Adult Dosing
Rheumatoid Arthritis and Osteoarthritis (immediate and extended-release capsules)
- Start with 75 mg PO tid; Alt: 50 mg PO qid; Max: 300 mg/day
- 200 mg ECAPS PO qd; Max: 200 mg PO qd
Management of mild-to-moderate pain and dysmenorrhea (immediate-release capsules)
- 25-50 mg PO q6-8 hours as inidicated; Max: 300 mg PO qd
Notes:- Use the lowest effective dose for the shortest duration consistent with individual response
- Concomitant use of ketoprofen immediate-release and extended-release capsules is not recommended
- Should be taken with food, milk, or antacids to minimize gastrointestinal adverse effects
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Therapy may cause an increased risk of serious cardiovascular thrombotic events, MI, and stroke, which could be fatal. This risk may increase with the duration of use, especially in patients with cardiovascular disease or risk factors for CV disease [US Black Box Warning]
- Risk for an adverse CV event in patients treated with ketoprofen can be minimized by using the lowest effective dose for the shortest duration. Also, physicians and patients should remain alert for the development of such events, even in the absence of previous CV symptoms. Advise patients about the signs and symptoms of serious CV events and the steps to take if they occur
- Onset of new hypertension or worsening of preexisting hypertension may occur during therapy. Monitor BP prior to initiation of therapy and throughout the course of therapy
- Instances of fluid retention and edema have been observed in some patients taking ketoprofen
- Ketoprofen use may lead to an increased risk of serious GI adverse events such as inflammation, bleeding, ulceration, and perforation of the stomach or intestines. These events can be fatal and can occur at any time during use without any warning symptoms; elderly patients are at greater risk for serious GI events [US Black Box Warning]
- Risk for developing a GI bleed may increase in patients with prior history of peptic ulcer disease and GI bleed who use ketoprofen
- Concomitant use of oral corticosteroids or anticoagulants, longer duration of NSAID therapy, smoking, use of alcohol, older age, and poor general health status are the other factors that increase the risk of GI bleed
- Fatal GI events are most commonly reported in elderly or debilitated patients; however, special care should be taken in treating this population
- Risk for an adverse GI event in patients treated with ketoprofen can be minimized by using the lowest effective dose for the shortest duration. Physicians and patients should remain alert for signs and symptoms of GI ulceration and bleeding during therapy with appropriate treatment; this may include discontinuation of therapy until a serious GI adverse event is ruled out
- Long-term use may result in renal papillary necrosis and other renal injury. Renal toxicity has been reported in patients in whom renal prostaglandins have a role in maintaining renal perfusion
- Elevated liver transaminases and rare cases of severe hepatic reactions such as jaundice, fatal fulminant hepatitis, liver necrosis and hepatic failure have been reported during therapy
- Anaphylactoid reactions may occur in patients without known prior exposure to ketoprofen. Emergency help should be sought if anaphylactoid reaction occurs
- Therapy may cause fatal serious skin adverse events like exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), which could be fatal. Advise patients about the signs and symptoms of serious skin manifestations, and to discontinue therapy if skin rash or any other sign of hypersensitivity occurs
- Avoid therapy during late pregnancy because it may cause premature closure of the ductus arteriosus
- Ketoprofen cannot be substituted for corticosteroids or used to treat corticosteroid insufficiency. Abrupt withdrawal of corticosteroids may lead to disease exacerbation
- The pharmacological actions of ketoprofen in reducing inflammation and fever may diminish the utility of these diagnostic signs in detecting complications of presumed noninfectious, painful conditions
- Interstitial nephritis or nephrotic syndrome have been seen in certain patients receiving ketoprofen
- Anemia may result in patients receiving ketoprofen, which may be due to fluid retention, occult or gross GI blood loss. Patients on prolonged use should have their hemoglobin or hematocrit checked
- NSAIDs inhibit platelet aggregation and may prolong bleeding time in certain patients
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment
- CHF
- Corticosteroid use
- Coagulation disorder
- Elderly or debilitated patients
- Dehydration
- Concurrent diuretics
- Asthma
- ACEI or ARB use
- Prolonged use
Supplemental Patient Information
- Advise patients not to take aspirin while on ketoprofen therapy as aspirin increases the level of unbound ketoprofen
Pregnancy Category:C
Breastfeeding: Because of the low levels of ketoprofen in breastmilk and its short half-life, it is unlikely to adversely affect the breastfed infant. However, because there is no published experience with breastfeeding during ketoprofen use, other agents may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 10 March 2011). It is unknown whether this drug is excreted in breast milk. According to the manufacturer's data, ketoprofen is not recommended for use during lactation.
Pricing data from www.DrugStore.com in U.S.A.
- Ketoprofen 75 MG CAPS [Bottle] (TEVA PHARMACEUTICALS USA)
60 mg = $16.99
180 mg = $34.98 - Ketoprofen 50 MG CAPS [Bottle] (TEVA PHARMACEUTICALS USA)
90 mg = $20.98
180 mg = $31.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
