Ketonal - official instructions for use. Instructions for use. Therapeutic effects of Ketonal

• Solution - ketoprofen , propylene glycol, ethanol, benzyl alcohol, sterile water.
• Gel- ketoprofen, trolamine, ethanol, lavender essential oil, sterile water.
• Cream- ketoprofen, isopropyl myristate, methylhydroxybenzoate, propylene glycol, propylhydroxybenzoate, white petrolatum, magnesium sulfate, elfakos ST9, propylene glycol oleate, glyceryl, water.
• Tablets- silicon dioxide, magnesium stearate, talc, corn starch, lactose, , hypromellose, titanium dioxide, indigo carmine, wax, talc.
• Capsules- ketoprofen, microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, povidone, polysorbate, purified water, eudragit, triethyl citrate, talc, yellow iron oxide, purified water, silicon dioxide, titanium dioxide, gelatin.
• suppositories- ketoprofen, solid fat, glyceryl caprylocaprate.

Release form

• Solution 50 mg/ml for intravenous and intramuscular administration - in dark glass ampoules of 2 ml, in a blister of 5 and 10 ampoules in a carton No. 10.2
• Gel 2.5%- for external use, colorless, transparent, homogeneous in an aluminum tube of 50, 100 g in a carton.
• Cream 5%- for external use, homogeneous, white in an aluminum tube of 30.50 g in a carton.
• Tablets Ketonal 50 mg- biconvex round shape, coated in dark glass bottles of 20 pcs. in carton.
• Capsules 50 mg with modified release - blue in a blister in a carton No. 20, 30.
• Suppositories rectal- smooth, white, homogeneous in a blister pack of 6 suppositories in a carton No. 12.

pharmachologic effect

Anti-inflammatory, decongestant, analgesic, antipyretic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Ketoprofen inhibits activity cyclooxygenases which inhibits the synthesis process prostaglandins .

The drug also inhibits the synthesis bradykinin , lipoxygenase , stabilizes lysosomal membranes in the cell and inhibits the production of enzymes that are involved in the inflammatory process. Ketoprofen has no negative effect on the state of the articular cartilage.

Pharmacokinetics

Suction process ketoprofen in the body is very slow and in the body it practically does not accumulate. Bioavailability - 5%. The drug penetrates well and reaches therapeutic concentrations in the synovial fluid, muscles, ligaments, subcutaneous tissue. In plasma, its concentration is negligible. Metabolized in the liver to form conjugates. Excreted with urine. Slowly.

Indications for use

Indications for the use of various forms of the drug are identical. The choice of the form of release of the drug is carried out on the basis of a number of factors (type of disease, ease of administration).

The drug is prescribed in the following cases:

• Symptomatic treatment of inflammatory and degenerative diseases of the musculoskeletal system ( different genesis, , , , articular and non-articular , myalgia , tendinitis , , , shoulder-shoulder syndrome, injuries of the musculoskeletal system - sprains and ruptures of ligaments, muscle bruises)
• Relief of pain syndrome with myalgia, bursitis, tendinitis, neuralgia, sciatica, , headache, algomenorrhea , renal colic, post-traumatic pain syndrome, oncological diseases, , lumbago , and lymphangitis , phlebitis .

Contraindications

Individual hypersensitivity to the drug and other NSAIDs, blood clotting disorders, childhood, liver/renal failure , , exacerbation , , the period after surgery, lactation and during pregnancy in the 3rd trimester.

Administer cautiously if there is a history of , peptic ulcer; , arterial hypertension , simultaneous reception anticoagulants , cardiovascular diseases, long-term treatment with NSAIDs, in the elderly.

Side effects

Side effects of the drug can be manifested by violations from different body systems:

• anaphylactic reactions;
• anemia , leukopenia , thrombocytopenia , , disorders of bone marrow function;
• asthenia , insomnia, depression , drowsiness, dizziness, headache, convulsions, confusion;
• tinnitus, eye pain, blurred vision, , hearing loss;
• , increased blood pressure, heart failure;
• nosebleeds, bronchospasm , , swelling of the larynx;
• nausea, dyspepsia pain in the abdomen, , , ;
• hepatitis ;
• skin itching and rash, photosensitivity;
• , , hematuria ;
• peripheral edema, fatigue;
• weight gain, thirst, .

Application instruction of Ketonal (Way and dosage)

Tablets Ketonal, instructions for use

Take orally 1 tablet of Ketonal (50 mg) twice a day or Ketonal Forte (100 mg), swallowing whole and drinking at least 100 ml of liquid (water, milk) after meals.

The maximum daily dose of the drug should not exceed 200 mg per day. In this case, Ketonal tablets can be combined with other forms of the drug (cream, suppositories). You can take prolonged-release tablets (Ketonal Retard) - once a day, 150 mg (1 tablet).

Cream Ketonal, instructions for use

Apply a little 5% of the cream (3–5 cm) to the skin and rub Ketonal cream 2–3 times a day into problem areas of the body with light movements. The duration of self-treatment should not exceed two weeks. If there is no effect, you should contact a specialist. Sometimes, cream patients mistakenly say "ointment".

Gel Ketonal, instructions for use

The gel is applied in the same way as a cream. The dosage of the gel must be selected in accordance with the area of ​​\u200b\u200bthe problem area. Approximate dosage - 5 cm of the gel corresponds to 100 mg of Ketonal.

Capsules Ketonal, instructions for use

For arthritis, dysmenorrhea, osteoarthritis and mild to moderate pain, take one capsule orally with meals with milk or water every six hours. It is possible in combination with a solution for injection, suppositories, taking into account the maximum daily dose. It is recommended to take it concomitantly with antacids .

Ketonal injections, instructions for use

For parenteral use, the drug is administered as an intramuscular injection in the amount of 100 mg 1-2 times a day. In / infusion: the procedure is carried out in a hospital. Short infusion - ketoprofen in ampoules (100–200 mg) is diluted in a solution of 0.9% sodium chloride (100 ml) and administered over one hour, repeated administration no earlier than eight hours later. With prolonged infusion, the drug (100–200 mg) is diluted in 500 ml or 0.9% sodium chloride and administered over eight hours. IV Ketonal can be administered together with centrally acting analgesics .

Candles Ketonal, instructions for use

Enter rectal suppositories into the rectum, as deep as possible, one suppository 1-2 times a day. You can combine the administration of suppositories with oral forms of the drug (tablets, capsules).

Overdose

An overdose of the drug is accompanied by nausea, abdominal pain, vomiting, impaired consciousness, convulsions, respiratory depression, and renal failure.

Interaction

Ketoprofen reduces efficiency antihypertensive drugs and diuretics , enhances the action hypoglycemic oral drugs and a number anticonvulsants ( ).

Simultaneous reception with anticoagulants , antiplatelet agents and thrombolytics increases the risk of bleeding. Taking Ketonal with salicylates , others NSAIDs , ethanol and GKS increases the risk of developing complications from the gastrointestinal tract.

Ketonal increases blood concentration lithium preparations , cardiac glycosides , bkk , , , and when administered simultaneously with potassium-sparing diuretics , ACE inhibitors , , low molecular weight heparins and an increased risk of developing hyperkalemia .

Terms of sale

Without recipe.

Storage conditions

Ketonal's analogs in the form suppositories - Artrum , Orouvel , Flexen , artrosilene .

The price of analogues can differ significantly from the cost of Ketonal. When changing the drug, you should consult a specialist.

Reviews about Ketonal

On the Internet, you can find numerous reviews about Ketonal, mostly favorable. The most favorable reviews about Ketonal tablets and injections:

• “... I had a kidney stone coming out, hellish pain, neither baralgin nor other analgesics helped. The ambulance doctor gave injections of Ketonal and the pain was almost immediately relieved. An excellent pain reliever, not a drug and affordable.”.
• “… I was extracting a tooth. When the tooth was removed, it crumbled and when they began to pull out the roots, there was a hell of a pain. But after the injection of Ketonal, I stopped feeling pain. Good medicine for toothache.
• "... I suffer from osteochondrosis, from which I drink Ketonal tablets and use a cream, it helps a lot."

Many patients leave good reviews about Ketonal cream and often call it "ointment": “... my mother has been using Ketonal ointment for arthrosis for a long time. The drug well and quickly relieves pain in the knee joints. It's not the cheapest drug, but it's very effective.".

There are also negative reviews: “... I ride a horse. After the fall, the ankle joint began to hurt badly. I have been using the cream for a month. It did not help, the joint continued to hurt. We got “horse balm” at the hippodrome - an excellent result”.

Those who are not familiar with the drug ask the question: “ what is Ketonal ointment for?» It is successfully used for injuries of the ligamentous apparatus and muscles, which is very important for people leading an active lifestyle. What else can ointment be used for? Topical treatment in the form of a cream, ointment, gel is very effective for inflammation of the veins (phlebitis). In this case, NSAIDs are prescribed in parallel with venotonics and thrombolytics.

Reviews of the gel are also positive, and it is noted that this dosage form is absorbed more easily and quickly, leaving no marks on the skin and clothes, the use of the gel is more economical.

There are numerous positive reviews about candles in gynecology: “... My menstrual cycle is almost always accompanied by severe pain. That I just didn't drink. The emergency doctor advised Ketonal suppositories and the pain receded. Of course, the application procedure is not very pleasant. After the introduction of the candle, I feel discomfort (slight burning and itching), but they quickly stop the pain and the effect lasts all day. Great tool".

Ketonal price, where to buy

The price of Ketonal depends on the form of the drug.

Price Ketonala in injections(ampoules 2 ml 100 mg) No. 10 varies between 230 - 305 rubles per pack; ampoules Ketonal No. 50 - 957 - 1490 rubles.

Price Ketonal tablets 100 mg No. 20 ranges from 200 to 210 rubles; tablets Ketonal Retard 150 mg No. 20 -235 - 302 rubles.

Price Ketonal capsules 50 mg No. 25 is 105 - 115 rubles.

Price cream Ketonal 5% in a tube of 30 g varies between 230 - 297 rubles; 50 g - from 310 to 395 rubles.

Price Gel Ketonal 2.5% in a tube of 100 g ranges from 338 to 466 rubles per pack.

Price Ketonala in candles No. 12 pieces varies from 283 to 345 rubles.

You can buy drugs without difficulty in most pharmacies in Moscow and other cities.

• Internet pharmacies in Russia Russia
• Internet pharmacies in Ukraine Ukraine
• Internet pharmacies of Kazakhstan Kazakhstan

WER.RU

Ketonal Duo capsules 150 mg 30 pcs. Lek d. d. [Lek d.d.]

Ketonal forte tablets 100 mg 20 pcs. Lek d. d. [Lek d.d.]

Ketonal capsules 50 mg 25 pcs. Lek d. d. [Lek d.d.]

Ketonal suppositories 100 mg 12 pcs. Lek d. d. [Lek d.d.]

Ketonal cream for external use 0.05 30 gSalutas Pharma

Europharm * 4% discount with promo code medical11

Ketonal suppositories 100 mg n12Sandoz Ilach Sanai Ve Tijaret A.S.

Ketonal cream 5% 50 gSalutas Pharma Gmbh

Ketonal gel 2.5% 50 gSandoz d.d./Salutas Pharma GmbH

Ketonal cream 5% 100 gSalutas Pharma Gmbh

Ketonal gel 2.5% 100 gSalutas Pharma Gmbh

Instructions for use

Active ingredients

Release form

Compound

1 capsule contains: Active substance: ketoprofen 50 mg. Excipients: lactose, magnesium stearate, colloidal silicon dioxide. Capsule shell composition: gelatin, titanium dioxide, patent blue dye Patent blue V.

Pharmacological effect

NSAIDs, a derivative of propionic acid. It has analgesic, anti-inflammatory and antipyretic effects. By inhibiting COX-1 and COX-2 and, in part, lipoxygenase, ketoprofen inhibits the synthesis of prostaglandins and bradykinin, stabilizes lysosomal membranes. Ketoprofen does not adversely affect the state of articular cartilage.

Pharmacokinetics

Absorption When taken orally, ketoprofen is readily absorbed from the gastrointestinal tract. Bioavailability - 90%. When taking the drug at a dose of 100 mg, Cmax in blood plasma is reached after 1 hour 22 minutes and is 10.4 μg / ml. When taking prolonged-release tablets, Cmax is reached after 4-6 hours. Food intake does not affect the bioavailability of ketoprofen. The distribution of Vd is 0.1-0.2 l / kg. Plasma protein binding is 99%. Ketoprofen penetrates well into the synovial fluid. Metabolism It undergoes intensive metabolism in the liver through microsomal enzymes, conjugates with glucuronic acid. Excretion T1 / 2 of ketoprofen is 1.6-1.9 hours. Ketoprofen is mainly metabolized in the liver. About 80% of ketoprofen is excreted in the urine, mainly as a conjugate with glucuronic acid (90%). About 10% is excreted unchanged through the intestines. Pharmacokinetics in special clinical situations In patients with renal insufficiency, ketoprofen is excreted more slowly, T1 / 2 increases by 1 hour. In patients with hepatic insufficiency, ketoprofen may accumulate in tissues. In elderly patients, metabolism and excretion ketoprofen occur more slowly, but this is of clinical importance only for patients with reduced renal function.

Contraindications

diseases of the gastrointestinal tract in the acute phase; severe liver dysfunction; severe renal dysfunction; blood disorders (leukopenia, thrombocytopenia, disorders of the blood coagulation system); Children's age up to 15 years; hemorrhoids and proctitis (for suppositories); hypersensitivity to ketoprofen, acetylsalicylic acid or other NSAIDs (a history of bronchospasm, urticaria and rhinitis caused by taking acetylsalicylic acid).

Use during pregnancy and lactation

The use of ketoprofen in the third trimester of pregnancy is contraindicated. In the I and II trimesters of pregnancy, the appointment of the drug is possible only if the intended benefit to the mother outweighs the potential risk to the fetus. When taking the drug during lactation, the issue of stopping breastfeeding should be decided.

Dosage and administration

Adults: the drug is prescribed 1-2 caps. 2-3 times / day, or 1 tab. 2 times / day, or 1 tab. prolonged action 1 time / day. Capsules and tablets should be taken during or immediately after a meal, without chewing, drinking plenty of water or milk (liquid volume - at least 100 ml). Oral forms can be combined with the use of rectal suppositories or dosage forms Ketonal for external use (cream, gel). The maximum daily dose (including when using various dosage forms) is 200 mg.

Side effects

Allergic reactions: common - skin reactions (itching, urticaria); uncommon - rhinitis, shortness of breath, bronchospasm, angioedema, anaphylactoid reactions. Digestive system: common - dyspepsia (nausea, diarrhea or constipation, flatulence, vomiting, decreased or increased appetite), abdominal pain, stomatitis, dry mouth, uncommon (with long-term use in high doses) - ulceration of the gastrointestinal mucosa, impaired liver function; rare - perforation of the digestive tract, exacerbation of Crohn's disease, melena, gastrointestinal bleeding. CNS: common - headache, dizziness, sleep disturbance, fatigue, nervousness, nightmares; rare - migraine, peripheral polyneuropathy; very rare - hallucinations, disorientation and speech disorder. Sense organs: rare - tinnitus, change in taste, blurred vision, conjunctivitis. CCC: uncommon - tachycardia, arterial hypertension, peripheral edema. nephritis, nephrotic syndrome, hematuria (more often develop in people who take NSAIDs and diuretics for a long time). Others: rare - hemoptysis, menometrorrhagia. Laboratory indicators: ketoprofen reduces platelet aggregation; transient increase in the level of liver enzymes; rare - anemia, thrombocytopenia, agranulocytosis, purpura.

Overdose

Symptoms: nausea, vomiting, abdominal pain, vomiting with blood, melena, impaired consciousness, respiratory depression, convulsions, impaired renal function, renal failure. Treatment: gastric lavage, administration of activated charcoal, symptomatic therapy is carried out. The use of histamine H2 receptor blockers, proton pump inhibitors, prostaglandin inhibitors is shown. There is no specific antidote.

Interaction with other drugs

Ketoprofen reduces the effect of diuretics, antihypertensive drugs. Enhances the effect of oral hypoglycemic drugs. Enhances the effect of some anticonvulsants (eg, phenytoin). When used simultaneously with other NSAIDs, salicylates, corticosteroids and ethanol, the risk of gastrointestinal bleeding increases. When used simultaneously with anticoagulants , thrombolytics, antiplatelet agents increases the risk of bleeding. The risk of developing renal dysfunction increases when taken with diuretics or ACE inhibitors. When used simultaneously, it increases the concentration of cardiac glycosides, slow calcium channel blockers, lithium preparations, cyclosporine, methotrexate. Ketoprofen may reduce the effectiveness of mifepristone. NSAIDs should be started no earlier than 8-12 days after the abolition of mifepristone.

special instructions

Ketonal can be taken with milk or taken with antacids to reduce the frequency of gastrointestinal disorders (milk and antacids do not affect the absorption of ketoprofen). With prolonged use of NSAIDs, it is necessary to monitor the state of the blood, as well as liver and kidney function, especially in elderly patients It is necessary to be careful and control blood pressure more often when using ketoprofen for the treatment of patients with arterial hypertension, cardiovascular diseases that lead to fluid retention. Like other NSAIDs, ketoprofen may mask the symptoms of infectious diseases. there is no negative effect of Ketonal at recommended doses on the ability to drive a car or work with mechanisms. At the same time, patients who notice non-standard effects when taking Ketonal should be careful when engaging in potentially hazardous activities that require increased concentration and psychomotor speed.

In this article, you can read the instructions for using the drug Ketonal. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Ketonal in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Ketonal in the presence of existing structural analogues. Use for symptomatic treatment of inflammatory diseases and pain relief in adults, children, as well as during pregnancy and lactation.

Ketonal- non-steroidal anti-inflammatory drug, a derivative of propionic acid. It has analgesic, anti-inflammatory and antipyretic effects. By inhibiting COX-1 and COX-2 and, in part, lipoxygenase, ketoprofen inhibits the synthesis of prostaglandins and bradykinin, and stabilizes lysosomal membranes.

Ketoprofen (the active substance of the drug Ketonal) does not adversely affect the condition of the articular cartilage.

Pharmacokinetics

When taken orally, Ketonal is easily absorbed from the gastrointestinal tract. Eating does not affect the bioavailability of Ketoprofen. Ketoprofen penetrates well into the synovial fluid. Ketoprofen is mainly metabolized in the liver. About 80% of ketoprofen is excreted in the urine, mainly as a conjugate with glucuronic acid (90%). About 10% is excreted unchanged through the intestines.

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;
• tendonitis, bursitis;
• myalgia;
• neuralgia;
• radiculitis;
• injuries of the musculoskeletal system (including sports), bruises of muscles and ligaments, sprains, ruptures of ligaments and tendons of muscles.

Release forms

Tablets 100 mg and 150 mg.

Candles for rectal use 100 mg.

Cream or ointment for external use 5%.

Gel for external use 2.5%.

Capsules Ketonal Uno 200 mg.

Capsules Ketonal Duo 150 mg.

Solution for intravenous and intramuscular administration (injections in ampoules for injection) 50 mg / ml.

Instructions for use and dosing regimen

Tablets and capsules

For adults, the drug is prescribed 1-2 capsules 2-3 times a day, or 1 tablet 2 times a day, or 1 tablet of prolonged action 1 time a day. Capsules and tablets should be taken during or immediately after a meal, without chewing, drinking plenty of water or milk (liquid volume - at least 100 ml).

Oral forms can be combined with the use of rectal suppositories or dosage forms of Ketonal for external use (cream, gel).

The maximum daily dose (including the use of various dosage forms) is 200 mg.

Ampoules

The solution is administered intramuscularly or intravenously. In / m administered 100 mg 1-2 times a day. In / in the infusion administration of ketoprofen is carried out only in a hospital.

Short intravenous infusion: 100-200 mg, diluted in 100 ml of 0.9% sodium chloride solution, is administered over 0.5-1 hour. Re-introduction is possible after 8 hours.

Long-term intravenous infusion: 100-200 mg diluted in 500 ml infusion solution (0.9% sodium chloride solution, lactated Ringer's solution, 5% dextrose solution) is administered over 8 hours. Re-introduction is possible after 8 hours.

Ketonal Uno and Duo

The standard dose of Ketonal Uno for adults and children over 15 years of age is 200 mg per day. Capsules should be taken during or after a meal with water or milk (the volume of liquid should be at least 100 ml). A similar regimen for Ketonal Duo with a dosage of 150 mg in one capsule.

The maximum dose of ketoprofen is 200 mg per day.

Parenteral administration can be combined with the use of oral forms (capsules, tablets) or rectal suppositories. The maximum daily dose (including the use of various dosage forms) is 200 mg.

Candles

Adults are prescribed 1 suppository 1-2 times a day rectally.

Rectal suppositories can be used in combination with ketoprofen formulations for systemic or topical use. The maximum daily dose of ketoprofen (including when using various dosage forms) is 200 mg.

Side effect

• dyspepsia (nausea, flatulence, diarrhea or constipation, vomiting, decreased or increased appetite);
• abdominal pain;
• stomatitis;
• dry mouth;
• ulceration of the gastrointestinal mucosa;
• liver dysfunction;
• exacerbation of Crohn's disease;
• bleeding from the gastrointestinal tract;
• headache;
• dizziness;
• drowsiness;
• fatigue;
• nervousness;
• nightmares;
• peripheral neuropathy;
• hallucinations;
• disorientation;
• noise in ears;
• taste change;
• blurred vision;
• conjunctivitis;
• tachycardia;
• arterial hypertension;
• peripheral edema;
• decreased platelet aggregation;
• anemia, thrombocytopenia, agranulocytosis, purpura;
• hematuria (with long-term use of NSAIDs and diuretics);
• hives;
• rhinitis;
• bronchospasm;
• angioedema;
• anaphylactoid reactions;
• liquid stool;
• hemoptysis;
• menometrorrhagia.

Contraindications

• peptic ulcer of the stomach and duodenum in the acute phase;
• UC, Crohn's disease;
• hemophilia and other bleeding disorders;
• severe liver failure;
• severe renal failure;
• uncompensated heart failure;
• postoperative period after coronary artery bypass grafting;
• gastrointestinal, cerebrovascular and other bleeding or suspected bleeding;
• chronic dyspepsia;
• 3rd trimester of pregnancy;
• lactation (breastfeeding);
• children's age up to 15 years;
• inflammatory diseases of the rectum;
• hypersensitivity to ketoprofen, acetylsalicylic acid or other NSAIDs;
• indications in the anamnesis of bronchial asthma, urticaria and rhinitis caused by taking acetylsalicylic acid or other NSAIDs.

Use during pregnancy and lactation

The use of Ketonal in the 3rd trimester of pregnancy is contraindicated. The use of Ketonal in the 1st and 2nd trimesters of pregnancy is possible only if the potential benefit to the mother outweighs the risk to the fetus.

If it is necessary to use Ketonal during lactation, the issue of stopping breastfeeding should be resolved.

special instructions

Patients with inflammatory diseases of the rectum should not be prescribed Ketonal in the form of rectal suppositories.

With prolonged use of Ketonal, as well as other NSAIDs, regular monitoring of hematological parameters, indicators of liver and kidney function is required, especially in elderly patients.

Ketoprofen should be used with caution in patients with arterial hypertension and heart disease, accompanied by fluid retention in the body, blood pressure monitoring is recommended.

Ketonal may mask the symptoms of infectious diseases.

Influence on the ability to drive vehicles and control mechanisms

There are no data on the negative effect of Ketonal at recommended doses on the ability to drive a car and work with mechanisms.

At the same time, patients who notice non-standard effects when using Ketonal should be careful when engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

drug interaction

Ketoprofen reduces the effect of diuretics, antihypertensive drugs.

Enhances the effect of oral hypoglycemic drugs and some anticonvulsants (phenytoin).

With simultaneous use with other NSAIDs, salicylates, corticosteroids and ethanol (alcohol), the risk of developing gastrointestinal bleeding increases.

With simultaneous use with anticoagulants, thrombolytics, antiplatelet agents, the risk of bleeding increases.

The risk of developing renal dysfunction increases when taken with diuretics or ACE inhibitors.

With simultaneous use, it increases the concentration of cardiac glycosides, slow calcium channel blockers, lithium preparations, cyclosporine, methotrexate.

Ketonal can be combined with centrally acting analgesics.

Analogues of the drug Ketonal

Structural analogues for the active substance:

• Arketal Rompharm;
• artrosilene;
• Artrum;
• Bystrumgel;
• Quickcaps;
• VALUSAL;
• Ketoprofen;
• Ketoprofen Vramed;
• Ketoprofen MB;
• Ketoprofen Organic;
• Ketoprofen-Verte;
• Ketoprofen-ESCOM;
• Ketospray;
• Orouvel;
• Profenid;
• Fastum;
• Fastum gel;
• Febrofid;
• Flamax forte;
• Flamax;
• Flexen.

Instruction
on the use of the medicinal product
for medical use

Save this manual as it may be needed again.
If you have any questions, please contact your doctor.

Registration number:

Trade name of the drug:

Ketonal ® .

International non-proprietary name:

ketoprofen.

Dosage form:

Compound:

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

Pharmacotherapeutic group:

ATX code: M01AE03.

Pharmacological properties

Indications for use

Contraindications

Carefully

History of peptic ulcer disease, history of bronchial asthma, clinically significant 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 (GIT), the presence of infection Helicobacter pylori, older age, smoking, concomitant therapy with anticoagulants (eg, warfarin), antiplatelet agents (eg, acetylsalicylic acid), oral glucocorticosteroids (eg, prednisolone), selective serotonin reuptake inhibitors (eg, citalopram, sertraline), long-term use of NSAIDs.

Use during pregnancy and during breastfeeding

Dosage and administration

inside.
Capsules Ketonal ® should be swallowed whole during or after a meal with water or milk (the volume of liquid should be at least 100 ml). Usually the drug is prescribed 1-2 capsules 2-3 times a day.
Preparations Ketonal ® for oral administration can be combined with the use of rectal suppositories; for example, a patient may take 1 capsule of 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), adverse 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).
Hematopoietic and lymphatic system disorders
rarely: hemorrhagic anemia;
frequency unknown: agranulocytosis, thrombocytopenia, bone marrow dysfunction.
Immune System Disorders
frequency unknown: anaphylactic reactions (including anaphylactic shock).
Nervous System Disorders
infrequently: headache, dizziness, drowsiness;
rarely: paresthesia;
frequency unknown: convulsions, taste disturbance.
Mental disorders
frequency unknown: emotional lability.
Sensory disturbances
rarely: blurred vision, tinnitus.
Cardiovascular disorders
frequency unknown: heart failure, increased blood pressure, vasodilation.
Respiratory system disorders
rarely: exacerbation of bronchial asthma;
frequency unknown: bronchospasm (especially in patients with hypersensitivity to NSAIDs), rhinitis.
Gastrointestinal disorders
often: nausea, vomiting, dyspepsia, abdominal pain;
infrequently: constipation, diarrhea, bloating, gastritis;
rarely: peptic ulcer, stomatitis;
very rarely: exacerbation of ulcerative colitis or Crohn's disease, gastrointestinal bleeding, perforation.
Liver and biliary tract disorders
rarely: hepatitis, increased activity of "liver" transaminases, increased concentration of bilirubin.
Skin and subcutaneous tissue disorders
infrequently: skin rash, skin itching;
frequency unknown: photosensitivity, alopecia, urticaria, angioedema, erythema, bullous rash, including Stevens-Johnson syndrome, toxic epidermal necrolysis.
Renal and urinary tract disorders
frequency unknown: acute renal failure, interstitial nephritis, nephritic syndrome, nephrotic syndrome, abnormal values ​​of indicators of kidney function.
Other
infrequently: swelling;
rarely: weight gain;
frequency unknown: increased fatigue.

Overdose

Interaction with other drugs

Ketoprofen may weaken the effect diuretics and antihypertensive drugs and enhance action oral hypoglycemic drugs and some anticonvulsants(phenytoin).
Sharing with others NSAIDs, salicylates, glucocorticosteroids, ethanol increases the risk of adverse events in the gastrointestinal tract.
Simultaneous use with anticoagulants(heparin, warfarin), thrombolytics, antiplatelet agents(ticlopidine, clopidogrel), pentoxifylline increases the risk of bleeding.
Simultaneous use with potassium salts, potassium-sparing diuretics, ACE inhibitors, NSAIDs, low molecular weight heparins, cyclosporine, tacrolimus and trimethoprim increases the risk of developing hyperkalemia.
Increases plasma concentration cardiac glycosides, "slow" calcium channel blockers, lithium preparations, cyclosporine, methotrexate and digoxin.
Increases toxicity methotrexate and nephrotoxicity cyclosporine.
Simultaneous use with probenecid significantly reduces the clearance of ketoprofen in plasma.
Combined reception 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 abolition of mifepristone.

special instructions

Influence on the ability to drive vehicles, mechanisms

There are no data on the negative effect of the drug Ketonal ® 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 visual impairment, while using the drug, should refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Release form

Storage conditions

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

Best before date

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 destroying the unused product.

Holiday conditions

On prescription.

Manufacturer

Ketonal (tablets, ointment, cream, injections, suppositories) - instructions for use, analogues, reviews, price

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Ketonal is a non-narcotic and non-hormonal drug with a powerful analgesic, anti-inflammatory and antipyretic effect. Ketonal is used to relieve severe or moderate pain of various origins, for example, with arthritis, spondylitis, osteoarthritis, sciatica, myalgia, neuralgia, colic, menstruation, trauma and after surgery.

Varieties, names, forms of release and composition of Ketonal

• Ketonal;
• Ketonal Duo;
• Ketonal Uno.

Dosage forms of Ketonal varieties are different. So, each of the preparations Ketonal Duo and Ketonal Uno is produced in a single dosage form, and Ketonal - in seven forms. So, Ketonal Uno and Ketonal Duo are available in the form of capsules for oral administration, but simply Ketonal in the following dosage forms:

• Prolonged action tablets;
• Coated tablets;
• Capsules;
• Solution for intramuscular or intravenous administration;
• rectal suppositories;
• Cream;
• Gel.

The composition of all varieties and dosage forms of Ketonal includes the same active substance - ketoprofen in the following dosages:

• Coated tablets Ketonal - 100 mg;
• Long-acting tablets Ketonal - 150 mg;
• Capsules Ketonal - 50 ml;
• Solution for injection Ketonal - 50 mg / ml;
• Rectal suppositories Ketonal - 100 mg;
• Gel Ketonal - 2.5% (2.5 mg per 1 g of gel);
• Cream Ketonal - 5% (5 mg per 1 g of cream);
• Capsules Ketonal Duo - 150 mg;
• Capsules Ketonal Uno - 200 mg.

Therapeutic effects of Ketonal

• Anesthetic;
• Anti-inflammatory;
• Antipyretic.

All three effects of Ketonal are provided by the ability of the active substance to block the work of enzymes cyclooxygenases and lipoxygenase, as a result of which the formation of special substances - prostaglandins, which provoke the development and support the inflammatory reaction, cause a pain impulse and an increase in body temperature, stops. That is, Ketonal blocks the formation of substances that cause inflammation, temperature and pain.

A distinctive feature of Ketonal is a wide range of analgesic action, which consists in the impact on both central and peripheral nerve fibers responsible for the perception of pain impulses. That is why Ketonal is highly effective anesthetic drug in the presence of pain in various peripheral tissues and organs, such as joints, skin, ligaments, muscles, veins, lymphatic and blood vessels. By reducing the inflammatory response, Ketonal not only relieves pain in diseases of the joints, but also reduces morning stiffness and swelling, increasing the range of motion.

Indications for use

Injections, tablets, capsules, suppositories Ketonal, Ketonal Duo and Ketonal Uno - indications for use

• Rheumatoid arthritis ;
• psoriatic arthritis;
• Various types of arthritis with no rheumatic factor in the blood;
• ankylosing spondylitis;
• reactive arthritis;
• Polyarthritis;
• periarthritis;
• Artrosynovitis;
• Osteoarthritis;
• pseudogout;
• Articular and non-articular rheumatism;
• Shoulder syndrome.

• Muscle pain (myalgia);
• Radiculitis;
• sciatica;
• Lumbalgia;
• Lumbago;
• Phlebitis;
• Lymphangitis and lymphadenitis;
• tendinitis;
• Pain after an injury;
• Pain after surgery;
• Pain in malignant tumors of various localization;

Ointment and gel Ketonal - indications for use

• Rheumatoid arthritis;
• periarthritis;
• ankylosing spondylitis;
• psoriatic arthritis;
• Reactive arthritis (Reiter's syndrome);
• Bursitis;
• Neuralgia;
• Radiculitis;
• Injuries of the musculoskeletal system (bruises, sprains, tendons, etc.).

Instructions for use

Ketonal tablets, Ketonal Duo and Ketonal Uno - instructions for use

In principle, you can take capsules and tablets before meals, and drink them with water, not milk, but in this case, a person may experience pain or an unpleasant painful sensation in the stomach, which disappears on its own within 40-60 minutes.

To relieve pain, the drug is taken in the following standard dosages:

• Capsules Ketonal - 1 - 2 pieces 2 - 3 times a day;
• Regular tablets in the Ketonal shell - 1 piece 2 times a day;
• Long-acting tablets Ketonal - 1 piece once a day;
• Capsules Ketonal Uno - 1 piece once a day;
• Capsules Ketonal Duo - 1 piece once a day.

The duration of therapy with Ketonal is individual and is determined by the rate of disappearance of the pain syndrome. That is, the drug is taken as needed when pain occurs and continues until they stop. Ketonal is suitable for long-term use in pain syndromes of various localization.

Tablets and capsules must be taken, observing approximately equal time intervals between two subsequent doses, which will ensure reliable relief of pain and minimal risk of complications. For example, if regular tablets need to be taken twice a day, then it is best to drink them, observing a gap of 10 to 12 hours. Long-acting tablets are optimally taken every day at the same time.

Ketonal tablets and capsules can be used in combination with rectal suppositories, gel or cream. However, it must be ensured that the total daily dosage of the active substance in all forms used does not exceed 200 mg.

When taking Ketonal, it should be remembered that the drug does not cure the disease, but only eliminates painful symptoms, allowing a person to fully work and lead a normal life. Therefore, in combination with Ketonal, it is necessary to carry out the necessary treatment aimed at the complete elimination of the disease or a change in its course.

Ketonal injections - instructions for use

Intramuscularly, the administration of Ketonal 100 mg (1 ampoule) 1 to 2 times a day is indicated in the area of ​​the body where the muscle layer comes close to the skin, for example, in the outer upper third of the thigh, upper shoulder, etc. It is not recommended to inject the solution into the buttock, since in this area the muscles lie very deep, and there is a fat layer directly under the skin. If the solution gets into the fat layer, it will not be absorbed into the blood and the desired effect will not be achieved.

Intramuscular injections can be made at home on their own, if the person is not afraid and knows the technique of manipulation. To make an injection, it is necessary to draw the contents of the ampoule into a sterile syringe, then lift it up with a needle and tap the surface with your finger in the direction from the piston to the needle holder so that air bubbles come off the walls and collect at the surface of the liquid. After that, you should press on the piston so that a drop of solution comes out at the tip of the needle and all the air comes out with it. Then the syringe, ready for injection, is put aside in some clean place and the place where the injection will be made is prepared.

The selected injection site is wiped with a cotton swab moistened with alcohol or other antiseptic. Then, holding the syringe with the working hand, the needle is inserted vertically into the tissues, after which, slowly pressing the piston, the entire solution is released. The needle is removed from the tissues and the injection site is again wiped with a swab moistened with an antiseptic.

For each injection, it is necessary to choose a place that is at least 1 cm away from the previous one so that purulent foci do not form under the skin.

Intravenously, Ketonal is administered only in the form of an infusion (dropper) in a hospital setting. You can not put droppers with Ketonal on your own. Depending on the duration of the administration of the solution, all intravenous infusions are divided into long and short.

For short intravenous infusions, 100-200 mg (1-2 ampoules) of Ketonal should be diluted in 100 ml of saline and administered over 30-90 minutes. Ketonal can be re-introduced only after at least 8 hours.

For long-term infusions, 100-200 mg (1-2 ampoules) of Ketonal are diluted in 500 ml of saline and administered within 8 hours. Re-introduction of the solution is also possible no earlier than after 8 hours. Ketonal can also be dissolved in a lactate-containing Ringer's solution or 5% dextrose solution.

Since Ketonal solutions are sensitive to light, the infusion bottles must be wrapped in foil until the end of the drug administration.

Intravenous or intramuscular administration of Ketonal is carried out if it is impossible to take the drug orally or if a quick analgesic effect is needed. Injections can be combined with the simultaneous administration of oral forms of Ketonal (capsules, tablets) or rectal suppositories. The maximum allowable daily dosage when using all forms of Ketonal is 200 mg. The duration of the use of drugs is determined by the rate of relief of pain.

Ketonal candles - instructions for use

Candles are used up to the normalization of the condition and the relief of pain syndrome sufficient for maintaining a habitual lifestyle.

Candles must be inserted into the rectum after a bowel movement. If bowel movements do not occur on their own, then an enema or laxative should be taken. After defecation, the area of ​​the anus and the skin of the perineum are washed with warm water and soap and a suppository is inserted into the rectum.

For a minimally traumatic introduction of a candle, it is necessary to kneel and elbows or squat down, after which the index finger of the working hand (right for right-handers and left for left-handers) gently push the suppository inward. The candle should be pushed into the intestine until the finger plunges into the anus to the middle.

After the introduction of the suppository, the hands are again washed with soap and water.

Do not use Ketonal suppositories in the presence of any diseases of the rectum.

Instructions for use Ketonal cream (ointment) and gel

In the process of applying a cream or gel, it is necessary to avoid getting it on the mucous membranes, on the eyes and on the skin around the eyes. During the entire period of therapy and two weeks after its completion, it is necessary to avoid exposure to direct sunlight and not to be near sources of ultraviolet radiation.

If irritation appears on the skin or side effects develop, then you should stop using the Ketonal gel or cream. After stopping the irritation, if necessary, you can resume the use of the gel or cream.

When deciding on the amount of Ketonal gel or cream used, as well as the frequency of their use, one should remember what the content of active substances is:

• 5 cm of gel or 2.5 cm of cream contain 100 mg of active substance;
• 10 cm of gel or 5 cm of cream contain 200 mg of ketoprofen.

Ketonal cream or gel can be used simultaneously in combination with other dosage forms (tablets, capsules, suppositories and injections), however, it must be remembered that the total dosage of all drug options should not exceed 200 mg per day.

Ketonal during pregnancy and breastfeeding

In the first and second trimesters of pregnancy (up to and including the 27th week), any varieties and forms of Ketonal can be used only if the intended benefit to the woman outweighs all possible risks to the fetus.

If it is necessary to use Ketonal during breastfeeding, the child should be transferred to artificial mixtures.

special instructions

With prolonged use of Ketonal (more than 1 week), it is necessary to regularly take a complete blood count, as well as monitor the performance of the kidneys and liver. Particular attention should be paid to the indicators of blood, liver and kidneys while taking Ketonal in elderly people over 65 years of age.

Ketonal must be used carefully if a person has hypertension and heart pathologies that are combined and associated with edema. In these cases, during the entire course of the use of Ketonal, it is necessary to constantly monitor the level of blood pressure.

Influence on the ability to control mechanisms

Overdose

Ketonal goes well with narcotic analgesics. A solution of Ketonal can be mixed in the same syringe with morphine, but not with tramadol, because in this case, a precipitate forms due to chemical interaction.

Side effects of Ketonal

1. Gastrointestinal tract:

• Nausea;
• Diarrhea or constipation;
• Vomit;
• Increased or decreased appetite;
• Abdominal pain;
• Ulceration of the mucous membrane of the digestive tract;
• Violation of the liver;
• Perforation of the digestive tract;
• Exacerbation of Crohn's disease;
• Melena (black stool);
• Increased activity of liver enzymes (AST and ALT).

• Headache;
• Nightmares;
• Migraine;
• Disorientation in space;
• Speech disorder.

• Change in taste;
• Blurred vision;

• Tachycardia (palpitations);
• Arterial hypertension ;
• Edema.

• Decreased ability of platelets to stick together;
• Thrombocytopenia (decrease in the total number of platelets in the blood);
• Agranulocytosis (complete absence of neutrophils, eosinophils and basophils in the blood);
• Purpura.

• Liver dysfunction;
• Nephritis (inflammation of kidney tissue);
• nephrotic syndrome;
• Hematuria (blood in the urine).

• Rhinitis;
• Bronchospasm;
• Angioedema.

• Burning and irritation of the mucous membrane;

• Hemoptysis;
• Menometrorrhagia (bleeding from the uterus).

Gel and cream Ketonal as side effects can only provoke purpura, reddening of the skin, exanthema and photosensitivity.

Contraindications to the use of Ketonal

• Past asthma, rhinitis or urticaria, provoked by taking Aspirin or other drugs of the NSAID group (Ibuprofen, Diclofenac, Nimesulide, etc.);
• Exacerbation of peptic ulcer of the stomach or duodenum;
• Exacerbation of inflammatory bowel diseases (for example, Crohn's disease, ulcerative colitis, enteritis, etc.);
• Hemophilia or any other bleeding disorder;
• Severe renal or hepatic insufficiency;
• progressive kidney disease;
• Heart failure in the stage of decompensation;
• Coronary artery bypass grafting transferred less than 2 months ago;
• Suspicion or presence of bleeding of any localization (gastrointestinal, uterine, cerebral, etc.);
• Chronic indigestion (flatulence, belching, diarrhea or constipation, etc.);
• Age under 15;
• III trimester of pregnancy (from 28 to 40 weeks of gestation inclusive);
• The period of breastfeeding;

• peptic ulcer in the past;
• Cardiovascular, cerebrovascular diseases and pathologies of peripheral arteries that occur with clinical symptoms;
• Dyslipidemia (violation of the ratio of blood lipoprotein fractions - HDL, LDL);
• progressive liver disease;
• Hyperbilirubinemia (increased levels of bilirubin in the blood);
• kidney failure;
• Chronic heart failure;
• blood diseases;

• Past asthma, rhinitis or urticaria, provoked by taking Aspirin or other drugs of the NSAID group (Ibuprofen, Diclofenac, Nimesulide, etc.);
• Wounds on the skin (eczema, weeping dermatitis, open wound, etc.);
• III trimester of pregnancy (from 28 to 40 weeks);
• Age under 12;
• Hypersensitivity to the components of the drug or other drugs of the NSAID group.

Instructions for use of the drug Ketonal: release forms, therapeutic effect, dosage, contraindications - video

Ketonal - analogues

• Arketal Rompharm solution for injection;
• Artrosilene capsules, rectal suppositories and injection solution;
• Artrum rectal suppositories, tablets and solution for injection;
• Quickcaps capsules;
• Ketoprofen tablets and solution for injection;
• OKI granules and rectal suppositories;
• Flamax capsules and injection;
• Flamax forte tablets;
• Flexen capsules, rectal suppositories and lyophilisate for solution for injections.

• Artrosilene aerosol and gel;
• Artrum gel;
• Bystrumgel gel;
• Valusal gel;
• Ketoprofen gel;
• Febrofid gel;
• Flexen gel.

Ketonal - reviews

People who left positive reviews about the drug, in addition to the advantages, also indicated disadvantages, to which they attributed the high cost and the relatively slow development of the analgesic effect. However, such disadvantages of the drug are not able to overshadow its high efficiency.

Negative reviews about Ketonal are mainly associated with the appearance of side effects or with the long-term development of an analgesic effect, when you had to wait and apply the drug for 2 to 3 days until the pain was completely relieved.

Ketonal (cream, gel, injections, tablets, suppositories), Ketonal Duo - price

• Ketonal 50 mg, 25 capsules - 105 - 115 rubles;
• Ketonal ampoules 100 mg 2 ml, 10 pieces - 230 - 305 rubles;
• Ketonal ampoules 100 mg 2 ml, 50 pieces - 957 - 1490 rubles;
• Ketonal cream 5% 30 g - 230 - 297 rubles;
• Ketonal cream 5% 50 g - 310 - 395 rubles;
• Ketonal gel 2.5% 50 g - 185 - 260 rubles;
• Ketonal gel 2.5% 100 g - 338 - 466 rubles;
• Ketonal rectal suppositories 100 mg 12 pieces - 283 - 345 rubles;
• Ketonal Retard 150 mg, 20 tablets -235 - 302 rubles;
• Ketonal tablets 100 mg, 20 pieces -200 - 210 rubles;
• Ketonal Duo capsules 150 mg, 30 pieces - 260 - 302 rubles.

Ketonal - how to buy?