Ketonal pills 100 mg 20 pcs
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Active ingredients
Ketoprofen
Release form
Pills
Composition
Active ingredient: Ketoprofen Concentration of active ingredient (mg): 100 mg
Pharmacological effect
NSAIDs, a derivative of propionic acid. It has an analgesic, anti-inflammatory and antipyretic effect. Due to inhibition of COX-1 and COX-2 and, in part, of lipoxygenase, ketoprofen inhibits the synthesis of prostaglandins and bradykinin, stabilizes lysosomal membranes. Ketoprofen does not adversely affect the state of articular cartilage.
Pharmacokinetics
Absorption When ingested, ketoprofen is easily absorbed from the gastrointestinal tract. Bioavailability - 90%. When taking the drug in a dose of 100 mg Cmax in the blood plasma is reached after 1 h 22 min and is 10.4 mcg / ml. When taking the pills, the prolonged action of Cmax is achieved in 4-6 hours. Eating does not affect the bioavailability of ketoprofen. The distribution of Vd is 0.1-0.2 l / kg. Plasma protein binding is 99%. Ketoprofen penetrates well into the synovial fluid. Metabolism Intensive metabolism in the liver through microsomal enzymes, conjugates with glucuronic acid. Excretion of ketoprofen T1 / 2 - 1.6-1.9 h. Ketoprofen is mainly metabolized in the liver. About 80% of ketoprofen is excreted in the urine, mostly as a conjugate with glucuronic acid (90%). About 10% is excreted unchanged through the intestines. Pharmacokinetics in special clinical situations In patients with renal insufficiency, ketoprofen is eliminated more slowly, T1 / 2 increases by 1 hour. In patients with hepatic insufficiency, ketoprofen may accumulate in the tissues. ketoprofena occur more slowly, but this is of clinical significance only for patients with reduced kidney function.
Contraindications
• hypersensitivity to ketoprofen or other components of the drug, as well as salicylates or other NSAIDs; • complete or incomplete combination of asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to ASA or other NSAIDs (including a history of); • history of rhinitis or urticaria caused by taking acetylsalicylic acid or other NSAIDs; • peptic ulcer of the stomach or duodenum in the acute stage,• ulcerative colitis; Crohn's disease; • hemophilia and other bleeding disorders; • children's age (up to 15 years); • severe liver failure; • severe renal failure (creatinine clearance (CC) less than 30 ml / min); • decompensated heart failure; • the postoperative period after coronary artery bypass surgery; • gastrointestinal, cerebrovascular and other bleeding (or suspected bleeding); • progressive kidney disease, diverticulitis, active liver disease, inflammatory bowel disease, confirmed hyperkalemia; • lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome; • chronic dyspepsia; • III trimester of pregnancy; • breastfeeding period.
Use during pregnancy and lactation
Ketonal can be taken with milk or taken with antacids to reduce the frequency of gastrointestinal disorders (milk and antacids do not affect the absorption of ketoprofen). With prolonged use of NSAIDs, it is necessary to monitor the condition of the blood, as well as liver and kidney function, especially in elderly patients . It is necessary to be careful and more often to control blood pressure when using ketoprofen for the treatment of patients with arterial hypertension, cardiovascular diseases that lead to fluid retention. To K and other NSAIDs, ketoprofen can mask the symptoms of infectious diseases. Effect on ability to drive vehicles and control mechanisms There are no data on the negative effect of ketonal in the recommended doses on the ability to drive a car or work with mechanisms. At the same time, patients who notice non-standard effects while taking the drug Ketonal should be careful when practicing potentially hazardous activities that require high concentration of attention and speed of psychomotor reactions.
Dosage and administration
Inside Ketonal film-coated pills, 100 mg should be swallowed whole during or after a meal, washed down with water or milk (the volume of liquid should be at least 100 ml). Usually the drug is prescribed 1 tablet 2 times a day.Preparations for oral Ketonal can be combined with the use of rectal suppositories, for example, the patient can take 1 tablet (100 mg) Ketonal in the morning and enter 1 suppository (100 mg) rectally in the evening. The maximum dose of ketoprofen is 200 mg / day. It is not recommended to exceed the maximum daily dose of the drug. In order to reduce the risk of the development of adverse events from the gastrointestinal tract (GIT), patients with risk factors are advised to simultaneously administer proton pump inhibitors.
Side effects
Ketoprofen reduces the effect of diuretics, antihypertensive drugs. Strengthens the effect of oral hypoglycemic drugs. Strengthens the effect of some anticonvulsants (such as phenytoin). When used simultaneously with other NSAIDs, salicylates, GCS and ethanol increases the risk of gastrointestinal bleeding. , thrombolytic agents, antiplatelet agents increase the risk of bleeding. The risk of developing impaired renal function is increased when taken simultaneously with iuretikami or inhibitors APF.Pri applied simultaneously increases the concentration of cardiac glycosides, calcium channel blockers slow, lithium preparations cyclosporin metotreksata.Ketoprofen may reduce the effectiveness of mifepristone. Acceptance of NSAIDs should begin no earlier than 8-12 days after the abolition of mifepristone.
Overdose
According to the World Health Organization (WHO), undesirable effects are classified according to their development frequency as follows: very often (≥1 / 10), often (≥1 / 100, <1/10), infrequently (≥1 / 1000, < 1/100), rarely (≥1 / 10000, <1/1000) and very rarely (<1/10000); the frequency is unknown (the frequency of occurrence of events cannot be determined on the basis of available data). Disorders of the hematopoietic system and the lymphatic system are rare: hemorrhagic anemia; frequency is unknown: agranulocytosis, thrombocytopenia, impaired bone marrow function. Immune system impairment frequency unknown: anaphylactic reaction (including anaphylactic shock). Nervous system disorders are rare: headache, dizziness, drowsiness; rarely: paresthesias; frequency unknown: seizures, taste disturbance.Psychiatric disorders frequency unknown: emotional lability. Disturbances of the senses are rare: blurred vision, tinnitus. Violations of the cardiovascular system, the frequency is unknown: heart failure, increased blood pressure, vasodilation. Respiratory disorders are rare: exacerbation of bronchial asthma; frequency is unknown: bronchospasm (especially in patients with hypersensitivity to NSAIDs), rhinitis. Disorders of the gastrointestinal tract are often: nausea, vomiting, dyspepsia, pain in the abdomen; infrequently: constipation, diarrhea, bloating, gastritis; seldom: peptic ulcer, stomatitis; very rarely: aggravation of ulcerative colitis or Crohn's disease, gastrointestinal bleeding, perforation. Disorders of the liver and biliary tract rarely: hepatitis, increased activity of "liver" transaminases, increasing the concentration of bilirubin. Disorders of the skin and subcutaneous tissue infrequently: skin rash, pruritus; frequency is unknown: photosensitivity, alopecia, urticaria, angioedema, erythema, bullous rash, including Stevens-Johnson syndrome, toxic epidermal necrolysis. Disturbances of the kidneys and urinary tract frequency is unknown: acute renal failure, interstitial nephritis, nephritic syndrome, nephrotic syndrome, abnormal values of indicators of renal function. Other infrequently: edema; rarely: weight gain; frequency unknown: increased fatigue.
Interaction with other drugs
Precautionary measures
special instructions
Symptoms: nausea, vomiting, abdominal pain, vomiting of blood, melena, impaired consciousness, respiratory depression, convulsions, impaired renal function, renal failure. Treatment: gastric lavage, the appointment of activated carbon, carry out symptomatic therapy. The use of histamine H2-receptor blockers, proton pump inhibitors, and prostaglandin inhibitors has been shown. There is no specific antidote.