Home Drug Guide Ketoprofen

Drug Guide

Generic Name

Ketoprofen

Brand Names Orudis, Oruvail, Orudis Kt, Actron, Nexcede

Classification

Therapeutic: Nonsteroidal anti-inflammatory drug (NSAID)

Pharmacological: Propionic acid derivative

FDA Approved Indications

Relief of mild to moderate pain
Inflammation associated with rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis

Mechanism of Action

Ketoprofen inhibits cyclooxygenase (COX-1 and COX-2), leading to decreased formation of prostaglandins, thereby reducing inflammation, pain, and fever.

Dosage and Administration

Adult: Oral: 25-50 mg every 6-8 hours as needed; max dose typically 200 mg/day.

Pediatric: Not recommended for children under 16 due to safety profile.

Geriatric: Start at lower end of dosing range; monitor renal and hepatic function.

Renal Impairment: Adjust dose; use with caution due to increased risk of renal toxicity.

Hepatic Impairment: Use with caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the placenta and enters breast milk.

Metabolism: Hepatically metabolized mainly via hydroxylation and conjugation.

Excretion: Primarily via the kidneys as metabolites; small amount excreted unchanged.

Half Life: Approximately 2 hours.

Contraindications

Hypersensitivity to ketoprofen or other NSAIDs
History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
Active gastrointestinal bleeding or ulceration.

Precautions

Use with caution in patients with cardiovascular disease, hypertension, renal or hepatic impairment.
Risk of gastrointestinal bleeding, ulceration, and perforation.

Adverse Reactions - Common

Gastrointestinal upset (nausea, dyspepsia) (Common)
Dizziness, headache (Common)

Adverse Reactions - Serious

Gastrointestinal bleeding or ulceration (Less common)
Cardiovascular thrombotic events (myocardial infarction, stroke) (Less common)
Allergic reactions (anaphylaxis, skin reactions) (Uncommon)

Drug-Drug Interactions

Warfarin, other anticoagulants
Other NSAIDs, corticosteroids—risk of bleeding
ACE inhibitors and diuretics—reduced efficacy and renal risks

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of bleeding, gastrointestinal disturbances, and renal function.

Diagnoses:

Risk for bleeding
Impaired kidney function
Gastrointestinal discomfort

Implementation: Administer with food or milk to decrease gastrointestinal irritation; monitor renal function periodically.

Evaluation: Assess pain relief, reduction in inflammation, and side effects.

Patient/Family Teaching

Take with food or milk to minimize GI upset.
Report unusual bleeding, stomach pain, or signs of allergic reaction.
Do not exceed recommended dose.
Avoid alcohol and smoking.

Special Considerations

Black Box Warnings:

Serious cardiovascular thrombotic events, including myocardial infarction and stroke, have been reported with NSAID use.
Gastrointestinal bleeding, ulceration, and perforation risk.

Genetic Factors: None specified.

Lab Test Interference: May increase bleeding times, affect renal function tests.

Overdose Management

Signs/Symptoms: Nausea, vomiting, epigastric pain, dizziness, and somnolence; severe cases may involve gastrointestinal bleeding or renal impairment.

Treatment: Supportive care, activated charcoal if early, monitor renal function, and treat symptoms. Hemodialysis is not typically effective.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended conditions for shelf life.