Orudis® KT [OTC]; Oruvail®|
Novo-Keto-EC; Nu-Ketoprofen; Nu-Ketoprofen-E; Orafen; PMS-Ketoprofen;
Nonsteroidal Anti-Inflammatory Agent (NSAID)
Dental: Management of pain and swelling
Medical: Acute and long-term treatment of rheumatoid arthritis and
osteoarthritis; primary dysmenorrhea; mild to moderate pain
B (D in 3rd trimester)
Known hypersensitivity to ketoprofen or other
Use with caution in patients with congestive heart failure, dehydration,
hypertension, decreased renal or hepatic function, history of GI disease
(bleeding or ulcers), or those receiving anticoagulants; safety and efficacy in
children <6 months of age have not yet been established
Central nervous system: Dizziness
Gastrointestinal: Abdominal cramps, heartburn, indigestion, nausea
1% to 10%:
Central nervous system: Headache, nervousness
Endocrine & metabolic: Fluid retention
<1%: Congestive heart failure, hypertension, arrhythmias, tachycardia,
confusion, hallucinations, mental depression, drowsiness, insomnia, aseptic
meningitis, 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 apnea, metabolic acidosis, coma, and nystagmus;
leukocytosis, renal failure
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. Seizures tend to be very
short-lived and often do not require drug treatment. Although, recurrent
seizures should be treated with I.V. diazepam. Since many of the NSAIDs undergo
enterohepatic cycling, multiple doses of charcoal may be needed to reduce the
potential for delayed toxicities.
CYP2C and 2C9 enzyme inhibitor
Increased effect/toxicity with probenecid, lithium
Increased toxicity of methotrexate
Inhibits prostaglandin synthesis by decreasing the activity of the enzyme,
cyclo-oxygenase, which results in decreased formation of prostaglandin
Peak levels in 1-2 hours
Absorption: Almost completely
Metabolism: In the liver
Half-life: 1-4 hours
Time to peak serum concentration: 0.5-2 hours
Elimination: Renal excretion (60% to 75%), primarily as glucuronide
Children >12 years and Adults:
Rheumatoid arthritis or osteoarthritis: 50-75 mg 3-4 times/day up to a
maximum of 300 mg/day
Mild to moderate pain: 25-50 mg every 6-8 hours up to a maximum of 300 mg/day
In order to minimize gastrointestinal effects, ketoprofen can be prescribed
to be taken with food or milk; although food affects the bioavailability of
ketoprofen, analgesic efficacy is not significantly diminished; food slows rate
of absorption resulting in delayed and reduced peak serum
|Mental Health: Effects
on Mental Status|
Dizziness is common; may cause nervousness; may rarely cause insomnia,
confusion, depression, or hallucinations
Effects on Psychiatric
May rarely cause agranulocytosis; use caution with clozapine and
carbamazepine; may decrease lithium clearance resulting in an increase in serum
lithium levels and potential lithium toxicity; monitor serum lithium
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
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
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. Breast-feeding precautions:
Consult prescriber if breast-feeding.
Dose must be lowest recommended in renal insufficiency and hypoalbuminemia.
There are no clinical guidelines to predict which NSAID will give response in a
particular patient. Trials with each must be initiated until response
determined. Consider dose, patient convenience, and cost.
Capsule (Orudis®): 25 mg, 50 mg, 75 mg
Actron®, Orudis® KT [OTC]: 12.5
Capsule, extended release (Oruvail®): 100 mg, 150 mg,
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