Yes

Nonsteroidal Anti-Inflammatory Agent (NSAID)

Symptomatic treatment of acute and chronic rheumatoid arthritis and osteoarthritis; relief of mild to moderate pain

B (D in 3rd trimester or near delivery)

Known hypersensitivity to fenoprofen or other NSAIDs

Use with caution in patients with congestive heart failure, dehydration, hypertension, decreased renal or hepatic function, history of GI disease, or those receiving anticoagulants

>10%:

Central nervous system: Dizziness

Dermatologic: Rash

Gastrointestinal: Abdominal cramps, heartburn, indigestion, nausea

1% to 10%:

Central nervous system: Headache, nervousness

Dermatologic: Itching

Endocrine & metabolic: Fluid retention

Gastrointestinal: Vomiting

Otic: Tinnitus

<1%: Congestive heart failure, hypertension, arrhythmias, tachycardia, confusion, hallucinations, aseptic meningitis, mental depression, drowsiness, insomnia, urticaria, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, angioedema, polydipsia, hot flashes, gastritis, GI ulceration, cystitis, polyuria, agranulocytosis, anemia, hemolytic anemia, bone marrow suppression, leukopenia, thrombocytopenia, hepatitis, peripheral neuropathy, toxic amblyopia, blurred vision, conjunctivitis, dry eyes, decreased hearing, acute renal failure, allergic rhinitis, shortness of breath, epistaxis

Symptoms of overdose include acute renal failure, vomiting, drowsiness, leukocytosis

Management of a nonsteroidal anti-inflammatory drug (NSAID) intoxication is primarily supportive and symptomatic. Fluid therapy is commonly effective in managing the hypotension that may occur following an acute NSAID overdose, except when this is due to an acute blood loss.

Decreased effect with phenobarbital; ACE-inhibitor effects may be decreased by concurrent therapy with NSAIDs

Increased effect/toxicity of phenytoin, sulfonamides, sulfonylureas

Increased toxicity with salicylates, oral anticoagulants

Inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin precursors

Onset of effect: Begins in a few days

Absorption: Rapid (to 80%) from upper GI tract

Distribution: Does not cross the placenta

Protein binding: 99%

Metabolism: Extensively in the liver

Half-life: 2.5-3 hours

Time to peak serum concentration: Within 2 hours

Elimination: In urine 2% to 5% as unchanged drug; small amounts appear in feces

Adults: Oral:

Mild to moderate pain: 200 mg every 4-6 hours as needed

May be administered with food to decrease GI distress

Monitor CBC, liver enzymes; monitor urine output and BUN/serum creatinine in patients receiving diuretics

Therapeutic: 20-65 mg/mL (SI: 82-268 mmol/L)

chloride (S), sodium (S)

Dizziness is common; may cause nervousness; rarely may cause insomnia, confusion, depression, or hallucinations

May rarely cause agranulocytosis; use caution with clozapine and carbamazepine; may decrease the clearance of lithium resulting in elevated serum levels and potential toxicity; monitor serum lithium levels; use acetaminophen, if possible, for pain

No information available to require special precautions

NSAID formulations are known to reversibly decrease platelet aggregation via mechanisms different than observed with aspirin. The dentist should be aware of the potential of abnormal coagulation. Caution should also be exercised in the use of NSAIDs in patients already on anticoagulant therapy with drugs such as warfarin (Coumadin®).

Take this medication exactly as directed; do not increase dose without consulting prescriber. Do not crush tablets or break capsules. Take with food or milk to reduce GI distress. Maintain adequate fluid intake (2-3 L/day of fluids unless instructed to restrict fluid intake). Do not use alcohol, aspirin, or aspirin-containing medication, and all other anti-inflammatory medications without consulting prescriber. You may experience drowsiness, dizziness, nervousness, or headache (use caution when driving or engaging in tasks requiring alertness until response to drug is known); anorexia, nausea, vomiting, or heartburn (frequent small meals, frequent mouth care, sucking lozenges, or chewing gum may help); fluid retention (weigh yourself weekly and report unusual (3-5 lb/week) weight gain). GI bleeding, ulceration, or perforation can occur with or without pain; discontinue medication and contact prescriber if persistent abdominal pain or cramping, or blood in stool occurs. Report breathlessness, difficulty breathing, or unusual cough; chest pain, rapid heartbeat, palpitations; unusual bruising/bleeding; blood in urine, stool, mouth, or vomitus; swollen extremities; skin rash or itching; acute fatigue; or changes in hearing or ringing in ears. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Breast-feeding is not recommended.

Monitor CBC, liver enzymes; monitor urine output and BUN/serum creatinine in patients receiving diuretics

Capsule, as calcium: 200 mg, 300 mg

Tablet, as calcium: 600 mg

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