Ketoprofen

What Is Ketoprofen and How Does It Work?

Ketoprofen is a prescription and an over-the-counter nonsteroidal anti-inflammatory (NSAID) used for pain management, rheumatoid arthritis, osteoarthritis, and dysmenorrhea.

Ketoprofen is available under the following different brand names: Nexcede.

What Are the Dosages of Ketoprofen?

Dosages of Ketoprofen:

Adult and Pediatric Dosages:

Tablets/Capsules

  • 50 mg
  • 75 mg

Capsules, extended-release

  • 200 mg

Oral Film

  • 12.5 mg (OTC)

Dosage Considerations – Should be Given as Follows:

Pain Management

Adult Dosage

  • Immediate-release: 25-50 mg orally every 6-8 hours as necessary
  • Extended-release: 200 mg orally each day; not recommended for acute pain

Geriatric

  • Initial: 25-50 mg orally every 6-8 hours; increase to 150-300 mg/day; not to exceed 300 mg

Rheumatoid Arthritis or Osteoarthritis

  • Immediate-release: 75 mg orally every 8 hours or 50 mg orally every 6 hours
  • Extended-release: 200 mg orally each day

Dysmenorrhea

  • Immediate-release: 25-50 mg every 6-8 hours as needed
  • Extended-release: Not recommended for acute pain

Administration

Other Indications and uses

Gout

Pediatric Dosage

  • Safety and efficacy not established

What Are Side Effects Associated with Using Ketoprofen?

Common side effects of ketoprofen include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Ketoprofen?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

What Are Warnings and Precautions for Ketoprofen?

Warnings

  • Cardiovascular Risk
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of serious cardiovascular thrombotic events, myocardial infarction (MI), and stroke, which can be fatal.
    • The risk may increase with the duration of use.
    • Patients with risk factors for or existing cardiovascular disease may be at greater risk.
    • NSAIDs are contraindicated for perioperative pain in the setting of coronary artery bypass graft (CABG) surgery (increased risk of MI and stroke).
  • Gastrointestinal Risk
    • NSAIDs increase the risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.
    • Gastrointestinal adverse events may occur at any time during use and without warning symptoms.
    • Elderly patients are at greater risk for serious gastrointestinal events.
    • This medication contains ketoprofen. Do not take Nexcede if you are allergic to ketoprofen or any ingredients contained in this drug.
    • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

  • Absolute: ASA allergy
  • Relative: Bleeding disorders, hepatic disease, peptic ulcer, stomatitis, ulcerative colitis, upper gastrointestinal disease, and late pregnancy (may cause premature closure of the ductus arteriosus).

Effects of Drug Abuse

  • No information available

Short-Term Effects

  • See "What Are Side Effects Associated with Using Ketoprofen?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Ketoprofen?"

Cautions

  • Use caution in asthma (bronchial), cardiac disease, chronic heart failure, hypertension, renal impairment, and systemic lupus erythematosus (SLE).
  • Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injuries; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or angiotensin receptor blockers (ARBs).
  • Heart Failure (HF) risks.
  • NSAIDs have the potential to trigger heart failure by prostaglandin inhibition that leads to sodium and water retention, increased systemic vascular resistance, and blunted response to diuretics.
  • NSAIDs should be avoided or withdrawn whenever possible.
  • American Heart Association (AHA)/American College of Cardiology (ACC) Heart Failure Guidelines; Circulation. 2016; 134.

Pregnancy and Lactation

  • Use of ketoprofen may be acceptable during pregnancy. Either animal studies show no risk or human studies are not available or animal studies showed minor risk and human studies were done and showed no risk. Use ketoprofen late in pregnancy only in LIFE-THREATENING emergencies when no safer drug is available. Positive evidence of human fetal risk: premature closure of ductus arteriosus closure.
  • The Quebec Pregnancy Registry identified 4705 women who had spontaneous abortions by 20 weeks gestation; each case was matched to 10 control subjects (n=47,050) who had not had spontaneous abortions; exposure to nonaspirin NSAIDs during pregnancy was documented in approximately 7.5% of cases of spontaneous abortions and approximately 2.6% of controls. (CMAJ, September 6, 2011; DOI:10.1503/cmaj.110454).
  • It is unknown whether ketoprofen is excreted in breast milk. It is not recommended if breastfeeding.

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References
Medscape. Ketoprofen.
https://reference.medscape.com/drug/ketoprofen-343291

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