Ketoprofen

Indications & Dose:

Pain and mild inflammation in rheumatic disease

• BY MOUTH

Adult: 100–200mg once daily,dose to be taken with food

EC 100: One tablet twice daily. In more severe cases one tablet thrice daily can be given.

Patch: one patch twice daily on the affected area. daily.

Pain and dysmenorrhoea

50 mg up to 3 times daily

Children

Not recommended.

Contraindications:

Bronchospasm, nasal polyps, angioedema precipitated by aspirin or other NSAIDs 

Side Effects:

Cautions:

Precautions:

History of GI ulceration, bleeding, or perforation; renal dysfunction, hypertension or cardiac conditions aggravated by fluid retention and edema, history of liver dysfunction, history of coagulation 

Interaction:

Drugs
Aminoglycosides: Reduced clearance with elevated aminoglycoside levels and potential for toxicity (especially indomethacin in premature infants; other NSAIDs probably)

Anticoagulants: Excessive hypoprothrombinemia, decreased platelet aggregation with increased risk of GI bleeding

Antihypertensives (a-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, ß-blockers, diuretics): Inhibition of antihypertensive and other favorable hemodynamic effects

Corticosteroids: Increased risk of GI ulceration

Cyclosporine: Increased nephrotoxicity risk

Lithium: Decreased clearance of lithium (mediated via prostaglandins) resulting in elevated serum lithium levels and risk of toxicity

Methotrexate: Decreased renal secretion of methotrexate resulting in elevated methotrexate levels and risk of toxicity

Phenylpropanolamine: Possible acute hypertensive reaction

Potassium-sparing diuretics: Additive hyperkalemia potential

Triamterene: Acute renal failure reported with addition of indomethacin; caution with other NSAIDs 

Warnings:

Adverse Effects:

Lactations:

if used in 3rd trimester); could cause constriction of the ductus arteriosus in utero; persistent pulmonary hypertension of the newborn or prolonged labor; unknown if excreted into human breast milk

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Dizziness, headache, lightheadedness 
CV: Chest pain, CHF, dysrhythmias, edema, hypertension, hypotension, palpitation, tachycardia
EENT: Dry eyes, hearing disturbances, photophobia, tinnitus, visual disturbances
GI: Abdominal cramps, constipation, diarrhea, dyspepsia, flatulence, gastric or duodenal ulcer with bleeding or perforation, hepatitis, nausea, occult blood in stool, pancreatitis, vomiting
GU: Acute renal failure
HEME: Agranulocytosis, eosinophilia, leukopenia, neutropenia, pancytopenia, thrombocytopenia
METAB: Hyperglycemia, hyperkalemia, hypoglycemia, hyponatremia
RESP: Bronchospasm, dyspnea
SKIN: Photosensitivity, rash, urticaria 

Patient And Carer Advice: