FENOPROFEN CALCIUM
| FENOPROFEN CALCIUM (fen-oh-proe'fen) Nalfon Classifications: analgesic, nonsteroidal antiinflammatory drug (nsaid); antipyretic; Therapeutic: nsaid, analgesic; antipyretic Prototype: Ibuprofen Pregnancy Category: B first and second trimester; D third trimester |
Availability
200 mg, 300 mg capsules; 600 mg tablets
Action
Exhibits antiinflammatory, analgesic, and antipyretic properties of an NSAID. Fenoprofen competitively inhibits both cyclooxygenase COX-1 and COX-2 enzymes by blocking arachidonate binding to prostaglandin G2 resulting in its pharmacologic effects.
Therapeutic Effect
Has nonsteroidal, antiinflammatory, antipyretic, antiarthritic properties that provide relief from mild to severe pain.
Uses
Antiinflammatory and analgesic effects in the symptomatic treatment of acute and chronic rheumatoid arthritis and osteoarthritis; relief of mild to moderate pain.
Unlabeled Uses
Juvenile rheumatoid arthritis, acute gouty arthritis, ankylosing spondylitis; fever associated with pulmonary tuberculosis, type A influenza, colds; neoplasms.
Contraindications
Hypersensitivity to fenoprofen or other NSAIDS; history of nephrotic syndrome associated with aspirin or other NSAIDs; patient in whom urticaria, severe rhinitis, bronchospasm, angioedema, nasal polyps are precipitated by aspirin or other NSAIDs; severe renal or hepatic dysfunction; perioperative pain associated in CABG; pregnancy (category B first and second trimester, and category D in third trimester). Safety in lactation or children is not established.
Cautious Use
History of upper GI tract disorders; lupus; older adults; renal failure; renal impairment; hemophilia or other bleeding tendencies; compromised cardiac function, hypertension; impaired hearing; lactation.
Route & Dosage
| Inflammatory Disease Adult: PO 300–600 mg t.i.d. or q.i.d. (max: 3200 mg/d) Child: PO 900 mg/m2 in divided doses, may increase over 4 wk to 1.8 g/m2 Mild to Moderate Pain Adult: PO 200 mg q4–6h prn |
Administration
Oral- Give on an empty stomach 30–60 min before or 2 h after meals. Give with meals, milk, or antacid (prescribed) if patient experiences GI disturbances.
- May crush tablets or empty capsule and mix with fluid or mix with food.
- Store capsules and tablets in tightly closed containers at 15?–30? C (59?–86? F); avoid freezing.
Adverse Effects (≥1%)
CNS: Headache, drowsiness, dizziness, fatigue, lassitude, tremor, confusion, insomnia, nervousness, depression. Special Senses: Tinnitus, decreased hearing, deafness; blurred vision. GI: Indigestion, nausea, vomiting, anorexia, constipation, diarrhea, flatulence, abdominal pain, dry mouth; infrequent: gastritis, peptic ulcer, GI bleeding. Urogenital: Dysuria, cystitis, hematuria, oliguria, azotemia, anuria, allergic nephritis, papillary necrosis, nephrotoxicity (rare). Hematologic: (infrequent) Thrombocytopenia, hemolytic anemia, agranulocytosis, pancytopenia. Skin: (may or may not be hypersensitivity reaction) Pruritus, rash, purpura, increased sweating, urticaria. Body as a Whole: Dyspnea, malaise, anaphylaxis, edema.Interactions
Drug: Fenoprofen may prolong bleeding time; should not be given with oral anticoagulants, heparin; action and side effects of phenytoin, sulfonylureas, sulfonamides, and fenoprofen may be potentiated. Herbal: Feverfew, garlic, ginger, gingko may increase bleeding potential.Pharmacokinetics
Absorption: 80% from GI tract. Onset: 2 h. Peak: 2 h. Duration: 4–6 h. Distribution: Small amounts distributed into breast milk. Metabolism: In liver. Elimination: Primarily in urine; some biliary excretion. Half-Life: 3 h.Nursing Implications
Assessment & Drug Effects
- Lab tests: Baseline evaluations of Hct and Hgb, kidney and liver function.
- Baseline and periodic auditory and ophthalmic examinations are recommended in patients receiving prolonged or high-dose therapy.
- Monitor for S&S of GI bleeding.
- Note: Dosage adjustment of fenoprofen may be required when phenobarbital is added to or withdrawn from patient's drug regimen.
Patient & Family Education
- Do not drive or engage in potentially hazardous activities until response to drug is known; fenoprofen may cause dizziness and drowsiness.
- Report immediately the onset of unexplained fever, rash, arthralgia, oliguria, edema, weight gain to physician. Possible symptoms of nephrotic syndrome are rapidly reversible if drug is promptly withdrawn.
- Understand that alcohol and aspirin may increase risk of GI ulceration and bleeding tendencies; avoid both unless otherwise advised by physician.
- Inform dentist or surgeon that you are taking fenoprofen because it may prolong bleeding time.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug