In this article you can read the instructions for use of the drug Ketonal. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Ketonal in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Ketonal in the presence of existing structural analogues. Use for the symptomatic treatment of inflammatory diseases and pain relief in adults, children, as well as during pregnancy and lactation.

Ketonal- non-steroidal anti-inflammatory drug, a derivative of propionic acid. It has analgesic, anti-inflammatory and antipyretic effects. By inhibiting COX-1 and COX-2 and, partially, lipoxygenase, ketoprofen suppresses the synthesis of prostaglandins and bradykinin and stabilizes lysosomal membranes.

Ketoprofen (the active ingredient of the drug Ketonal) does not have a negative effect on the condition of articular cartilage.

Pharmacokinetics

When taken orally, Ketonal is easily absorbed from the gastrointestinal tract. Food intake does not affect the bioavailability of ketoprofen. Ketoprofen penetrates well into synovial fluid. Ketoprofen is mainly metabolized in the liver. About 80% of ketoprofen is excreted in the urine, mainly in the form of a conjugate with glucuronic acid (90%). About 10% is excreted unchanged through the intestines.

Indications

Symptomatic treatment of painful and inflammatory processes of various origins, including:

• rheumatoid arthritis and periarthritis;
• ankylosing spondylitis (ankylosing spondylitis);
• psoriatic arthritis;
• reactive arthritis (Reiter's syndrome);
• osteoarthritis of various localizations;
• tendonitis, bursitis;
• myalgia;
• neuralgia;
• radiculitis;
• injuries of the musculoskeletal system (including sports), bruises of muscles and ligaments, sprains, ruptures of ligaments and muscle tendons.

Release forms

Tablets 100 mg and 150 mg.

Suppositories for rectal use 100 mg.

Cream or ointment for external use 5%.

Gel for external use 2.5%.

Ketonal Uno capsules 200 mg.

Capsules Ketonal Duo 150 mg.

Solution for intravenous and intramuscular administration (injections in injection ampoules) 50 mg/ml.

Instructions for use and dosage regimen

Tablets and capsules

For adults, the drug is prescribed 1-2 capsules 2-3 times a day, or 1 tablet 2 times a day, or 1 tablet of prolonged action 1 time a day. Capsules and tablets should be taken during or immediately after meals, without chewing, with a sufficient amount of water or milk (liquid volume - at least 100 ml).

Oral forms can be combined with the use of rectal suppositories or dosage forms of Ketonal for external use (cream, gel).

The maximum daily dose (including when using various dosage forms) is 200 mg.

Ampoules

The solution is administered intramuscularly or intravenously. 100 mg is administered intramuscularly 1-2 times a day. IV infusion of ketoprofen is carried out only in a hospital setting.

Short intravenous infusion: 100-200 mg, diluted in 100 ml of 0.9% sodium chloride solution, administered over 0.5-1 hour. Repeated administration is possible after 8 hours.

Continuous intravenous infusion: 100-200 mg, diluted in 500 ml of infusion solution (0.9% sodium chloride solution, lactated Ringer's solution, 5% dextrose solution), administered over 8 hours. Repeated administration is possible after 8 hours.

Ketonal Uno and Duo

The standard dose of Ketonal Uno for adults and children over 15 years of age is 200 mg per day. Capsules should be taken during or after meals with water or milk (the volume of liquid must be at least 100 ml). Ketonal Duo has a similar dosage regimen with a dosage of 150 mg in one capsule.

The maximum dose of ketoprofen is 200 mg per day.

Parenteral administration can be combined with the use of oral forms (capsules, tablets) or rectal suppositories. The maximum daily dose (including when using various dosage forms) is 200 mg.

Candles

Adults are prescribed 1 suppository 1-2 times a day rectally.

Rectal suppositories can be used in combination with dosage forms of ketoprofen for systemic or external use. The maximum daily dose of ketoprofen (including when using various dosage forms) is 200 mg.

Side effect

• dyspepsia (nausea, flatulence, diarrhea or constipation, vomiting, decreased or increased appetite);
• abdominal pain;
• stomatitis;
• dry mouth;
• ulceration of the gastrointestinal mucosa;
• liver dysfunction;
• exacerbation of Crohn's disease;
• bleeding from the gastrointestinal tract;
• headache;
• dizziness;
• drowsiness;
• fatigue;
• nervousness;
• nightmares;
• peripheral neuropathy;
• hallucinations;
• disorientation;
• noise in ears;
• change in taste;
• blurred visual perception;
• conjunctivitis;
• tachycardia;
• arterial hypertension;
• peripheral edema;
• decreased platelet aggregation;
• anemia, thrombocytopenia, agranulocytosis, purpura;
• hematuria (with long-term use of NSAIDs and diuretics);
• hives;
• rhinitis;
• bronchospasm;
• angioedema;
• anaphylactoid reactions;
• loose stools;
• hemoptysis;
• menometrorrhagia.

Contraindications

• peptic ulcer of the stomach and duodenum in the acute phase;
• UC, Crohn's disease;
• hemophilia and other bleeding disorders;
• severe liver failure;
• severe renal failure;
• uncompensated heart failure;
• postoperative period after coronary artery bypass surgery;
• gastrointestinal, cerebrovascular and other bleeding or suspected bleeding;
• chronic dyspepsia;
• 3rd trimester of pregnancy;
• lactation (breastfeeding);
• children under 15 years of age;
• inflammatory diseases of the rectum;
• hypersensitivity to ketoprofen, acetylsalicylic acid or other NSAIDs;
• indications in the anamnesis of bronchial asthma, urticaria and rhinitis caused by taking acetylsalicylic acid or other NSAIDs.

Use during pregnancy and breastfeeding

The use of Ketonal in the 3rd trimester of pregnancy is contraindicated. The use of Ketonal in the 1st and 2nd trimesters of pregnancy is possible only when the potential benefit to the mother outweighs the risk to the fetus.

If it is necessary to use Ketonal during lactation, the issue of stopping breastfeeding should be decided.

special instructions

Patients with inflammatory diseases of the rectum should not be prescribed Ketonal in the form of rectal suppositories.

With long-term use of Ketonal, like other NSAIDs, regular monitoring of hematological parameters, liver and kidney function parameters is required, especially in elderly patients.

Ketoprofen should be prescribed with caution to patients with arterial hypertension and heart disease accompanied by fluid retention in the body; blood pressure monitoring is recommended.

Ketonal can mask the symptoms of infectious diseases.

Impact on the ability to drive vehicles and operate machinery

There is no data on the negative effect of Ketonal in recommended doses on the ability to drive a car or operate machinery.

At the same time, patients who notice unusual effects when using Ketonal should be careful when engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Drug interactions

Ketoprofen reduces the effect of diuretics and antihypertensive drugs.

Enhances the effect of oral hypoglycemic drugs and some anticonvulsants (phenytoin).

When used simultaneously with other NSAIDs, salicylates, corticosteroids and ethanol (alcohol), the risk of gastrointestinal bleeding increases.

When used simultaneously with anticoagulants, thrombolytics, and antiplatelet agents, the risk of bleeding increases.

The risk of developing renal dysfunction increases when taken simultaneously with diuretics or ACE inhibitors.

When used simultaneously, it increases the concentration of cardiac glycosides, slow calcium channel blockers, lithium preparations, cyclosporine, methotrexate.

Ketonal can be combined with centrally acting analgesics.

Analogues of the drug Ketonal

Structural analogues of the active substance:

• Arketal Rompharm;
• Artrosilene;
• Artrum;
• Bystrumgel;
• Bystrumcaps;
• VALUSAL;
• Ketoprofen;
• Ketoprofen Vramed;
• Ketoprofen MB;
• Ketoprofen Organics;
• Ketoprofen-Verte;
• Ketoprofen-ESKOM;
• Ketospray;
• Oruvel;
• Profenid;
• Fastum;
• Fastum gel;
• Febrofeed;
• Flamax forte;
• Flamax;
• Flexen.

People have to deal with pain regularly in everyday life. Malaise can be caused by various reasons: inflammation, fatigue, colds, insomnia, neurological pathologies, and so on. To quickly get rid of painful sensations and bring your health back to normal, drug manufacturers are creating the latest drugs. One of these was “Ketanov”.

Can I take this medicine with alcohol or not? This question often arises among patients. Today's article will help you answer it. You will learn what consequences of this combination may arise in different cases.

Characteristics of the drug: release forms and composition

Before you find out whether you can drink Ketanov with alcohol or not, you need to get acquainted with this medicine. It contains a substance called ketorolac tromethamine. The drug is available in the form of tablets for internal use and ampoules. The amount of active ingredient is 10 and 30 milligrams, respectively.

The medicine belongs to anti-inflammatory non-steroidal drugs that have a pronounced analgesic effect. After use, the medication inhibits the synthesis of prostaglandins and inhibits cyclooxygenase. This provides analgesic, antipyretic and anti-inflammatory effects. The consumer feels the effect of the medication within the first half hour.

Alcohol and Ketanov: what does the instructions say about the combination?

What information is provided by the abstract? Is it possible to use the drug and drink alcoholic beverages at the same time? The instructions for use contain detailed indications and contraindications. You can also find here the algorithm for using the medication. But nothing is said about alcohol.

The manufacturer says that the medicine does not have a sedative effect and does not cause an opioid effect. Many consumers mistakenly believe that this fact allows them to take alcohol and Ketanov together. Let's consider whether such use is safe.

Pay attention to indications for use

If we consider the question of whether it is possible to combine alcohol and Ketanov, you need to pay attention to the indications for its use. The drug is prescribed in the following situations:

• febrile syndrome;
• toothache, headache;
• postoperative pain;
• periodic ailments in women;
• fractures, dislocations and soft tissue injuries;
• postpartum condition and pain due to cancer;
• sciatica and osteoarthritis.

In all of the above situations, drinking alcoholic beverages is unacceptable. After all, they can only worsen the patient’s condition.

The effect of the drug and ethanol on the digestive system

What happens if you take Ketanov and alcohol at the same time? The compatibility of these substances is zero due to the fact that both components are capable of destroying the mucous membrane of the stomach and intestines. It is known that the drug "Ketanov" is not prescribed for ulcers, intestinal bleeding, colitis and some other diseases of the digestive tract. This prohibition operates due to the fact that the medication is capable of releasing hydrogen ions. They penetrate the mucous and muscular lining of the digestive system, destroying its structure. This leads to the formation of ulcers and hematomas.

Alcohol in large doses works the same way. Ethanol has a detrimental effect on the gastric mucosa; alcohol disrupts the intestinal microflora and causes diarrhea. If you combine alcohol and Ketanov, the negative effect will not just increase, it will increase several times.

Consequences of the combination

Ketanov is not compatible with alcohol. After taking the drug, lethargy is noted. Despite the manufacturer's assurances that there is no opioid effect, many consumers report a sedative effect. If you take alcohol with everything, it will only get worse. Combining medication with alcohol increases the likelihood of side effects. The consequences may be as follows:

• gastritis, change in taste, bleeding in the intestines, stomatitis;
• nervousness, drowsiness;
• nephritis, acute renal failure, frequent urination;
• changes in blood pressure, heart failure;
• shortness of breath, swelling, allergies;
• water-electrolyte imbalance.

In particularly severe situations, combining the drug with ethanol causes fainting, clouding of consciousness, severe intoxication and coma. The liver cannot cope with both the drug and the incoming alcohol. Hepatitis occurs, irreversible changes in the hematopoietic organ.

Hangover and "Ketanov"

Often the next morning after a fun feast one becomes very sad, because a hangover sets in. It is manifested by general malaise, abdominal pain, diarrhea, nausea and headache. When drinking large amounts of strong alcohol, intoxication occurs, resulting in an increase in temperature. It is known that the medicine “Ketanov” can relieve pain and eliminate fever. So can it be used for treatment?

Doctors categorically prohibit such therapy. After use, the drug remains in the human body for 24 hours. The half-life ranges from 5 to 9 hours. This means that you can drink alcohol only one day after taking the medicine. The opposite rule also works with medication: Ketanov can be used after completely eliminating alcohol from the body (a day or two after the feast).

Is it possible to drink Ketanov with alcohol? Many users of the drug answer this question positively. They say they took medication and drank repeatedly. In fact, they were just lucky. Most likely, the dose of ethanol was insignificant. Doctors also say that the consequences of such combinations may occur after some time.

Doctors do not recommend drinking during treatment. In most cases, the drug is used for 2-4 days. The medication is not intended for the relief of chronic pain and long-term use. Therefore, it is quite possible to wait a few days and only then drink alcohol.

Summarize

If you are to be treated with Ketanov, then give up alcoholic beverages. Otherwise, delay treatment. After all, with the simultaneous consumption of alcohol and Ketanov, the effect of the latter is eliminated. Not only will you not get the effect of the treatment, but you will also end up with a lot of problems. Don't listen to seasoned consumers. Follow the doctor's recommendations and follow the rules stated in the instructions. Best wishes!

Ketonal refers to an analgesic (pain-relieving) drug that helps eliminate pain of a completely different nature, as well as intensity (moderate or severe).

Also, the drug has good anti-inflammatory and antipyretic effects, which can significantly reduce the inflammatory process in the body.

The main active medicinal substance of Ketonal is ketoprofen, which has excellent analgesic properties.

Ketonal is available in the form of tablets, solution, capsules, gel, suppositories, as well as ointments for local application to the affected area of ​​the body.

Compared to other known analgesics, Ketonal exhibits a more pronounced and effective analgesic effect.

Main indications for use of Ketonal:

• severe or moderate headache;
• toothache;
• various injuries (bruise, sprain);
• otitis media (ear inflammation);
• rheumatoid polyarthritis;
• periodic pain in women during menstruation;
• salt deposition in joints;
• intestinal colic;
• migraine;
• prolonged pain in muscles and joints;
• bursitis;
• analgesia (pain relief) for various oncological diseases;
• neuralgia;
• inflammatory diseases of the joints and back (radiculitis, osteochondrosis);
• hepatic or renal colic;
• gout;
• postoperative and postpartum period.

Attention: It is advisable to use Ketonal only for a temporary analgesic (pain-relieving) effect; however, it is not recommended to use it for long-term pain relief, since the drug has a fairly large number of different side effects.

How to drink Ketonal?

In case of severe pain, the total dose of the drug can be increased to 2-3 tons per day with a minimum interval between each dose of 4-5 hours. The analgesic effect after using Ketonal develops in approximately 30-35 minutes.

To achieve the most effective and fairly rapid analgesic effect, it is recommended to use Ketonal in the form of a solution for intramuscular administration.

The average daily dose of Ketonal is 1 ampoule 1-2 r. per day with a minimum interval between injections of 7-8 hours. The full analgesic (pain-relieving) effect after administration of Ketonal develops in approximately 15-20 minutes. and lasts, as a rule, from 4-6 to 8-10 hours. The maximum course of continuous treatment with this anesthetic should not exceed more than 7-10 days.

It is advisable to place Ketonal pain-relieving suppositories in the anal (rear) passage, 1 pc. 1-2 r. per day, best in the morning, and also in the evening just before bedtime.

Remember: Before taking Ketonal, it is recommended to consult with a general practitioner in order to prevent the possible development of unwanted complications.

Contraindications to the use of Ketonal

• age up to 15 years;
• stomach and duodenal ulcers;
• Crohn's disease;
• gastrointestinal bleeding;
• diabetes;
• diarrhea (diarrhea);
• acute or chronic cardiovascular diseases (heart failure);
• pregnancy and childbirth;
• high levels of bilirubin in the blood;
• stomatitis;
• renal or liver failure;
• hemophilia;
• allergy to aspirin;
• chronic kidney diseases (pyelonephritis, glomerulonephritis);

How compatible are the painkiller Ketanov and alcohol? What awaits a person after using both simultaneously? In order not to become a victim of a dangerous combination, you need to know the answers to these, as well as many other questions.

Pain, whatever it may be, dental, joint or muscle, is always a very unpleasant sensation. And what’s most interesting is that pain can overtake an unsuspecting person anywhere: at home, at work, at school, and even during a celebration. And when this happens, the first thought that comes to mind is to get rid of the unpleasant feeling as soon as possible. Of course, other than taking an analgesic, nothing comes to mind. Ketanov, better known as ketonal, is, of course, used as an analgesic. However, a person is not always sober at the time of taking the medicine. This is especially true for holidays and celebrations, when the table is literally filled with alcohol of all kinds and stripes. Someone will take it and take a painkiller without hesitation, but someone will think and ask the question: “Are ketanov and alcohol compatible?”

The question is actually very serious. It is impossible to say that you can drink ketans after drinking alcohol. The active ingredient of the drug is ketorolac, an active analgesic anti-inflammatory drug. Thanks to it, already 40 minutes after administration, the patient slowly ceases to feel pain, and after an hour and a half, the peak activity of the substance occurs. This indicates the powerful penetrating effect of the medicine. In this regard, there are a number of contraindications to the use of this drug.

Ketonal is prohibited for those who suffer from the following diseases:

• Kidney failure;
• Liver disease, in which the protective function is weakened;
• Chronic diseases of the gastrointestinal tract;
• Aspirin asthma;
• Stroke.

In addition, nursing and pregnant women, as well as persons under 16 years of age, are prohibited from taking ketans.

Neglecting contraindications entails serious consequences:

• Exacerbation of gastric ulcer;
• Preventing ulcer healing;
• Bleeding from the stomach.

What happens if you drink ketane and alcohol at the same time? Any doctor will tell you that nothing is good. This disappointing response is due to the unpredictability of the interaction between the drug and alcohol. It should be mentioned right away that ketonal is a very strong drug that belongs to drugs with the fourth class of danger. This painkiller, if it is in tablet form, like many other medications, is metabolized in the liver. And after drinking alcohol, as you know, the liver works at an accelerated pace. So it turns out that when taking the non-steroidal drug ketan and alcohol simultaneously, the load on this organ increases significantly.

Among other things, the consequences of using the medicine for acute gastric ulcers manifest themselves in the form of heavy bleeding. This happens because the active substance, ketorolac, prevents inflammation of the mucous membrane. But this process, although it is not painless, is necessary primarily for wound healing. What do we get as a result? The ulcer remains open, and blood leaks out of it.

In addition, ketonal, interacting with ethyl alcohol, is itself capable of changing the composition of the gastric mucosa. Time after time, the walls of the stomach become thinner, which leads first to gastritis and then to ulcers. In general, the vast majority of medications have poor compatibility with ethyl alcohol.

Some of them, interacting with alcohol, can even lead to death in a healthy person. In the end, no one has canceled the natural individual incompatibility of the drug with the body, which is observed in some.

The extremely poor compatibility of the analgesic ketan with alcohol is noticed not only when problems with the gastrointestinal tract occur. The list of side effects also includes a negative effect on the central nervous system.

So, after drinking one or two tablets of ketans and drinking alcohol today, the next day you can find the following ailments:

• Dizziness;
• Drowsiness;
• Headache;
• Slow reaction to events happening around.

The latter side effect is often observed in people who are “hooked” on drugs of synthetic origin. This is why ketonal is sometimes compared to opium.

Due to the fact that when alcohol and Ketanov are combined, the liver does not have time to neutralize all compounds that are toxic to the body, the analgesic effect of the medication weakens. But this increases the side effects. So, the more alcohol you drink, the more harm is done to the body, and the expected result, that is, pain relief, is not observed. In other words, the use of the medication becomes pointless. Some drunk people, unaware of this fact, and who have not found a decrease in pain after taking one pill, exceed the permissible dose in an attempt to drown out the growing pain. How does it all end?! Inpatient treatment of the consequences of unsuccessful self-medication.

For those whose profession requires attention, speed and reaction speed, taking Ketanov with alcohol is highly not recommended. In addition, it would be funny if the analgesic was initially taken to relieve a headache, but due to a side effect, the headache began to hurt even more.

In view of the numerous side effects, the question arises: “How and in what doses should I use ketans so that the pain goes away and my mood is not spoiled by another illness?” To begin with, it is necessary that there is no excess alcohol in the body, otherwise, instead of the expected effect, you may get unexpected dizziness or drowsiness. If you are completely convinced of your sobriety, and also that there are no grounds for contraindications, you can safely take Ketonal. According to the instructions, you are allowed to take up to two tablets at a time. The maximum daily dose is 9 tablets.

As for the medicine in the form of ampoules, everything is simple: one injection for one single use. The injection is given intramuscularly. As a rule, after 40 minutes the pain begins to subside, and after another hour and a half the pain goes away completely.

If you take the drug Ketonal according to all the rules, without violating the dose recommended by the manufacturer and without combining it with any alcoholic drinks, you can get rid of almost any pain for a long time:

• Dental;
• Head;
• Kidney pain;
• Ailments due to cancer;
• Damage to soft tissues, bones and joints;
• The period after childbirth, operations.

However, self-medication does not always lead to positive results. Consultation with a specialist will never be superfluous, especially when it comes to such a potent remedy as Ketanov. It is quite possible that taking this medicine will cause a powerful allergic reaction, but then there will be no time for jokes. Therefore, it is not only possible, but also necessary to consult a doctor before using ketan tablets or injections.

Ketonal (active ingredient - ketoprofen) is a non-steroidal anti-inflammatory drug (NSAID) from the Slovenian pharmaceutical company Lek, well known in Russia. The main, and perhaps the only area of ​​its application is the symptomatic treatment of inflammatory processes (including various diseases of the musculoskeletal system) and the relief of pain of a wide variety of etiologies (for example, headaches and postoperative pain, myalgia, neuralgia, radiculitis).

Inflammatory processes are constant companions of a great variety of diseases. In this regard, the appearance of NSAIDs on the pharmacological “front stage” has become a real salvation. However, these drugs, unfortunately, are not free from a number of negative side effects due to the mechanism of action of NSAIDs, which is known to be associated with suppression of the activity of the enzyme cyclooxygenase (COX). This enzyme exists in two isoforms: COX-1 and COX-2. The effect of NSAIDs on COX-1 causes damage to the gastrointestinal mucosa of an erosive and ulcerative nature, as well as a number of other undesirable effects, including increased blood pressure and the development of peripheral edema. It was found that NSAIDs with a pronounced anti-inflammatory and analgesic effect cause a greater number of side effects. This is also true for NSAIDs with a long half-life. Ketonal has a short half-life of about 2 hours. At the same time, the drug is endowed with a pronounced analgesic effect, sufficient for its use in surgical, gynecological and oncological practice.

As comparative clinical trials have shown, the analgesic effect of ketonal is stronger than that of such “colosses” of the NSAID group as diclofenac, indomethacin and ibuprofen. In addition, ketonal “works” in more than 90% of patients, which should be recognized as a rather impressive figure, especially compared to other NSAIDs, for which the percentage of patients responding to the drug is about 70-80%.

Ketonal is available in several dosage forms: tablets, capsules, cream, gel, injection solution and suppositories. Such a wide range of release forms gives doctors a large space for therapeutic “maneuver”, allowing them to select the method of administration in accordance with the nature of the disease, its severity and the individual characteristics of the patient. As already mentioned, ketonal, like other NSAIDs, can cause gastrointestinal disorders. To prevent them, you can take tablets or capsules with milk, not water, or accompany the intake of ketonal with drugs that reduce stomach acidity - antacids (neither milk nor antacids affect the degree of absorption of the drug in the gastrointestinal tract). Long-term use of ketonal requires the patient and his doctor to carefully monitor liver and kidney functions, as well as regularly monitor blood counts. Another important point to keep in mind when prescribing ketonal: it, like other NSAIDs, can mask the symptoms of infectious diseases, so the use of drugs in this group should be done after consultation with a doctor.

Pharmacology

NSAID, propionic acid derivative. It has analgesic, anti-inflammatory and antipyretic effects. By inhibiting COX-1 and COX-2 and, partially, lipoxygenase, ketoprofen suppresses the synthesis of prostaglandins and bradykinin and stabilizes lysosomal membranes.

Ketoprofen does not have a negative effect on the condition of articular cartilage.

Pharmacokinetics

Distribution

Vd is 0.1-0.2 l/kg. Plasma protein binding is 99%. Ketoprofen penetrates well into synovial fluid.

Metabolism

It is intensively metabolized in the liver through microsomal enzymes and conjugates with glucuronic acid.

Removal

T1/2 ketoprofen - 1.6-1.9 hours. Ketoprofen is mainly metabolized in the liver. About 80% of ketoprofen is excreted in the urine, mainly in the form of a conjugate with glucuronic acid (90%). About 10% is excreted unchanged through the intestines.

Pharmacokinetics in special clinical situations

In patients with renal failure, ketoprofen is eliminated more slowly, T1/2 increases by 1 hour.

In elderly patients, the metabolism and elimination of ketoprofen occurs more slowly, but this is of clinical significance only for patients with reduced renal function.

Release form

Rectal suppositories are white, smooth, homogeneous.

	1 sup.
ketoprofen	100 mg

Excipients: solid fat - 1850 mg, glyceryl caprylocaprate (miglyol 812) - 200 mg.

6 pcs. - strips (2) - cardboard packs.

Dosage

Adults are prescribed 1 suppository 1-2 times/day rectally.

Rectal suppositories can be used in combination with dosage forms of ketoprofen for systemic or external use. The maximum daily dose of ketoprofen (including when using various dosage forms) is 200 mg.

Overdose

Cases of overdose were obtained during the use of ketoprofen in doses of up to 2.5 g. In most cases, the symptoms were mild, limited to drowsiness, nausea, vomiting and epigastric pain.

Treatment: There are no specific antidotes for ketoprofen. In cases of suspected overdose when taking large doses, gastric lavage is recommended along with symptomatic and supportive therapy to compensate for dehydration, monitor diuresis and correct acidosis if it develops. In patients with renal failure, hemodialysis is advisable to remove the drug from the systemic circulation.

Interaction

Ketoprofen may weaken the effect of diuretics and antihypertensive drugs and enhance the effect of oral hypoglycemic and some anticonvulsants (phenytoin).

Combined use with other NSAIDs, salicylates (including acetylsalicylic acid), corticosteroids, ethanol increases the risk of developing gastrointestinal complications.

Simultaneous administration with anticoagulants (heparin, warfarin), thrombolytics, antiplatelet agents (ticlopidine, clopidogrel) increases the risk of bleeding.

When taking NSAIDs concomitantly with diuretics or ACE inhibitors, the risk of renal dysfunction increases.

The drug increases the plasma concentration of cardiac glycosides, slow calcium channel blockers, lithium preparations, cyclosporine, methotrexate.

NSAIDs may reduce the effectiveness of mifepristone. Taking NSAIDs should be started no earlier than 8-12 days after stopping mifepristone.

When combined with pentoxifylline, there is an increased risk of bleeding. More frequent monitoring of clinical status and bleeding time is mandatory.

When combined with probenecid, the rate of plasma clearance of ketoprofen may be reduced.

Side effects

Classification of adverse reactions according to the frequency of their detection: very often (≥1/10), often (≥1/100,<1/10), нечасто (≥1/1000, <1/100), редко (≥10 000, <1/1000), очень редко (<1/10 000), включая единичные сообщения. Неизвестной частоты: данных для оценки частоты развития недостаточно.

From the blood and lymphatic system: rarely - hemorrhagic anemia, purpura; unknown frequency - agranulocytosis, thrombocytopenia, pancytopenia.

From the immune system: unknown frequency - anaphylactic reactions (including anaphylactic shock).

Mental disorders: unknown frequency - dysphoria.

From the nervous system: infrequently - headache, dizziness, drowsiness, decreased or increased appetite; rarely - paresthesia; unknown frequency - convulsions, dysgeusia.

From the senses: rarely - blurred vision, conjunctivitis, ringing in the ears.

From the cardiovascular system: unknown frequency - heart failure, tachycardia, arterial hypertension, vasodilation.

From the respiratory system: rarely - asthma; unknown frequency - bronchospasm (especially in patients with established hypersensitivity to acetylsalicylic acid and other NSAIDs), rhinitis.

From the gastrointestinal tract: often - dyspepsia, nausea, abdominal pain, vomiting, dry mouth; infrequently - constipation, diarrhea, flatulence, gastritis; rarely - stomatitis, peptic ulcers; unknown frequency - exacerbation of colitis and Crohn's disease, gastrointestinal bleeding and gastrointestinal perforation.

From the liver and biliary tract: rarely - hepatitis, increased levels of transaminases, increased serum bilirubin levels due to hepatitis.

From the skin and subcutaneous tissue: infrequently - rash, itching; unknown frequency - photosensitivity reactions, alopecia, urticaria, angioedema, bullous rash, including Stevens-Johnson syndrome and toxic epidermal necrolysis.

From the urinary system: unknown frequency - acute renal failure, tubulointerstitial nephritis, nephrotic syndrome, abnormal renal function tests.

General reactions: infrequently - swelling, fatigue; rarely - weight gain.

The use of suppositories can cause local reactions: burning sensation, loose stools, irritation of the mucous membrane.

Indications

Symptomatic treatment of painful and inflammatory processes of various origins, including:

inflammatory and degenerative diseases of the musculoskeletal system:

• rheumatoid arthritis;
• seronegative arthritis (ankylosing spondylitis / Bechterew's disease /, psoriatic arthritis, reactive arthritis / Reiter's syndrome/);
• gout, pseudogout;
• osteoarthritis.

pain syndrome:

• headache;
• extra-articular rheumatism (tendinitis, bursitis, inflammatory damage to periarticular tissues);
• myalgia, neuralgia, radiculitis;
• post-traumatic and postoperative pain syndrome;
• algodismenorrhea;
• pain syndrome in cancer.

Contraindications

• bronchial asthma, bronchospasm, rhinitis, urticaria in history caused by taking salicylates (for example, acetylsalicylic acid) or other NSAIDs;
• peptic ulcer of the stomach and duodenum in the acute phase;
• UC, Crohn's disease;
• hemophilia and other bleeding disorders;
• severe liver failure;
• severe renal failure;
• progressive kidney disease;
• uncompensated heart failure;
• postoperative period after coronary artery bypass surgery;
• gastrointestinal, cerebrovascular and other bleeding (or suspected bleeding);
• chronic dyspepsia;
• inflammatory diseases of the rectum and/or rectal bleeding;
• children under 15 years of age;
• III trimester of pregnancy;
• lactation period (breastfeeding);
• hypersensitivity to ketoprofen or other components of the drug, as well as salicylates, tiaprofenic acid or other NSAIDs.

The drug should be prescribed with caution if there is a history of peptic ulcer disease, a history of bronchial asthma, clinically significant cardiovascular, cerebrovascular diseases and peripheral arterial diseases, dyslipidemia, progressive liver diseases, hyperbilirubinemia, alcoholism, renal failure, chronic heart failure, arterial hypertension, diseases blood, dehydration, diabetes mellitus, anamnestic data on the development of gastrointestinal ulcers, smoking, concomitant therapy with anticoagulants (for example, warfarin), antiplatelet agents (for example, acetylsalicylic acid), oral corticosteroids (for example, prednisolone), selective serotonin reuptake inhibitors (for example, citalopram, sertraline), long-term use of NSAIDs.

Features of application

Use during pregnancy and breastfeeding

The use of ketoprofen in the third trimester of pregnancy is contraindicated. In the first and second trimesters of pregnancy, the drug can be prescribed only if the expected benefit to the mother outweighs the potential risk to the fetus.

There are no data on the excretion of ketoprofen in human milk. If it is necessary to take the drug for a long time during lactation, the issue of stopping breastfeeding should be decided.

Use for liver dysfunction

Contraindicated in cases of severe liver failure.

Use for renal impairment

Contraindicated in cases of severe renal impairment.

Use in children

Contraindication: children under 15 years of age.

special instructions

At the beginning of NSAID therapy, it is necessary to monitor the state of the blood and liver; monitoring of renal function is mandatory for patients with heart failure, cirrhosis and nephrosis, patients undergoing diuretic therapy, patients with chronic kidney disease, especially the elderly. Taking ketoprofen in such patients can lead to a decrease in renal blood flow, which is associated with an inhibitory effect on prostaglandins, and to decompensation of renal function.

It is necessary to be careful and monitor blood pressure more often when using ketoprofen to treat patients with arterial hypertension and cardiovascular diseases that lead to fluid retention in the body.

Like other NSAIDs, ketoprofen can mask signs of infectious diseases.

Patients with bronchial asthma associated with chronic rhinitis, chronic sinusitis and/or nasal polyposis are more prone to allergic reactions to acetylsalicylic acid and/or NSAIDs, so the risk of an attack increases in this group of patients.

Women planning pregnancy should refrain from taking the drug, because the likelihood of egg implantation may decrease.

Treatment with Ketonal should be discontinued at the first appearance of skin rash, lesions of the mucous membranes or other signs of hypersensitivity.

If visual disturbances, including blurred vision, occur, treatment should be discontinued.

There is no need for special precautions when disposing of used drug.

Impact on the ability to drive vehicles and operate machinery

There is no evidence that the use of the drug Ketonal ® in recommended doses affects the ability to drive a car or move machinery. However, drowsiness and dizziness have been reported, therefore, when these signs appear, patients are not recommended to drive or engage in other activities that require concentration and speed of psychomotor reactions.