KETOPROFEN

KETOPROFEN
(kee-toe-proe'fen)
Oruvail
Classifications: analgesic, nonsteroidal antiinflammatory drug (nsaid); antipyretic;
Therapeutic: nsaid, analgesic

Prototype: Ibuprofen
Pregnancy Category: B

Availability

25 mg, 50 mg, 75 mg capsules; 100 mg, 150 mg, 200 mg sustained release capsules

Action

Nonsteroidal antiinflammatory drug (NSAID) that inhibits both COX-1 and COX-2 enzymes; thus it also inhibits prostaglandin synthesis, and therefore interferes with the inflammatory process. It inhibits platelet aggregation and prolongs bleeding time.

Therapeutic Effect

Has analgesic, antiinflammatory, and antiplatelet properties.

Uses

Acute or long-term treatment of rheumatoid arthritis and osteoarthritis; primary dysmenorrhea; headache; symptomatic relief of postoperative, dental, and postpartum pain; visceral pain associated with cancer.

Unlabeled Uses

Reiter's syndrome, juvenile arthritis, acute gouty arthritis, biliary pain, renal colic.

Contraindications

Patient in whom aspirin or another NSAID induces asthma, urticaria, bronchospasm, severe rhinitis, shock; renal nephritis, nephritic syndrome. Safety in children <16 y is not established.

Cautious Use

History of GI disease, GI bleeding, active ulcer; renal or hepatic impairment, patient who may be adversely affected by prolongation of bleeding time; heart failure, fluid retention; hypertension; patient receiving diuretics; geriatric patient; myasthenia gravis; pregnancy (category B).

Route & Dosage

Inflammatory Disease
Adult: PO 75 mg t.i.d. or 50 mg q.i.d. (max: 300 mg/d) or 200 mg sustained release q.d.
Geriatric: PO Start with 25 mg q.i.d., may also start with 50 mg t.i.d.

Mild to Moderate Pain, Dysmenorrhea
Adult: PO 12.5–50 mg q6–8h

Administration

Oral
  • Do not crush.
  • Give with food, milk, or prescribed antacid to reduce GI irritation.
  • Store drug at 15°–30° C (59°–86° F) in tightly closed, light-resistant container unless otherwise directed.

Adverse Effects (≥1%)

CNS: Trouble in sleeping, nervousness, headache, dizziness; depression, drowsiness, confusion, migraine, vertigo. CV: Peripheral edema, palpitations, hypertension, tachycardia. Special Senses: Visual disturbances, conjunctivitis, eye pain, retinal hemorrhage, pigmentation changes; Dry nose or throat, tinnitus, hearing impairment. GI: Dyspepsia, drug-induced peptic ulcer, GI bleeding, nausea, vomiting, diarrhea, constipation, flatulence, stomach pain, anorexia, dry mouth, gingivitis, rectal burning and hemorrhage, melena, jaundice, elevated ALT, AST. Hematologic: Prolonged bleeding time, anemia, purpura, agranulocytosis, thrombocytosis. Urogenital: Gynecomastia, changes in libido, urinary tract irritation (dysuria, frequency/urgency), renal impairment. Respiratory: Laryngospasm, bronchospasm, laryngeal edema, pharyngitis. Skin: Rash, pruritus, urticaria, erythema, photosensitivity. Endocrine: Aggravation of diabetes mellitus.

Interactions

Drug: oral anticoagulants, heparin may prolong bleeding time; may increase lithium toxicity; may increase methotrexate toxicity. Herbal: Feverfew, garlic, ginger, ginkgo increases bleeding potential.

Pharmacokinetics

Absorption: Readily from GI tract. Onset: 1–2 h. Peak: 1–2 h. Duration: 4–6 h. Metabolism: In liver. Elimination: Primarily in urine, some biliary excretion. Half-Life: 1.1–4 h.

Nursing Implications

Assessment & Drug Effects

  • Lab tests: Monitor baseline and periodic evaluations of hemoglobin, renal and hepatic function.
  • Monitor for and report tinnitus, hearing impairment, and visual disturbance, especially during prolonged or high-dose therapy.
  • Monitor for S&S of GI ulceration (e.g., stool for occult blood, persistent indigestion).

Patient & Family Education

  • Report promptly signs of jaundice (see Appendix F) as well as the following: blurred vision, tinnitus, urinary urgency or frequency, unexplained bleeding, weight gain with edema.
  • Note: Possible CNS adverse effects (e.g., light-headedness, dizziness, drowsiness).
  • Do not drive or engage in potentially hazardous activities until response to drug is known.
  • Note: Alcohol, aspirin, or other NSAIDs may increase risk of GI ulceration and bleeding tendencies and therefore should be avoided.
  • Tell dentist or surgeon that you are taking ketoprofen.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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