Compound
- Solution - ketoprofen , propylene glycol, ethanol, benzyl alcohol, sterile water.
- Gel - ketoprofen, trolamine, carbomer , ethanol, lavender essential oil, sterile water.
- Cream - ketoprofen, isopropyl myristate, methylhydroxybenzoate, propylene glycol, propylhydroxybenzoate, white petrolatum, magnesium sulfate, elphacos ST9, propylene glycol oleate, glyceryl, water.
- Tablets - silicon dioxide, magnesium stearate, talc, corn starch, lactose, macrogol , hypromellose, titanium dioxide, indigo carmine, wax, talc.
- Capsules - ketoprofen, microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, povidone, polysorbate, purified water, eudragit, triethyl citrate, talc, yellow iron oxide, purified water, silicon dioxide, titanium dioxide, gelatin.
- Suppositories - ketoprofen, solid fat, glyceryl caprylocaprate.
Release form
- Solution 50 mg/ml for intravenous and intramuscular administration - in dark glass ampoules of 2 ml, in a blister of 5 and 10 ampoules in cardboard packaging No. 10.2
- Gel 2.5% - for external use, colorless, transparent, homogeneous in an aluminum tube of 50, 100 g in a cardboard package.
- Cream 5% - for external use, homogeneous, white in aluminum tube, 30, 50 g in a cardboard package.
- Ketonal tablets 50 mg are biconvex round, film-coated in dark glass bottles of 20 pcs. in cardboard packaging.
- Capsules 50 mg with modified release - blue in blister in cardboard packaging No. 20, 30.
- Rectal suppositories are smooth, white, homogeneous in a blister of 6 suppositories in a cardboard package No. 12.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Ketoprofen inhibits the activity of cyclooxygenase , which inhibits the process of prostaglandin .
The drug also inhibits the synthesis of bradykinin , lipoxygenase , stabilizes lysosomal membranes in the cell and suppresses the production of enzymes that are involved in the inflammatory process. Ketoprofen does not have a negative effect on the condition of articular cartilage.
Pharmacokinetics
The process of absorption of ketoprofen in the body is very slow and it practically does not accumulate in the body. Bioavailability - 5%. The drug penetrates well and reaches therapeutic concentrations in synovial fluid, muscles, ligaments, and subcutaneous tissue. Its concentration in blood plasma is insignificant. Metabolized in the liver to form conjugates. Excreted in urine. Slowly.
Pharmacological properties of the drug Ketonal
Pharmacodynamics. Ketoprofen is an NSAID that has analgesic, anti-inflammatory and antipyretic effects. During inflammation, ketoprofen inhibits the synthesis of prostaglandins and leukotrienes, inhibiting the activity of cyclooxygenase and partially lipoxygenase; it also inhibits the synthesis of bradykinin and stabilizes lysosomal membranes. It has an analgesic effect and eliminates the manifestations of symptoms of inflammatory and degenerative diseases of the musculoskeletal system. Pharmacokinetics. When taken orally, ketoprofen is rapidly absorbed into the gastrointestinal tract. After oral administration (50 mg 4 times a day) with meals, the maximum concentration of ketoprofen in the blood plasma is reached after 1.5 hours and is 3.9 mcg/ml, whereas when taken on an empty stomach it is 2.0 mcg/ml and is achieved after 2 hours; for extended-release tablets, the maximum concentration in the blood plasma is achieved after 4–6 hours. The bioavailability of ketoprofen in oral forms is 90–93% and is directly proportional to the dose that is used. After rectal administration of 100 mg of ketoprofen, the maximum concentration in blood plasma (10.4 μg/ml) is determined after 1.05–1.22 hours. The bioavailability of ketoprofen is 71–96%. With intravenous infusion, the average level in blood plasma 5 minutes from the start and 4 minutes after completion of the administration is 26.4 ± 5.4 μg/ml. Bioavailability is 90%. The degree of protein binding is 99%. Volume of distribution - 0.1–0.2 l/kg. Ketoprofen penetrates into the synovial fluid. A stable concentration of ketoprofen in the blood plasma is achieved within 24 hours after taking oral forms. The pharmacokinetics of ketoprofen do not differ significantly depending on the age of the patients. Cumulation of ketoprofen in tissues is not observed. Ketoprofen is extensively metabolized in the liver via microsomal oxidation. It is excreted from the body in the form of a conjugate with glucuronic acid. The half-life is 2 hours. Up to 80% of the administered dose of ketoprofen is excreted in the urine, usually (over 90%) in the form of glucuronide, about 10% in feces. In patients with renal failure, the elimination of ketoprofen is slowed down, the half-life increases by 1 hour. In patients with liver failure, ketoprofen may accumulate in tissues. In elderly patients, the metabolism and excretion of ketoprofen is slow, but this is of clinical significance only in cases of impaired renal function.
Indications for use
Indications for use of various forms of the drug are identical. The choice of the form of release of the drug is based on a number of factors (type of disease, ease of administration).
The drug is prescribed in the following cases:
- Symptomatic treatment of inflammatory and degenerative diseases of the musculoskeletal system ( arthritis of various origins, osteochondrosis , osteoarthritis , gout , articular and non-articular rheumatism , myalgia , tendonitis , bursitis , neuralgia , glenohumeral syndrome, injuries of the musculoskeletal system - sprains and ruptures of ligaments, muscle bruises )
- Relief of pain syndrome in myalgia, bursitis, tendinitis, neuralgia, radiculitis, migraine , headache, algodismenorrhea , renal colic, post-traumatic pain syndrome, cancer, adnexitis , lumbago , lymphadenitis and lymphangitis , phlebitis .
KETONAL
Side effects
According to the World Health Organization (WHO), adverse effects are classified according to their frequency as follows: very common (≥1/10), common (≥1/100, <1/10), uncommon (≥1/1000, < 1/100), rare (≥1/10000, <1/1000) and very rare (<1/10000);
frequency unknown (the frequency of events cannot be determined from the available data). Hematopoietic and lymphatic system disorders
rarely: hemorrhagic anemia; frequency unknown: agranulocytosis, thrombocytopenia, bone marrow dysfunction.
Immune system disorders
frequency unknown: anaphylactic reactions (including anaphylactic shock).
Nervous system disorders
uncommon: headache, dizziness, drowsiness; rarely: paresthesia; frequency unknown: convulsions, disturbance of taste.
Mental disorders
frequency unknown: emotional lability.
Sensory disorders
rarely: blurred vision, tinnitus.
Cardiovascular disorders
frequency unknown: heart failure, increased blood pressure, vasodilation.
Respiratory system disorders
rarely: exacerbation of bronchial asthma; frequency unknown: bronchospasm (especially in patients with hypersensitivity to NSAIDs), rhinitis.
Gastrointestinal disorders
often: nausea, vomiting, dyspepsia, abdominal pain; uncommon: constipation, diarrhea, bloating, gastritis; rarely: peptic ulcer, stomatitis; very rarely: exacerbation of ulcerative colitis or Crohn's disease, gastrointestinal bleeding, perforation.
Disorders of the liver and biliary tract
rarely: hepatitis, increased activity of liver transaminases, increased bilirubin concentration.
Skin and subcutaneous tissue disorders
uncommon: skin rash, itching; frequency unknown: photosensitivity, alopecia, urticaria, angioedema, erythema, bullous rash, including Stevens-Johnson syndrome, toxic epidermal necrolysis.
Renal and urinary tract disorders
frequency unknown: acute renal failure, interstitial nephritis, nephritic syndrome, nephrotic syndrome, abnormal values of renal function tests.
Other
uncommon: swelling; rarely: weight gain; frequency unknown: increased fatigue.
Contraindications
Individual hypersensitivity to the drug and other NSAIDs, bleeding disorders, childhood, liver/renal failure , chronic dyspepsia , exacerbation of peptic ulcer , ulcerative colitis , period after surgery, lactation and during pregnancy in the 3rd trimester.
Prescribe with caution if there is a history of bronchial asthma , peptic ulcer; diabetes mellitus , arterial hypertension , simultaneous use of anticoagulants , cardiovascular diseases, long-term treatment with NSAIDs, in old age.
Special instructions for the use of the drug Ketonal
When prescribing Ketonal for systemic use, caution should be exercised in patients with a history of gastric or duodenal ulcers or gastrointestinal bleeding. Perforation or gastrointestinal bleeding may occur without the development of previous symptoms. Caution is recommended in patients with impaired liver or kidney function, as well as in patients taking coumarin anticoagulants. The drug is not recommended for use in porphyria. If renal function is impaired, dose adjustment is necessary. Ketoprofen may worsen the course of hypertension (arterial hypertension) and increase the risk of developing peripheral edema. Ketoprofen should be prescribed with caution to elderly people due to the increased risk of side effects. As with the treatment of other NSAIDs, with long-term use of ketoprofen it is necessary to monitor the composition of peripheral blood, liver and kidney function, especially in the elderly. Like other NSAIDs, ketoprofen may mask symptoms and signs of infectious diseases. Smoking and drinking alcohol are not recommended during treatment with Ketonal. The safety of using ketoprofen during pregnancy and lactation has not been established. Ketoprofen can be used in the first and second trimesters of pregnancy only if the expected therapeutic effect for the expectant mother exceeds the potential risk to the fetus. NSAIDs are not recommended for use during pregnancy beyond 36 weeks. When treating with Ketonal, you must stop breastfeeding. The drug does not affect the ability to drive vehicles or operate potentially dangerous machinery. However, in rare cases, NSAIDs may cause dizziness or drowsiness. In this case, you should refuse to manage such funds.
Side effects
Side effects of the drug can manifest as disturbances in different body systems:
- anaphylactic reactions;
- anemia , leukopenia , thrombocytopenia , agranulocytosis , bone marrow function disorders;
- asthenia , insomnia, depression , drowsiness, dizziness, headache, convulsions, confusion;
- tinnitus, eye pain, blurred vision, conjunctivitis , hearing loss;
- tachycardia , increased blood pressure, heart failure;
- nosebleeds, bronchospasm , rhinitis , laryngeal edema ;
- nausea, dyspepsia , pain in the abdomen, gastritis , constipation , diarrhea ;
- hepatitis;
- skin itching and rash, photosensitivity;
- urethritis , cystitis , hematuria ;
- peripheral edema, fatigue;
- weight gain, thirst, shortness of breath .
Side effects of the drug Ketonal
As usual, transient. Most often, gastrointestinal disorders are observed (digestive disorders, dyspepsia, nausea, vomiting, constipation, diarrhea, heartburn, abdominal pain). Rarely - headache, dizziness, confusion, hypersomnia, drowsiness, swelling, mental changes, insomnia. In isolated cases, possible ulcerative stomatitis, ground, hematemesis, peptic ulcer, gastrointestinal hemorrhage or perforation, gastritis, duodenal and stomach ulcers. From the blood system: rarely - anemia, hemolysis, purpura, thrombocytopenia, agranulocytosis. High doses of ketoprofen can inhibit platelet aggregation, thereby prolonging bleeding time, and cause epistaxis and hematoma formation. From the immune system: asthma, bronchospasm or shortness of breath (especially in patients with hypersensitivity to acetylsalicylic acid and other NSAIDs); very rarely - angioedema and anaphylaxis. Mental disorders: common - depression, nervousness, nightmares, drowsiness; rarely - delirium with visual and auditory hallucinations, disorientation, dyslalia. From the side of the central nervous system: often - headache, asthenia, discomfort, increased fatigue, weakness, dizziness, paresthesia; very rarely - there have been isolated reports of cases of pseudotumor cerebri. From the organ of vision: often - visual impairment; very rarely - conjunctivitis. On the part of the hearing organ: common - tinnitus. From the cardiovascular system: often - edema; rarely - heart failure, hypertension (arterial hypertension). Clinical studies and epidemiological evidence suggest that a small increased risk of arterial thrombotic events (eg, myocardial infarction and stroke) may be associated with the use of some NSAIDs (especially at high doses and long-term use). There is insufficient data to exclude such a risk for ketoprofen. From the respiratory system: uncommon - hemoptysis, shortness of breath, pharyngitis, rhinitis, bronchospasm, laryngeal edema (signs of an anaphylactic reaction); rarely - asthma attacks. From the gastrointestinal tract: very - dyspepsia; often - nausea, abdominal pain, diarrhea, constipation, flatulence, anorexia, vomiting, stomatitis; very rarely - colitis, intestinal perforation (as complications of diverticula), exacerbation of ulcerative colitis or Crohn's disease, enteropathy with perforation, stenosis. Enteropathy may be accompanied by mild bleeding with loss of protein. There have been case reports of rectal perforation in elderly women. Peptic ulcers, perforation or gastrointestinal bleeding may occur, sometimes fatal, especially in elderly patients. Ulceration, hemorrhage or perforation may develop in 1% of patients after 3–6 months of treatment or in 2–4% of patients after 1 year of treatment with NSAIDs. Melena, bloody vomiting, and exacerbations of ulcerative colitis or Crohn's disease have been reported after use. Gastritis was rarely observed. From the hepatobiliary system: very rarely - severe liver dysfunction, which is accompanied by jaundice and hepatitis. Skin disorders: common - skin rash; in isolated cases - alopecia, eczema, purple-like rash, increased sweating, urticaria, exfoliative dermatitis; rarely – photosensitivity, photodermatitis; very rarely - bullous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis. From the urinary system: very rarely - acute renal failure, interstitial nephritis, nephrotic syndrome, acute pyelonephritis. From the reproductive system: very rarely - menometrorrhagia. Laboratory indicators: very often - deviation from the norm in liver function tests; rarely - during treatment with NSAIDs, ALT and AST levels increase significantly. Ketoprofen reduces platelet aggregation, thereby prolonging bleeding time.
Instructions for use of Ketonal (Method and dosage)
Ketonal tablets, instructions for use
Take 1 tablet Ketonal (50 mg) orally twice a day or Ketonal Forte (100 mg), swallowing whole and drinking at least 100 ml of liquid (water, milk) after meals.
The maximum daily dose of the drug should not exceed 200 mg per day. In this case, Ketonal tablets can be combined with other forms of the drug (cream, suppositories). You can take extended-release tablets (Ketonal Retard) - 150 mg (1 tablet) once a day.
Cream Ketonal, instructions for use
Apply a little 5% cream (3–5 cm) to the skin and lightly rub Ketonal cream 2–3 times a day into problem areas of the body. The duration of self-treatment should not exceed two weeks. If there is no effect, you should contact a specialist. Sometimes patients mistakenly say “ointment” when referring to the cream.
Gel Ketonal, instructions for use
The gel is applied similarly to the cream. The dosage of the gel must be selected in accordance with the area of the problem area. Approximate dosage - 5 cm of gel corresponds to 100 mg of Ketonal.
Ketonal capsules, instructions for use
For arthritis, dysmenorrhea, osteoarthritis and mild or moderate pain syndrome, take one capsule orally with meals, with milk or water every six hours. Can be used in combination with injection solution, suppositories, taking into account the maximum daily dose. Concomitant use with antacids .
Ketonal injections, instructions for use
For parenteral use, the drug is administered as an intramuscular injection in an amount of 100 mg 1–2 times a day. IV infusion: the procedure is carried out in a hospital setting. Short infusion - ketoprofen in ampoules (100–200 mg) is diluted in a solution of 0.9% sodium chloride (100 ml) and administered over one hour, repeated administration no earlier than eight hours later. For continuous infusion, the drug (100–200 mg) is diluted in 500 ml of Ringer's solution or 0.9% sodium chloride and administered over eight hours. Ketonal IV can be administered together with centrally acting analgesics .
Ketonal suppositories, instructions for use
Rectal suppositories are inserted into the rectum, as deeply as possible, one suppository 1-2 times a day. You can combine the administration of suppositories with oral forms of the drug (tablets, capsules).
Use of the drug Ketonal
Ketonal capsules Doses are selected individually, depending on the patient’s condition and his response to treatment. The usual daily dose of ketoprofen is 100–300 mg, depending on the condition and nature of the disease. The maximum daily dose of ketoprofen is 300 mg. Ketonal capsules take 1 capsule 3 times a day. For rheumatoid arthritis and osteoarthritis, take 1 capsule every 6 hours. For pain during menstruation, the recommended dose is 1 capsule every 6–8 hours. Ketonal capsules can be taken with Ketonal suppositories according to the following scheme: 1 capsule in the morning and afternoon and 1 suppository in the evening. Capsules are taken during meals with water or milk (at least 100 ml). To prevent the negative effect of ketoprofen on the mucous membranes of the gastrointestinal tract, you can simultaneously take antacids. Ketonal Duo capsules The standard dose for adults and children over 15 years of age is 1 capsule (150 mg) per day. For short-term use, the maximum daily dose is 300 mg - 1 capsule every 12 hours. Capsules should be taken with food, swallowed whole and with plenty of water. They can also be washed down with milk or taken together with antacids to reduce the incidence of gastrointestinal disorders; milk and antacids do not affect the adsorption of the drug. The duration of treatment depends on the course and severity of the disease. Ketonal solution IM administration: the dose recommended for IM administration is 1 ampoule (100 mg) 1-2 times a day. The maximum daily dose of ketoprofen for intramuscular administration is 300 mg. If necessary, intramuscular administration can be supplemented with the administration of oral, rectal or transdermal forms of Ketonal. The daily dose of Ketonal can be increased to 300 mg or reduced to 100 mg, depending on the severity of the disease and the patient's condition. IV administration: ketoprofen infusions should be carried out only in a hospital setting. The infusion should be carried out over 0.5–1 hour, the course of treatment with intravenous administration should not exceed 48 hours. The maximum daily dose of ketoprofen for intravenous administration is 300 mg. Intermittent IV infusion: 100–200 mg of ketoprofen is diluted in 100 ml of sodium chloride solution (0.9%) for injection and administered over 0.5–1 hour; after 8 hours the infusion can be repeated. Continuous IV infusion: 100–200 mg of ketoprofen is diluted in 500 ml of infusion solution (sodium chloride solution 0.9% for injection, Ringer's solution with lactate, glucose solution) and administered over 8 hours ; after 8 hours the infusion can be repeated. Ketoprofen can be combined with narcotic analgesics; it can be mixed with morphine in one container: 10–20 mg of morphine and 100–200 mg of ketoprofen are diluted in 500 ml of infusion solution (sodium chloride solution 0.9% for injection, Ringer’s solution with lactate); after 8 hours the infusion can be repeated. The maximum daily dose of ketoprofen is 300 mg. Caution: do not mix tramadol and ketoprofen due to the formation of sediment. The bottle of solution for infusion should be wrapped in dark paper or aluminum foil, since ketoprofen is sensitive to light. Ketonal Retard tablets The recommended dose for adults and children over 15 years of age is 1 tablet once a day. To prevent unwanted effects, treatment should be short-term. The maximum daily dose is 200 mg. Ketonal Retard tablets should be taken after meals or during meals with a glass of water or milk. At the same time, you need to take antacids to reduce the side effects of ketoprofen on the gastrointestinal tract. Elderly patients. In elderly patients, the risk of adverse reactions increases. After 4 weeks from the start of treatment, monitoring for manifestations of gastrointestinal bleeding is necessary. Suppositories Ketonal Suppositories are inserted into the rectum, 1 suppository 1-2 times a day. Suppositories can be used in combination with other oral forms of Ketonal capsules or tablets according to the following scheme: 1 capsule (50 mg) in the morning and afternoon and 1 suppository (100 mg) in the evening; 1 forte tablet (100 mg) in the morning (in exceptional cases, you can take an additional 1 forte tablet in the afternoon) and 1 suppository (100 mg) in the evening. Doses are selected individually, depending on the patient’s condition and his response to treatment. The maximum daily dose of ketoprofen is 300 mg. To prevent the negative effect of ketoprofen on the mucous membranes of the gastrointestinal tract, you can simultaneously take antacids.
Interaction
Ketoprofen reduces the effectiveness of antihypertensive drugs and diuretics , enhances the effect of hypoglycemic oral drugs and a number of anticonvulsants ( phenytoin ).
Concomitant use with anticoagulants , antiplatelet agents and thrombolytics increases the risk of bleeding. Taking Ketonal with salicylates , other NSAIDs , ethanol and corticosteroids increases the risk of developing gastrointestinal complications.
Ketonal increases the concentration in the blood of lithium drugs , cardiac glycosides , CCBs , methotrexate , cyclosporine , and when administered simultaneously with potassium-sparing diuretics , ACE inhibitors , tacrolimus , low molecular weight heparins and trimethoprim hyperkalemia increases .
Interactions of the drug Ketonal
Ketoprofen, when used systemically, increases the effectiveness of oral hypoglycemic and some antiepileptic drugs, reduces the effectiveness of diuretics and antihypertensive drugs. The simultaneous use of diuretics and NSAIDs increases the risk of developing renal failure. The use of Ketonal with ACE inhibitors increases the risk of nephrotoxicity. Patients taking ketoprofen in combination with warfarin and corticosteroids require regular medical monitoring due to the possibility of bleeding. Treatment of patients with ketoprofen simultaneously with lithium should be carried out under close medical supervision, since the toxicity of lithium increases. When ketoprofen is taken simultaneously with methotrexate and cyclosporine, the toxicity of the latter may increase. Ketoprofen should not be taken in combination with salicylates and other NSAIDs.
Ketonal's analogs
Level 4 ATC code matches:
Voltaren Emulgel
Ultrafastin
Indomethacin
Dicloran
Dicloran Plus
Dolgit
Nise
Ketorol
Febrofeed
Fastum gel
Diclofenac
Finalgel
Bystrumgel
Deep Relief
Butadion
Diklovit
Artrosilene
Olfen
Fanigan Fast
Analogs of Ketonal in tablets and capsules - Artrum , Ketoprofen , Indomethacin , Ibuprofen , Osteoartisi Active Plus , Artron Complex , Flamax Forte , Denebol , Ketoprofen MV , Chondra-Sila , Flexen , Bystrumkaps , Oruvel , Ultrafastin , Profenid and others.
Analogues of Ketonal in the form of a solution are Artrosilene , Diclofenac , Denebol , OKI , Emodol , Oruvel , Flamax , Flexen , Chondrolone and others.
Analogs of cream and gel Ketonal - Artrosilen , Ketoprofen , Voltaren , Febrofid , Bystrumgel , F-gel , Fastum- , Ketoprom , Oruvel , Ketum-gel , Reanimator Thermo-gel , Valusal , Arthropod , Ultrafastin , Fort-gel , Profenid , Flexen .
Analogues of Ketonal in the form of suppositories are Artrum , Oruvel , Flexen , Artrosilen .
The price of analogues may differ significantly from the cost of Ketonal. When replacing the drug, you should consult a specialist.
Reviews about Ketonal
On the Internet you can find numerous reviews about Ketonal, mostly favorable. The most favorable reviews about Ketonal in tablets and injections:
- “... I had a kidney stone pass, hellish pain, neither baralgin nor other analgesics helped. The emergency doctor gave Ketonal injections and the pain went away almost immediately. An excellent pain reliever, not a narcotic and affordable.”
- “... I had a tooth removed. During extraction, the tooth crumbled and when they began to pull out the roots, there was hellish pain. But after the Ketonal injection I stopped feeling pain. A good cure for toothache."
- “... I suffer from osteochondrosis, for which I take Ketonal tablets and use cream, it helps a lot.”
Many patients leave good reviews about Ketonal cream and often call it “ointment”: “...my mother has been using Ketonal ointment for arthrosis for quite a long time. The drug relieves pain in the knee joints well and quickly. It’s not the cheapest drug, but it’s very effective.”
There are also negative reviews: “... I ride a horse. After the fall, my ankle began to hurt severely. I used the cream for a month. It didn’t help, the joint continued to hurt. We got “horse balm” at the hippodrome – excellent results.”
Those who are not familiar with the drug ask the question: “what is Ketonal ointment for?” It is successfully used for injuries to the ligamentous apparatus and muscles, which is very important for people leading an active lifestyle. What else can the ointment be used for? Local treatment in the forms of cream, ointment, gel is very effective for inflammation of the veins (phlebitis). In this case, NSAIDs are prescribed in parallel with venotonics and thrombolytics.
Reviews about the gel are also positive, and it is noted that this dosage form is absorbed more easily and quickly, without leaving marks on the skin and clothing; the use of the gel is more economical.
There are also numerous positive reviews about suppositories in gynecology: “... For me, the beginning of the menstrual cycle is almost always accompanied by severe pain. Whatever I drank. The emergency doctor recommended Ketonal suppositories and the pain subsided. Of course, the application procedure is not very pleasant. After inserting the suppository, I feel some discomfort (slight burning and itching), but they quickly relieve the pain and the effect lasts the whole day. Excellent product."
Ketonal film-coated tablets 100 mg 20 pcs. in Moscow
Ketoprofen should not be combined with other NSAIDs and/or COX2 inhibitors.
With long-term use of NSAIDs, it is necessary to periodically evaluate a clinical blood test, monitor kidney and liver function, especially in elderly patients (over 65 years), and conduct a stool test for occult blood.
It is necessary to be careful and monitor blood pressure more often when using ketoprofen to treat patients suffering from arterial hypertension and cardiovascular diseases that lead to fluid retention in the body.
If visual disturbances occur, treatment should be stopped immediately.
Like other NSAIDs, ketoprofen can mask the symptoms of infectious and inflammatory diseases. If you notice signs of infection or deterioration in health while using the drug, you should immediately consult a doctor.
If there is a history of contraindications from the gastrointestinal tract (bleeding, perforation, peptic ulcer), long-term therapy and the use of high doses of ketoprofen, the patient should be under close medical supervision.
Because of the important role of prostaglandins in maintaining renal blood flow, particular caution should be exercised when using ketoprofen in patients with cardiac or renal insufficiency, as well as in the treatment of elderly patients taking diuretics and patients who, for any reason, have a decrease in circulating volume. blood.
The drug should be discontinued before major surgery.
The use of ketoprofen can affect female fertility, therefore, patients with infertility (including those undergoing examination) are not recommended to use the drug.
Impact on the ability to drive vehicles and machinery
There is no data on the negative effect of the drug Ketonal® in recommended doses on the ability to drive a car or operate machinery. At the same time, patients who experience drowsiness, dizziness or other unpleasant sensations from the nervous system, including visual impairment, while using the drug, should refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Ketonal price, where to buy
The price of Ketonal depends on the form of the drug.
The price of Ketonal in injections (ampoules 2 ml 100 mg) No. 10 varies from 230 to 305 rubles per pack; Ketonal ampoules No. 50 – 957 – 1490 rubles.
The price of Ketonal in tablets 100 mg No. 20 ranges from 200 to 210 rubles; tablets Ketonal Retard 150 mg No. 20 –235 – 302 rubles.
The cost of Ketonal in capsules 50 mg No. 25 is 105 – 115 rubles.
The price of Ketonal cream 5% in a 30 g tube varies from 230 to 297 rubles; 50 g – from 310 to 395 rubles.
The price of Ketonal gel 2.5% in a 100 g tube ranges from 338 to 466 rubles per package.
The price of Ketonal in candles No. 12 pieces varies from 283 to 345 rubles.
You can purchase medications without difficulty in most pharmacies in Moscow and other cities.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Ketonal tablets p.p.o.
100 mg 20 pcs. Lek dd RUB 141 order - Ketonal suppositories rectal. 100 mg 12 pcs. Sandoz Ilach Sanai / Genveon Ilach Sanai
RUB 254 order
- Ketonal active granules for the preparation of a solution for oral administration 40 mg pack. 1g 12 pcs. Fine Foods & Pharmaceuticals N.T.M. S.p.A.
155 rub. order
- Ketonal solution for intravenous and intramuscular administration. 50mg/ml 2ml 10 pcs. Lek dd
RUB 241 order
- Ketonal gel 2.5% 50gLek dd/Salutas Pharma GmbH
RUB 369 order
Pharmacy Dialogue
- Ketonal (supp. 100 mg No. 12)Sandoz
RUB 237 order
- Ketonal (amp. 50 mg/ml 2 ml No. 10)Lek
RUB 222 order
- Ketonal 2.5% gel 50gSalutas Pharma GmbH
RUB 355 order
- Ketonal 2.5% gel 50gLek
RUR 366 order
- Ketonal gel (tube 2.5% 100g)Salutas Pharma GmbH
RUB 493 order
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Pharmacy24
- Ketonal 100 mg 2 ml No. 10 injection solution Lek pharmaceutical company d.d., Slovenia
204 UAH.order - Ketonal forte 100 mg No. 20 tablets Lek pharmaceutical company d.d., Slovenia
133 UAH order
- Ketonal 100 mg No. 12 suppositories Lek pharmaceutical company d.d. Slovenia / Sandoz Ilac Sanay ve Ticaret A.S., Turecchina
149 UAH order
- Ketonal retard 150 mg No. 2 tablets Lek pharmaceutical company d.d., Slovenia
182 UAH order
- Ketonal 2.5% 50 g gel Salutas Pharma GmbH, Nimechchina
93 UAH order
PaniPharmacy
- Ketonal capsule Ketonal capsules 50 mg No. 25 Slovenia, Lek
117 UAH. order
- Ketonal suppository Ketonal suppository 100 mg No. 12 Slovenia, Lek
152 UAH order
- Ketonal retard tablets Ketonal retard tablets 150 mg No. 20 Slovenia, Lek
198 UAH order
- Ketonal duo capsule Ketonal DUO capsules 150 mg No. 20 Slovenia, Lek
192 UAH order
- Ketonal forte tablets Ketonal forte film-coated tablets 100 mg No. 20 Slovenia, Lek
144 UAH order
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