Ketoprofen (NSAIDS): Mechanism of Action, Uses, Dosage, Side Effect, Contraindications

Ketoprofen is a NSAIDs included in propionic class of non-steroidal ant-inflammatory drugs. There are 5 NSAIDs included in propionic acid derivatives and often used to treat pain and inflammation. The five NSAIDs included in propionic acid derivatives are Ibuprofen, Ketoprofen, Naproxen, Oxaprozin and Fenoprofen.

Ketoprofen like most NSAIDs causes gastric or duodenal ulcer. Ketoprofen is thus combined with omeprazole, sucralfate and cimetidine to prevent ulcer formation and bleeding. Ketoprofen is been used since 1972.

1. Alternative Name of Ketoprofen

   Ketoprofen is sold as generic medications. The alternative name for generic medications are Oruvail and Orudis. The local application like ointment and gel are sold as Ketoflam, Fstum and Ketospray. The ointment and gel contains concentration of 2-5% of ketoprofen and spray contains 10% of active medications.

2. Mechanism of Action: How Does Ketoprofen Work?

   Ketoprofen therapy provides better pain relief than ibuprofen in patient suffering with joint pain and arthritis. Ketoprofen blocks the action of cyclooxygenase (COX 1 and COX 2) enzyme and prevents conversion of Arachnoidic acid to Prostaglandin. The inflammation become less severe with absence of prostaglandin that follows less pain and fever. The blocking of cyclooxygenase enzyme is reversible. The cyclooxygenase resumes normal function within more or less 72 hours after Ketoprofen is discontinued. Decrease prostaglandin concentration in stomach and intestine causes formation of ulcer and bleeding.

3. Uses: Ketoprofen Is Used For Treatment Of Following Symptoms

   Soft Tissue Pain- Ketoprofen is used to treat acute or chronic inflammatory pain caused by soft tissue diseases like skin infection, boil and cellulitis.

   Inflammation- Reduces inflammatory reaction in Joint or soft tissue like skin, subcutaneous tissue, muscles, tendon and ligaments;

   Joint Pain and Arthritis– Ketoprofen is used as local application and pills to treat arthritis caused by osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. The joint pain and bone pain caused by dislocation and fracture is also effectively treated with ketoprofen.

   Musculoskeletal Pain- Musculoskeletal pain following muscle spasm, injury and tear are treated by ketoprofen pills or local application using gel or spray.

   Neurogenic Nerve Pain- Nerve pain caused by sciatic, radicular pain and post-herpetic neuralgia are treated with ketoprofen for 10 to 15 days.

   Perioperative Analgesics- Ketoprofen is used as premedication in children for perioperative pain. Ketoprofen in injection form has helped to decrease opioid dosage during surgery. The effects of analgesics last during post op period and opioids are avoided in children as a pain medication following minor surgery.

   Headache– Ketoprofen is used as an analgesics to treat tension headache and migraine.

   Dental Pain- Dental aches and pain are treated with ketoprofen when patient is unable to tolerate opioids or refuses to take opioids.

   Ketoprofen is Used To Treat Following Diseases

   • Dysmenorrhea;
   • Rheumatoid arthritis;
   • Osteoarthritis.

4. Dosage of Ketoprofen

   Ketoprofen is prescribed as a pills, ointment, spray and gel. The local applications like 2.5% ointment and gel are sold over the counter in most pharmacy. Some ketoprofen ointment or gel are combined with lidocaine and ketamine to achieve better pain relief.

   Ketoprofen dosage is calculated as 4 to 5 mg / kgm The pills are sold as 50 and 75 mg. The dosage is divided as 1 pills 3 to 4 times a day. The long acting pills of strength 200 mg are slow release pills and given once a day.

5. Duration of Action Ketoprofen

   The peak effects are observed between 1 and 2 hours after ingestion of pills. The effect last for 2 to 4 hours since ½ life of ketoprofen is 2.5 hours. The total duration of therapeutic effect is 4 to 6 hours.

6. Side Effects Caused by Ketoprofen

   • Abdominal pain secondary to stomach or intestinal ulcer;
   • Nausea;
   • Dizziness;
   • Diarrhea;
   • Rash;
   • Ringing in ear;
   • Headache;
   • Shortness of breath resulting in bronchospasm;
   • Peripheral edema because of fluid retention.

• Avoid simultaneous prescription of other NSAIDS;
• Do not combine with corticosteroid pills and local application like ointment;
• Avoided in patient suffering with heart, kidney and liver failure;
• Avoided in patient suffering with bronchial asthma

References