fenoprofen

Absorption: Well absorbed from the GI tract.

Distribution: Unknown.

Protein Binding: >99%.

Metabolism/Excretion: Mostly metabolized by the liver. 2–5% excreted unchanged by the kidneys.

Half-Life: 3 hr.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO (analgesic activity)	15–30 min	1–2 hr	4–6 hr
PO (anti-inflammatory activity)	several days	2–3 wk	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to fenoprofen, aspirin, or other NSAIDs;
Active GI bleeding or ulcer disease;
Severe renal impairment;
Coronary artery bypass graft surgery;
OB: Avoid use after 30 wk gestation.

Use Cautiously in:

Renal impairment;
Hepatic impairment;
Cardiovascular disease or risk factors for cardiovascular disease (may ↑ risk of serious cardiovascular thrombotic events, MI, and stroke, especially with prolonged use or use of higher doses); avoid use in patients with recent MI or HF;
History of ulcer disease;
OB: Use at or after 20 wk gestation may cause fetal or neonatal renal impairment; if treatment is necessary between 20 wk and 30 wk gestation, limit use to the lowest effective dose and shortest duration possible;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children;
Geri: risk of adverse events in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

CV: edema, HF, MI, palpitations

Derm: DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), pruritus, rash, STEVENS-JOHNSON SYNDROME (SJS), sweating

EENT: blurred vision, hearing loss, tinnitus

F and E: hyperkalemia

GI: dyspepsia, abdominal pain, constipation, diarrhea, GI BLEEDING, HEPATITIS, nausea, vomiting

GU: cystitis, dysuria, hematuria, renal failure

Hemat: prolonged bleeding time

Neuro: confusion, dizziness, drowsiness, headache, STROKE, tremor

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

Concurrent use with aspirin or antacids may ↓ effectiveness.
Additive adverse GI effects with aspirin, other NSAIDs, potassium supplements, corticosteroids, or alcohol.
May ↓ the effectiveness of diuretics or antihypertensives.
May ↑ serum lithium levels and ↑ the risk of toxicity.
↑risk of toxicity from methotrexate.
↑risk of bleeding with anticoagulants, aspirin, clopidogrel, ticagrelor, prasugrel, corticosteroids, fibrinolytics, SNRIs, or SSRIs.
↑risk of adverse hematologic reactions with antineoplastics or radiation therapy.
Phenobarbital may ↑ metabolism and ↓ effectiveness of fenoprofen.
May ↑ the risk of nephrotoxicity withcyclosporine.

Drug-Natural Products:

↑bleeding risk with anise, arnica, chamomile, clove, feverfew, garlic, ginger, ginkgo, Panax ginseng, and others.

Route/Dosage ⬆ ⬇

Rheumatoid Arthritis/Osteoarthritis

PO (Adults ): 400–600 mg 3–4 times daily (not to exceed 3.2 g/day).

Mild to Moderate Pain

PO (Adults ): 200 mg every 4–6 hr.

Availability ⬆ ⬇

(Generic available)

Capsules: 200 mg; 400 mg
Tablets: 600 mg

Assessment ⬆ ⬇

Patients who have asthma, aspirin-induced allergy, and nasal polyps are at ↑ risk for developing hypersensitivity reactions. Monitor for rhinitis, asthma, and urticaria.
Assess for rash periodically during therapy. May cause SJS. Discontinue therapy if severe or if accompanied with fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, hepatitis, and/or eosinophilia.
Monitor for signs and symptoms of DRESS (fever, rash, lymphadenopathy, facial swelling) periodically during therapy. Discontinue therapy if symptoms occur.
Arthritis: Assess pain and range of movement before and 1–2 hr after administration.
Pain: Assess pain (type, location, and intensity) before and 1–2 hr after administration.

Lab Test Considerations:

May cause prolonged bleeding time.
- May cause ↓ hemoglobin, hematocrit, leukocyte, and platelet counts.
- Monitor liver function tests periodically during long-term therapy. May cause ↑ serum alkaline phosphatase, LDH, AST, and ALT concentrations.
- Monitor BUN, serum creatinine, and electrolytes periodically during therapy. May cause ↑ BUN and serum creatinine.

Implementation ⬆ ⬇

Administration in higher than recommended doses does not provide ↑ effectiveness but may cause ↑ side effects. Use lowest effective dose for shortest duration to minimize risk of cardiovascular thrombotic events.
- Coadministration with opioid analgesics may have additive analgesic effects and may permit lower opioid doses.
PO: For rapid initial effect, administer 30 min before or 2 hr after meals. Administer after meals or with food to minimize gastric irritation.

Patient/Family Teaching ⬆ ⬇

Advise patient to take this medication with a full glass of water and to remain in an upright position for 15–30 min after administration.
Instruct patient to take medication as directed. Take missed doses as soon as remembered, but not if almost time for next dose. Do not double doses.
May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known.
Caution patient to avoid concurrent use of alcohol, aspirin, acetaminophen, other NSAIDs, or other OTC or herbal products without consulting health care professional.
Instruct patient to notify health care professional of medication regimen before treatment or surgery.
Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs.
Rep: May cause fetal harm. Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Advise women to avoid fenoprofen in the 3rd trimester of pregnancy (after 29 wk); may cause premature closure of the fetal ductus arteriosus. Use of fenoprofen after 20 wk may cause fetal renal dysfunction leading to oligohydramnios. May cause reversible infertility in women attempting to conceive; may consider discontinuing fenoprofen.

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇