Stabilizes in vitro and in vivo liposomal membranes at high concentrations in vitro ketoprofen inhibits masteron the synthesis of bradykinin and leukotrienes.
ketoprofen does not adversely affect the condition of the articular cartilage. With a single intramuscular injection of 100 mg of ketoprofen drug detected in plasma 15 minutes after the start of infusion, and peak concentration (1.3 mg / ml) is reached after 2 hours. The bioavailability of the drug increased linearly with increasing dose.Stationary plasma concentration of ketoprofen determined even 24 hours after administration.
Symptomatic treatment of pain, including in inflammatory processes of various origins:
• rheumatoid arthritis;
• seronegative arthritis: ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, reactive arthritis (Reiter’s syndrome);
• gout, pseudogout;
• degenerative diseases of the musculoskeletal system, including osteoarthritis;
• weak, moderate and severe pain with headaches, migraines, tendinitis, bursitis, myalgia, neuralgia, sciatica;
• post-traumatic and postoperative pain, incl accompanied by inflammation and fever;..
• pain in cancer syndrome ;
. • algomenorrhea
drug is intended for symptomatic therapy reduce pain and inflammation at the time of use, does not affect the progression of the disease.
• hypersensitivity to ketoprofen or other components of the drug, as well as salicylates or other nonsteroidal anti-inflammatory drugs (NSAIDs);
• complete or incomplete combination of bronchial asthma, recurrent nasal polyposis, and paranasal sinuses and intolerance of aspirin or other NSAIDs (including a history.. );
• gastric ulcer or duodenal ulcer in the acute stage;
• ulcerative colitis, Crohn’s disease;
• hemophilia and other bleeding disorders;
• children’s age (15 years);
• severe hepatic insufficiency;
• severe renal impairment: severe renal insufficiency (creatinine clearance (CC) of less than 30 ml / min), confirmed hyperkalemia, progressive kidney disease;
• decompensated heart failure;
• the postoperative period after coronary artery bypass surgery;
• gastrointestinal, cerebrovascular and other bleeding (or suspected bleeding);
• chronic dyspepsia;
• III of trimester of pregnancy;
• peptic masteron ulcer history, the presence of infection Helicobacter pylori;
• bronchial asthma in history;
• symptomatic cardiovascular disease, cerebrovascular disease and peripheral arterial disease;
• dyslipidemia, hepatic failure, hyperbilirubinemia, alcoholic cirrhosis of the liver;
• chronic renal insufficiency (creatinine clearance 30 -60 ml / min);
• chronic heart failure, hypertension, blood diseases;
• dehydration, diabetes mellitus;
• advanced age;
• long-term use of NSAIDs, concomitant use of anticoagulants (including warfarin), antiplatelet agents ( including clopidogrel), oral corticosteroids (including prednisone), selective serotonin reuptake inhibitors (including fluoxetine, paroxetine, citalopram, sertraline) (see. “Interaction with other medicinal products” section) .
Application of pregnancy and during breastfeeding
Inhibition of prostaglandin synthesis may have an adverse effect on pregnancy and / or embryonic development. Data from epidemiological studies in the application of inhibitors of prostaglandin synthesis in the early stages of pregnancy, confirm an increased risk of spontaneous abortion and the formation of heart disease (1.5%) and birth defects of the anterior abdominal wall. The risk increases with the dose and duration of treatment.
Prescribe drugs to pregnant women in I and II trimesters of pregnancy is possible only when the benefits to the mother justifies the potential risk to the fetus. In this case it is necessary to use the minimum effective dose of the shortest possible path.
Do not use this ketoprofen in pregnant women during the III trimester of pregnancy due to the possible development of uterine inertia uterine activity, increased bleeding time, an antiplatelet effect (even when taken in small doses), as well as effects on the fetus (cardiopulmonary toxicity, including premature closure of the ductus arteriosus and pulmonary hypertension, renal dysfunction, which may progress to the development of renal failure oligohydramnios).
to date there are no data on the allocation of ketoprofen in breast milk, so the ketoprofen need to appoint a nursing mother, you should decide the issue of termination of breastfeeding.
Dosing and Administration
Advisable to use the minimum effective dose to reduce the incidence of adverse reactions. The maximum daily dose is 200 mg.
It is necessary to carefully evaluate the ratio of the expected benefits and risks before you start taking ketoprofen 200 mg / day. Intramuscular: . 100 mg (1 ampoule) 1-2 times a day intravenous infusion administration of ketoprofen should only be in the hospital. Infusion duration should be from 0.5 to 1 hour. Intravenous route of administration should be used not more than 48 hours. A short intravenous infusion: 100 (200) mg of (1-2 ampoules) ketoprofen, diluted in 100 ml of 0.9% solution sodium chloride is introduced for 0.5-1 hours. Continuous intravenous infusion: 100 (200) mg of (1-2 ampoules) ketoprofen, diluted in 500 ml infusion solution (0.9% sodium chloride, lactated Ringer’s solution , 5% dextrose) is administered over 8 hours; possible re-introduction of 8 hours. The maximum daily dose is 200 mg. Ketoprofen can be combined with centrally acting analgesics; it may be mixed with opioids (eg morphine) in a vial with a solution of a pharmaceutically compatible tramadol due to precipitation.Parenteral drug Ketonal ® can be combined with the use of oral dosage forms (tablets, capsules) or rectal suppositories.
From the hematopoietic system and lymphatic system: rarely, hemorrhagic anemia, hemolytic anemia, leukopenia, the frequency is not known: agranulocytosis, thrombocytopenia, impaired bone marrow function. On the part of the immune system: the frequency unknown: anaphylactic reactions (including anaphylactic shock). From the nervous system: common: insomnia, depression, asthenia; masteron rare: headache, dizziness, drowsiness, rarely:paresthesia, confusion or loss of consciousness, peripheral neuropathy, the frequency is not known: convulsions, . taste, emotional lability From the senses: rare: blurred vision, tinnitus, conjunctivitis, dry mucous membrane of the eye, eye pain, hearing loss, the frequency is unknown: . optic neuritis cardio-vascular system: infrequently: tachycardia; the frequency is unknown: heart failure, high blood pressure, vasodilatation. respiratory system: rare: aggravation of asthma, epistaxis, laryngeal edema, the frequency is not known: bronchospasm (particularly in patients with hypersensitivity to NSAIDs) rhinitis. with gastrointestinal tract: common: nausea, vomiting, dyspepsia, abdominal pain, NSAID-gastropathy; rarely: constipation, diarrhea, bloating, gastritis rare: peptic ulcers, stomatitis; very rare: exacerbation of ulcerative colitis, disease Crohn’s disease, gingival, gastrointestinal, hemorrhoidal bleeding, melena, perforation of the gastrointestinal tract. frequency not known: gastrointestinal discomfort, pain in the stomach. liver and biliary tract: rare: hepatitis, increased activity of “liver” enzymes and . bilirubin With the skin: uncommon: rash, pruritus; the frequency is not known: photosensitivity, alopecia, urticaria, aggravation of chronic urticaria, angioneurotic edema, erythema, bullous rash, including Stevens-Johnson syndrome, toxic epidermal necrolysis, purpura. From the urinary system: rare: cystitis, urethritis, hematuria; very rare: acute renal failure, interstitial nephritis, nephrotic syndrome, abnormal values ??of the indicators of renal function, the frequency is unknown: . fluid retention in the body and therefore weight gain, hyperkalemia Miscellaneous: uncommon: peripheral edema, fatigue, rarely hemoptysis, menometrorrhagia, dizziness, thirst, muscle twitching.