Pharaoh’s Revenge

By TourCare Pharmacy — Reliable Care, Hurghada  ·  Updated March 2026  ·  8 min read

Pharaoh’s Revenge is the nickname tourists give to the stomach upset that strikes a significant proportion of visitors to Egypt every year. If you are reading this, you are probably either mid-symptoms and looking for a fast answer — or you are smart enough to research it before you travel. Either way, you are in the right place.

The good news: there is a highly effective Egyptian medicine called Antinal that most tourists have never heard of, costs under £2, and is available at any pharmacy in Hurghada including delivery to your hotel room. Imodium is still useful in the first few hours to control urgency, but Antinal is what actually cures the infection — and most tourists have never heard of it.

This guide covers everything: what causes it, how to prevent it, what symptoms to expect, exactly what to take, and when you need a doctor rather than a pharmacy.

What actually causes Pharaoh’s Revenge

The condition is a form of traveller’s diarrhoea — an acute gastrointestinal infection caused by ingesting bacteria or pathogens your immune system has no prior exposure to. The most common culprits in Egypt are E. coli, Salmonella, Shigella, and Campylobacter jejuni — all of which are effectively targeted by the right treatment.

The most common sources of infection for tourists in Hurghada:

• Tap water — the single biggest cause. Never drink from the tap. This includes brushing your teeth, rinsing your mouth, and ice cubes in drinks.
• Salads and raw vegetables washed in tap water at buffets — common culprit even in good hotels.
• Buffet food left at warm temperatures for extended periods.
• Shellfish and undercooked meat — especially outside main hotel restaurants.
• Touching contaminated surfaces then eating — door handles, handrails, and shared equipment.

Symptoms — what to expect and when to worry

Symptoms typically begin between 6 and 48 hours after consuming contaminated food or water. Most cases are unpleasant but not dangerous for otherwise healthy adults. Here is what to look out for:

Imodium vs Antinal — why you need both, but in the right order

Imodium (loperamide) is the medicine most British, German, and Russian tourists carry with them — and it does have a role to play. In the first few hours, Imodium is genuinely useful to control the urgency and frequency of diarrhoea, especially if you are travelling, on a tour, or simply cannot stay close to a toilet.

However, Imodium alone is not a cure. It works by slowing gut movement — which reduces symptoms but has no effect whatsoever on the bacteria causing the infection. If you only take Imodium, the bacteria remain inside your gut and the infection continues. The correct approach is to use Imodium for immediate symptom control in the first few hours, then start Antinal as the actual treatment to eliminate the bacteria and achieve full recovery.

Think of it this way: Imodium is the emergency brake — it gives you immediate relief and practicality. Antinal is the cure — it removes the cause. You may need the emergency brake, but you also need to fix the engine.

What is Antinal and how does it work

Antinal is the Egyptian brand name for Nifuroxazide 200mg — an intestinal antiseptic with broad-spectrum bactericidal activity. It is not a systemic antibiotic. It works locally inside the gut, targeting and eliminating the bacteria causing the infection without being significantly absorbed into the bloodstream. This means minimal systemic side effects and no disruption to your gut flora balance.

Antinal has a wide range of bactericidal activity against both Gram-positive and Gram-negative enteropathogenic bacteria, including Campylobacter jejuni, Shigella, Salmonella, and E. coli — the exact bacteria responsible for most cases of traveller’s diarrhoea in Egypt.

It is available in two forms:

• Capsules (200mg) — for adults and children 15 years and over
• Suspension (syrup) — for children under 15. Available in every pharmacy.

Antinal dosage — adults and children

The complete treatment plan — Antinal alone is not enough

Rehydration is just as important as Antinal. Diarrhoea causes rapid fluid and electrolyte loss, which is what makes you feel exhausted, dizzy, and weak — not the bacteria itself. Treating the infection with Antinal without replacing fluids will slow your recovery significantly.

1. Start Antinal immediately — 1 capsule with food, then 3 more at regular intervals through the day.
2. Drink oral rehydration salts (ORS) — available at any Egyptian pharmacy (ask for “Oral Rehydration Salts” or “Rehidrat”). Mix with bottled water and drink throughout the day. Plain water is not enough — you need the electrolytes.
3. Switch to bland food — plain rice, bread, boiled chicken, banana. Avoid dairy, spicy food, alcohol, and caffeine until symptoms resolve.
4. Drink only bottled water — including for brushing teeth and rinsing.
5. Rest — your body is fighting an infection. One day resting properly means two days saved later.
6. Continue for the full course — even if you feel better after a few doses, complete the 3-day course to ensure the infection is fully cleared.

Prevention — how to significantly reduce your risk

You cannot guarantee you will not get Pharaoh’s Revenge, but these steps reduce the risk dramatically:

• Never drink tap water — use bottled water exclusively, including for brushing teeth
• No ice in drinks outside of high-standard hotel restaurants where ice is made from purified water
• Avoid salads at buffets — raw vegetables are often washed in tap water
• Wash hands thoroughly before every meal — use soap and water, not just hand gel
• Choose freshly cooked, hot food over buffet food that has been sitting at room temperature
• Buy Antinal on arrival — so you have it immediately if symptoms start. Acting within the first 3 hours gives the fastest recovery.
• Take a pack home — Antinal is very difficult to obtain in the UK or Germany. If symptoms return after you land, having a pack with you avoids a very difficult conversation with your GP.

How to get Antinal in Hurghada

Antinal is available at every licensed pharmacy in Hurghada — it is one of the most commonly requested medicines by tourists and local residents alike. You do not need a prescription.

If you are too unwell to leave your hotel room:

Frequently asked questions