Ketoprofen

Indications
Oral
Rheumatic disorders
Adult: 100-200 mg/day in 2-4 divided doses. As modified-release formulation: Administer dose once daily. Max: 300 mg daily in divided doses.
Elderly: >75 yr: Reduce initial dose.
Renal impairment: Max dose: Mild impairment: 150 mg daily; severe impairment: 100 mg daily.
Hepatic impairment: Max dose: 100 mg daily if serum albumin <3.5 g/dL.
Oral
Pain and inflammation
Adult: 25-50 mg every 6-8 hr. Max: 300 mg daily in divided doses.
Elderly: >75 yr: Reduce initial dose.
Renal impairment: Max dose: Mild impairment: 150 mg daily; severe impairment: 100 mg daily.
Hepatic impairment: Max dose: 100 mg daily if serum albumin <3.5 g/dL.
Intramuscular
Pain and inflammation associated with musculoskeletal and joint disorders
Adult: 50-100 mg by deep inj into the gluteal muscle every 4 hr. Max: 200 mg in 24 hr for up to 3 days.
Intramuscular
Pain following orthopaedic surgery
Adult: 50-100 mg by deep inj into the gluteal muscle every 4 hr. Max: 200 mg in 24 hr for up to 3 days.
Topical/Cutaneous
Local pain relief
Adult: Apply 2.5% gel onto affected areas 2-4 times daily for up to 10 days.
Rectal
Rheumatic disorders
Adult: 100 mg at night or bid. Recommended total (including oral and rectal forms): Not to exceed 200 mg daily.

Special Populations: Max dose in patients with mild to moderate hepatic impairment, mild renal impairment or elderly is 50 mg.
Contraindications
Acute or history of peptic ulcer or dyspepsia. Hypersensitivity to aspirin or other NSAIDs or those suffering from bronchial asthma, angioedema, urticaria or rhinitis. Severe renal insufficiency.
Warnings / Precautions
Pregnancy, lactation. Renal or hepatic impairment. Elderly. Heart failure.
Adverse Reactions
Acute interstitial nephritis, reversible decline in renal function; GI symptoms e.g. discomfort, nausea, diarrhoea; pain and tissue damage at inj site (IM).
Potentially Fatal: Rarely, idiosyncrasy, anaphylaxis; very rarely GI haemorrhage.
Overdose Reactions
Symptoms: Lethargy, drowsiness, nausea, vomiting, epigastric pain. Respiratory depression, coma, convulsions (large overdoses). Rarely GI bleeding, hypotension, hypertension or acute renal failure. Management: Symptomatic and supportive.
Drug Interactions
Risk of nephrotoxicity increased with ACE inhibitors, ciclosporin, tacrolimus or diuretics. Increased risk of hyperkalaemia with ACE inhibitors and potassium-sparing diuretics. Reduces effects of antihypertensives (e.g. ACE inhibitors, β-blockers). Increased risk of convulsions with quinolones. Increased risk of adverse effects with aspirin. Increased risk of GI bleeding and ulceration with corticosteroids, SSRIs, clopidogrel and ticlopidine. Increased risk of haematotoxicity with zidovudine. May alter the efficacy of mifepristone. Increased plasma levels with probenecid.
Potentially Fatal: Enhances effects of oral anticoagulants, phenytoin and sulfonylureas. Increases plasma concentrations of lithium, methotrexate and cardiac glycosides.
See Below for More ketoprofen Drug Interactions
Mechanism of Actions
Ketoprofen exhibits anti-inflammatory, analgesic and antipyretic activities. It potently inhibits the enzyme cyclooxygenase resulting in prostaglandin synthesis inhibition. It also prevents formation of thromboxane A2 by platelet aggregation.
Absorption: Readily absorbed from the GI tract (oral); reduced absorption with food. Peak plasma concentrations after 0.5-2 hr. Well absorbed (IM, rectal); minimal (topical).
Distribution: Synovial fluid (substantial concentrations). Protein-binding: 99%.
Metabolism: Hepatic via conjugation with glucuronic acid.
Excretion: Urine (as glucuronide conjugates); 1.5-4 hr (elimination half-life).
Administration
Should be taken with food. (Preferably taken w/ or after meals.)
Storage Conditions
Intramuscular: Store below 30°C. Oral: Store at room temperature 15-30°C (59-86°F). Rectal: Store below 25°C. Topical/Cutaneous: Store below 25°C.
ATC Classification
M01AE03 - ketoprofen ; Belongs to the class of propionic acid derivatives of non-steroidal antiinflammatory and antirheumatic products.
M02AA10 - ketoprofen ; Belongs to the class of non-steroidal antiinflammatory preparations for topical use. Used in the treatment of joint and muscular pains.
Storage
Intramuscular: Store below 30°C. Oral: Store at room temperature 15-30°C (59-86°F). Rectal: Store below 25°C. Topical/Cutaneous: Store below 25°C.
Available As
  • Ketoprofen 100 mg
  • Ketoprofen 2.5%
  • Ketoprofen 2.5% w/w
  • Ketoprofen 200 mg
  • Ketoprofen 30 mg
  • Ketoprofen 5 mg
  • Ketoprofen 50 mg
  • Ketoprofen 8 mg
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