Ketonal (Ketanol) tablets: instructions for use. Use during pregnancy and during breastfeeding

Date: 01.04.2019

Instructions for use:

Ketonal is a non-steroidal anti-inflammatory drug used in the symptomatic treatment of diseases of the musculoskeletal system, as well as to eliminate pain of various origins.

Pharmacological action of Ketonal

Ketonal has anti-inflammatory, analgesic and antipyretic properties.

The action of ketoprofen, the active substance of Ketonal, determines the ability of the drug to increase the pain threshold by inhibiting the synthesis of bradykinin, stabilize lysosomal membranes and delay the release of enzymes from them, which contribute to tissue destruction in chronic inflammation.

The maximum concentration of ketoprofen in the blood can be observed already 1.5-2 hours after the use of Ketonal tablets, 65-80 minutes after the use of rectal suppositories and after 5 minutes with intravenous administration.

About 90% of Ketonal is excreted by the liver, the half-life is about 2 hours. Slow elimination of Ketonal in renal failure requires dose adjustment for patients with this disease.

Indications for use

psoriatic arthritis (inflammation of the joints during psoriasis);
rheumatoid arthritis (inflammatory and destructive damage to large and small joints of the limbs);
ankylosing spondylitis (persistent restriction of spinal mobility with possible involvement in the inflammatory process of internal organs);
osteoarthrosis (joint disease caused by damage to their cartilage tissue);
gouty arthritis (joint disease caused by the deposition of uric acid salts in various tissues).

The use of Ketonal is also advisable for:

muscle pain
neuralgia (damage to the peripheral nerves, accompanied by bouts of pain);
ossalgia (pain due to bone damage);
joint pain
tendonitis (inflammation around or inside the tendon);
radiculitis (damage to bundles of nerve fibers extending from the spinal cord);
bursitis (inflammation of the joint bags);
adnexitis (inflammation of the uterus);
toothache and headache.

Ketonal is used as an analgesic for post-traumatic and postoperative pain syndrome, accompanied by inflammation, cancer, algodismenorea (sore menstruation), childbirth.

Instructions for use of Ketonal

Ketonal is available in the forms intended for oral administration: capsules, tablets, granules for the preparation of a suspension.

For intramuscular injections, Ketonal is used in the form of a solution or lyophilisate for the preparation of a solution. Only the solution is administered intravenously. For external use, Ketonal is available in the form of a gel, cream, spray and solution. Ketonal suppositories are intended for rectal use.

Ketonal instruction recommends taking capsules three times a day, 1 pc. (50 mg), not exceeding a daily dose of 300 mg. With osteoarthritis and rheumatoid arthritis, 50 mg of the drug is taken four times a day. Ketonal should be washed down with a sufficient amount of milk or water, it is recommended to take the drug with meals. Ketonal Duo capsules containing 150 mg of ketoprofen, usually take 1 pc. once a day, and if necessary, the appointment of large doses of the drug for a short period, it is possible to increase the number of doses up to two times a day.

Ketonal tablets are usually prescribed 1-2 times a day for 1 pc. (150 mg), not exceeding a daily dose of 300 mg. The duration of treatment is two weeks, if necessary, the duration of the drug can be increased by the doctor. Ketonal tablets should be taken during or immediately after a meal, drinking plenty of water.

Ketonal candles, the use of which can be combined with the administration of tablets or capsules, are usually prescribed for 1 pc. (100 mg) morning and evening.

Intramuscular Ketonal injections are usually prescribed 1-3 times a day for 1 ampoule (100 mg). Intravenously Ketonal injections should be given only in a hospital setting. With intermittent administration, 1-2 ampoules of the drug are diluted with 100 ml of “saline” and administered within half an hour or an hour. With continuous administration, the same amount of Ketonal is diluted in 500 ml of "saline" or glucose and administered for 8 hours. Repeated intravenous ketone injections are administered after 8 hours.

Ketonal gel and cream are intended for external topical use. These forms of the drug are used for pain in joints and muscles that were caused by injuries or injuries, as well as for tendovaginitis (inflammation of the tendon and its sheath). Ketonal cream should be applied to the affected areas 2 times a day, and gel - 1 or 2 times. An occlusive dressing is not recommended. The maximum daily dose is 200 mg (10 cm of Ketonal cream). The duration of treatment is 7-10 days.

Side effects

According to the instructions, Ketonal may be the cause of the following adverse events:

abdominal pain, stool disorders, vomiting, nausea, dry mouth, stomatitis, impaired liver function, gastrointestinal bleeding;
nervousness, fatigue, headache, migraine, sleep disturbance, dizziness, speech disorder;
taste change, tinnitus, conjunctivitis, visual impairment, eye pain;
arterial hypertension, tachycardia, peripheral edema;
anemia, agranulocytosis, thrombocytopenia;
nephrotic syndrome, impaired renal function, the presence of blood in the urine in excess of normal;
allergic reactions to the skin, shortness of breath, bronchospasm, rhinitis, angioedema.

Ketonal cream and gel can provoke vascular edema, urticaria, skin rash, skin necrosis, and dermatitis.

Contraindications Ketonal

The use of Ketonal is prohibited in case of hypersensitivity, “aspirin” asthma, peptic ulcer, ulcerative colitis, peptic ulcer, diverticulitis (protrusion of the intestinal wall), Crohn’s disease (inflammation of the digestive tract, which can affect all its parts), blood clotting disorders, chronic kidney disease .

According to the instructions, Ketonal is contraindicated in children under 14 years of age, pregnant and lactating women.

With caution, Ketonal is prescribed to patients suffering from bronchial asthma, anemia, alcoholism, alcoholic cirrhosis of the liver, liver failure, sepsis, diabetes mellitus, hypertension, edema, stomatitis, and blood diseases. The use of Ketonal in elderly patients should occur as directed and under the supervision of a physician.

Additional Information

Ketonal should be stored in a dark, dry place, where the air temperature does not exceed 25 0 C.

Instruction manual
on the use of the drug
for medical use

Save this manual, it may be required again.
If you have any questions, consult your doctor.

Registration number:

Trade name of the preparation:

Ketonal ®.

International Nonproprietary Name:

ketoprofen.

Dosage form:

Composition:

1 capsule contains:
active substance: ketoprofen - 50.0 mg; excipients: lactose - 186.1 mg; magnesium stearate - 2.4 mg; colloidal silicon dioxide - 1.5 mg; capsule shell - titanium dioxide - 0.94 mg; patented blue dye - 0.17 mg; gelatin up to 47 mg.

Description:

Capsules: Opaque capsules No. 3 with a white body and a blue cap. The contents of the capsules: crumbly or compressed powder of white color with a yellowish tinge.

Pharmacotherapeutic group:

non-steroidal anti-inflammatory drug (NSAIDs).

ATX Code: M01AE03.

Pharmacological properties

Pharmacodynamics
Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID). Ketoprofen has anti-inflammatory, analgesic and antipyretic effects.
Ketoprofen blocks the action of the enzyme cyclooxygenase 1 and 2 (COX1 and COX2) and, in part, lipoxygenase, which leads to a suppression of prostaglandin synthesis (including in the central nervous system (CNS), most likely in the hypothalamus).
Stabilizes in vitro and in vivo liposome membranes at high concentrations in vitro ketoprofen inhibits the synthesis of bradykinin and leukotrienes.
Ketoprofen does not adversely affect articular cartilage.
Pharmacokinetics
Absorption
Ketoprofen is readily absorbed from the gastrointestinal tract, bioavailability is 90%. Communication with blood plasma proteins - 99%. When 100 mg of ketoprofen is ingested, the maximum concentration (Cmax) of the drug in plasma (10.4 μg / ml) is reached after 1 h 22 min.
Distribution
Ketoprofen is 99% bound to plasma proteins, mainly to the albumin fraction. The volume of distribution is 0.1 l / kg.
Ketoprofen penetrates into the synovial fluid and reaches a concentration there equal to 30% of the concentration in the blood plasma.
The plasma clearance of ketoprofen is approximately 0.08 l / kg / h.
Metabolism and excretion
Ketoprofen undergoes intensive metabolism under the action of microsomal liver enzymes, the half-life (T1 / 2) is less than 2 hours. Ketoprofen binds to glucuronic acid and is excreted in the form of glucuronide. There are no active metabolites of ketoprofen. Up to 80% of ketoprofen is excreted by the kidneys within 24 hours, mainly in the form of ketoprofen glucuronide. When using the drug in a dose of 100 mg or more, kidney excretion may be difficult.
In patients with severe renal failure most of the drug is secreted through the intestines. When taking high doses, hepatic clearance also increases. Through the intestines, up to 40% of the drug is excreted.
In patients with liver failure the plasma concentration of ketoprofen is doubled (probably due to hypoalbuminemia, and as a result of this a high level of unbound active ketoprofen); such patients should be prescribed the drug in the minimum therapeutic dose.
In patients with renal failure Ketoprofen clearance is reduced, however dose adjustment is required only in case of severe renal failure.
In elderly patients Ketoprofen metabolism and elimination proceed more slowly, which is of clinical importance only for patients with severe renal failure.

Indications for use

Symptomatic therapy of painful and inflammatory processes of various origins, including:
- inflammatory and degenerative diseases of the musculoskeletal system:
rheumatoid arthritis;
seronegative arthritis: ankylosing spondylitis - ankylosing spondylitis, psoriatic arthritis, reactive arthritis (Reiter's syndrome);
gout, pseudogout;
osteoarthrosis;
tendonitis, bursitis, myalgia, neuralgia, sciatica;
- pain syndrome, including mild, moderate and severe:
headache;
toothache;
post-traumatic and postoperative pain syndrome;
pain syndrome in oncological diseases;
algodismenorea;
- symptomatic therapy of pain in inflammatory diseases of the pelvic organs in women.

Contraindications

Hypersensitivity to ketoprofen or other components of the drug, as well as salicylates or other NSAIDs;
complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including a history);
peptic ulcer of the stomach or duodenum in the acute stage;
inflammatory bowel disease 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;
postoperative period after coronary artery bypass grafting;
gastrointestinal, cerebrovascular and other bleeding (or suspected bleeding);
chronic dyspepsia;
III trimester of pregnancy
the period of breastfeeding;
lactase deficiency, lactose intolerance, glucose-galactose malabsorption.

Carefully

A history of peptic ulcer, a history of bronchial asthma, clinically expressed cardiovascular, cerebrovascular and peripheral arterial diseases, dyslipidemia, progressive liver disease, hyperbilirubinemia, alcoholic cirrhosis of the liver, liver failure, renal failure (CC 30-60 ml / min), chronic heart failure, arterial hypertension, blood diseases, dehydration, diabetes mellitus, anamnestic data on the development of ulcerative lesions of the gastrointestinal tract ( Gastrointestinal tract), the presence of infection Helicobacter pylori, advanced age, smoking, concomitant therapy with anticoagulants (e.g. warfarin), antiplatelet agents (e.g. acetylsalicylic acid), oral glucocorticosteroids (e.g. prednisone), selective serotonin reuptake inhibitors (e.g. citalopram, sertraline), prolonged use of NSAIDs.

Use during pregnancy and during breastfeeding

Inhibition of prostaglandin synthesis may have an undesirable effect on pregnancy and / or embryonic development. Data obtained during epidemiological studies with the use of inhibitors of prostaglandin synthesis in early pregnancy confirm an increased risk of spontaneous abortion and the formation of heart defects (~ 1-1.5%).
It is possible to use the drug for pregnant women in the first and second trimesters of pregnancy only when the benefits for the mother justify the possible risk to the fetus.
The use of ketoprofen in pregnant women during the third trimester of pregnancy is contraindicated due to the possibility of developing weakness of the uterine uterine activity and / or premature closure of the ductus arteriosus, a possible increase in bleeding time, oligohydramnios and renal failure.
At present, there is no data on the release of ketoprofen into breast milk, so if necessary, the use of ketoprofen by a nursing mother should decide on the termination of breastfeeding.

Dosage and administration

Inside.
Ketonal ® capsules should be swallowed whole during or after a meal, washed down with water or milk (liquid volume should be at least 100 ml). Typically, the drug is prescribed for 1-2 capsules 2-3 times a day.
Ketonal ® preparations for oral administration can be combined with the use of rectal suppositories; for example, a patient can take 1 capsule Ketonal ® (50 mg) in the morning and in the middle of the day and administer 1 suppository (100 mg) rectally in the evening.
The maximum dose of ketoprofen is 200 mg / day.

Side effect

According to the World Health Organization (WHO), unwanted effects are classified according to their frequency of development as follows: very often (≥1 / 10), often (≥1 / 100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10000, <1/1000) и очень редко (<1/10000); частота неизвестна (частоту возникновения явлений нельзя определить на основании имеющихся данных).
Violations of the hematopoietic system and lymphatic system
seldom: hemorrhagic anemia;
unknown frequency: agranulocytosis, thrombocytopenia, bone marrow dysfunction.
Immune System Disorders
unknown frequency: anaphylactic reactions (including anaphylactic shock).
Disorders of the nervous system
infrequently: headache, dizziness, drowsiness;
seldom: paresthesia;
unknown frequency: convulsions, violation of taste sensations.
Mental disorders
unknown frequency: emotional lability.
Sensory Disorders
seldom: blurred vision, tinnitus.
Disorders of the cardiovascular system
unknown frequency: heart failure, increased blood pressure, vasodilation.
Respiratory system disorders
seldom: exacerbation of bronchial asthma;
unknown frequency: bronchospasm (especially in patients with hypersensitivity to NSAIDs), rhinitis.
Gastrointestinal Disorders
often: nausea, vomiting, dyspepsia, abdominal pain;
infrequently: constipation, diarrhea, bloating, gastritis;
seldom: peptic ulcer, stomatitis;
rarely: exacerbation of ulcerative colitis or Crohn's disease, gastrointestinal bleeding, perforation.
Violations of the liver and biliary tract
seldom: hepatitis, increased activity of “liver” transaminases, increased bilirubin concentration.
Disorders of the skin and subcutaneous tissue
infrequently: skin rash, itchy skin;
unknown frequency: photosensitization, alopecia, urticaria, angioedema, erythema, bullous rash, including Stevens-Johnson syndrome, toxic epidermal necrolysis.
Violations of the kidneys and urinary tract
unknown frequency: acute renal failure, interstitial nephritis, nephritic syndrome, nephrotic syndrome, abnormal values \u200b\u200bof indicators of renal function.
Other
infrequently: swelling
seldom: weight gain;
unknown frequency: fatigue.

Overdose

As with other NSAIDs, an overdose of ketoprofen can cause nausea, vomiting, abdominal pain, vomiting with blood, melena, impaired consciousness, respiratory depression, convulsions, impaired renal function and renal failure.
In case of an overdose, gastric lavage and the use of activated charcoal are indicated.
Treatment is symptomatic; the effect of ketoprofen on the gastrointestinal tract can be reduced with the help of agents that reduce the secretion of the glands of the stomach (for example, proton pump inhibitors) and prostaglandins.

Interaction with other drugs

Ketoprofen may attenuate diuretics and antihypertensive drugs and enhance action hypoglycemic drugs for oral administration and some anticonvulsants (phenytoin).
Joint use with others NSAIDs, salicylates, glucocorticosteroids, ethanol increases the risk of adverse events from the gastrointestinal tract.
Concomitant use with anticoagulants (heparin, warfarin), thrombolytics, antiplatelet agents (ticlopidine, clopidogrel), pentoxifylline increases the risk of bleeding.
Concomitant use with potassium salts, potassium-sparing diuretics, ACE inhibitors, NSAIDs, low molecular weight heparins, cyclosporine, tacrolimus and trimethoprim increases the risk of hyperkalemia.
Increases plasma concentration cardiac glycosides, “slow” calcium channel blockers, lithium preparations, cyclosporin, methotrexate and digoxin.
Increases toxicity methotrexate and nephrotoxicity cyclosporine.
Concomitant use with probenecid significantly reduces the clearance of ketoprofen in blood plasma.
Combined technique with glucocorticosteroids and others NSAIDs (including selective COX2 inhibitors) increases the likelihood of side effects (in particular, from the gastrointestinal tract).
NSAIDs may decrease effectiveness mifepristone. NSAIDs should be started no earlier than 8-12 days after the withdrawal of mifepristone.

special instructions

Ketoprofen should not be combined with other NSAIDs and / or COX2 inhibitors.
With prolonged use of NSAIDs, it is necessary to periodically evaluate a clinical blood test, monitor kidney and liver function, especially in elderly patients (over 65 years old), and perform fecal occult blood analysis.
Caution must be exercised and blood pressure should be more often monitored when ketoprofen is used to treat patients suffering from hypertension, cardiovascular diseases that lead to fluid retention in the body.
If there are violations on the part of the organs of vision, treatment should be stopped immediately.
Like other NSAIDs, ketoprofen can mask the symptoms of infectious and inflammatory diseases. In case of detection of signs of infection or worsening well-being with the use of the drug, you should immediately consult a doctor.
If there is a history of contraindications from the gastrointestinal tract (bleeding, perforation, peptic ulcer), prolonged therapy and the use of high doses of ketoprofen, the patient should be under close medical supervision.
Due to the important role of prostaglandins in maintaining renal blood flow, particular caution should be exercised when using ketoprofen in patients with heart or kidney failure, as well as in the treatment of elderly patients taking diuretics and patients who, for whatever reason, have a decrease in circulating volume blood.
The use of the drug should be discontinued before major surgery.
The use of ketoprofen can affect female fertility, therefore, patients with infertility (including those undergoing examination) are not recommended to use the drug.

Influence on the ability to drive vehicles, mechanisms

There is no evidence of a negative effect of the Ketonal ® preparation in recommended doses on the ability to drive a car or work with mechanisms. At the same time, patients who experience drowsiness, dizziness, or other unpleasant sensations from the nervous system, including impaired vision, should refrain from driving vehicles and engaging in potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

Release form

Capsules 50 mg.
Primary packaging: 25 capsules per bottle of dark glass, sealed with a polymer cap with a safety ring.
Secondary packaging: 1 bottle is placed in a cardboard box along with instructions for medical use.

Storage conditions

Store at a temperature not exceeding 25 ° C.
Keep out of the reach of children.

Shelf life

5 years.
Do not use the drug after the expiration date.

Special precautions for disposal of unused product

There is no need for special precautions when disposing of an unused drug.

Holiday Terms

On prescription.

Manufacturer

Holder RU: Lek dd Verovshkova 57, 1526 Ljubljana, Slovenia;
It is made: Lek dd, Slovenia.
Claims of consumers should be sent to ZAO Sandoz:
125315, Moscow, Leningradsky Prospekt, 72, bldg. 3.

Effectively relieves symptoms of heat and inflammation, and also has an analgesic effect.

Indications for taking the drug

As written in the instructions for use of Ketonal, the drug is used to get rid of the following conditions:

to relieve pain with algodismenorrhea;
for the treatment of gout;
for the treatment of bursitis;
for the treatment of any type of arthritis;
for the treatment of tendonitis;
for the treatment of spondylitis;
after any injuries and operating period;
with back pain;
to relieve any other severe pain quickly.

Before taking the drug, you must consult with a specialist who will calculate the correct, individual dosage for each patient. This will protect the treatment process itself and help reduce the risk of side effects.

Product release form

Ketonal is dispensed without a doctor’s prescription in several forms:

Candles Ketonal 0.1 g;
A solution for intravenous injection in ampoules of 1 m;
Ketonal ointment, cream or gel for external use;
Ketonal tablets;
Capsules, the dose of which is 0.05 g.

Capsule instructions

Capsules are taken orally, washed down with a small amount of water (about 100 ml):

With severe inflammation: 50 mg (1 capsule) 3 times a day. The maximum daily dose is 300 mg (6 capsules).
For arthritis and osteoarthritis: 50 mg (1 capsule) 4 times a day.
With algodismenorea: 50 mg (1 capsule) 3 times a day.
To prevent the development of NSAID gastropathy in patients, the doctor sometimes prescribes in parallel with
Ketonalom taking antacid drugs.
Capsules “Duo Ketonal” are taken with meals, washed down with plenty of water, at a dosage of 1 capsule / day. In rare cases, two capsules are prescribed per day at intervals of 12 hours.

Instructions for use of ampoules

Ketonal is also presented in the form of injections and a solution for intramuscular injection, so it is important to know how to inject the drug. The drug is prescribed 3 times a day in an amount of 0.1 g (1 ampoule). For more effective treatment in especially severe cases, it is recommended to take pills and use candles with injections.

The introduction of Ketonal intravenously is possible only with treatment in a hospital. The solution is administered intermittently or continuously to anesthetize a specific area where severe pain occurs.

Intermittent Introduction is carried out using two ampoules of Ketonal, which contain approximately 200 mg of active substance. Ampoules are diluted in 100 ml of the solution, and then the medicine is injected into the patient's vein. The whole procedure takes no more than an hour. A similar administration of the drug is repeated after 8 hours.

With continuous administration 2 Ketonal ampoules diluted in 500 ml of solution will be required. For these purposes, a special glucose solution is used in hospitals. The action of the injection lasts about 8 hours. The procedure is repeated after 9 hours. With severe painful pain, the patient is prescribed Ketonal injections together with a narcotic analgesic.

Instructions for use of tablets Ketonal

To relieve severe pain, Ketonal painkillers are taken once a day. The maximum daily dose that is allowed only as a last resort is 2 tablets. This drug is used with food, or immediately after a meal with a large amount of water.

Co-administration of the drug along with antacids will help prevent the development of NSAID gastropathy. The effect of the drug begins no later than 30 minutes after use.

Instructions for the use of rectal suppositories

Rectal suppositories Ketonal are indispensable in complex therapy. They are administered 2 times a day.
In parallel with the use of suppositories, you can take Ketonal tablets or capsules, maintaining a sufficient interval between using different forms of the drug - drink a pill in the morning, and introduce a candle at night.

The use of suppositories for elderly patients is allowed only under the supervision of a doctor. Patients at this age are prone to side effects, such as occult bleeding without external symptoms. As a result, such treatment can lead to very serious negative consequences.

Ketonal rectal suppositories go well with other analgesics.

The composition of the drug

Ketonal Capsules:

the active substance is ketoprofen - 150 mg;
lactose;
Candles Ketonal: Ketoprofen - 100 mg.

Ampoules for injection have the following composition:

propylene glycol;
ketoprofen - 50 mg;
sodium hydroxide;
small amounts of alcohol;
pure water.

Ketonal Forte tablets:

ketoprofen - 100 mg;
lactose.

Ketonal Retard:

ketoprofen - 150 mg;
cellulose.

Side effects of the drug

Side effects from taking the drug are rare and do not provoke serious complications in the body.

But taking Ketonal 5 may lead to the following possible side effects:

strong headache;
anemia or thrombocytopenia, but in very rare cases;
abdominal pain and stool disorder;
severe dizziness, but rarely enough;
feeling of nausea;
nosebleeds;
the appearance of a light rash on the skin;
the appearance of depressive states and panic;
bronchial asthma, in which cramps may occur;
the appearance of nightmares in a dream or vice versa, frequent insomnia;
the appearance of tinnitus;
visual impairment;
problems with the normal functioning of the liver;
rarely, but there are uterine bleeding.

Also, after using Ketonal, there is a risk of thrombosis, mild stroke and myocardial infarction. However, in clinical practice, such cases were not observed. When taken in a dose prescribed by a doctor, the occurrence of side effects from the drug is excluded.

In order to avoid the development of peptic ulcers, elderly patients taking Ketonal should be under the daily supervision of a physician.

The main contraindications

In the following cases, Ketonal is prohibited for use:

With diseases of the duodenum and gastric ulcer;
If you are allergic to the composition of this drug, especially to salicylates;
When taking the drug in patients with non-ulcer dyspepsia syndrome;
With various bleeding;
In severe renal failure;
If the patient has asthma;
Children and adolescents under 14 years old;
During pregnancy and during lactation.

Neglecting the contraindications of Ketonal leads not only to serious complications, but even to death. Required read the annotation and consult your doctor before taking the drug.

Interaction with other drugs

Concurrent administration of several drugs can lead to unexpected consequences. In the best case, this technique will affect the weakening or strengthening of the therapeutic effect, in the worst - the development of complications.

The main interactions of Ketonal with other drugs are as follows:

Increased action of antiglycemic drugs;
The effect of the use of diuretics is greatly reduced;
The nephrotoxic effect of ACE inhibitors is enhanced;
The action of anticonvulsants increases;
The toxicity of drugs with lithium and methotrexate is increased.

Drug overdose

Ketonal in amounts far exceeding the prescribed dosage leads to negative changes in the body and the manifestation of the following side effects:

bleeding in the stomach;
confusion of consciousness;
violation of the stomach;
impaired renal function;
vomiting
nausea.

At the first signs of an overdose and the appearance of unpleasant symptoms, you must urgently consult a doctor. The patient will immediately be washed out of the stomach, and then the specialist will prescribe the intake of sorbents and a course of symptomatic therapy.

Pregnancy and lactation

As a result of inhibition of prostaglandin synthesis, adverse events can occur in embryonic development and during pregnancy itself. Such data are confirmed by special epidemiological studies. As indicated in the instructions for use of Ketonal in various forms (tablets, capsules, solution for injections, ointment), the drug increases the risk of spontaneous abortion and the formation of heart defects in the child.

Pregnant women in the first and second trimesters of pregnancy can be prescribed this drug if the risk to the fetus is less than the benefits of its use for the mother.

Women during pregnancy in the third trimester are contraindicated in the use of the drug Ketonal. This threatens:

Premature closure of the ductus arteriosus;
The development of uterine labor weakness;
An increase in bleeding time;
Renal failure;
Low water.

When prescribing the drug during breastfeeding, women need to transfer the baby to food with special mixtures. This is due to the fact that the components of Ketonal, falling into the baby’s body along with mother’s milk, can negatively affect his health.

Proper storage of Ketonal

Ketonal should be stored in a ventilated room at a temperature of 13-18 degrees, protecting from direct sunlight. Children should not have access to medicine.

Taking the Ketonal drug will not cause any complications or dangerous side effects, if you strictly follow the prescription prescribed by your doctor.

But at the same time:

Patients with diseased kidneys and liver must be under the supervision of a physician.
In patients with a stomach ulcer and with bleeding in the past, it is very necessary to prescribe a medicine caution.
With arterial hypertension, Ketonal should also be taken as carefully as possible. Otherwise, the patient develops peripheral edema.
To smoke and take alcoholic beverages during treatment with Ketonal prohibited.
Blood tests are necessary throughout the entire period of therapy. So it will be easier for the doctor to determine the moment of the onset of anemia or thrombocythemia.
With drowsiness or dizziness from the drug taken, it is best for the period of treatment, refuse to drive transport.

Analogues of the drug

If the patient is intolerant of the components of the drug Ketonal, the doctor may prescribe another drug with a similar effect and composition.

Among the most common analogues of this medicine can be noted:

Ultrafastin;
Fort gel;
Fastum gel;
Arthrosilene;
Flexen;
Ketoprofen;
Quickgel;
Febrofid;
Arthrum;

All of these drugs have their own side effects and contraindications. Before taking these funds, it is advisable to consult with your doctor and carefully read the instructions.

Ketonal Cost

Ketonal in a pharmacy is offered at the following prices:

Ampoules Ketonal for injection of 2 ml - 260-290 rubles per 10 ampoules;
Ketonal Duo tablets - 260-290 rubles per 30 pieces;
Ketonal Retard - 250-280 rubles for 20 pieces;
Rectal suppositories Ketonal 100 mg - 270-300 rubles for 12 pieces;
Ketonal tablets 100 mg - 200-230 rubles per 20 pieces;
Ketonal capsules - 120-130 rubles for 25 pieces.

Every expectant mother knows that every kind of medicine during pregnancy should be treated with extreme caution. Yes, at every step we hear about the inadmissibility of self-medication, which is to say about the possible consequences of rash taking medications in the process of bearing a baby. Malformations, termination of pregnancy or fetal death - this is what can result in taking illegal drugs. But what if, as a result of overwork or atmospheric pressure drops, the pregnant woman got a headache or an untreated tooth made itself felt? Is it really necessary to consult a doctor with such seemingly harmless problems? Today we will talk about what kind of pain medication can be taken during pregnancy, without fear for possible consequences.

Approved painkillers for early pregnancy

The emergency help for the future mother may be the usual action of this drug is thoroughly studied, and it is proved that it does not affect the fetus. Paracetamol, as an antipyretic and analgesic, can be taken during pregnancy in the 1st, 2nd and 3rd trimesters, provided that the woman does not have individual intolerance.

For joint and lower back pain, which often accompany a woman in the early stages of pregnancy, you can take Diclofenac analgesic, or use gels and ointments for external use made on its basis (Voltaren-gel). In the third trimester, the use of Diclofenac should be agreed with the doctor.

Also, up to 32 weeks, in extreme cases, Ketonal analgesic is allowed to pregnant women.

Another pain medication that can be taken during pregnancy, but only in the early stages (1st and 2nd trimester) is Nurofen.

If a pregnant woman has doubts whether it is possible to drink a certain pain medication during pregnancy, or if there are some inaccuracies regarding the term, you can resort to the help of a proven one. This remedy is prescribed for future mothers with a tone and minor pulling pains in the lower abdomen. It also effectively eliminates other pain caused by spasms.

Is it possible to drink painkillers during pregnancy in the later stages?

At the end of the second trimester, the list of approved painkillers is slightly changing. So, at this time, you can still take No-Shpu or its analogue Duspatalin, Riabal, with severe pain, doctors make injections with Spazmalgon or Baralgin.

In this case, a pregnant woman should understand that drinking analgesics without consulting a doctor is extremely dangerous. It is also dangerous to often take even approved painkillers.

The price of Ketonal capsules (150 mg, 30 pcs.): 250-320 rubles.

pharmachologic effect

Ketonal contains the substance ketoprofen, which belongs to the group of derivatives of propionic acid and endowed with non-narcotic, anti-inflammatory and antipyretic properties. Ketonal acts by blocking the prostaglandins E2, suppressing the activity of COX, inhibiting the synthesis of bradykinin and stabilizing lysosomal membranes. Due to the above properties, Ketonal has an increased anti-inflammatory activity. Inflammatory and degenerative diseases are quickly treated, after which a steady analgesic effect can be observed.

After the patient swallows Ketonal by mouth, this drug is able to quickly absorb into the digestive tract, reaching the highest percentage in the blood 2 hours after the use of ordinary tablets and 4-6 hours after oral administration of tablets with a prolonged property.

Indications for use

Ketonal is prescribed in the presence of such diseases:

all forms of arthritis;
gout;
pain caused by injuries or surgical interventions;
tendonitis;
bursitis;
spondylitis.

Mode of application

Ketonal Capsules

The condition of the nose and the severity of inflammation affect the dose of the drug (daily or single), which is prescribed by the attending physician. Traditionally, Ketonal is prescribed 1 capsule three times a day. The most possible dose of the drug per day is 300 mg, which is equivalent to 6 capsules. If the patient has rheumatoid arthritis or osteoarthritis, it is recommended to use 1 capsule 4 p. in 24 hours. If the patient suffers from algodismenorrhea, then most likely you will have to drink 1 capsule 3-4 p. per day. Ketonal in capsules is washed down with a large volume of water or milk (from 100 ml). In order not to develop NSAID gastropathy, it is recommended to take Ketonal along with antacid drugs.

Capsules Ketonal Duo

As a rule, such a dosage form of Ketonal is used in 1 capsule of 1 r. per day. As a pulse therapy (if volume doses are required for a short time period), you can drink 1 capsule 2 r. per day. Between taking the capsules should take 12 hours. Duo capsules are taken orally during meals, washed down with large volumes of water or milk.

Ketonal solution

The usual dose of Ketonal in injection is 1 ampoule (0.1 g) from 1 to 3 r. per day. When the clinical situation is aggravated, in addition to Ketonal, other forms of the above drug are prescribed in injections: in suppositories or in tablets. If the patient is in the hospital, intravenous administration of Ketonal is possible. Such introductions are intermittent and continuous. For the interrupted type of infusion, 1-2 Ketonal ampoules (100-200 mg) should be diluted in 100 ml of physical. solution and enter into the patient's body within an hour. Repeated administration of Ketonal is possible after 8 hours. If a continuous method of administration of Ketonal is used, then 1-2 ampoules (100-200 mg) are diluted in 500 ml of glucose solution (you can use saline solution) and injected within 8 hours. After 8 hours, the drug can be administered again.

If the patient complains of severe pain, then the administration of Ketonal along with narcotic analgesics is allowed. Ketonal can be mixed with morphine, but it is administered separately with tramadol, since the mixing of Ketonal and tramadol provokes the formation of a precipitate.

Ketonal Retard Pills

The usual dose is 1 tab. 1 p. at 24 o’clock. For a day, it is permissible to take no more than 2 tablets of Ketonal Retard. This medication is taken during meals or as soon as the meal is over. You need to drink plenty of fluids. In order not to develop NSAIDs, Ketonal is taken with gastropathy along with drugs belonging to the antacid group.

Rectal Candles Ketonal

Ketonal in candles is used for 1-2 pcs. per day. Often candles are used together with other forms of this drug. If Ketonal in candles is prescribed to the patient along with capsule or tablet Ketonal, then candles are placed in the evening, and capsules or tablets are taken in the morning.

If Ketonal is prescribed for elderly patients, you need to control the reception, otherwise latent, asymptomatic bleeding may occur.

The use of Ketonal during pregnancy and lactation

The synthesis of substances contained in the drug can adversely affect the course of pregnancy and the embryo. Epidemiological studies of the use of Ketanol in early pregnancy indicate that there is an increased risk of spontaneous abortion, as well as the formation of a heart defect in the fetus.

Ketanol is prescribed to women who are in the first two trimesters of pregnancy exclusively when the positive effect for the mother justifies the risks to the fetus.

Ketonal should not be used in the 3rd trimester of pregnancy, since there can be such negative consequences:

weakness of the uterine labor activity develop;
premature closure of the ductus arteriosus occurs;
increase bleeding time;
water shortage is formed;
renal failure will occur.

There is no data on whether Ketoprofen is excreted in breast milk, therefore, as soon as there is a need to take this drug, it solves the problem of ending breast-feeding.

Side effects

Side effects are rare and fleeting. Usually, those who take Ketonal suffer from dyspeptic disorders, dizziness, and headaches.

Side effects are much less common:

the development of anemia and thrombocytopenia;
the appearance of bronchospasm and bronchial asthma;
the development of depression with confused consciousness, insomnia, bad dreams, asthenia, visual impairment, noise in the ears;
impaired liver function (often accompanied by an increase in transaminases);
the formation of acute renal failure (ARF);
development of drug jade;
the appearance of uterine bleeding.

There is evidence that using NSAIDs may increase the risk of thrombosis. Because of Ketonal, stroke attacks, as well as myocardial infarction, are possible.

The condition of patients residing in old age should always be controlled, since they may form peptic ulcers, complicated by the appearance of bleeding. There may be fatal outcomes.

Ketonal overdose

If an overdose of ketoprofen takes place, then such manifestations will take place:

nausea;
vomiting (often with bloody discharge);
pain in the abdomen;
impaired consciousness;
respiratory depression;
the appearance of seizures;
impaired renal function.

If an overdose occurs, urgently need to rinse the stomach and use activated charcoal. Treatment is based on symptoms. To weaken the effect of Ketonal on the gastrointestinal tract, H2 receptor blockers, proton pump and PG inhibitors are used, studies of the cardiovascular and respiratory systems are carried out. There is no specific antidote; hemodialysis effectiveness has a small percentage of effectiveness.