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Instructions for use Ketonal
Buy Ketonal cream 5% 50g
Dosage forms
cream for external use 5%
Manufacturers
Lek d.d. (Slovenia), Salutas Pharma GmbH (Germany)
Group
Anti-inflammatory drugs - derivatives of propionic acid
Compound
The active substance is ketoprofen.
International non-proprietary name
Ketoprofen
Synonyms
Arketal Rompharm, Arthrozilen, Artrum, Bystrumgel, Quickcaps, Valusal, Ketonal Duo, Ketoprofen, Ketoprofen MV, Ketoprofen Organic, Ketoprofen-Verte, Ketoprofen-Vramed, Oki, Fastum, Febrofid, Flamax, Flamax forte, Flexen
pharmachologic effect
Anti-inflammatory, analgesic, antipyretic, antiaggregatory. It has anti-bradykinin activity, stabilizes lysosomal membranes and delays the release of enzymes from them that contribute to tissue destruction during chronic inflammation. When administered orally, it is absorbed quite completely. Absorption is accompanied by a "first pass" effect through the liver. The concentration in the blood is dose-dependent. It easily passes through histohematic barriers and is distributed in tissues and organs. Biotransformirovatsya in the liver (almost completely). Metabolites are excreted in the urine. Reduces morning stiffness and swelling of the joints, increases range of motion.
Indications for use
Rheumatoid arthritis, non-specific spondyloarthritis (ankylosing and psoriatic spondylitis), pain syndrome (postoperative, post-traumatic pain, pain with bone metastases), gouty arthritis, pseudogout, osteoarthritis, extra-articular rheumatism (tendovaginitis, bursitis, capsulitis), renal colic, algomenorrhea. Gel - uncomplicated injuries (sprains and ruptures of tendons and ligaments, muscle bruises, swelling).
Contraindications
Hypersensitivity, renal and hepatic insufficiency, peptic ulcer of the stomach and duodenum in the acute phase, "aspirin" asthma, pregnancy and childhood. Candles - proctitis and proctorragia; Gel - dermatoses, eczema, infected abrasions and wounds (weeping).
Side effect
Headache, dizziness, tinnitus, drowsiness, weakness, visual disturbances, dyspepsia (nausea, vomiting, abdominal pain, diarrhea, flatulence, constipation, anorexia), stomatitis, impaired kidney and liver function, hyperemia, allergic reactions.
Interaction
Increases the toxicity of methotrexate. The concentration of ketoprofen in plasma increases against the background of probenecid (inhibits renal excretion). Enhances the effect of anticoagulants, heparin, ticlopidine, corticosteroids, oral antidiabetic agents and alcohol, weakens - spironolactone, peripheral vasodilators.
Method of application and dosage
Outwardly, the cream is applied in a thin layer over the inflammation 3-4 times a day, then carefully and gently rubbed. The duration of the course is not more than 14 days.
Overdose
No data.
special instructions
Taking ketoprofen may mask signs of an infectious disease. In case of impaired renal and hepatic function, dose reduction and careful monitoring are necessary. Do not allow the gel to get on the mucous membranes and in the eyes. Use with caution during work for drivers of vehicles and people whose profession is associated with increased concentration of attention. At the time of treatment, you should refuse to take alcoholic beverages. In patients with bronchial asthma or allergic diathesis, the use of Ketoprofen may cause bronchospasm.
Storage conditions
At room temperature, protected from light and out of the reach of children.
1 g of cream for external use contains 50 mg of ketoprofen.
Excipients: glycerol sorbitan oleo stearate (Arlacel 481V), copolymer of dodecyl glycol and macrogol 45 (Elfacos ST 9), isopropyl myristate, magnesium sulfate heptahydrate, methyl parahydroxybenzoate E 218, propylene glycol, propyl parahydroxybenzoate E 216, white petrolatum, purified water.
Pharmacotherapeutic group
Non-steroidal anti-inflammatory drugs for topical use.
ATX code: M02AA10.
Indications for use
Ketonal is a non-steroidal anti-inflammatory drug. It has a local analgesic and anti-inflammatory effect. In rheumatology, it is used for the treatment of arthrosis and extra-articular rheumatism as monotherapy or in combination with other systemic forms of ketoprofen. In traumatology, it is used to a lesser extent, mainly for sports injuries of the joints and soft tissues. According to a number of clinical studies, it has been established that ketoprofen for topical use in soft tissue injuries and sports injuries has a pronounced analgesic effect, exceeding the placebo effect and the effect of some other non-steroidal anti-inflammatory drugs.
Ketonal is used:
- for local treatment of pain and inflammation of the joints in rheumatic diseases;
- with post-traumatic pain.
Dosage and administration
For outdoor use.
Adult patients:
Cream for external use Ketonal should be applied to the painful or inflamed area 2-4 times a day, gently rubbing into the skin. The duration of treatment is up to 7 days. The dosage should be adjusted according to the size of the affected area.
Avoid contact with eyes or mucous membranes.
It is not recommended to wear tight clothing (see section "Contraindications").
Wash your hands thoroughly after each application of the cream.
Cream for external use Ketonal can be used in combination with other dosage forms of Ketonal (capsules, tablets, suppositories). The maximum daily dose, regardless of the dosage form, should not exceed 200 mg of ketoprofen.
Elderly patients
There are no specific dosage recommendations for elderly patients. In those most prone to adverse reactions, the lowest dose should be combined with adequate clinical safety monitoring.
Children
Not recommended as safety in children has not been established.
Contraindications
Cream for external use Ketonal is contraindicated in patients with hypersensitivity to ketoprofen or other components of the drug.
The use of cream for external use Ketonal is also contraindicated:
- patients with past hypersensitivity reactions (eg bronchospasm, rhinitis, urticaria) to ketoprofen, other non-steroidal antirheumatic drugs, salicylates (eg acetylsalicylic acid), fenofibrate and thiaprofenic acid;
- patients with acute gastric or duodenal ulcer;
- on damaged and pathologically altered skin, for example, eczema, acne, various dermatoses, open wounds or infectious lesions;
- with tight-fitting clothing;
- under occlusive dressings;
- simultaneously on the same site with other local means;
- during the last trimester of pregnancy;
- Patients with past photosensitivity reactions;
- patients with a history of allergic reactions to ketoprofen, fenofibrate, thiaprofenic acid, UV blockers or odors;
- Exposure of the area of application of the cream to sunlight (including in cloudy weather), as well as UV radiation (solarium) throughout the entire period of treatment and for 2 weeks after discontinuing the use of the drug.
Children: not recommended as safety in children has not been established.
Precautionary measures
Undesirable effects can be reduced by prescribing the lowest effective dose for the shortest period of time necessary to control symptoms.
Although systemic adverse reactions from topical application of ketoprofen should be low, the cream should be used with caution in patients with renal, cardiac or hepatic insufficiency, with a history of gastric or duodenal ulcer or inflammatory bowel disease, cerebrovascular bleeding or hemorrhagic diathesis.
Do not apply Ketonal cream for external use on the mucous membranes, the anus and genitals, around the eyes. Avoid contact with eyes.
When the first signs of a skin reaction appear, the use of ketoprofen should be immediately discontinued.
Topical application of ketoprofen may provoke asthma in susceptible individuals. A large amount of applied cream can cause systemic effects, including hypersensitivity and asthma.
During treatment and for 2 weeks after its completion, skin areas treated with Ketonal cream must be protected with clothing to avoid exposure to UV radiation and the risk of photosensitivity.
It is forbidden to apply the cream under occlusive dressings.
Important information about some Ketonal excipients
The cream contains methyl parahydroxybenzoate E218 and propyl parahydroxybenzoate E216, which are known to cause hives. Usually there is a delayed type of hypersensitivity reactions, such as, for example, contact dermatitis. Rarely, immediate hypersensitivity reactions such as urticaria and bronchospasm may occur.
Interaction with other drugs
Despite the unlikely interaction with other drugs due to the low concentration of ketoprofen in the blood after topical application, patients receiving methotrexate require special attention.
Serious interactions have been described following the use of a high dose of methotrexate and NSAIDs, including ketoprofen, when administered orally or parenterally.
It is advisable to monitor patients receiving coumarin treatment.
Pregnancy and lactation
Pregnancy
The safety of using ketoprofen during pregnancy has not been proven. During the first two trimesters of pregnancy, ketoprofen cannot be prescribed if the expected benefit to the mother does not outweigh the possible risk to the fetus.
Ketoprofen is contraindicated during the last trimester of pregnancy (see section "Contraindications").
The use of ketoprofen in the last third trimester may interfere with the development of labor, cause premature closure of the ductus arteriosus with the development of pulmonary hypertension in the newborn.
Lactation
Ketonal should not be used during breastfeeding, as the safety of using ketoprofen during lactation has not been proven.
Influence on the ability to drive vehicles and work with mechanisms
Not essential.
Side effect
The most common adverse effects associated with topical application of ketoprofen are localized skin reactions that may spread beyond the site of application.
Classification of adverse effects according to "MedDRA" by organs and systems and frequency of occurrence:
very frequent (≥1/10);
frequent (≥1/100,<1/10);
infrequent (≥1/1000,<1/100);
rare (≥1/10,000,<1/1 000);
very rare (<1/10 000), включая отдельные сообщения.
Immune system disorders
Hypersensitivity reactions may include non-specific reactions and anaphylaxis.
Very rare: Angioedema and anaphylaxis have been reported with systemic and local administration of ketoprofen.
Skin and subcutaneous tissue lesions
Uncommon: pruritic rash, erythema, pruritus, burning, eczema and mild transient dermatitis.
Rare: Urticaria, rashes, photosensitivity reactions, blister rupture, purpura, erythema multiforme, lichen-like dermatitis, skin necrosis and Stevens-Johnson syndrome. More severe skin reactions have been described, such as bullous and phlyctenular eczema, which may worsen and spread.
Very rare: Severe contact dermatitis has been described in a patient due to poor hygiene and sun exposure. A severe diffuse contact prolonged photoallergic reaction may occur.
Ketoprofen can cause very prolonged photosensitivity even after one application.
Toxic epidermal necrolysis has been described.
Kidney and urinary disorders
Very rare: Worsening of renal failure has been described.
Overdose
Given the low levels of ketoprofen in the blood when administered topically, no cases of overdose have yet been described.
Pharmacological properties
Pharmacodynamic properties
Mechanism of action
Ketoprofen is one of the most potent inhibitors of the cyclooxygenase enzyme. It also inhibits lipoxygenase activity and bradykinin synthesis. By stabilizing lysosomal membranes, ketoprofen prevents the release of enzymes that are involved in the inflammatory process. Ketoprofen has similar pharmacodynamic properties and effects with non-steroidal anti-inflammatory drugs. It has analgesic, anti-inflammatory and antipyretic effects. The effects of ketoprofen have been established in animal experiments and in many clinical studies in humans.
Pharmacokinetic properties
Absorption
Transdermal absorption of non-steroidal anti-inflammatory drugs in the form of topical dosage forms is determined by the physicochemical properties of the excipients, which determine the rate of release of the active substance from the base and its subsequent absorption. Animal studies (experimental model on mice) have shown an increase in transdermal absorption of ketoprofen and an improvement in skin blood supply with the use of certain bases.
The release rate of ketoprofen from the base of the cream also depends on the pH value: as the pH of the cream increases from 3 to 6, the release rate gradually increases.
Compared to oral formulations, the bioavailability of ketoprofen in cream form is about 5%. Due to the low bioavailability of ketoprofen in the form of a cream, it acts locally and does not have systemic effects.
Distribution
Ketoprofen actively binds to plasma proteins (99%). The active substance is found in the synovial fluid at therapeutic concentrations; its concentration in the blood is negligible. With a triple topical application of 70-80 mg of ketoprofen in the form of a cream on the area of the knee joint, the maximum plasma concentration (0.0182 μg / ml ± 0.118) is observed after 6 hours. Twelve hours after the last application of ketoprofen cream to the area of the knee joints, the following concentrations of ketoprofen in the articular tissues were noted: in adipose tissue 4.7 μg / ml ± 3.87, in the articular membrane 2.35 μg / ml ± 2.41 and in synovial fluid 1.31 µg/ml ± 0.89.
Metabolism and excretion
Ketoprofen is metabolized in the liver to form conjugates, which are excreted mainly in the urine. The metabolism of ketoprofen does not change in the elderly, with severe renal insufficiency or cirrhosis of the liver. Ketoprofen is slowly excreted into the urine.
Ketoprofen50 mg
Excipients: methyl parahydroxybenzoate - 2 mg, propyl parahydroxybenzoate - 0.5 mg, propylene glycol - 70 mg, isopropyl myristate - 50 mg, white petrolatum - 320 mg, Elfakos ST9 - 30 mg, propylene glycol glyceryl oleate - 90 mg, magnesium sulfate - 5 mg, purified water - 382.5 mg.
Release form
100 g - aluminum tubes (1) - packs of cardboard.
pharmachologic effect
NSAIDs. It has analgesic, anti-inflammatory and anti-edema effect. Inhibits the activity of COX, which leads to inhibition of the synthesis of prostaglandins. In addition, ketoprofen inhibits lipoxygenase, bradykinin synthesis, stabilizes lysosomal membranes and prevents the release of enzymes involved in the inflammatory process.
Ketoprofen does not adversely affect the condition of the articular cartilage.
Pharmacokinetics.
Suction
Ketoprofen is absorbed very slowly and practically does not accumulate in the body. Bioavailability is 5%.
Ketoprofen penetrates into the subcutaneous tissue, ligaments and muscles, synovial fluid and reaches therapeutic concentrations there. The concentration of the drug in plasma is extremely low.
Metabolism and excretion
Ketoprofen is metabolized in the liver to form conjugates, which are mainly excreted in the urine. Ketoprofen is characterized by slow excretion in the urine.
Pharmacokinetics in special clinical situations
The metabolism of ketoprofen does not depend on age, the presence of severe renal insufficiency or cirrhosis of the liver.
Indication for use
Symptomatic therapy of painful and inflammatory processes of various origins, including:
rheumatoid arthritis and periarthritis;
ankylosing spondylitis (Bekhterev's disease);
psoriatic arthritis;
reactive arthritis (Reiter's syndrome);
osteoarthritis of various localization;
tendinitis, bursitis;
neuralgia;
radiculitis;
injuries of the musculoskeletal system (including sports), bruises of muscles and ligaments, sprains, ruptures of ligaments and tendons of muscles.
Methods of application and doses
For outdoor use.
A small amount of cream (about 3-5 cm) is applied with light rubbing movements in a thin layer on the skin over the lesion. The cream is applied 2-3 times / day.
The duration of treatment without consulting a doctor should not exceed 14 days.
Side effects
Most often there are local reactions.
Determining the frequency of adverse reactions: very often (≥1/10), often (≥1/100 and<1/10), нечасто (≥1/1000 и<1/100), редко (≥1/10 000 и <1/1000), очень редко (<10 000).
Allergic reactions: very rarely - angioedema, anaphylaxis.
From the skin and skin appendages: infrequently - erythema, itching, burning, eczema, mild transient dermatitis; rarely - urticaria, rash, photosensitivity, bullous dermatitis, purpura, erythema multiforme, lichenoid dermatitis, skin necrosis, Stevens-Johnson syndrome; very rarely - a single case of severe contact dermatitis (against the background of poor hygiene and insolation), a single case of severe generalized photodermatitis, toxic epidermal necrolysis.
From the respiratory system: very rarely - asthmatic attacks (as a variant of an allergic reaction).
From the urinary system: very rarely - deterioration of kidney function in patients with chronic renal failure.
Contraindications
Hypersensitivity to the components of the drug;
hypersensitivity to salicylates, thiaprofenic acid or other NSAIDs, to fenofibrate, UV blockers, fragrances;
violation of the integrity of the skin (eczema, weeping dermatitis, open or infected wound);
indications in the history of asthma attacks caused by taking NSAIDs and salicylates;
history of photosensitivity reactions;
exposure to sunlight, incl. indirect sunlight and UV irradiation in a solarium throughout the entire period of treatment and for another 2 weeks after stopping treatment;
III trimester of pregnancy;
children's age up to 15 years.
With caution: impaired liver and / or kidney function, erosive and ulcerative lesions of the gastrointestinal tract, blood diseases, bronchial asthma, chronic heart failure.
Use during pregnancy and lactation
The drug is contraindicated for use in the third trimester of pregnancy.
Application in the I and II trimesters is possible in cases where the expected benefit of therapy for the mother outweighs the potential risk to the fetus.
The use of the drug Ketonal® during lactation (breastfeeding) is not recommended.
special instructions
It is necessary to avoid getting the cream in the eyes, on the skin around the eyes, mucous membranes.
If any side effects occur, stop using the drug and consult a doctor.
If the patient has forgotten to apply the cream, use it at the time the next dose is due, but do not double it.
Ketonal® cream for external use can be used in combination with other dosage forms of Ketonal® (capsules, tablets, suppositories). The total daily dose, regardless of the dosage form, should not exceed 200 mg.
With the appearance of skin reactions, incl. developed when used together with octocrylene-containing drugs, treatment should be stopped immediately.
To reduce the risk of developing photosensitivity, it is recommended to protect the skin areas treated with the cream with clothing from exposure to UV radiation throughout the entire treatment period and for another 2 weeks after stopping the use of the gel.
Do not use as an occlusive dressing.
Wash your hands thoroughly after each application of the drug.
Influence on the ability to drive vehicles and control mechanisms
There are no data on the negative effect of Ketonal® cream on the ability to drive vehicles and other potentially hazardous activities that require concentration and psychomotor speed.
Overdose
Symptoms: irritation, erythema, itching.
Treatment: stop using the drug. The patient needs to see a doctor.
Drug Interactions
Since the concentration of the drug in the blood plasma is extremely low, manifestations of symptoms of interaction with other drugs (similar symptoms with systemic use) are possible only with frequent and prolonged use.
Simultaneous administration of acetylsalicylic acid reduces the degree of binding of ketoprofen to plasma proteins.
Ketoprofen reduces the excretion of methotrexate and increases its toxicity.
Interaction with other drugs and the effect on their excretion are not significant.
Patients taking coumarin-containing anticoagulants should be treated under medical supervision.
Storage conditions
The drug should be stored out of the reach of children at a temperature not exceeding 25 ° C.
Excipients: methyl parahydroxybenzoate - 2 mg, propyl parahydroxybenzoate - 0.5 mg, propylene glycol - 70 mg, isopropyl myristate - 50 mg, white petrolatum - 320 mg, Elfakos ST9 - 30 mg, propylene glycol glyceryl oleate - 90 mg, - 5 mg, purified water - 382.5 mg.
30 g - aluminum tubes (1) - packs of cardboard.
50 g - aluminum tubes (1) - packs of cardboard.
pharmachologic effect
NSAIDs. It has analgesic, anti-inflammatory and anti-edema effect. Inhibits the activity of COX, which leads to inhibition of the synthesis of prostaglandins. In addition, ketoprofen inhibits lipoxygenase, bradykinin synthesis, stabilizes lysosomal membranes and prevents the release of enzymes involved in the inflammatory process.
Ketoprofen does not adversely affect the condition of the articular cartilage.
Pharmacokinetics
Suction
Ketoprofen is absorbed very slowly and practically does not accumulate in the body. Bioavailability is 5%.
Ketoprofen penetrates into the subcutaneous tissue, ligaments and muscles, synovial fluid and reaches therapeutic concentrations there. The concentration of the drug in the blood is extremely low.
Metabolism and excretion
Ketoprofen is metabolized in the liver to form conjugates, which are mainly excreted in the urine. Ketoprofen is characterized by slow excretion in the urine.
Pharmacokinetics in special clinical situations
The metabolism of ketoprofen does not depend on age, the presence of severe or cirrhosis of the liver.
Indications
Symptomatic therapy of painful and inflammatory processes of various origins, including:
- rheumatoid arthritis and periarthritis;
- ankylosing spondylitis (Bekhterev's disease);
- psoriatic arthritis;
- reactive arthritis (Reiter's syndrome);
- osteoarthritis of various localization;
- tendinitis, bursitis;
- myalgia;
- neuralgia;
- radiculitis;
- injuries of the musculoskeletal system (including sports injuries), bruises of muscles and ligaments, sprains, ruptures of ligaments and tendons of muscles.
Contraindications
- hypersensitivity to the components of the drug;
- hypersensitivity to salicylates, thiaprofenic acid or other NSAIDs, to fenofibrate, UV blockers, fragrances;
- violation of the integrity of the skin (eczema, weeping dermatitis, open or infected wound);
- indications in the anamnesis of attacks of bronchial asthma caused by taking NSAIDs and salicylates;
- history of photosensitivity reactions;
- exposure to sunlight, incl. indirect sunlight and UV irradiation in a solarium throughout the entire period of treatment and for another 2 weeks after stopping treatment;
- III trimester of pregnancy;
- children's age up to 15 years.
Carefully: dysfunction of the liver and / or kidneys, erosive and ulcerative lesions of the gastrointestinal tract, blood diseases, bronchial asthma, chronic insufficiency.
Dosage
For outdoor use.
A small amount of cream (about 3-5 cm) is applied with light rubbing movements in a thin layer on the skin over the lesion. The cream is applied 2-3 times / day.
The duration of treatment without consulting a doctor should not exceed 14 days.
Side effects
Most often there are local reactions.
Determining the frequency of adverse reactions: very often (≥1/10), often (≥1/100 and<1/10), нечасто (≥1/1000 и<1/100), редко (≥1/10 000 и <1/1000), очень редко (<10 000).
Allergic reactions: very rarely - angioedema, anaphylaxis.
From the skin and skin appendages: infrequently - erythema, itching, burning, eczema, mild transient dermatitis; rarely - urticaria, rash, photosensitivity, bullous dermatitis, purpura, erythema multiforme, lichenoid dermatitis, skin necrosis, Stevens-Johnson syndrome; very rarely - a single case of severe contact dermatitis (against the background of poor hygiene and insolation), a single case of severe generalized photodermatitis, toxic epidermal necrolysis.
From the respiratory system: very rarely - asthmatic attacks (as a variant of an allergic reaction).
From the urinary system: very rarely - deterioration of kidney function in patients with chronic renal failure.
Overdose
Symptoms: irritation, erythema, itching.
Treatment: the drug should be discontinued. The patient needs to see a doctor.
drug interaction
Since the concentration of the drug in the blood plasma is extremely low, manifestations of symptoms of interaction with other drugs (similar symptoms with systemic use) are possible only with frequent and prolonged use.
Simultaneous administration reduces the degree of binding of ketoprofen to plasma proteins.
Ketoprofen reduces the excretion of methotrexate and increases its toxicity.
Interaction with other drugs and the effect on their excretion are not significant.
Patients taking coumarin-containing anticoagulants should be treated under medical supervision.
special instructions
It is necessary to avoid getting the cream in the eyes, on the skin around the eyes, mucous membranes.
If any side effects occur, stop using the drug and consult a doctor.
If the patient has forgotten to apply the cream, use it at the time the next dose is due, but do not double it.
Cream for external use can be used in combination with other dosage forms of the drug Ketonal (capsules, tablets, suppositories). The total daily dose, regardless of the dosage form, should not exceed 200 mg.
With the appearance of skin reactions, incl. developed when used together with octocrylene-containing drugs, treatment should be stopped immediately.
To reduce the risk of developing photosensitivity, it is recommended to protect the skin areas treated with the cream with clothing from exposure to UV radiation throughout the entire treatment period and for another 2 weeks after stopping the use of the gel.
Content
Ketonal ointment, familiar to many, has a broad therapeutic effect, antipyretic effect and is mainly used in the treatment of edema of muscle tissues, inflammation of the joints or injuries of the musculoskeletal system. The drug is a non-steroidal anti-inflammatory drug (NSAID), you can buy it at the pharmacy. Before using the medicine, it is necessary to find out the main points - composition, price, pharmacodynamics and pharmacokinetics, side effects, interactions with other drugs.
Ointment Ketonal - what helps
It is easy to figure out whether the ointment is effective in eliminating inflammatory reactions in the joints and cartilage that cause discomfort - just use it. Has an antipyretic effect. Find out below about the benefits and main warnings, taking into account the form of release, indications for use, nuances of the active substance, interaction with alcohol and drugs in order to avoid allergic and other negative reactions.
Compound
Cream Ketonal in composition is no different from an ointment, in fact, this is the same form of the drug, which has a different name. The medicine is an anesthetic that relieves pain in inflammatory diseases of the joints. The dose of ketoprofen (the main active ingredient) per gram of ointment is 50 mg. Due to good penetration into the synovial fluid in the joint cavity, this component has an analgesic and antiaggregatory effect, relieves inflammation in the joints and muscles.
Release form
Ketonal belongs to the group of non-steroidal drugs, has a uniform white consistency. This drug is sold in aluminum tubes at a dosage of 30 to 50 grams with a protective membrane, packed in white-orange cardboard packs. The drug can be produced both in the form of an ointment and a cream, in addition to this, you can also find the gel structure of the drug. In addition, Ketonal is available in the following forms:
- injections (solution for injection with a volume of 2 mg);
- tablets;
- capsules;
- candles.
Pharmacodynamics and pharmacokinetics
Due to the fact that the concentration of ketoprofen in the ointment is high, the drug has an anti-inflammatory effect, and in addition, it has an analgesic and antipyretic effect. The active ingredient is responsible for blocking the enzymes cyclooxygenase and lipogenesis, which are responsible for the synthesis of prostaglandins. This contributes to the reduction of inflammatory processes, relieves the pain syndrome or fever caused by them.
The impact of even a small amount of ketoprofen occurs both on the central nerve fibers and on the peripheral ones responsible for the perception / transmission of a pain impulse. For this reason, Ketonal is considered an effective drug that not only relieves pain, but also helps even with chronic inflammation of the joints. In case of problems with the joints, the cream relieves swelling and eliminates the stiffness of the affected areas of the body.
The adsorption process is slow, so the concentration of the drug in the blood is minimal, but may increase if the ointment is used for a long time. The breakdown of the drug occurs in the liver, after which it is excreted by the kidneys. The agent has a weak pharmacokinetic effect, due to which accumulation in the body does not occur. Bioavailability does not exceed 5%. The maximum concentration is achieved in the muscular and ligamentous apparatus. When using an ointment or gel, the concentration in the blood is minimal.
Indications for use Ketonal ointment
The drug is used in the treatment of any inflammatory or painful processes, it is used for:
- radiculitis;
- periarthritis;
- neuralgia;
- arthritis;
- ankylosing spondylitis;
- Reiter's syndrome;
- tendinitis;
- bursitis;
- psoriatic disease of the joints;
- osteoarthritis of various localization.
The composition is prescribed for any diseases of the musculoskeletal system, as well as for those who suffer from severe pain syndromes in the muscles due to excessive physical exertion. The drug has an analgesic effect when:
- bruises;
- dislocations;
- sprains;
- tendon ruptures.
Ketonal ointment - instructions for use
In accordance with the instructions for external use, before using the drug, a medical consultation is necessary to identify contraindications. If the latter are absent, then you can start using the medicine. The doctor prescribes an individual dosage, frequency of application and course of treatment. The areas of the skin covered with cream should be located above the site of localization of pain or inflammation.
The average dosage is a strip with a layer of 3 to 5 centimeters, which must be applied with massage movements. After a while, the drug has an analgesic effect. The treated area does not require the application of an occlusive dressing. In rare cases, a bandage is used. The maximum dose per day is 200 mg of ketoprofen. This amount is applied 1-2 times a day. The duration of the course of treatment with this anti-inflammatory drug is no more than 14 days. Longer use may lead to the development of side effects.
special instructions
Do not apply ointment to the eyelids, mucous membranes or skin around the eyes. Do not use the drug on skin with weeping dermatitis, diaper rash, rash, open wounds or scratches. Hands should be washed thoroughly after use. The maximum daily dose should not exceed 0.2 grams of the active substance. In case of side effects, you should consult a doctor. To reduce photosensitivity, it is required to limit the smeared areas of the skin from contact with UV rays during the entire period of treatment plus two weeks after stopping the use of the ointment.
When interacting with thrombolytics, antiplatelet agents, anticoagulants and benzoylacetic acid derivatives, bleeding of different localization may begin. Gel and ointment do not affect the speed of reaction, there are no restrictions on driving vehicles. Ketoprofen can affect the rate of excretion of Methotrexate, which increases its toxicity. Treatment of patients taking drugs that reduce blood clotting is carried out under the strict supervision of a physician.
When using Ketonal for more than 1 week, it is mandatory. take a general blood test, as well as monitor the functioning of the kidneys and liver. Particular attention should be paid to the indicators of elderly people over 65 years of age. The drug is used with caution if the patient has hypertension or heart pathologies that are combined with edema. In such cases, it is necessary to carefully monitor the level of blood pressure.
During pregnancy and lactation
The instruction indicates that it is strictly forbidden to use the drug upon the onset of the 28th week of pregnancy. Use is allowed only in the 1st and 2nd trimester, under medical supervision. The use of the drug without consultation is fraught with serious consequences - the occurrence of complications. The use of the drug is possible only when the benefits to the mother's body outweigh the risks. Ketonal during lactation is used under the condition of temporary refusal of breastfeeding.
drug interaction
Only a small amount of the drug enters the blood, so the interaction with other drugs is poorly expressed. However, with prolonged use, Ketonal can interact with anticoagulants, as a result of which there is a risk of bleeding of different localization. Other clarifications:
- It is necessary to avoid the use of ointment with large doses of Methotrexate.
- With simultaneous use with ethyl alcohol or glucocorticosteroids, there is a risk of manifestations of peptic ulcer or bleeding in the gastrointestinal tract.
- When used with diuretic drugs, there is a risk of kidney problems. In addition, the drug reduces the effectiveness of drugs of this type, designed to lower blood pressure.
- The therapeutic effect of hypoglycemic agents increases when interacting with Ketonal.
Side effects
If you do not violate the instructions indicated on the drug, then it is practically safe, otherwise you can get a lot of problems and negative skin reactions. Side effects of Ketonal include skin redness, itching or burning, transient dermatitis, eczema. Rare manifestations of photosensitivity, urticaria, rash, bullous dermatitis, erythema multiforme, purpura, lichenoid dermatitis, skin necrosis and Stevens-Johnson syndrome. Among isolated cases, severe contact dermatitis and generalized photodermatitis are noted.
Overdose
The main symptoms of an excess of the drug in the body are redness of the skin, itching or burning, skin irritation. Ketonal in the form of tablets and injections can cause nausea, vomiting with bloody discharge, abdominal pain, impaired consciousness, respiratory depression, convulsions. To eliminate the symptoms of an overdose, you must try to remove all the remnants of the cream on the body and remove the substance from the body. It is necessary to wash the stomach and use sorbents. After that, symptomatic therapy is carried out.
Contraindications
The ointment should not be used in patients who are allergic to the active ingredient of the drug - ketoprofen. Not recommended for people suffering from bronchial asthma. The use of the drug is prohibited under the age of 15 years and in patients suffering from photosensitivity, rhinitis, chronic dyspepsia, exacerbation of peptic ulcer of the stomach, severe renal failure. Ketonal is not used for skin diseases, on damaged surfaces.
The cost of this drug depends on the pricing policy of the place of sale, region and localization, as well as delivery conditions. In addition, the brand of the pharmacy where this product is sold affects the price, the more popular the brand, the more expensive the drug. Find out how much Ketonal costs in Russia from the table:
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