Ketonal Tablets: instructions for use

Tablets Ketonal has anti-inflammatory, antipyretic and analgesic effect, refers to NSAIDs. It is used in various pain syndromes and inflammatory processes of various etiologies.

The active substance inhibits the production of bradykinin and prostaglandins, stabilizes the functioning of lysosomal membranes. Simultaneously, ketoprofen does not negatively affect the state of the cartilage of the joints.

On this page you will find all information about Ketonal: full instructions for use with this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used Ketonal. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

NSAIDs.

Conditions of leave from pharmacies

Released without a doctor's prescription.

Price list

How much does Ketonal cost? The average price in pharmacies is at the level of200 rubles.

Form of issue and composition

Tablets Ketonal 50 mg - biconvex round, covered with a shell in glass dark bottles of 20 pcs. in a cardboard box.

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Each tablet contains 100 mg of ketoprofen.
Excipients: magnesium stearate, silicon dioxide colloidal anhydrous, povidone, corn starch, talc purified, lactose monohydrate.
Sheath of tablet: hypromellose E464, macrogol 400, dye blue indigotin E132, titanium dioxide E171, talc purified, carnauba wax.

Pharmacological effect

The active substance Ketonal - ketoprofen - belongs to the group of NSAIDs and has analgesic, anti-inflammatory and antipyretic effect. The mechanism of Ketonal's action is associated with blockade of prostaglandins E2, suppression of COX activity (cyclooxygenase), inhibition of bradykinin synthesis and stabilization of lysosomal membranes.

All these effects of Ketonal provide its high anti-inflammatory activity, resulting in a decrease manifestations of inflammatory-degenerative diseases and provides a stable analgesic effect. After oral administration, Ketonal is rapidly absorbed into the digestive tract, the maximum concentration in the blood is reached already 1.5 to 2 hours after taking conventional tablets and 4 to 6 hours after taking the tablets with prolonged action.

If Ketonal is applied rectally, the maximum concentration of the drug is achieved even faster, through 65-80 minutes, with intravenous administration the maximum concentration is reached within 5 minutes. Ketonal is not cumulated and does not need a dose adjustment, depending on the age of the patient. The half-life is about 2 hours, Ketonal is excreted mainly by the liver (approximately 90%). In the presence of kidney failure, excretion of Ketonal slows down by approximately 1 hour, so patients with renal insufficiency require a dose adjustment.

Indications for use

Ketonal is a non-steroidal antirheumatic drug with anti-inflammatory, analgesic and antipyretic effects. It is used to relieve pain in a number of pain syndromes and to treat inflammatory, degenerative and metabolic rheumatic diseases.

Indications for use Pain:

painful menstruation;
posttraumatic;
postoperative;
pain due to bone metastases in patients with tumors.

Rheumatic diseases:

rheumatoid arthritis;
gout, pseudogout; osteoarthritis;
ankylosing spondylitis, psoriatic arthritis, reactive arthritis;
extra-articular rheumatism (tendinitis, bursitis, capsulitis of the shoulder joint).

Contraindications

Contraindications to the use of all forms of Ketonal are:

III trimester of pregnancy;
Children under the age of 15;
Hypersensitivity to the active ingredient or auxiliary components of the drug, as well as salicylates or other NSAIDs.

Tablets, capsules, solutions and suppositories are contraindicated in the following cases:

NNC, Crohn's disease;
Pronounced hepatic insufficiency;
Pronounced renal failure;
Hemophilia and other disorders of blood clotting;
Progressive kidney disease;
Uncompensated heart failure;
Chronic dyspepsia;
The period of breastfeeding;
Postoperative period after aortocoronary shunting;
Gastrointestinal, cerebrovascular and other bleeding (or suspicion of bleeding);
Bronchial asthma, rhinitis or hives in history caused by taking acetylsalicylic acid or other NSAIDs;
Stomach ulcer and 12 duodenal ulcer in the phase of exacerbation.

Tablets, capsules, suppositories and Ketonal solution with caution appoint at:

Renal failure;
Chronic heart failure;
Arterial hypertension;
Diseases of the blood;
Dehydration;
A history of peptic ulcer disease;
Bronchial asthma in history;
Dyslipidemia;
Progressive liver disease;
Hyperbilirubinemia;
Alcoholism;
Diabetes mellitus;
Anamnestic data on the development of gastrointestinal lesions;
Presence of Helicobacter pylori infection;
Smoking;
To patients of advanced age;
Pregnancy in I and II trimester;
Hereditary intolerance to galactose, fructose, lactase deficiency lapp, glucose-galactose malabsorption syndrome, sucrose-isomaltase insufficiency;
The use of concomitant therapy with antiplatelet agents, anticoagulants, selective serotonin reuptake inhibitors, oral GCS;
Clinically expressed cardiovascular, cerebrovascular diseases and diseases of peripheral arteries.

Application in pregnancy and lactation

Inhibition of prostaglandin synthesis may have an adverse effect on the course of pregnancy and / or on embryonic development. Data from epidemiological studies using early-stage inhibitors of prostaglandin synthesis pregnancy, confirm the increased risk of spontaneous abortion and the formation of heart defects (about 1-1.5%).

The administration of the drug to pregnant women in the first and second trimesters of pregnancy is possible only if the benefits for the mother justify the possible risk to the fetus.

Contraindicated in the use of ketoprofen in pregnant women during the third trimester of pregnancy because of the possibility of developing weakness in labor activity uterus and / or premature closure of the arterial duct, possible increase in bleeding time, lack of water and renal failure.

To date, there is no data on the isolation of ketoprofen in breast milk, so if necessary the use of ketoprofen in a nursing mother, the question of stopping breastfeeding should be addressed.

Instructions for use

The instructions for use indicate that Ketonal is taken internally.

Capsules or tablets should be swallowed whole during or after meals, washed down with water or milk (the volume of the liquid should be at least 100 ml).

The maximum dose of ketoprofen is 200 mg / day.
Capsules 50 mg: usually prescribed 1-2 caps. 2-3 times / day.
Tablets, film-coated, 100 mg: usually prescribed 1 tab. 2 times / day.

Ketonal in these dosage forms for oral administration can be combined with the use of rectal suppositories; for example, a patient can take 1 capsule (50 mg) in the morning and in the middle of the day and administer 1 suppository (100 mg) rectally in the evening; or the patient can take 1 tablet coated with a film coating (100 mg) in the morning and inject 1 suppository (100 mg) rectally in the evening.

Tablets of prolonged action, 150 mg: appoint 1 tab. 1 time / day.

The maximum daily dose (including when using different dosage forms) is 200 mg.

Side effects

With systemic and rectal administration:

Nervous system: infrequently - fatigue, nervousness, headache, drowsiness, dizziness, nightmares; rarely - migraine, paresthesia, peripheral neuropathy; frequency unknown - impaired taste sensations, convulsions, hallucinations, speech disorder, disorientation;
System of hematopoiesis and lymphatic system: rarely - leukopenia, hemorrhagic anemia; frequency unknown - thrombocytopenia, agranulocytosis, impaired bone marrow function;
Immune system: frequency unknown - anaphylactic reactions;
Digestive system: often - abdominal pain, indigestion, nausea, vomiting; infrequently - bloating, diarrhea or constipation, gastritis; rarely - stomatitis, peptic ulcer; very rarely - perforation, gastrointestinal bleeding, exacerbation of Crohn's disease or ulcerative colitis;
Cardiovascular system: the frequency is unknown - tachycardia, hypertension, heart failure, vasodilation;
Respiratory system: rarely - laryngeal edema, nosebleeds, asthma; frequency unknown - rhinitis, bronchospasm (especially in patients who are hypersensitive to NSAIDs);
Liver and biliary tract: rarely - increased levels of bilirubin and hepatic enzymes, hepatitis;
Urinary system: very rarely - nephrotic syndrome, interstitial nephritis, abnormal values of renal function, acute renal failure;
Skin: rarely - itching and rash; frequency unknown - alopecia, erythema, photosensitivity, urticaria, bullous rash, angioedema, toxic epidermal necrolysis;
Sensory organs: rarely - tinnitus, blurred vision, taste change, conjunctivitis;
Other: infrequently - fatigue, swelling; rarely hemoptysis, metrorrhagia, weight gain.
Local reactions when applying suppositories: irritation of the mucosa, burning sensation and loose stools.

Overdose

Overdose of oral forms manifests itself in the form of nausea, vomiting, abdominal pain, vomiting with blood, melena, impaired consciousness, respiratory depression, seizures, impaired renal function, renal insufficiency.

In this case, gastric lavage, activated charcoal, symptomatic therapy, administration of histamine H2-receptor blockers, proton pump inhibitors, prostaglandin inhibitors are shown. The specific antidote is not known.

special instructions

Tablets and capsules can be washed down with milk or antacids (for example, Almagel, Maalox, Fosfalugel, etc.), since these substances do not affect the absorption of active component Ketonal and at the same time contribute to reducing the likelihood of complications and side effects from the digestive tract.

With prolonged use of Ketonal (more than 1 week), it is necessary to regularly give a general blood test, as well as monitor the performance of kidneys and liver. Particular care should be taken to monitor the blood, liver and kidneys against Ketonal's administration in the elderly over 65 years of age.

Ketonal must be used with caution in the presence of a person with hypertension and heart pathologies that are combined and mated with swelling. In these cases, throughout the course of Ketonal's application, it is necessary to constantly monitor the blood pressure level.

Drug Interactions

In combination with other NSAIDs, salicylates, GCS and ethanol, the risk of bleeding in the digestive tract is increased.
Ketonal increases the concentration of cardiac glycosides, blockers of slow calcium channels, lithium preparations, cyclosporine, methotrexate with simultaneous application.
In combination with anticoagulants, thrombolytic agents, antiaggregants, the risk of bleeding increases.
With simultaneous administration with diuretics or ACE inhibitors, the risk of impaired renal function is increased.
When administered orally, the drug reduces the effect of diuretics and antihypertensive drugs, increases the effect of hypoglycemic and some anticonvulsants.
The drug may reduce the effectiveness of mifepristone, so you should maintain the interval between courses in 8-12 days.

Reviews

We picked up some feedback from people about Ketonal:

Anna. "Ketanol" itself is accepted only in very extreme cases, mainly it is associated with toothache, after going to the dentist, when it takes a day or two to endure, and strength and desire have long left me. I know that it is very harmful, and because there are no side effects, it is not so. When breastfeeding, the doctor recommended a couple of days to take ketanol, as an anesthetic after tooth extraction, but noted that while I take this drug, in no case can not breast-feed and necessarily express milk. Well, apart from that, after receiving it, I have a terrible condition: heartburn, nausea. But with severe pain, only he saves me.
Natalia. Ketonal - an excellent pain killer, without it I would literally not survive the critical days. And with it the pain passes a maximum in 20 minutes - and again it is possible to work and live as if nothing had happened. From toothache, it also works great and works after 24 hours - tested for yourself. Regarding price - yes, not the cheapest one offered, but much more effective than the same no-shpa, which can last up to one hour. I always carry it with me just in case. I recommend!
Lydia. What can I say, the ketonal has helped me more than once with various inflammations and pains. So, recently decided to resort to it when pain in the knee (gonarthrosis) and in the hands of both hands (inflammation of the tendons) became intolerable and no physiotherapy and gels could cope. I bought a pack of 150 mg tablets, took it according to the instructions, on the 1st 1 time a day. The pains disappeared on the second day of admission. But on the third day there was a strong allergic reaction in the form of a rash on the skin, the drug had to be discontinued. As they say: "one heals, and the other maims."