DEXKETOPROFEN

Dexketoprofen is a nonsteroidal anti-inflammatory drug (NSAID). It is manufactured by Menarini, under the trade name Ketesse. It is available within the UK, as dexketoprofen trometamol, as a prescription drug and in Latin America as Enantyum. In Italy and Spain it is available as an over-the-counter drug (OTC) under the trade names Enantyum, and Ketesgel, respectively. In Latvia, Lithuania and Estonia it is available as an OTC under the trade name Dolmen. In Mexico it’s available in tablet form as “Stadium”. It is the dextrorotatory stereoisomer of ketoprofen.

Uses

For the short-term relief of mild to moderate pain, including dysmenorrhoea

Warnings

This medicine should not be used inhibitors of CYP3A4 and protease inhibitors. Caution should be exercised when this used in people with hyperthyroidism, renal or hepatic impairment, pre-existing vascular ailment including coronary heart disease, obliterative vascular disease, angina, claudication, peripheral ischaemia, Raynaud’s syndrome and hypertension. This is not to be used when there is sepsis and in pregnant or lactating women.

Side Effects

Nausea, vomiting, dyspepsia, abdominal pain, diarrhoea, gastric, peptic ulcer, GI bleeding, dry mouth, flatulence, headache, dizziness, somnolence, insomnia, palpitations, paraesthesia, syncope, HTN, hypotension, bradypnoea, bronchosposm, fatigue, asthenia, malaise, rash, urticaria, photosensitivity reactions, acne, facial oedema, nephrotic syndrome, menstrual disorder, polyruria, prostatic disorder, pancreatitis, peripheral oedema, neutropenia, abnormal LFT, thrombocytopenia, and increased plasma urea nitrogen.

Potentially Fatal: Anaphylactic shock, Steven-Johnson Syndrome and toxic epidermal necrolysis.

Precautions

History of GI disease, GI symptoms; NSAIDS are associated with serious GI side effects e.g. bleeding, ulceration or perforation. May result in deterioration of fluid retention, renal function and oedema; HTN, hepatic and/or renal mpairment, heart failure.

May inhibit platelet aggregation and prolong bleeding time, concomitant use with warfarin or heparin is not recommended. Non-selective NSAIDs are also associated with a small increased risk of thrombotic events (e.g. stroke, MI). Long term use may impair female fertility. Safety and efficiency in children and adolescent have not been reported. Increased risk of NSAIDS unfavourable reactions in elderly patients.

Associated use of salicylates, other NSAIDs, anticoagulant (e.g. warfarin, heparin) or corticosteroids may increase risk of bleeding and combination use is not recommended.

Caution if used with anti-platelets, thrombolytics, pentoxyfylline, selective serotonin reuptake inhibitors due to increased bleeding risk.

May increase toxic effects of hydantoines and sulphonamides. May reduce effects of antihypertensives. Increased risk of red cell line toxicity with zidovudine, monitor complete blood count and reticulocyte count. Renal function may be worsened when used with ciclosporin or tacrolimus. May increase hypoglycaemic effect of sulfonylureas.

Fatal conditions: NSAIDS may elevate blood lithium levels and haematological toxicity of methotrexate.

Overdose & Brands

Administer activated charcoal if more than 5 mg/kg has been ingested by an adult or a baby within an hour. Symptomatic remedy must be provided. Dexketoprofen is dialysable.

Available brand:

Ketesse