fenoprofen

Contraindicated in:

Hypersensitivity to fenoprofen, aspirin, or other NSAIDs;
Active GI bleeding or ulcer disease;
Severe renal impairment;
Coronary artery bypass graft surgery;
Recent MI;
HF;
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);
History of long duration of NSAID use, smoking, alcohol use, advanced liver disease, coagulopathy, or poor general health (↑ risk of GI bleeding);
History of peptic ulcer disease and/or GI bleeding;
Bleeding tendency or concurrent anticoagulant therapy;
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: Appears on Beers list. ↑ risk GI bleeding or peptic ulcer disease in older adults. Avoid chronic use unless other alternatives are not effective and the patient can take a gastroprotective agent; avoid short-term use in combination with oral or parenteral corticosteroids, anticoagulants, or antiplatelet agents unless other alternatives are not effective and the patient can take a gastroprotective agent.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), EXFOLIATIVE DERMATITIS, GENERALIZED BULLOUS FIXED DRUG ERUPTION, pruritus, rash, STEVENS-JOHNSON SYNDROME , TOXIC EPIDERMAL NECROLYSIS, sweating

EENT: blurred vision, hearing loss, tinnitus

F and E: hyperkalemia

GI: dyspepsia, abdominal pain, constipation, diarrhea, GI BLEEDING, GI PERFORATION, GI ULCERATION, 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 AND SERIOUS SKIN REACTIONS)

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 ↑ levels and risk of toxicity of lithium.
↑risk of toxicity from methotrexate.
↑risk of GI bleeding with anticoagulants, aspirin, clopidogrel, ticagrelor, prasugrel, corticosteroids, fibrinolytics, SNRIs, or SSRIs.
↑risk of adverse hematologic reactions with antineoplastics or radiation therapy.
Phenobarbital may ↓ levels and effectiveness.
May ↑ the risk of nephrotoxicity withcyclosporine.

Drug-Natural Products:

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

Availability ⬆ ⬇

(Generic available)

Capsules: 200 mg; 400 mg
Tablets: 600 mg

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.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits prostaglandin synthesis.

Therapeutic effects:

Suppression of pain and inflammation.

Classifications ⬆ ⬇

Therapeutic Classification: antirheumatics, nonopioid analgesics

Pharmacologic Classification: propionic acid derivatives, nonsteroidal anti inflammatory drugs nsaids

Pharmacokinetics ⬆ ⬇

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

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Advise patient to take with food or a full glass of water or milk and to remain upright for 15–30 min after 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 provider.
Instruct patient to notify health care provider of medication regimen before treatment or surgery.
Inform patient of ↑ risk of MI and stroke. Use lowest effective dose for shortest time. Advise patient to notify health care provider immediately if signs and symptoms (shortness of breath or trouble breathing, chest pain, weakness in one part or side of body, slurred speech, swelling of the face or throat) occur.
Advise patient to notify health care provider promptly if signs or symptoms of GI toxicity (abdominal pain, black stools) occur.
Advise patient to consult health care provider if visual disturbances, tinnitus, weight gain, edema, or persistent headache occur.
Advise patient to stop fenoprofen and notify health care provider if signs of liver dysfunction (nausea, fatigue, diarrhea, pruritus, jaundice, right upper quadrant pain, flu-like symptoms, rash) occur.
Instruct patient to discontinue therapy immediately and notify health care provider for fever, lymphadenopathy, or rash.
Rep: May cause fetal harm. Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding. Advise patient to avoid fenoprofen in the 3rd trimester of pregnancy; may cause premature closure of the fetal ductus arteriosus. Use of fenoprofen after 20 wk may cause fetal renal impairment leading to oligohydramnios. May cause reversible female infertility.

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Indications ⬇

Contraind./Precautions ⬆ ⬇