause: consider aggressive statin therapy with niacin to bring down LDL to less than 60 mg/dl.

For Premature Ejaculation:

If due to ED treat as ED, If due to primarly PE with no ED try EMLA anthetic cream or durjoy (Dapoxetine) 30-60 mg 1-2 hour before sex. both can be also tried for PE due to ED. pelvic or keagel exercises may help both. Durjoy is expensive 1 pill about 100 LE.

For women unable to acheive orgasm:

One of the gels applied 15 minutes before sex as well twice a day: Argi-Gel, Argi B3, aqua V, pre seed, tricogyn.Women can also try PDE 5 particularly those taking SSRI's. Keagel exercise may help women also to acheive orgasm. Sexual positions that allow friction of clitoris or manual stimulation can be tried during intercourse. Online cream that looks promising is scream cream. It contains a combination of ingredients described as blood flow enhancers and vasodilators. Scream Cream includes: Arginine 5%, Sildenafil 5% and Isosorbide 1.2% in a gentle warming gel. A pea-sized amount should be applied directly to the clitoris at least 30 minutes prior to anticipated sexual relations. Duration of effect ranges from 30 minutes to 2 hours and heightens both ease of stimulation and intensity of orgasm. Theoritcally this cream can improve ED in man however given the fear of priapism it need to be studied well first.

                        L arginine plus for erectile dysfunction ED

By: Maged Taman

L arginine enhances the production of nitric oxide, which in turn helps relax penile arterioles causing increase blood flow and erection. However given alone is not effective except for milder forms of ED or normal males want to augment erection. For most males with true ED it need to be added to another drug/drugs. Arginine dose in ED is 5 gram daily easier taken in powder form than large 5 pills (see GNC website).

5 grams of L arginine daily can be combined with:

1- 5-PDE inhibitors like viagra, levitra and cialis.

2- Pycnogenol 40 mg three times daily.

3- 6 mg of yohimbine daily.

4- choline supplements (1,000-3,000 mg) and vitamin B5 (Pantothenic acid), 500-1,500 mg).

5- sulbutiamine as arcalion 200 mg 2 tab every morning.

6- Local treament of ED: no current studies but theoritcally can help creams, intracaveronal injections and intraurethral insertions.

Citrulline can be used to augment arginine and prolong its duration.

A study in humans also showed the citrulline supplementation?s ?time release? effect on arginine production. In this study an oral dose of 3.8 grams of citrulline resulted in a 227% peak increase in plasma arginine levels after 4 hours, compared with a 90% peak increase with the same dose of arginine. There is small risk when you combine ED drugs so one has to go slow with doses and need to run to the ER if has painful erection for more than 4 hours.

SOME OF IMPORTANT ENDOCRINE DRUGS IN EGYPT

Growth hormone: very expensive

Genotropin 4 iu/vial, genotropin 16 iu/vial,

humatrope 4 iu/vial,

somatotropin 4 iu/vial

norditropin nordilet 1.5 ml pen 5 mg/1.5 ml

all expensive 4 iu vial of any about 110 LE.

Thyroid hormone: very cheap

Eltroxin, euthyrox, and T4 thyro 50 and 100 micrograms tabs all cheap

Androgen: testosterone: very cheap

Testonon 250 mg IM Q 2-3 weeks. draw by 18 needle guage and inject by 25 guage.

Kollidinogenase

Padutin one tab 5 LE for male infertility, PVD, expelling kidney stones.

Anti-thyroid meds: all cheap

Carbimazol and neomercazol both 5 mg tab, usual dose is 2.5 mg-40 mg daily once or in divided doses. (both are carbimazol)

Thyrocil 50 (propylthioracil) more safe in pregnancy than carbimazole.

For hyperparathyroidism and in renal failure:

Mimpara 30,60,90 mg or sensipar 30 (all are Cinacalcet)

Zemplar 1 micg (paricalcitol)

all very expensive over 1300 LE for 20 pills

Corticosteroids: all cheap

Deltazone 0.75 mg tab, dexazone 0.5 mg tab, orazone 0.5 mg tab (Dexamethazone). Dexamethazone 8 mg IM/IV amp.

Solucortef 100 mg vial IV/IM (Hydrocortisone)

Urbasone 4, 8 mg tab or Depot medrol 40 mg/vial (both methylprednisolone)

Hostacortin 5 mg (prednisone)

Hostacotin H, predilone, prednisolone, predsol, xiolne all 5 mg, solupred 5 and 20 mg (all prednisolone)

Kenacort A 4mg tab and Kenacort A 40 mg/vial (both are trimacinolone)

Betasone 0.5 mg tab, betafos, diprocotrin and diprofos all three are amp (all are betamethazone).

Antidiuretic hormone: Desmopressin

Minirin 0.1, 0.2 mg tab,

minirin nasal spray 10 ugm/dose,

minirin 4 mcg/ 1 amp.

              ENT: Nasal drops

Direct vasoconstrictor: Oxymetazoline:

Afrin and oxymet  adult 0.05%, pedi 0.025% 1 drop each nostril bid

Direct vasoconstrictor: Xylometazoline:

Balkis, nasostop, otrivin, Rhinex all 1% and pedi 0.5% one drop bid

Direct vasoconstrictor: Naphazoline + chlorpheniramine maleate

Neozoline, nostamine, prisoline, rhinosin eye/nasal drops one drop tid

Direct vasoconstrictor: Naphazoline + ephedrine

DeltaRhino nasal spray bid.

Saline:

Physiomer spray, salinex N drops, salinol gel all tid physiomer expensive 50 LE

Mast cell stabilizer: Sodium cromoglycate

Nazocrom and nasotal nasal drops and vividrin spray bid all cheap

Long acting antihistamine: Azelastine

Azelast 0.05% nasal drops. Zalastin 1 spray both bid cheap

Long acting antihistamine: levocabastine

Livostin 0.5mg/ml nasal spray bid expensive 40 LE

Corticosteroid nasal preparations:

Rhinocort, rhinocort Aqua 64 and 32, Avamys, flixonase, ticanase, beclo, nasocort all nasal sprays , rhinocrot aqua, avamys, and nasocort about 40 LE each beclo 200 doses only 19 LE

Sodium chloride + sodium bicarb + borax

Alkaline wash, alkamint, Alka-misr. Alka sachet, nasal clean all are cheap and all are sachets.

Anti-snoring preparations:

Snore nomore at bed time

Most nasal meds cheap except mentioned

Most nasal drops one drop

Steroid nasal sprays 2 each nostril

COMMONLY USED ANTI-EPILEPTICS IN EGYPT:

BY: Maged Taman

Clonazepam

Amotril, apetryl, klozapam, rivotril all 0.5 and 2 mg pills and all are cheap 0.25 mg to 6 mg daily.

Ethosuximide

Ethoxa 250/5ml, zarontin 250/5ml or caps dose is 25-250 mg daily according to age start slow. About 2 LE cost per day, best for absences seziures.

Famotrigine

Famotrine 25,100 mg 25 mg every other day, for 2 weeks, 25 mg daily for 2 weeks average dose 100-200 mg as single dose or twice a day.

Gabapentin

Conventin, gaptin, neuroglopentin all 100,300,400 mg. dose is 100-1800 mg daily in divided doses.

Pregabalin

Lyrica 75, 150, kemirica 50,75,100,150, lyribalin 50, 150 the last is the cheapest dose is 50-300 mg daily start slow use in divided doses.

Lamotrigine

Controlepsy, lamictal, lamotrine all 25,50 and 100 mg contralepsy is the cheapest about 1-1.5 LE per tab.

Start as 25 mg daily for 2 weeks then 50 mg daily for 2 weeks then maintain at 100-200 mg daily.

Levitiracetam

Keppra 250,500,1000, kepilepsy 250,500,750, 1000, kepradil 500, 1000 tiratam 500, 1000, all about 3-5 LE keppra is most expensive. Initial dose is 1 gram per day oral or IV infusion maximum is 3 gram per day decrease dose in renal and hepatic disease.

Oxcarbazepine

Oxaleptal and trileptal 300 and 600 mg dose is 300-600 mg daily oxaleptal is cheaper about 1.5 LE per pill

Topiramate

Topamax, topiramate 25, 100 (both t the last is cheaper about 1-3 LE per one tab. Starting dose 50 mg daily increase by 50 mg weekly maintainance dose 200-400 mg daily.

Valproate

Convulex 100,300,500, dekadol 200, depakine 200, 500 SR, valpokine 200,500 all price OK dose is 15-30 mg/kg/ daily.

Phenytoin

Epanutin 100, ipanten 50, 100, Phenytoin 50,100 phenytin 50,100, all cheap, Loading dose is 1 gram IV infusion or divided oral dose. Maintainance according to level average about 300 mg daily.

Carbamazepin

Tegretol or carbapex 100, 200, cr 200, cr 400 mg, all cheap average dose is 800-1200 mg daily for seizure follow tegretol level.

                           Fatigue

B12 1000 micg daily

Arcalion 200 one tab q am

Vitamax plus one tab qam

Regenerate (ATP) 1 tab bid or adenosin forte one amp twice weekly.

Vitacid C 1 gram

Testenon injection 250 mg IM twice weekly

                             GERD and ANTACID PREPARATIONS IN EGYPT:

By: Maged Taman

most antacids comes as tablets that you suck on until dissolves and then you swallow it or sachets that you mix with water or suspension that you have to shake every time before use. They are usually sold as combination of one or more antacids. It contains as well simethicone or dimethicone to help as well with abdominal gases. In renal failure try to avoid magnesium, aluminum or the combination magaldrate.

Antacids and Renal Impairment from drug.com

Aluminum Antacids: Long-term administration in patients with renal failure or chronic renal failure may result in hyperaluminemia since small amounts of aluminum are absorbed from the GI tract and excretion of aluminum is decreased in patients with renal failure.b Aluminum accumulation in the CNS may be the cause of dialysis encephalopathy, while aluminum accumulation in the bones may result in or worsen dialysis osteomalacia.b

Calcium Carbonate: Patients with renal impairment or dehydration and electrolyte imbalance are predisposed to developing the milk-alkali syndrome.b Hypercalcemia risk in chronic hemodialysis patients.b

Magnesium Antacids: In patients with severe renal impairment, hypermagnesemia characterized by hypotension, nausea, vomiting, ECG changes, respiratory or mental depression, and coma.b Do not administer in patients with renal failure, and antacids containing more than 50 mEq of magnesium in the recommended daily dosage should be used cautiously and only under the supervision of a clinician who should monitor electrolytes in patients with renal disease.

Sodium Bicarbonate: May cause metabolic alkalosis in patients with renal insufficiency.

Thus it appears to me that it is better not to use antacids in patients with renal impairment or possible very few doses until H2 blockers or proton pump inhibitors start to work.

Antacids in Egypt:

Dose in most is 15 ml or 1 chewable tablet 3-4 times daily as needed.

Antacids: acicone tab or susp, algicap susp, alkomag susp, alucal tab, antacid tab, fawar fruit sachetes, gevescon susp, glycodal-M susp, magna sachets, miopan sachets, mucogel susp, pharocola sachets, pharofruit sachet, rennie tb, xenos (cola, fruit, lemon) sachets

Antacids with fomatidine: antodine, famo-plus, peptifix all 10 mg chewable tablets bid prn all cheap

Antacids with anti-gas: acicone-s tab, alkasilon susp, alucal plus tab, antacidin plus tab, asylon tab, epicogel susp, gaviscon susp, glycodal tab, loburna susp, miopan plus syrup, maloox plus tabs or susp, magsilon tab or susp, sedo-mag all cheap except gaviscon 25 LE per bottle.

TREATMENT OF GERD and PEPTIC ULCER DISEASE IN EGYPT:

H2 Blockers: Rantidine:

Aciloc 75, 150 sachets, 300 mg, gastroprotect, ranitidine, ranitak, zantac 150, 300 mg, histac 75, 300 mg, histac and gastroprotect amp, noerosive 75 mg/5ml suspension. All cheap ranitidine cheaper.

Famotidine:

Antodine, famocid, famotak, famotin, peptic, gastrodomina all 20 and 40 mg

Antodine has also 20 mg amp

Nizatidine:

Nizatine, nizatect  150 and 300 mg ulcfree 150 mg

Proton Pump Inhibitors: Esomeprazole:

Esomepex, semopump, esmatac, Esoprotocol, ezogast, nexium all 40 mg all about 3 LE per pillm nexium 10 LE per pill

PPI: Lansoprazole:

Gastrocure, lantanon, lanzor, lopral, loral, peptazol, prevacid, zollipak all has 30 mg, lansoprazol 15 mg all about 3 LE per pill lanzor expensive

Omeprazole:

Epirazole 20 , fastcure, gastroloc, healsec, pepzol, risek all 40 mg all about 2-3 LE per caps prilosec is very expensive

Omeprazole+ Sod bicarb:

Azgovance 20, 40 mg.

Gastrofait 1000 is sucralfate cheap 20 tab 6.5 LE before meals and qhs

Pantoprazole:

Antopral, controloc, pantazol, pantoloc, protofix, Pantopi, all 40 mg all about 2-3 LE per pill with pantopi the cheapest.

Rabeprazol:

Bepra, idizole, pariet, rabezole,  rabicid all 20 mg all about 2-3 LE per pill but pariet is expensive.

Misopristole

Cytotec or misoprost 200 mg 2 tab bid after meals for 8 weeks misoprost much cheaper

Rebamipride cytoprotective

Mucosta 100 mg tid 20 tab 30LE

TREATMENT OF H.PYLORI IN EGYPT:

Most meds are combination of 3 medications one is PPI and the other two are antibiotics. In Egypt common medications are: Peptic care, trio, trioclar, helicure or pyloact 42 caps 56 LE one cap tid. Other meds are trio and trio-clar. All about one tab three times daily for 2 weeks except trio-clar twice daily.

HELICOBACTER PYLORI OVERVIEW from up to date

Helicobacter pylori, also known as H. pylori, is a bacterium that is commonly found in the stomach. It is present in approximately one-half of the world's population.

The vast majority of people infected with H. pylori infection have no symptoms and will never develop problems. However, H. pylori is capable of causing a number of digestive problems, including ulcers, and, much less commonly, stomach cancer. It is not clear why some people with H. pylori get these conditions and others do not.

This article discusses the symptoms, testing, and treatment of H. pylori infections. Stomach ulcers, also known as peptic ulcers, are discussed separately.

H. PYLORI RISK FACTORS

H. pylori is probably spread by consuming food or water contaminated with fecal matter. H. pylori causes changes to the stomach and duodenum (the first part of the small intestine. The bacteria infect the protective tissue that lines the stomach. This leads to the release of certain enzymes and toxins and activation of the immune system. Together, these factors may directly or indirectly injure the cells of the stomach or duodenum. This causes chronic inflammation in the walls of the stomach (gastritis) or duodenum (duodenitis).

As a result of these changes, the stomach and duodenum are more vulnerable to damage from digestive juices, such as stomach acid.

In the United States and other developed countries, infection with H. pylori is unusual during childhood but becomes more common during adulthood. However, in developing countries, most children are infected with H. pylori before age 10.

H. PYLORI SYMPTOMS

Most individuals with chronic gastritis or duodenitis have no symptoms. However, some people develop more serious problems, including stomach or duodenal ulcers.

Ulcers can cause a variety of symptoms or no symptoms at all, with the most common ulcer symptoms including:

Ñ Pain or discomfort (usually in the upper abdomen)

Ñ Bloating

Ñ Feeling full after eating a small amount of food

Ñ Lack of appetite

Ñ Nausea or vomiting

Ñ Dark or tar-colored stools

Ulcers that bleed can cause a low blood count and fatigue (see

Less commonly, chronic gastritis causes abnormal changes in the stomach lining, which can lead to certain forms of cancer. It is uncommon to develop cancer as a result of H. pylori infection. Nevertheless, because so many people in the world are infected with H. pylori, it is considered to be an important cause of stomach cancer. People who live in countries in which H. pylori infection occurs at an early age are at greatest risk of stomach cancer.

H. PYLORI DIAGNOSIS

There are several ways to diagnose H. pylori. The most commonly used tests include the following:

Blood tests ╤ Blood tests can detect specific antibodies (proteins) that the body's immune system develops in response to the H. pylori bacterium.

Breath tests ╤ Breath tests (known as urea breath tests) require that you drink a specialized solution containing a substance that is broken down by the H. pylori bacterium. The breakdown products can be detected in your breath.

Stool tests ╤ Tests are available that detect H. pylori proteins in stool.

WHO SHOULD BE TESTED FOR H. PYLORI?

If you have symptoms ╤ Diagnostic testing for H. pylori infection is recommended if you have active gastric or duodenal ulcers or if you have a past history of ulcers.

Although H. pylori infection is the most common cause of ulcers, not all patients with ulcers have H. pylori. Certain medications (eg, aspirin, ibuprofen [Motrin, Advil], naproxen [Aleve]) can also cause peptic ulcers.

If you do not have symptoms ╤ H. pylori testing is usually not recommended if you have no symptoms and no past history of peptic ulcer disease. However, it may be considered for selected people, such as those with a family history or concern about stomach cancer, particularly individuals of Chinese, Korean, Japanese, or Central American descent; these groups have a higher incidence of stomach cancer.

H. PYLORI TREATMENT

People with a history of peptic ulcer disease, active gastric ulcer, or active duodenal ulcer associated with H. pylori infection should be treated. Successful treatment of H. pylori can help the ulcer to heal, prevent ulcers from coming back, and reduce the risk of ulcer complications (like bleeding).

Medications ╤ No single drug cures H. pylori infection. Treatment involves taking several medications for 7 to 14 days.

Ñ Most of the treatment regimens include a medication called a proton pump inhibitor. This medication decreases the stomach's production of acid, which allows the tissues damaged by the infection to heal. Examples of proton pump inhibitors include lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (AcipHex), dexlansoprazole (Dexilant), and esomeprazole (Nexium).

Ñ Two antibiotics are also generally recommended; this reduces the risk of treatment failure and antibiotic resistance.

Ñ There are increasing numbers of patients with H. pylori infection that is resistant to antibiotics so it is important to take all the medications prescribed and to have a test that confirms that the infection has been cleared.

Although the optimal H. pylori treatment regimen continues to be investigated, the American College of Gastroenterology has recommended four specific drug regimens that use a combination of at least three medications. These regimens successfully cure infection in up to 90 percent of people. For the H. pylori treatment to be effective, it is important to take the entire course of all medications.

Side effects ╤ Up to 50 percent of patients have side effects while taking H. pylori treatment. Side effects are usually mild, and fewer than 10 percent of patients stop treatment because of side effects. For those who do experience side effects, it may be possible to make adjustments in the dose or timing of medication. Some of the most common side effects are described below.

Ñ Some of the treatment regimens use a medication called metronidazole (Flagyl) or clarithromycin (Biaxin). These medications can cause a metallic taste in the mouth.

Ñ Alcoholic beverages (eg, beer, wine) should be avoided while taking metronidazole; the combination can cause skin flushing, headache, nausea, vomiting, sweating and a rapid heart rate.

Ñ Bismuth, which is contained in some of the regimens, causes the stool to become black and may cause constipation.

Ñ Many of the regimens cause diarrhea and stomach cramps.

Treatment failure ╤ Up to 20 percent of patients with H. pylori infection are not cured after completing their first course of treatment. A second treatment regimen is usually recommended in this case. Retreatment usually requires that the patient take 14 days of a proton pump inhibitor and two antibiotics. At least one of the antibiotics is different from those used in the first treatment course.

Follow-up ╤ After completing H. pylori treatment, repeat testing is usually performed to ensure that the infection has resolved. This is typically done with a breath or stool test (see 'Breath tests' above). Blood tests are not recommended for follow up testing; the antibody detected by the blood test often remains in the blood for four or more months after treatment, even after the infection is eliminated.

SUMMARY

Ñ Helicobacter pylori, also known as H. pylori, is a bacterium that is commonly found in the stomach. Most people infected with H. pylori infection have no problems. However, some people develop problems, such as stomach ulcers.

Ñ Ulcers may cause no symptoms, or may cause pain or discomfort (usually in the upper abdomen), bloating, feeling full after eating a small amount of food, lack of appetite, nausea, vomiting, and dark or tar-colored stools. Ulcers that bleed can cause a low blood count.

Ñ H. pylori can be diagnosed with a test of the blood, breath, or stool.

Ñ H. pylori testing is recommended for anyone with a peptic (stomach or duodenal) ulcer.

Ñ Anyone diagnosed with H. pylori should be treated. H. pylori treatment helps to heal the ulcer, lowers the risk that the ulcer will return, and lowers the risk of bleeding from the ulcer.

Ñ H. pylori treatment usually includes several medicines. At least two of the medicines are antibiotics that help to kill the bacteria. The other medication causes the stomach to make less acid; lower acid levels help the ulcer to heal.

Ñ Most people are cured after finishing one to two weeks of medicine. Some people need to take another two weeks of medicine. It is important to finish all of the medicine to ensure that the bacteria are killed.

Ñ A breath or stool test is usually done after finishing the medication. This is done to be sure that the bacteria were killed.

                      Anti- Infection

DRUGS COMMONLY USED TO IMPORVE IMMUNITY IN EGYPT:

Echinecia, fluran 200, immune c, immulant, immuno plus, immuno flu, mulone (all has echinecia) all cheap one tid all capsules except mulone is syrup or drops.

Carnivita cotain L carnitine 500 mg one tab tid

Baraka ( nigella sativa) caps chaep as well for opiod dependence and reduce calculi.

Coenzyme Q10, 30 mg, co-Q10 30 mg, Euro Q 10 50 mg ( all coenzyme Q 10) all capsules and cheap about 1 capsule 1 LE

Oxyplex (grapeseed extract and green tea) one tab daily

olive leafs and grape seed extracts internet to order.

COMMON ANTIBIOTICS IN EGYPT

Ampecillin 500 mg tid

Amoxacillin 500 mg tid

Augmentin 625 mg bid

Amoclox 500 mg bid (amoxicillin + dicloxacillin)

Invanz 1 gram IM daily 285 LE VERY EXPENSIVE

Keflex 500 mg tid

Duricef 500 mg bid

Ceftriaxone 1 gram IM daily

Cefepime 1 gram Q 12 h IM 21 LE per one vial

Ceftazidime 1 gram IM q 12 h 25 EP per one vial

Garamycin 80 mg IM q 8h 3 vials 6 EP

Amikacin 15 mg/kg/day divided into 2 doses 500 mg vial is 9 EP

Togamycin (spectinomycin) 2000 one vial 13.70

Azomycin ( azithromycin) 250 mg daily 6 caps 21 EP

Clindacine (clindamycin) 300 mg tid 12 caps 10 EP

Erythroprim (erythro + trimethoprim) 400/100 1 tab bid 20 tab 10 EP

Averozolid 600 (linezolid) 10 tab 79 EP 1 tab bid

Cipro 500 mg 1 tab bid 10 tab 11.5 EP

Floxabact 500 tab 1 tab daily 5 tabs 7.5 EP

Rowamoxiflox 400 mg 1 tab daily (moxifloxacin like avelox) 5 tab 25 EP

Doxymycin (doxcycline) 100 mg 1 tab bid 10 caps 4 EP

Entrim 1 tab bid (like bactrim DS In America)

Azomycin 250 mg

Augmentin 625 mg or 1000 mg

Vibramycin 100 mg

Meronem 1000 mg

Penicid LA 1.2 millions iu

Keflex 500 mg

Amoxicillin 500 mg

Invanz 1 gram im

Tienem 500 mg (imipenm + cilastatin)

Zinacef 500 mg

Pracef 1 gram im bid (cefobid)

Omnicef 300 mg bid cheaper denrocef 300 mg

Ceftriaxone 1000 mg cheaper wintriaxone 1 gram

Cefepime 500-2 gram im bid

Ceftazidime 1 gram im bid cheaper sigmazidim

Gentamycin or garamycin 80 mg

Amikacin 500 mg 15mg/kg divided into two doses

Nebcin  80 mg (tobramycin)

Vancomycin 1 gram iv

Clindacine, delacine C,  clinacyn 300 mg dalacin C 600 mg amp IM or IV

Averozolid 600 mg tab bid x 10 days cost 160 LE

Cipro 500 mg po or ciprofloxacin 500 mg IV

Floxabact 500 mg (levaquin) cheap oral levoxin 500 mg IV

Avalox 400 mg cheaper advancrib 5 tab 26 LE

Sutrim forte 1 tab bid

Acyclovir 400 mg

Tamiflu 75 and taminil 75 bid for 5 days

Valtrex 500 mg  cheaper valtrovir and valysemex 1 gram tid cost 200 LE

Diflucan 150 mg cheaper amriflucan 150 mg 2 tab 7 LE one tab now repeat in 4 days once.

Itranox for fungal infections 100 mg 2 tab daily for one week. Cost 48 LE

Ketoconazole 200 mg daily for 10 days cost 20 LE

Lamisil 250 mg daily, cheaper Lamifen 250 mg daily

COMMONLY USED MEDS FOR INSOMNIA, ANXIETY, DEPRESSION IN EGYPT:

Xanax 0.25 and 0.5 as well restolam and zolam , alprax 1, (all alprazolam) all cheap

Amribromazepam, bropam, calmpam, lexotanil all 1.5 and 3 mg (all bromzepam) all cheap and works like valium.

Valium, neuril, farcozepam (all diazepam) all 2 and 5 mg valium expensive other two cheap

Busbar 10 and 15 mg, neurobus 5 and 10 mg (both buspirone) both about 1 LE per one tab 5 mg tid up to 60 mg daily

Kava 150 mg bid (kava kava) cheap

Abilia 15 and 20 mg dose 10-30 mg daily same as abilify but much cheaper. For schizophrenia or acute manic or mixed episodes.

Midathetic amp 5 mg/ 1ml (midazolum)

Seroquel 25 mg, 100 ,200 mg, psyquel, quitapex (all quetiapine) seroquel is much more expensive than the other two.

Dogmatil, dobrin, dogmapride, topmode all 50 and 200 mg (all Sulpiride) twice daily in peptic ulcer and spastic colon up to 200 mg daily and in schezophrenia bid up to 800 mg total daily

Sleep aid 5 and 10 mg (zaleplon) cheap but zaleplon itself very expensive

                      Treatment of Osteoprosis

Vit D

Calci-plus calcium 500 mg + vit D3 400 iu 1 tab bid.

Osteonate 70 4 tabs 40 EP one tab weekly

Osteo 60 mg daily cheaper than evista.

D3 natural drops 4500 one droplet daily--,

Vidrop 2800 iu one droplet daily.

Bone one and one alpha 0.25 mcg in osteoprosis and .5 and 1 mcg in renal failure.

Genecalcin 200 iu daily alternate nostrils

Forteo 20 mg sq daily one pen 3 ml 2500 LE

MOUTH PREPARATIONS IN EGYPT

TRETMENT OF APHHOUS ULCER IN EGYPT

Numb gel can be used to diminish pain of the ulcer as well can be used for other painful mouth lesions like dentocaine, dentocalm, dentogel + aphthatab 1-3 each ulcer daily for 10 days.

oral based steroid like trimacinolone orabase paste three times daily to the ulcer . According to rxlist.com

Aphthasol is Amlexanox oral paste, 5%, is indicated for the treatment of aphthous ulcers in people with normal immune systems. (Available in Egypt as adhesive tablets 20 tab 40 LE called Aphthatab).

DOSAGE AND ADMINISTRATION

The paste should be applied as soon as possible after noticing the symptoms of an aphthous ulcer and should be used four times daily, preferably following oral hygiene after breakfast, lunch, dinner, and at bedtime. Squeeze a dab of paste approximately ¼ inch (0.5 cm) onto a finger tip. With

gentle pressure, dab the paste onto each ulcer in the mouth. Use of the medication should be continued until the ulcer heals. If significant healing or pain reduction has not occurred in 10 days, consult your dentist or physician. (As well oral tablet is 1 tab apply to the ulcer 4 times daily x 10 days).

GINGIVITIS

DG Long, elgydium, emoform, sensogum all are gum pastes

Mouth washs MW like b-fresh, cepachol, biosterine, listerine, oraldene, oroguard, oramax, tricare, view, chloecol, perox and betadine. Mouth wash also for other oral and throat infections.

Oral thrush:

Nystatin swish and swallow 5 ml 4 times daily for 10 days. drops i ml 100,000 units.

Or

buccazole, daktarin, micazole, micoban miconaz (all oral gel all miconazole all cheap except daktarin 18 LE.

Or/and

Diflucan 100 mg daily for 7 days

Sensitive tooth

sensodyne gel/paste or sensigel price OK.

Dry mouth:

                    Treatment for Parkinson Egypt

Levodopa + carbidopa:

Sinmet 250 CR, 275 tab, levocar, lecardopa, all price OK , madopar 50 mg + benserazide 25 mg one tab about 3 LE

Entacapone + Levodopa + carbidopa:

Stalevo 262.5, 325, 387.5  one tab about 7 LE

Lysuride: like bromocriptine

Dopagon 5, dopergin 5 mg the later is expensive

Pramipexole: as bromocriptine

Sifrol 0.25, .0.7, 1 mg, mirapax 0.25, 0.5, 1 mg, ramixole 1 mg.  very expensive except ramixole 1 tab 3 LE

Rosagiline: MAO type B

Parkintreat 1, rasanopark 1 both about 6 LE per one tab.

Selegiline: MAO type B

Jumex 5 mg, parkineast 5, tonus 5 5 mg tid about 0.75 LE per one tab

Antimuscarinic: Benzotropine

Cogenstin 2 mg tab , cogetropine 2 mg amp, cogintol 2  mg tab start 2 mg  daily increase slowly

Antimuscarinic: Biperiden

Achtenon 2 mg tab, akineton 2 mg tab and 5 mg amp, kinoprid  5 mg amp price ok. 2 mg tid

Robinirole:

Tremodect 1 mg cheap

                      Prostate drugs in Egypt

Alpha blocker: Alfuzosin

Prosterol 10 mg, Xatral 5 mg , Xatral XL 10 mg 1 tab qhs after meal. Prosterol cheaper 1 tab about 1.2 LE

Alpha blocker: Tamsulosin

Block alpha, cure pro, firmazin, omnic, tamic, tamsul, tamsulin, all o.4 mg once daily Firmazin cheaper 1 cap 1.6 LE

Alpha blocker: Doxazosin

Cardura 1, 4, xl4 mg tab , doxazin 1 and 4 mg, doxacor 2 and 4 mg, dosin 1, 2 and 4 mg, duracin 1 and 4 mg, doxazosin 2 mg the cheapist about 0.7 LE per one tab,

Alpha blockers: terazosin

E-Ze- P 1, 2 and 5 mg, Itrin, prostasin, terazin all 2 and 5 mg. All chap, cheapist E-Ze-P about 0.5 LE per one cap.

5 alpha reductase inhibitor: Finasteride

proscar, prostec, prostaride, prostat all 5 mg tab all one tab daily. Cheapest prostaride one cap about 3 LE

5 alpha reductase inhibitor: Dustasteride

Avodart 0.5 mg cap daily  1 cap about 5.2 LE

Prostatic decongestant:

Decongestyl, De-prosteyl 2, prostalin all are suppository one twice daily. All cheap.

Herbal prostate medicines:

P plus has all important herbals one cap 2.3 LE

Others: prostacap, prostacure, procare, prosta-S, rostac, ?..

Anti-cholinergic for urinary incontinence: Solifenacin

In America vesicare, sofenacin 5 and 10 mg one tab daily one tab about 2 LE.

Anti-cholinergic for urinary incontinence:  Oxybutynin

Detronin, detrusan, ditropan, dry tropan, uripan all 5 mg dry tropan and unripan 10 mg as well. Dose 5 mg tid or Uripan XR 10 mg faily all cheap except ditropan

Anti-cholinergic for urinary incontinence: Propiverine

Mictonorm 15 mg once daily may increase to bid or tid one pill 3 LE

Anti-cholinergic for urinary incontinence:  Tolterodine

Detrusitol 2 and 4 mg retard, terodine 1, 2, uricontrol 2 Icontina LA 2 all OK except detrusitol expensive.

Evista 60 mg daily cheaper osteo 60 mg daily

Magnsium plus one tab qhs

Folic acid 500 mcg

                            Skin, hair and nails

Skin, hair, nail vitamins:

Biotin forte 5 mg daily

                   Taman Androgenic alopecia method

Most effective for androgenic alopeica is minoxidil and finestaride. Newly found is retina A. My method to my patients is:

Use the minoxidil 5 % for for men and 2% for women in America rogaine 5% and 2% in Egypt performa 5% and regaine 2% the usual daily dose to be divided in 3 portions:

1- In the morning minoxidil with finasteride 5 mg tab that is either in a capusle like prostaride in Egypt that you open and mix with minoxidil spray then apply in the areas of hair loss in the scalp. In America you will need to crush the fiastaride pill.

2- At night apply retina a 0.05% or cheaper in Egypt acretin apply in the areas of hair loss in the scalp in mix with minoxidil spray.

3- You can also try a mix cream of arginine+B3 like in Egypt argi-B3 with minoxidil in mid day.

Do not exceed the total daily recommended minoxidil 5% dose.

In women finasteride oral or topical is only for women who can not get pregnant since it is determintal for a boy infant.

Oral finasteride 1 mg as propecia in America and in Egypt nopcia or prohair can also be taken once daily for men and for women who can not get pregnant for hair loss. My recommendation is to avoid it particularly topical finasteride is likely better and some men can end by sexual problems from oral finasteride though quite low percent possibly less than 2% it is still high percent for young men. Topical finasteride is very mildly absorped and highly unlikely to affect men's sex life. However consider to hold if any sexual concern. Women in fertile age should not touch finasteride pill or topical application.

Brusies:

Hemoclar or thrombexx bid creams

Muscle, joint pain:

Maxi care or bioflex cream on am and voltaren pm

 COMMONLY USED SKIN MEDICATIONS FOR WRINKELS, BLACK HALOS UNDER THE EYES AND ACNE IN EGYPT

for all of the three good cleaning of the face, retina A or cheaper acretin 0.05% at night and sun block on the morning like UV block SPF 50+. For acne added as well antibiotic cream and oral antibiotic like doxycyline 100 mg twice daily for 2 weeks. Dark under eyes cream appears to have best vitamins and antioxidants to the skin of the face and can be used particularly for dark under eyes and for wrinkles.

http://darkundereyes.com/products-page/product-category/dark-under-eyes-treatment-cream/

COMMONLY USED CREAMS FOR ANTI-SCAR AND ANTI-STRETCH POST-WEIGHT LOSS CREAM IN EGYPT:

Blendex, celisia, demark, derm pure, gincal, hyper dermo care, margena, Mira, jenico, stretch redux, streetal, vente cream most in the range of 30 dollars. Procream 120 and stretch redux 330 LE.

Hydroquinon:

Clearalique,eldoquin, quinol bid and avoid sun exposure use UB block

Non-hydroquinon whitening and anti-aging

Ageless, dana, white & bright , romix q 10 hand and nail, q 10 face, q 10 eye contour

Scar removing

Scarease, scarfix, scaro, scartex

Good and cheap antifungals:

Lamisil cream and lotion and nizoral cream

Scalp eczyma?:

Betnovate scalp solution 0.5% bid

COMMONLY USED ANTI-MICROBIAL AND ANTI-VIRALS CREAMS IN EGYPT:

Betadine, povidine-iodine? or povidin ointment (all Povidine Iodine) all ointments , 10% and all cheap

Argiderm-p, burnazin, dermazine, silvazine? (all silver-sulfadiazine) all creams for second and third degree burns, sounds, ulcers, fissures and bed sorees. Clean with normal saline, apply the cream with tongue depressor, apply telfa and dressing.

Bactroban, bactrocin, forderm, mupirocin, probactcin, mupirax (all 2/% mupirocin) to apply tid for10 days, particularly with MRSA all price reasonable about 15-22 dollars.

Altargo 1% (Retapamulin) ointment for MSSA and strept pyogenes? 31 LE

Fucidel, fucidin, fuci top, fusiderm, futasole,? fusi (all are 2% )Fusidic acid all have both cream and ointment and all are very cheap to apply bid to tid onskin wounds, folliculitisÉ..

Apigent, biogentacin, farocin, garamycin ( all gentamycin) all are ?creams all 1-2 per day, all are very cheap.

NPB oint, utopia neo oint or cram, trivatracin aresol, polybiotic spray,? polybiocid spray (all contain neomycin, bacitracin and polymyxin) all bid all price reasonable 7 to 22 LE.

Panthenol cream, panthoeva solution, or emulgel, adcopantin (All have d-panthol 5%) promotes healing a component of coenzyme A all very cheap. sensicare cream and wound healing cram both contain as well herbals. Topica cream is also herbal? for first degree burn.Mebo cream, pentaburn oint (both beta-sitosterol) bid for wound healing about 16 LE both.

Icthammol 10% for boils

Solcoseryl gel (deprotonized calves blood extract 5%

Mamy care cream for Cracked nipples

Acyclostad, acyclovir, novirus, virustat, zovirax (all acyclovir 5%) all creams, all cheap, all qid

Pandrocear cream ( penciclovir 1%) cream 10 LE qid

COMMONLY USED HEMORRHOIDAL PREPARATIONS IN EGYPT

Anusol ointment, supp (zinc, bisthmus, balsam) anusol HC oint or sup same but with hydrocortisone.

Factu oint or sup (policresuloen and cinchocaine)

GTN oint ( contain glyceril trinitrates) for anal fissure more.

H formula oint or sup contain? phenylephrine and dibucaine.

All above very cheap except GTN 25 LE and Faktu 18 LE

COMMONLY USED MEDS FOR SMOKING CESSATION IN EGYPT:

Champix like chantix in America very expensive. O.5 mg q am for one week then bid then 1 mg bid for 3-6 month

Nicorette gums 2 mg or 4 mg about 40-50 LE for 15 pieces. Chew every 2 h as needed.

COMMONLY USED MEDS FOR VAGINAL INFECTIONS IN EGYPT:

Dalcin 2% 30 LE, vagiclind 2% 15 LE one applicator daily for 3 days (both clindamycin) for bacterial vaginosis.

Butoconazole 2 % cream or pessary daily for 3 days for candida cheap.

Cansten or candistan vaginal tablets daily for 3 days. Locastan vaginal supp 1 daily for 3 days (all clotrimazole) all are cheap

Gyno-daktarin, gynozol, gynoconazole, micoban, monicure all has vaginal supp all cheap (miconazole )

Gynotrosyd, mipazol, gytro vaginal tab daily for 3 days all tioconazole all cheap

Amrizole n or krema-rosa or nystazole vaginal supp once daily for 2 weeks ( both metronidazole and both cheap.

Betadine vaginal ovules one q 12 h for 2-4 weeks cheap

Tergynan, mocicure nh vaginal daily for one week cheap and conver most vaginal infections and inflammation.

Be fresh, be sure, cleanza, clinso (all vaginal antiseptic solutions and cheap) one measure in one liter of warm water twice daily

Diflucan 150 mg cheaper amriflucan 150 mg 2 tab 7 LE one tab now repeat in 4 days once.

COMMONLY USED DRUGS FOR VASCULAR INSUFFICIENCY IN EGYPT:

Maxilase , medmylezen, megalase (all Alpha Amylase) all syrup 5 ml tid all cheap post-op reduces edema by inhibiting capillary permeability.

Bekcium, dilasal, doxium (all calcium dobesilate) all has 250 and 500 mg capsules one tid for venous inflammation, prevention of hemorrhage in gyna diseases.

Daflon, dantrex, diosed, dioven, veintonic, venowest (all Disomin) all inexpensive 300-500 mg tid for venous ciruculation disorder like VV, swollen legs, restless legs, acute hemorrhoidal attacks.

Ruta c, rutalex, rutin c (all contain rutin + vitamin c) 1-2 tab tid for increase blood capillary fragility

Noxylife, gervital, activin (all contain grape seed extract which contain proanthocyanidin) 1-2 capsules daily, cheapist is grevital 150 20 caps 15 LE Pine barck has also pine barck extract and grape seed.

Alphintern, ambezim, newbezim ( all contain chymotrypsin and trypsin) for post-op and post-trauma soft tissues swelling

Difrarel (vaccinium) one cap tid for one month

Reparil (aescin) one cap tid

Venotec ( procynidins) one cap tid

TREAMENT OF VITAMINS AND MINERAL DEFICIENCY IN EGYPT

Low Magnesium: Magnesuim plus (MGO 400 mg and Magnesium gluconate 100 mg) one tablet QHS. consider IV infusion of Magnesuim or IM Magnesium for levels below 1.4 normal about 1.6-2.2

Low Iron:

Iron SR natural iron supplement 1-3 per day. Consider IV infusion of iron in severe cases.

Low B12

B12 1000 tab or IM injection for tab once a day for injection IM once a month.

Low potassium

K-Chlor syrup 300 mg/ 5ml, Slow K 600 mg tab give according to K level. Level below 3.0 may need to give it IV slow infusion.

TREATMENT OF VOMITING IN EGYPT:

Domperidone 10 30 tab 6 LE ( EGYPTIAN POUND) one tab 1/2 hour before meals tid

Primperan 10 20 tabs 5 LE one tab ½ hours before meals.

Emedrotec 3mg (procholrperazine) 20 buccal tablets 12 LE 1-2 tab buccal tablets tid PRN for nausea.

Emezine 20 tab 12 LE (meclizine + vitamin B 6) safe in pregnancy 1 tab bid prn nausea, dizziness.

Cortigen B 6 for nausea one amp IM bid prn nausea, cheap

Ginger tablets 400 mg? cheap 30 tab 6 LE one tab tid for nausea particularly in pregnancy.

                     Urologic Dysuria, UTI and renal stones Meds in Egypt:

Individual ingradients: proximol (halfabarol) help renal spasm and expel stone, proximadiol urinary dilator help to dilate the ureter and expel renal stone, hexamine urinary antiseptic,

Pain control for renal stones:

In America usually agressive pain control with diludid or morphine IV 1-4 mg every 4 hour as needed with PRN nausea medicine like zofran 4 mg IV every 6 hour as needed.

In Egypt pain control but antispasmodics are more used as Khellalgine ampoules.

Antiseptics and antispasmodics:

Khellalgine ampoules

Or

Coli-urinal 60 mg granules bid has piperzine, hexamine and khellin for dysuria and antiseptic, similar to that is uricol Sachetes and renal S sachets.

Or

Rouatinex capsuls 1 tid is cheap ( has anethol, fenchone, camphene) Urinex capsules are similar

Expelling stone:

for bigger stones: lthotripys, cystouroscopy removal and stent or nephrostomy and stone extraction or cut surgery according to place of stone.

For smaller stones

Flomax 0.4 mg po daily or equivalent.

Or

Cystone or cystinol herbals cheap expel and prevent renal stones.

Or

Septobar (halfabar + hexamine 1gram /5 grams) propulsive expeller for uretric stones and urinary antiseptic Sachets

most stones are clacuim oxalate

Nephroflam or genurin SF ( both are Flavoxate) 1 tab bid for dysuria, cystitis, Quite cheap 30 tab 13 and 18 LE respectively.

Citrocid magnesium plus, epimag, jedcomag, xenomag (all Magnesium citrate) all are very cheap 12 sachets 4 LE one sachet in 100 ml water tid for prevention of oxalate stone.

Cranberry capsules on bid for recurrent UTIs.

Zyloric, no-uric (allopurinol) both comes as 100 and 300 mg tables both cheap. Comes also with combinations with piperzine that increase ureat solubility or/and atropine or khellin or/and halfabar that are antispasmodics.

Weight Loss Treamtent

By: Maged Taman

There is no magic pill for weight loss. If it is there it will be all around the news and at least 25% of us will take it not necessarly for weight loss but to cut down in diabetes. Many products comes and goes for weight loss some were dangerous like phen/phen and others did burn qucikly more than seeing people burn fat.

As we stand now my choice will be for combining mild weight loss drugs or supplements that are safe. There is no study to show this combination work and no study to show us it is completely safe. In the same time there apparently no biochemical reason at least evident now to say it is unsafe.

Thus it is the patient choice with this information honestly provided. This combination is:

1- GLA (gamma linolenic acid) : burn brown fat, take 90 mg daily

2- CLA (conjugated linoleic acid): Burn visceral fat, take 1 gram daily

3- Chitosan: block fat absorption when taken with meals, take two tablets 500 mg each with your large meal daily

4- Green tea extract: speeds up energy, take 100-200 mg daily.

5- Green coffee bean extract: Speed up energy through chlorogenic acid, dose is 400 mg of extract (200 mg of chlorogenic acid) 1/2 hour before meal twice daily. Green coffee bean supplement has only around 20 mg of caffeine per serving, whereas your daily cup of coffee has over 100 mg. If you use with green tea you can use decaffeinatted green tea and cut on caffeine through out the day.

I would advise one multivitamin daily like silver centrum, for women silver centrum women once daily. Reducing total calories and execricse is necessary. GLA, CLA, green tea or Green coffee bean extract burn fat mainly when you exercise.

In Egypt Chitosan is available in pharmacies as well green tea. GLA, CLA and green coffee Bean extract can be ordered over the internet from GNC and other famous health stores.

COMMONLY USED DRUGS FOR WEIGHT LOSS IN EGYPT:

Organo-orlistat, orlismart, orlistat, orly, quick slim, regimax, slim safe, xenical (all are orlistat) all are 120 mg capsules taken tid before or after meals. Cheapist is ragimax 30 capsules 40 LE.

Hydroxycut herbal capsules 30 caps 40 LE one capsule before meal bid has garcinia, green tea, phenylalanine, ginger root. Other herbals likely less effective.

Green tea one bag bid

Actlife, chromax, chromium, dieto Plex, Hi-Chrome (all are Chromium) hi-chrome cheapest 30 tab 20 LE. One capsule bid

Cate keen, chitocal, chitosan, del-fat, diet one, merti, superslim (all have Chitosan) most 500 mg of chitosan, trap fat and excreted as grease ball in stools, once a day with big meal. Cheapest delfat, diet one and merti about 1 LE for one capsule.

                          Appetite stimulants:

Mosegor 1 tab before meals bid

Periavit syrup 5 ml before meals bid