Ketonal DUO, 150 mg 30 pcs.

How to take, the dosage

Adults take 1-2 capsules 2-3 times a day; or 1 tablet forte 2-3 times a day; or 1 tablet retard 1-2 times a day.

The capsules and tablets should be taken with or immediately after a meal, without chewing, with plenty of water.

Interaction

Ketoprofen reduces the effect of diuretics, antihypertensive agents.

It enhances the effect of oral hypoglycemic drugs.

Accelerates the effect of some anticonvulsants (e.g., phenytoin).

Concomitant use with other NSAIDs, salicylates, GCS and ethanol increases the risk of gastrointestinal bleeding.

Concomitant use with anticoagulants, thrombolytics, antiaggregants increases the risk of bleeding.

The risk of renal dysfunction increases with concomitant use of diuretics or ACE inhibitors.

Concomitant use increases concentrations of cardiac glycosides, slow calcium channel blockers, lithium preparations, cyclosporine, methotrexate.

Ketoprofen may decrease the effectiveness of mifepristone. NSAIDs should not be started before 8-12 days after withdrawal of mifepristone.

Special Instructions

Ketonal may be washed with milk or taken with antacids in order to reduce the frequency of gastrointestinal disorders (milk and antacids do not affect absorption of ketoprofen).

When prolonged use of NSAIDs, the blood count and hepatic and renal function should be monitored, especially in elderly patients.

Caution should be exercised and BP should be monitored more frequently when using ketoprofen to treat patients with arterial hypertension, cardiovascular disease, which leads to fluid retention.

Like other NSAIDs, ketoprofen can mask the symptoms of infectious diseases.

Influence on driving and operating machinery

There are no data on adverse effects of Ketoprofen in recommended doses on the ability to drive or operate machinery. However, patients who have noted unusual effects while taking Ketonal® should be cautious when driving or operating machinery during potentially dangerous activities requiring increased concentration and rapid psychomotor reaction time.

Contraindications

• bronchial asthma, rhinitis, urticaria in the anamnesis caused by taking acetylsalicylic acid or other NSAIDs,
• gastric and duodenal ulcer in the acute phase,
• NEC, Crohn’s disease,
• hemophilia and other blood clotting disorders,
• severe liver failure,
• severe renal failure,
• uncompensated heart failure,
• a postoperative period after aortocoronary bypass,
• gastrointestinal, cerebrovascular, and other bleeding (or suspected bleeding),
• chronic dyspepsia,
• high sensitivity to ketoprofen or other components of the drug, and salicylates or other NSAIDs.

With caution: the drug should be prescribed in case of a history of peptic ulcer disease, history of bronchial asthma, clinically pronounced cardiovascular, cerebrovascular disease, peripheral artery disease, dyslipidemia, liver failure, hyperbilirubinemia, alcoholic liver cirrhosis, renal failure, chronic heart failure, arterial hypertension, In addition, the following conditions should be adhered to: – blood diseases, dehydration, diabetes, history of peptic ulcer disease, smoking, concomitant therapy with anticoagulants (e.g., warfarin), antiplatelet agents (e.g., acetylsalicylic acid), oral GCS (e.g., prednisolone), selective serotonin reuptake inhibitors (e.g., citalopram, sertraline).

Side effects

Prevalence of adverse reactions:

• Very common ( > 10%).
• Prevalent ( > 1%, but < 10%).
• Uncommon ( > 0.1%, but < 1%).
• Rare ( > 0.01%, but < 0.1%).
• Very rare ( < 0.01%).

Digestive system disorders: widespread – dyspepsia (nausea, flatulence, diarrhea or constipation, vomiting, decreased or increased appetite), abdominal pain, stomatitis, dry mouth; non-spread (with long-term use in high doses – ulceration of the mucous membrane of the GIT, liver function disorders); rare – GIT perforation, worsening Crohn’s disease, melena, GIT bleeding, transient increase in liver enzymes.

CNS and peripheral nervous system disorders: common – headache, dizziness, drowsiness, fatigue, nervousness, nightmares; rare – migraine, peripheral neuropathy; very rare – hallucinations, disorientation, speech disorders.

Sensory organs: rare – tinnitus, change in taste, blurred vision, conjunctivitis.

Cardiovascular system disorders: uncommon – tachycardia, arterial hypertension, peripheral edema.

Hematopoietic system disorders: decreased platelet aggregation; rare – anemia, thrombocytopenia, agranulocytosis, purpura.

Urinary system disorders: rare – renal dysfunction, interstitial nephritis, nephrotic syndrome, hematuria (with prolonged use of NSAIDs and diuretics).

Allergic reactions: common – itching, urticaria; non-spread – rhinitis, dyspnea, bronchospasm, angioedema, anaphylactoid reactions.

Others: rare – hemoptysis, metrorrhagia.

Overdose

Symptoms: nausea, vomiting, abdominal pain, vomiting blood, melena, impaired consciousness, respiratory depression, seizures, renal failure, renal failure.

Treatment: gastric lavage, administration of activated charcoal, symptomatic therapy is carried out.

Histamine H2-receptor blockers, proton pump inhibitors, prostaglandin inhibitors are indicated. There is no specific antidote.

Pregnancy use

The use of ketoprofen in the third trimester of pregnancy is contraindicated. In I and II trimesters of pregnancy the drug may be administered only if the estimated benefit to the mother exceeds the potential risk to the fetus.

If the drug is taken during lactation, discontinuation of breastfeeding should be considered.

It is contraindicated in children under 15 years of age.

Similarities

Ketonal, OKI, Bystromgel, Febrofid, Flamax forte, Ketoprofen, Flamax, Fastum, Rocketal Rompharm, Pentalgin Extra Gel, Ketoprovel, OKI ACT, Brustel