1. Introduction
Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain, inflammation, and fever. It works by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, thereby reducing the production of prostaglandins, which are mediators of inflammation, pain, and fever.
2. Indications
- Approved Indications:
- Pain relief (mild to moderate).
- Rheumatoid arthritis.
- Osteoarthritis.
- Ankylosing spondylitis.
- Dysmenorrhoea (menstrual pain).
- Postoperative pain or injury-related pain.
- Off-Label Uses:
- Gout (acute flares).
- Bursitis and tendinitis.
3. Dosage
- Oral (Capsules or Tablets):
- Adults:
- Pain and inflammation: 50–75 mg 2–3 times daily.
- Maximum dose: 300 mg/day.
- Elderly:
- Start with the lowest effective dose, usually 50 mg twice daily.
- Adults:
- Topical (Gel or Cream):
- Apply a thin layer to the affected area 2–4 times daily.
- Injectable:
- 50–100 mg intramuscularly or intravenously every 6–8 hours as needed.
- Maximum daily dose: 300 mg.
4. Administration
- Oral: Take with food or milk to reduce gastrointestinal irritation.
- Topical: Apply to clean, dry skin; avoid open wounds or mucous membranes.
- Injection: Administer under medical supervision.
5. Forms Available
- Oral: Capsules (50 mg, 100 mg), tablets (200 mg extended-release).
- Topical: Gel (2.5%, 5%).
- Injectable: Ampoules (50 mg/mL, 100 mg/mL).
6. Side Effects
6.1. Common Side Effects
- Nausea.
- Indigestion or heartburn.
- Dizziness.
- Headache.
6.2. Less Common Side Effects
- Diarrhoea or constipation.
- Rash or skin irritation (with topical use).
6.3. Rare but Serious Side Effects
- Gastrointestinal bleeding or ulcers.
- Kidney dysfunction.
- Cardiovascular events (e.g., heart attack, stroke).
- Severe allergic reactions (e.g., anaphylaxis).
7. Warnings
- Gastrointestinal Risks: Prolonged use may increase the risk of stomach ulcers, bleeding, or perforation.
- Cardiovascular Risks: Increased risk of thrombotic events such as heart attack or stroke with long-term use.
- Renal Impairment: Use cautiously in patients with kidney disease or dehydration.
8. Precautions
- Avoid in patients with:
- History of peptic ulcers or gastrointestinal bleeding.
- Severe heart failure or cardiovascular disease.
- Severe kidney or liver impairment.
- Use cautiously in asthma patients, as NSAIDs may exacerbate symptoms.
9. Interactions
- Drug-Drug Interactions:
- Anticoagulants (e.g., warfarin): Increased risk of bleeding.
- Diuretics and ACE inhibitors: Reduced effectiveness and increased risk of kidney damage.
- Corticosteroids: Increased risk of gastrointestinal side effects.
- Aspirin or other NSAIDs: Increased risk of side effects without additional benefit.
- Drug-Food Interactions:
- Take with food to reduce stomach irritation.
10. Monitoring Parameters
- Signs of gastrointestinal bleeding (e.g., black stools, vomiting blood).
- Kidney function (e.g., creatinine, eGFR) during prolonged use.
- Liver function tests (LFTs) if used long-term.
- Blood pressure in hypertensive patients.
11. Use in Children
- Not typically recommended in children under 12 years. Consult a paediatric specialist for appropriate dosing in older children.
12. Use in Pregnancy
- Category C (1st and 2nd Trimester): Use only if necessary.
- Category D (3rd Trimester): Contraindicated due to risks of premature closure of the ductus arteriosus and delayed labour.
13. Use in Elderly
- Use cautiously due to increased risk of gastrointestinal bleeding, kidney dysfunction, and cardiovascular events. Start with the lowest effective dose.
14. Use in Kidney Disease
- Use cautiously in mild to moderate renal impairment. Avoid in severe kidney disease.
15. Use in Liver Disease
- Use cautiously in liver impairment; monitor liver function during prolonged therapy.
16. Patient Counselling Points
- Take oral ketoprofen with food or milk to minimise stomach upset.
- Avoid prolonged use unless prescribed by a doctor to reduce the risk of side effects.
- For topical use, apply sparingly and avoid exposure to sunlight on treated areas to prevent photosensitivity.
- Report any signs of stomach bleeding (e.g., black stools, persistent stomach pain) or unusual symptoms to your doctor.
- Avoid alcohol while taking ketoprofen, as it increases the risk of gastrointestinal bleeding.
- Do not use alongside other NSAIDs without medical advice.
17. Table of Brand Names, Manufacturers, and Prices
Brand Name | Manufacturer | Price (USD) |
---|---|---|
Orudis (capsules) | Sanofi | $15–25 (30 capsules, 50 mg) |
Oruvail (extended-release) | Sanofi | $25–40 (30 tablets, 200 mg) |
Ketoprofen Gel | Various manufacturers | $5–10 (50 g, 2.5%) |
Generic Ketoprofen | Various manufacturers | $5–15 (30 capsules, 50 mg) |
18. FAQs (15 Questions)
- What is ketoprofen used for?
Ketoprofen is used to treat pain, inflammation, and fever associated with arthritis, injuries, and other conditions. - How does ketoprofen work?
It reduces inflammation and pain by inhibiting prostaglandin production. - How long does it take for ketoprofen to work?
Pain relief usually begins within 30 minutes to 1 hour after taking an oral dose. - Can ketoprofen cause side effects?
Yes, common side effects include nausea, indigestion, and dizziness. Serious effects like gastrointestinal bleeding and kidney problems are rare but possible. - Is ketoprofen safe during pregnancy?
It should be avoided during the third trimester and used cautiously during the first two trimesters under medical supervision. - Can ketoprofen be used for gout?
Yes, it may be used to relieve pain and inflammation during acute gout flares. - Can I take ketoprofen with paracetamol?
Yes, they can be taken together as they have different mechanisms of action. - What should I do if I miss a dose?
Take it as soon as you remember, unless it’s close to the next dose. Do not double up. - How should ketoprofen gel be applied?
Apply a thin layer to the affected area and rub gently. Avoid exposure to sunlight on the treated area. - Can ketoprofen cause photosensitivity?
Yes, especially with topical use. Avoid prolonged sun exposure on treated areas. - Can ketoprofen be taken with alcohol?
Avoid alcohol, as it increases the risk of gastrointestinal bleeding. - Is ketoprofen safe for elderly patients?
Yes, but start with lower doses and monitor for side effects like gastrointestinal bleeding. - Can I use ketoprofen for menstrual pain?
Yes, it is effective for managing dysmenorrhoea. - Does ketoprofen interact with other medications?
Yes, it interacts with anticoagulants, diuretics, and other NSAIDs. - How should ketoprofen be stored?
Store at room temperature, away from moisture and heat.