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Ketoprofen: Drug information

Ketoprofen: Drug information
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For additional information see "Ketoprofen: Patient drug information"

For abbreviations, symbols, and age group definitions show table
ALERT: US Boxed Warning
Serious cardiovascular thrombotic events:

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.

Ketoprofen is contraindicated during the perioperative setting of coronary artery bypass graft (CABG) surgery.

Serious gastrointestinal bleeding, ulceration, and perforation:

NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

Brand Names: US
  • Kiprofen
Brand Names: Canada
  • Anafen [DSC];
  • Ketoprofen-E
Pharmacologic Category
  • Analgesic, Nonopioid;
  • Nonsteroidal Anti-inflammatory Drug (NSAID), Oral
Dosing: Adult

Note: The enteric coated tablet and ER formulations are not recommended for the treatment of acute pain. Lower doses should be considered in small or debilitated patients.

Dysmenorrhea, pain

Dysmenorrhea, pain: Oral: Immediate release: 25 to 50 mg every 6 to 8 hours up to a maximum of 300 mg/day.

Osteoarthritis, rheumatoid arthritis

Osteoarthritis, rheumatoid arthritis:

Oral:

Immediate release: 50 mg 4 times daily or 75 mg 3 times daily; maximum: 300 mg/day.

Enteric coated [Canadian product]: Usual dose: 50 mg 3 or 4 times daily; up to 200 mg daily; twice daily regimen (eg, 100 mg twice daily) may be considered after maintenance dose is established; maximum: 300 mg/day.

Extended release: 200 mg once daily; maximum: 200 mg/day.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

In general, nonsteroidal anti-inflammatory drugs (NSAIDs) are not recommended for use in patients with advanced renal disease.

Manufacturer's labeling:

Canadian label: Contraindicated in severe renal impairment (CrCl <30 mL/minute).

GFR ≥25 mL/minute/1.73 m2: There are no specific dosage adjustments provided in the manufacturer's labeling. In patients with mild impairment, the manufacturer's labeling recommends a maximum dose of 150 mg/day.

GFR <25 mL/minute/1.73 m2: There are no specific dosage adjustments provided in the manufacturer's labeling. Maximum dose: 100 mg/day

KDIGO 2012 guidelines provide the following recommendations for NSAIDs:

eGFR 30 to <60 mL/minute/1.73 m2: Temporarily discontinue in patients with intercurrent disease that increases risk of acute kidney injury. Prolonged therapy is not recommended.

eGFR <30 mL/minute/1.73 m2: Avoid use.

Dosing: Liver Impairment: Adult

Hepatic impairment and serum albumin <3.5 g/dL: Maximum initial dose: 100 mg/day; use with caution to avoid adverse effects and discontinue if hepatic function worsens.

Dosing: Older Adult

Note: Unless alternative agents are ineffective and a gastroprotective agent can be administered, avoid short-term scheduled use in combination with corticosteroids, anticoagulants, or antiplatelet agents or chronic use with or without medications that increase risk for bleeding (Ref).

Oral: An initial dose reduction of 33% to 50% has been recommended (Ketoprofen Canadian product labeling 2011).

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Gastrointestinal: Dyspepsia (11%)

Hepatic: Abnormal hepatic function tests (≤15%)

1% to 10%:

Cardiovascular: Edema (≤9%)

Dermatologic: Skin rash (>1%)

Gastrointestinal: Abdominal pain (3% to 9%), anorexia (>1%), constipation (3% to 9%), diarrhea (3% to 9%), flatulence (3% to 9%), nausea (3% to 9%), stomatitis (>1%), vomiting (>1%)

Genitourinary: Urinary tract irritation (>1%)

Nervous system: Abnormal dreams, depression, dizziness (>1%), drowsiness, headache (3% to 9%), insomnia, malaise, nervousness

Ophthalmic: Visual disturbance (>1%)

Otic: Tinnitus (>1%)

Renal: Kidney impairment (3% to 9%; including increased blood urea nitrogen)

<1%:

Cardiovascular: Acute myocardial infarction, cardiac arrhythmia, heart failure, hypertension, palpitations, peripheral vascular disease, shock, tachycardia, vasodilation

Dermatologic: Alopecia, bullous rash, diaphoresis, eczema, erythema multiforme, exfoliative dermatitis, fixed drug eruption, onycholysis, pruritus, purpuric rash, skin discoloration, skin photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria

Endocrine & metabolic: Change in libido, exacerbation of diabetes mellitus, gynecomastia, hyponatremia, increased thirst, microvesicular steatosis, weight gain, weight loss

Gastrointestinal: Buccal necrosis, dysgeusia, eructation, gastritis, gastrointestinal hemorrhage, gastrointestinal perforation, gastrointestinal ulcer, hematemesis, increased appetite, melena, occult blood in stools, pancreatitis, peptic ulcer, rectal hemorrhage, salivation, ulcerative colitis, xerostomia

Genitourinary: Erectile dysfunction, hematuria, uterine hemorrhage

Hematologic & oncologic: Agranulocytosis, anemia, disorder of hemostatic components of blood, hemolysis, purpuric disease, thrombocytopenia

Hepatitis: Cholestatic hepatitis, hepatitis, jaundice

Hypersensitivity: Facial edema, hypersensitivity reaction (including anaphylaxis)

Infection: Infection, septicemia

Nervous system: Amnesia, aseptic meningitis, chills, confusion, dysphoria, hallucination, migraine, nightmares, paresthesia, personality disorder, vertigo

Neuromuscular & skeletal: Myalgia

Ophthalmic: Conjunctivitis, dry eye syndrome, eye pain, retinal hemorrhage, retinal pigment changes

Otic: Auditory impairment

Renal: Acute renal tubular disease, interstitial nephritis, kidney failure, nephrotic syndrome

Respiratory: Bronchospasm, dyspnea, epistaxis, hemoptysis, laryngeal edema, pharyngitis, rhinitis

Frequency not defined:

Cardiovascular: Coronary thrombosis

Gastrointestinal: Gastrointestinal inflammation

Nervous system: Cerebrovascular accident

Postmarketing:

Hepatic: Hepatotoxicity (idiosyncratic) (Chalasani 2021)

Hypersensitivity: Drug rash with eosinophilia and systemic symptoms

Contraindications

Hypersensitivity to ketoprofen or any component of the formulation; history of asthma, urticaria, or allergic-type reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs); use in the setting of CABG surgery.

Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to other NSAIDs; active duodenal, gastric, or peptic ulcer; active GI bleeding; inflammatory bowel disease; cerebrovascular bleeding or other bleeding disorders; heart failure; severe liver impairment or active liver disease; severe renal impairment (CrCl <30 mL/minute) or deteriorating renal disease; known hyperkalemia; pregnancy (third trimester); breastfeeding; pediatric patients <12 years of age.

Warnings/Precautions

Concerns related to adverse effects:

• Anaphylactoid reactions: Even in patients without prior exposure anaphylactoid reactions may occur; patients with "aspirin triad" (bronchial asthma, aspirin intolerance, rhinitis) may be at increased risk. Contraindicated in patients who experience bronchospasm, asthma, rhinitis, or urticaria with nonsteroidal anti-inflammatory drug (NSAID) or aspirin therapy.

• Cardiovascular events: NSAIDs cause an increased risk of serious (and potentially fatal) adverse cardiovascular thrombotic events, including MI and stroke. Risk may occur early during treatment and may increase with duration of use. Relative risk appears to be similar in those with and without known cardiovascular disease or risk factors for cardiovascular disease; however, absolute incidence of serious cardiovascular thrombotic events (which may occur early during treatment) was higher in patients with known cardiovascular disease or risk factors and in those receiving higher doses. New onset hypertension or exacerbation of hypertension may occur (NSAIDs may also impair response to ACE inhibitors, thiazide diuretics, or loop diuretics); may contribute to cardiovascular events; monitor blood pressure; use with caution in patients with hypertension. May cause sodium and fluid retention, use with caution in patients with edema. Avoid use in heart failure (FDA 2015). Avoid use in patients with a recent MI unless benefits outweigh risk of cardiovascular thrombotic events. Use the lowest effective dose for the shortest duration of time, consistent with individual patient goals, to reduce risk of cardiovascular events; alternate therapies should be considered for patients at high risk.

• CNS effects: May cause drowsiness, dizziness, blurred vision, and other neurologic effects which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

• Drug reaction with eosinophilia and systemic symptoms: Potentially serious, sometimes fatal, drug reaction with eosinophilia and systemic symptoms (DRESS), also known as multiorgan hypersensitivity reactions, has been reported with NSAIDs. Monitor for signs and symptoms (eg, fever, rash, lymphadenopathy, eosinophilia) in association with other organ system involvement (eg, hepatitis, nephritis, hematological abnormalities, myocarditis, myositis). Early symptoms of hypersensitivity reaction (eg, lymphadenopathy, fever) may occur without rash; discontinue therapy and further evaluate if DRESS is suspected.

• GI events: NSAIDs cause increased risk of serious GI inflammation, ulceration, bleeding, and perforation (may be fatal); elderly patients and patients with history of peptic ulcer disease and/or GI bleeding are at greater risk of serious GI events. These events may occur at any time during therapy and without warning. Avoid use in patients with active GI bleeding. In patients with a history of acute lower GI bleeding, avoid use of non-aspirin NSAIDs, especially if due to angioectasia or diverticulosis (Strate 2016). Use caution with a history of GI ulcers, concurrent therapy known to increase the risk of GI bleeding (eg, aspirin, anticoagulants and/or corticosteroids, selective serotonin reuptake inhibitors), advanced hepatic disease, coagulopathy, smoking, use of alcohol, or in elderly or debilitated patients. Use the lowest effective dose for the shortest duration of time, consistent with individual patient goals, to reduce risk of GI adverse events; alternate therapies should be considered for patients at high risk. When used concomitantly with aspirin, a substantial increase in the risk of GI complications (eg, ulcer) occurs; concomitant gastroprotective therapy (eg, proton pump inhibitors) is recommended (Bhatt 2008).

• Hematologic effects: Platelet adhesion and aggregation may be decreased; may prolong bleeding time; patients with coagulation disorders or who are receiving anticoagulants should be monitored closely. Anemia may occur; patients on long-term NSAID therapy should be monitored for anemia. Rarely, NSAID use has been associated with potentially severe blood dyscrasias (eg, agranulocytosis, thrombocytopenia, aplastic anemia).

• Hepatic effects: Transaminase elevations have been reported with use; closely monitor patients with any abnormal LFT. Rare (sometimes fatal) severe hepatic reactions (eg, fulminant hepatitis, hepatic necrosis, hepatic failure) have occurred with NSAID use; discontinue immediately if signs or symptoms of hepatic disease develop or if systemic manifestations occur.

• Hyperkalemia: NSAID use may increase the risk of hyperkalemia, particularly in the elderly, diabetics, renal disease, and with concomitant use of other agents capable of inducing hyperkalemia (eg, ACE-inhibitors). Monitor potassium closely.

• Ophthalmic events: Blurred/diminished vision has been reported; discontinue therapy and refer for ophthalmologic evaluation if symptoms occur. Periodic ophthalmic exams may be necessary with prolonged use.

• Renal effects: NSAID use may compromise existing renal function; dose-dependent decreases in prostaglandin synthesis may result from NSAID use, reducing renal blood flow which may cause renal decompensation (usually reversible). Patients with impaired renal function, dehydration, hypovolemia, heart failure, hepatic impairment, those taking diuretics, and ACE inhibitors, and the elderly are at greater risk of renal toxicity. Rehydrate patient before starting therapy; monitor renal function closely. Long-term NSAID use may result in renal papillary necrosis and other renal injury.

• Skin reactions: NSAIDs may cause potentially fatal serious skin adverse events including exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN); may occur without warning; discontinue use at first sign of skin rash (or any other hypersensitivity).

Disease-related concerns:

• Aseptic meningitis: May increase the risk of aseptic meningitis, especially in patients with systemic lupus erythematosus (SLE) and mixed connective tissue disorders.

• Asthma: Contraindicated in patients with aspirin-sensitive asthma; severe and potentially fatal bronchospasm may occur. Use caution in patients with other forms of asthma.

• Bariatric surgery: Gastric ulceration: Avoid chronic use of oral nonselective NSAIDs after bariatric surgery; development of anastomotic ulcerations/perforations may occur (Bhangu 2014; Mechanick 2020). Short-term use of celecoxib or IV ketorolac are recommended as part of a multimodal pain management strategy for postoperative pain (Chou 2016; Horsley 2019; Thorell 2016).

• Coronary artery bypass graft surgery: Use is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Risk of MI and stroke may be increased with use following CABG surgery.

• Hepatic impairment: Use with caution in patients with hepatic impairment; patients with advanced hepatic disease are at an increased risk of GI bleeding and kidney failure with NSAIDs (AASLD [Biggins 2021]; AASLD [Runyon 2013]). Systemic exposure may be increased in patients with chronic disease and/or hypoalbuminemia. Closely monitor patients with any abnormal LFT.

• Renal impairment: Avoid use in patients with advanced renal disease; discontinue use with persistent or worsening abnormal renal function tests.

Special populations:

• Older adult: Older adult patients are at greater risk for serious GI, cardiovascular, and/or renal adverse events; use with caution.

Other warnings/precautions:

• Surgical/dental procedures: Withhold for at least 4 to 6 half-lives prior to surgical or dental procedures.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Kiprofen: 25 mg [contains fd&c blue #1 (brilliant blue), fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]

Generic: 25 mg, 50 mg, 75 mg [DSC]

Capsule Extended Release 24 Hour, Oral:

Generic: 200 mg

Generic Equivalent Available: US

Yes

Pricing: US

Capsule ER 24 Hour Therapy Pack (Ketoprofen ER Oral)

200 mg (per each): $10.82

Capsules (Ketoprofen Oral)

25 mg (per each): $14.96

50 mg (per each): $25.28

Capsules (Kiprofen Oral)

25 mg (per each): $16.42

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Generic: 50 mg [DSC]

Solution, Injection:

Anafen: 10 mg/mL ([DSC])

Tablet, Oral:

Anafen: 5 mg [DSC], 20 mg [DSC]

Tablet Delayed Release, Oral:

Generic: 50 mg, 100 mg

Tablet Extended Release 24 Hour, Oral:

Generic: 200 mg

Administration: Adult

Oral: Administer with food to reduce GI upset. Do not crush or break ER capsules.

Bariatric surgery: Capsule, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Nonsteroidal anti-inflammatory drugs are not recommended for routine use after bariatric surgery. Where possible, cyclooxygenase-2 selective therapy should be used.

Medication Guide and/or Vaccine Information Statement (VIS)

An FDA-approved patient medication guide, which is available with the product information and at NSAIDs Class Medication Guide, must be dispensed with this medication.

Use: Labeled Indications

Osteoarthritis: Management of the signs and symptoms of osteoarthritis

Pain (immediate release only): Management of pain

Primary dysmenorrhea (immediate release only): Treatment of primary dysmenorrhea

Rheumatoid arthritis: Management of the signs and symptoms of rheumatoid arthritis

Medication Safety Issues
Sound-alike/look-alike issues:

Ketoprofen may be confused with ketotifen

Older Adult: High-Risk Medication:

Beers Criteria: Ketoprofen is identified in the Beers Criteria as a potentially inappropriate medication to be avoided for chronic use in patients 65 years and older (unless alternative agents ineffective and patient can receive concomitant gastroprotective agent) due to increased risk of GI bleeding and peptic ulcer disease in older adults in high risk category (eg, older than 75 years of age or receiving concomitant oral/parenteral corticosteroids, anticoagulants, or antiplatelet agents). In addition, avoid for short-term scheduled use in combination with oral/parenteral corticosteroids, anticoagulants, or antiplatelet agents unless alternatives are ineffective and patient can receive concomitant gastroprotective agent (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Substrate of OAT1/3; Inhibits OAT1/3;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

5-Aminosalicylic Acid Derivatives: Nonsteroidal Anti-Inflammatory Agents may increase nephrotoxic effects of 5-Aminosalicylic Acid Derivatives. Risk C: Monitor

Abciximab: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Abrocitinib: Agents with Antiplatelet Effects may increase antiplatelet effects of Abrocitinib. Risk X: Avoid

Acalabrutinib: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Acemetacin: May increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Risk X: Avoid

Alcohol (Ethyl): May increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Specifically, the risk of GI bleeding may be increased with this combination. Risk C: Monitor

Aliskiren: Nonsteroidal Anti-Inflammatory Agents may increase nephrotoxic effects of Aliskiren. Nonsteroidal Anti-Inflammatory Agents may decrease antihypertensive effects of Aliskiren. Risk C: Monitor

Aminoglycosides: Nonsteroidal Anti-Inflammatory Agents may decrease excretion of Aminoglycosides. Data only in premature infants. Risk C: Monitor

Aminolevulinic Acid (Systemic): Photosensitizing Agents may increase photosensitizing effects of Aminolevulinic Acid (Systemic). Risk X: Avoid

Aminolevulinic Acid (Topical): Photosensitizing Agents may increase photosensitizing effects of Aminolevulinic Acid (Topical). Risk C: Monitor

Anagrelide: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Angiotensin II Receptor Blockers: Nonsteroidal Anti-Inflammatory Agents may decrease therapeutic effects of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function. Angiotensin II Receptor Blockers may increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Risk C: Monitor

Angiotensin-Converting Enzyme Inhibitors: Nonsteroidal Anti-Inflammatory Agents may decrease antihypertensive effects of Angiotensin-Converting Enzyme Inhibitors. Angiotensin-Converting Enzyme Inhibitors may increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Risk C: Monitor

Anticoagulants (Miscellaneous Agents): Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Anticoagulants (Miscellaneous Agents). Risk C: Monitor

Antiplatelet Agents (P2Y12 Inhibitors): Agents with Antiplatelet Effects may increase antiplatelet effects of Antiplatelet Agents (P2Y12 Inhibitors). Risk C: Monitor

Aspirin: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may decrease therapeutic effects of Aspirin. Aspirin may increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents (Nonselective). Specifically, the risk for bleeding may be increased. Aspirin may decrease serum concentration of Nonsteroidal Anti-Inflammatory Agents (Nonselective). Management: In general, avoid regular, frequent use of NSAIDs with aspirin whenever possible. If combined, monitor for increased bleeding and a reduced cardioprotective effect of aspirin. Risk D: Consider Therapy Modification

Bemiparin: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Bemiparin. Management: Avoid this combination if possible, due to an increased risk of bleeding. If coadministration cannot be avoided, monitor patients closely for clinical and laboratory evidence of bleeding. Risk D: Consider Therapy Modification

Beta-Blockers: Nonsteroidal Anti-Inflammatory Agents may decrease antihypertensive effects of Beta-Blockers. Risk C: Monitor

Bile Acid Sequestrants: May decrease absorption of Nonsteroidal Anti-Inflammatory Agents. Risk C: Monitor

Bisphosphonate Derivatives: Nonsteroidal Anti-Inflammatory Agents may increase adverse/toxic effects of Bisphosphonate Derivatives. Both an increased risk of gastrointestinal ulceration and an increased risk of nephrotoxicity are of concern. Risk C: Monitor

Caplacizumab: Agents with Antiplatelet Effects may increase adverse/toxic effects of Caplacizumab. Specifically, the risk of bleeding may be increased. Risk C: Monitor

Cardiac Glycosides: Nonsteroidal Anti-Inflammatory Agents may increase serum concentration of Cardiac Glycosides. Risk C: Monitor

Clofarabine: OAT1/3 Inhibitors may increase serum concentration of Clofarabine. Risk C: Monitor

Collagenase (Systemic): Agents with Antiplatelet Effects may increase adverse/toxic effects of Collagenase (Systemic). Specifically, the risk of injection site bruising and or bleeding may be increased. Risk C: Monitor

Corticosteroids (Systemic): May increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents (Nonselective). Risk C: Monitor

CycloSPORINE (Systemic): Nonsteroidal Anti-Inflammatory Agents may increase nephrotoxic effects of CycloSPORINE (Systemic). Nonsteroidal Anti-Inflammatory Agents may increase serum concentration of CycloSPORINE (Systemic). CycloSPORINE (Systemic) may increase serum concentration of Nonsteroidal Anti-Inflammatory Agents. Management: Consider alternatives to nonsteroidal anti-inflammatory agents (NSAIDs). Monitor for evidence of nephrotoxicity, as well as increased serum cyclosporine concentrations and systemic effects (eg, hypertension) during concomitant therapy with NSAIDs. Risk D: Consider Therapy Modification

Dasatinib: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Deferasirox: Nonsteroidal Anti-Inflammatory Agents may increase adverse/toxic effects of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Risk C: Monitor

Deoxycholic Acid: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Desirudin: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Desirudin. Risk C: Monitor

Desmopressin: Nonsteroidal Anti-Inflammatory Agents may increase hyponatremic effects of Desmopressin. Risk C: Monitor

Dichlorphenamide: OAT1/3 Inhibitors may increase serum concentration of Dichlorphenamide. Risk C: Monitor

Direct Oral Anticoagulants (DOACs): Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Direct Oral Anticoagulants (DOACs). Risk C: Monitor

Drospirenone-Containing Products: May increase hyperkalemic effects of Nonsteroidal Anti-Inflammatory Agents. Risk C: Monitor

Enoxaparin: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Enoxaparin. Management: Discontinue nonselective NSAIDs prior to initiation of enoxaparin whenever possible. If coadministration cannot be avoided, monitor patients closely for clinical and laboratory evidence of bleeding. Risk D: Consider Therapy Modification

Eplerenone: Nonsteroidal Anti-Inflammatory Agents may decrease antihypertensive effects of Eplerenone. Nonsteroidal Anti-Inflammatory Agents may increase hyperkalemic effects of Eplerenone. Risk C: Monitor

Fexinidazole: May increase serum concentration of OAT1/3 Substrates (Clinically Relevant). Management: Avoid use of fexinidazole with OAT1/3 substrates when possible. If combined, monitor for increased OAT1/3 substrate toxicities. Risk D: Consider Therapy Modification

Fondaparinux: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Fondaparinux. Management: Discontinue nonselective nonsteroidal anti-inflammatory agents prior to the initiation of fondaparinux, if possible. If coadministration is required, monitor patients closely for signs and symptoms of bleeding. Risk D: Consider Therapy Modification

Glycoprotein IIb/IIIa Inhibitors: Agents with Antiplatelet Effects may increase antiplatelet effects of Glycoprotein IIb/IIIa Inhibitors. Risk C: Monitor

Heparin: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Heparin. Risk C: Monitor

Heparins (Low Molecular Weight): Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Heparins (Low Molecular Weight). Risk C: Monitor

Herbal Products with Anticoagulant/Antiplatelet Effects: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

HydrALAZINE: Nonsteroidal Anti-Inflammatory Agents may decrease antihypertensive effects of HydrALAZINE. Risk C: Monitor

Ibritumomab Tiuxetan: Agents with Antiplatelet Effects may increase antiplatelet effects of Ibritumomab Tiuxetan. Risk C: Monitor

Ibrutinib: Agents with Antiplatelet Effects may increase adverse/toxic effects of Ibrutinib. Specifically, the risk of bleeding and hemorrhage may be increased. Risk C: Monitor

Inotersen: Agents with Antiplatelet Effects may increase adverse/toxic effects of Inotersen. Specifically, the risk of bleeding may be increased. Risk C: Monitor

Ketorolac (Nasal): May increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Risk X: Avoid

Ketorolac (Systemic): Nonsteroidal Anti-Inflammatory Agents may increase adverse/toxic effects of Ketorolac (Systemic). Risk X: Avoid

Leflunomide: May increase serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor

Limaprost: May increase adverse/toxic effects of Agents with Antiplatelet Effects. Specifically, the risk of bleeding may be increased. Risk C: Monitor

Lithium: Nonsteroidal Anti-Inflammatory Agents may increase serum concentration of Lithium. Management: Consider reducing the lithium dose when initiating a NSAID. Monitor for increased lithium therapeutic/toxic effects if a NSAID is initiated/dose increased, or decreased effects if a NSAID is discontinued/dose decreased. Risk D: Consider Therapy Modification

Loop Diuretics: Nonsteroidal Anti-Inflammatory Agents may decrease diuretic effects of Loop Diuretics. Loop Diuretics may increase nephrotoxic effects of Nonsteroidal Anti-Inflammatory Agents. Management: Monitor for evidence of kidney injury or decreased therapeutic effects of loop diuretics with concurrent use of an NSAID. Consider avoiding concurrent use in CHF or cirrhosis. Concomitant use of bumetanide with indomethacin is not recommended. Risk D: Consider Therapy Modification

Macimorelin: Coadministration of Nonsteroidal Anti-Inflammatory Agents and Macimorelin may alter diagnostic results. Risk X: Avoid

MetFORMIN: Nonsteroidal Anti-Inflammatory Agents may increase adverse/toxic effects of MetFORMIN. Risk C: Monitor

Methotrexate: Nonsteroidal Anti-Inflammatory Agents may increase serum concentration of Methotrexate. Management: Avoid coadministration of higher dose methotrexate (such as that used for the treatment of oncologic conditions) and NSAIDs. Use caution if coadministering lower dose methotrexate and NSAIDs. Risk D: Consider Therapy Modification

Methoxsalen (Systemic): Photosensitizing Agents may increase photosensitizing effects of Methoxsalen (Systemic). Risk C: Monitor

Methoxyflurane: Nonsteroidal Anti-Inflammatory Agents may increase nephrotoxic effects of Methoxyflurane. Risk X: Avoid

Mifamurtide: Nonsteroidal Anti-Inflammatory Agents may decrease therapeutic effects of Mifamurtide. Risk X: Avoid

Miscellaneous Antiplatelets: Agents with Antiplatelet Effects may increase antiplatelet effects of Miscellaneous Antiplatelets. Risk C: Monitor

Nadroparin: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Nadroparin. Management: Coadministration of NSAIDs and nadroparin is not recommended due to an increased risk of bleeding. If coadministration is required, monitor patients closely for clinical and laboratory signs of bleeding. Risk D: Consider Therapy Modification

Naftazone: May increase antiplatelet effects of Nonsteroidal Anti-Inflammatory Agents. Risk C: Monitor

Nitisinone: May increase serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor

Nonsteroidal Anti-Inflammatory Agents (Topical): Nonsteroidal Anti-Inflammatory Agents (Topical) may increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Specifically, the risk of gastrointestinal (GI) toxicity is increased. Management: Coadministration of systemic nonsteroidal anti-inflammatory drugs (NSAIDs) and topical NSAIDs is not recommended. If systemic NSAIDs and topical NSAIDs, ensure the benefits outweigh the risks and monitor for increased NSAID toxicities. Risk D: Consider Therapy Modification

Nonsteroidal Anti-Inflammatory Agents: May increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Specifically, the risk for gastrointestinal toxicity is increased. Risk X: Avoid

Obinutuzumab: Agents with Antiplatelet Effects may increase adverse/toxic effects of Obinutuzumab. Specifically, the risk of bleeding may be increased. Management: Consider avoiding coadministration of obinutuzumab and agents with antiplatelet effects, especially during the first cycle of obinutuzumab therapy. Risk D: Consider Therapy Modification

Omacetaxine: Nonsteroidal Anti-Inflammatory Agents may increase adverse/toxic effects of Omacetaxine. Specifically, the risk for bleeding-related events may be increased. Risk C: Monitor

Pentosan Polysulfate Sodium: Agents with Antiplatelet Effects may increase adverse/toxic effects of Pentosan Polysulfate Sodium. Specifically, the risk of hemorrhage may be increased. Risk C: Monitor

Phenylbutazone: May increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Risk X: Avoid

Pirtobrutinib: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Polyethylene Glycol-Electrolyte Solution: Nonsteroidal Anti-Inflammatory Agents may increase nephrotoxic effects of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor

Porfimer: Photosensitizing Agents may increase photosensitizing effects of Porfimer. Risk X: Avoid

Potassium Salts: Nonsteroidal Anti-Inflammatory Agents may increase hyperkalemic effects of Potassium Salts. Risk C: Monitor

Potassium-Sparing Diuretics: Nonsteroidal Anti-Inflammatory Agents may increase hyperkalemic effects of Potassium-Sparing Diuretics. Nonsteroidal Anti-Inflammatory Agents may decrease antihypertensive effects of Potassium-Sparing Diuretics. Risk C: Monitor

PRALAtrexate: Nonsteroidal Anti-Inflammatory Agents may increase serum concentration of PRALAtrexate. More specifically, NSAIDS may decrease the renal excretion of pralatrexate. Management: Avoid coadministration of pralatrexate with nonsteroidal anti-inflammatory drugs (NSAIDs). If coadministration cannot be avoided, closely monitor for increased pralatrexate serum levels or toxicity. Risk D: Consider Therapy Modification

Pretomanid: May increase serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor

Probenecid: May increase serum concentration of Ketoprofen. Risk X: Avoid

Prostaglandins (Ophthalmic): Nonsteroidal Anti-Inflammatory Agents may decrease therapeutic effects of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents may also enhance the therapeutic effects of Prostaglandins (Ophthalmic). Risk C: Monitor

Quinolones: Nonsteroidal Anti-Inflammatory Agents may increase neuroexcitatory and/or seizure-potentiating effects of Quinolones. Nonsteroidal Anti-Inflammatory Agents may increase serum concentration of Quinolones. Risk C: Monitor

Salicylates: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase adverse/toxic effects of Salicylates. An increased risk of bleeding may be associated with use of this combination. Risk X: Avoid

Seladelpar: OAT1/3 Inhibitors may increase serum concentration of Seladelpar. Risk X: Avoid

Selective Serotonin Reuptake Inhibitor: May increase antiplatelet effects of Nonsteroidal Anti-Inflammatory Agents (Nonselective). Nonsteroidal Anti-Inflammatory Agents (Nonselective) may decrease therapeutic effects of Selective Serotonin Reuptake Inhibitor. Management: Consider alternatives to NSAIDs. Monitor for evidence of bleeding and diminished antidepressant effects. It is unclear whether COX-2-selective NSAIDs reduce risk. Risk D: Consider Therapy Modification

Selumetinib: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Serotonin/Norepinephrine Reuptake Inhibitor: May increase antiplatelet effects of Nonsteroidal Anti-Inflammatory Agents (Nonselective). Risk C: Monitor

Sincalide: Drugs that Affect Gallbladder Function may decrease therapeutic effects of Sincalide. Management: Consider discontinuing drugs that may affect gallbladder motility prior to the use of sincalide to stimulate gallbladder contraction. Risk D: Consider Therapy Modification

Sodium Phosphates: May increase nephrotoxic effects of Nonsteroidal Anti-Inflammatory Agents. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor

Sulopenem Etzadroxil: OAT1/3 Inhibitors may increase serum concentration of Sulopenem Etzadroxil. Risk C: Monitor

Sulprostone: Nonsteroidal Anti-Inflammatory Agents may decrease therapeutic effects of Sulprostone. Risk X: Avoid

Tacrolimus (Systemic): Nonsteroidal Anti-Inflammatory Agents may increase nephrotoxic effects of Tacrolimus (Systemic). Risk C: Monitor

Taurursodiol: May increase serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk X: Avoid

Tenofovir Products: Nonsteroidal Anti-Inflammatory Agents may increase nephrotoxic effects of Tenofovir Products. Management: Seek alternatives to these combinations whenever possible. Avoid use of tenofovir with multiple NSAIDs or any NSAID given at a high dose due to a potential risk of acute renal failure. Diclofenac appears to confer the most risk. Risk D: Consider Therapy Modification

Tenoxicam: May increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Risk X: Avoid

Teriflunomide: May increase serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor

Thiazide and Thiazide-Like Diuretics: Nonsteroidal Anti-Inflammatory Agents may decrease therapeutic effects of Thiazide and Thiazide-Like Diuretics. Thiazide and Thiazide-Like Diuretics may increase nephrotoxic effects of Nonsteroidal Anti-Inflammatory Agents. Risk C: Monitor

Thrombolytic Agents: Agents with Antiplatelet Effects may increase adverse/toxic effects of Thrombolytic Agents. Specifically, the risk of bleeding may be increased. Risk C: Monitor

Tipranavir: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Tolperisone: Nonsteroidal Anti-Inflammatory Agents may increase adverse/toxic effects of Tolperisone. Specifically, the risk of hypersensitivity reactions may be increased. Tolperisone may increase therapeutic effects of Nonsteroidal Anti-Inflammatory Agents. Risk C: Monitor

Tricyclic Antidepressants: May increase antiplatelet effects of Nonsteroidal Anti-Inflammatory Agents. Tricyclic Antidepressants may increase adverse/toxic effects of Nonsteroidal Anti-Inflammatory Agents. Specifically, the risk of major adverse cardiac events (MACE), hemorrhagic stroke, ischemic stroke, and heart failure may be increased. Risk C: Monitor

Vaborbactam: May increase serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor

Vadadustat: May increase serum concentration of Ketoprofen. Ketoprofen may increase serum concentration of Vadadustat. Risk C: Monitor

Vancomycin: Nonsteroidal Anti-Inflammatory Agents may increase serum concentration of Vancomycin. Risk C: Monitor

Verteporfin: Photosensitizing Agents may increase photosensitizing effects of Verteporfin. Risk C: Monitor

Vitamin E (Systemic): May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Vitamin K Antagonists: Nonsteroidal Anti-Inflammatory Agents (Nonselective) may increase anticoagulant effects of Vitamin K Antagonists. Management: Consider alternatives to this combination when possible. If the combination must be used, monitor coagulation status closely and advise patients to promptly report any evidence of bleeding or bruising. Risk D: Consider Therapy Modification

Volanesorsen: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Zanubrutinib: May increase antiplatelet effects of Agents with Antiplatelet Effects. Risk C: Monitor

Reproductive Considerations

Nonsteroidal anti-inflammatory drugs (NSAIDs) may delay or prevent rupture of ovarian follicles. This may be associated with infertility that is reversible upon discontinuation of the medication. Consider discontinuing use in patients having difficulty conceiving or those undergoing investigation of fertility (Matyas 2015; Micu 2011).

Based on available information, NSAIDs can be continued in males with rheumatic and musculoskeletal diseases who are planning to father a child (ACR [Sammaritano 2020]).

Pregnancy Considerations

Ketoprofen crosses the placenta (Bannwarth 1999).

Birth defects have been observed following in utero nonsteroidal anti-inflammatory drug (NSAID) exposure in some studies; however, data are conflicting (Bloor 2013). Nonteratogenic effects, including prenatal constriction of the ductus arteriosus, persistent pulmonary hypertension of the newborn, oligohydramnios, necrotizing enterocolitis, renal dysfunction or failure, and intracranial hemorrhage, have been observed in the fetus/neonate following in utero NSAID exposure (Bermas 2014; Bloor 2013). Maternal NSAID use may cause fetal renal dysfunction leading to oligohydramnios. Although rare, this may occur as early as 20 weeks' gestation and is more likely to occur with prolonged maternal use. Oligohydramnios may be reversible following discontinuation of the NSAID (Dathe 2019; FDA 2020). In addition, nonclosure of the ductus arteriosus postnatally may occur and be resistant to medical management (Bermas 2014; Bloor 2013).

Maternal use of NSAIDs should be avoided beginning at 20 weeks' gestation. If NSAID use is necessary between 20 and 30 weeks' gestation, limit use to the lowest effective dose and shortest duration possible; consider ultrasound monitoring of amniotic fluid if treatment extends beyond 48 hours, and discontinue the NSAID if oligohydramnios is found (FDA 2020). Because NSAIDs may cause premature closure of the ductus arteriosus, prescribing information for ketoprofen specifically states use should be avoided starting at 30 weeks' gestation.

Based on available information, NSAIDs can be continued during the first 2 trimesters of pregnancy in patients with rheumatic and musculoskeletal diseases; use in the third trimester is not recommended (ACR [Sammaritano 2020]).

NSAIDs may be used as part of a multimodal approach to pain relief following cesarean delivery (ACOG 2019).

Breastfeeding Considerations

Ketoprofen is present in breast milk (Jacqz-Aigrain 2007).

One case each of esophageal ulcer, erosive gastritis, meningeal hemorrhage, and renal insufficiency following ketoprofen exposure via breast milk were spontaneously reported to the French Pharmacoviligance Database between 1984 and 2011 (Soussan 2014).

Nonopioid analgesics, including nonsteroidal anti-inflammatory drugs (NSAIDs), are preferred for breastfeeding patients who require pain control peripartum or for surgery outside of the postpartum period (ABM [Martin 2018]; ABM [Reece-Stremtan 2017]). NSAIDs are considered compatible for the treatment of rheumatic and musculoskeletal diseases in lactating patients; agents with a short half-life and established safety data in infants may be preferred (ACR [Sammaritano 2020]).

Breastfeeding is not recommended by the manufacturer. Maternal use of NSAIDs should be avoided if the breastfeeding infant has platelet dysfunction, thrombocytopenia, or a ductal-dependent cardiac lesion (ABM [Martin 2018]; ABM [Reece-Stremtan 2017]; Bloor 2013).

Dietary Considerations

To minimize gastrointestinal effects, administer with food or milk.

Monitoring Parameters

CBC (periodically during long-term therapy or if develop signs/symptoms of anemia); chemistry profile (periodically during long-term therapy); weight gain or edema in patients with predisposing conditions, such as heart failure; signs of bleeding (occult or gross blood loss); periodic liver function tests; renal function (urine output, serum BUN, creatinine); blood pressure; periodic ophthalmic exams in patients receiving prolonged therapy

Mechanism of Action

Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors; has antipyretic, analgesic, and anti-inflammatory properties

Other proposed mechanisms not fully elucidated (and possibly contributing to the anti-inflammatory effect to varying degrees), include inhibiting chemotaxis, altering lymphocyte activity, inhibiting neutrophil aggregation/activation, and decreasing proinflammatory cytokine levels.

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Regular release: <30 minutes

Duration: Regular release: Up to 6 hours

Absorption: Almost complete

Distribution: 0.1 L/kg

Protein binding: >99%, primarily to albumin; Hepatic impairment: Unbound fraction is approximately doubled

Metabolism: Hepatic via glucuronidation; metabolite (inactive) can be converted back to parent compound; may have enterohepatic recirculation

Bioavailability: ~90%

Half-life elimination:

Regular release: 2 to 4 hours; Renal impairment: Mild: 3 hours; moderate to severe: 5 to 9 hours

Enteric coated tablet [Canadian product]: 2 hours

Extended release: ~3 to 7.5 hours

Rectal suppository [Canadian product]: ~2 to 2.5 hours

Time to peak, serum:

Regular release: 0.5 to 2 hours

Enteric coated tablet [Canadian product]: 1 to 2 hours

Extended release capsule: 6 to 7 hours; Extended release tablet [Canadian product]: 5 to 6 hours

Rectal suppository [Canadian product]: ~1 hour

Excretion: Urine (~80%, primarily as glucuronide conjugates)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Clearance is decreased and half-life is prolonged.

Hepatic function impairment: Unbound fraction is approximately doubled, probably due to hypoalbuminemia.

Older adult: Plasma and renal clearance are reduced and the unbound fraction increases.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Alrheumat | Fastum | Kefentech | Ketotop | Orudis | Oruvail | Profenid;
  • (AR) Argentina: Helenil | Orudis;
  • (AT) Austria: Fastum | Keprodol | Profenid;
  • (AU) Australia: Orudis | Oruvail;
  • (BD) Bangladesh: Fastum | Festam | Kefen | Keto-A | Ketofen | Ketonac | Ketonal | Ketron | Ketronil | Kontrol tr | Kop | Kynol | Orket | Oruvail | Profenid | Profenid e | Top | Wakoflex | Xynofen | Zerofen;
  • (BE) Belgium: Fastum | Rofenid;
  • (BF) Burkina Faso: Axen | Ketonal | Ketoprofene ubigen | Ketum | Profemigr | Profenid | Profenid lp;
  • (BG) Bulgaria: Bi profenid | Fastum | Ketoflex | Ketonal | Ketum | Okitask | Profenid | Profenid lp | Topogel;
  • (BR) Brazil: Algie | Algiprofen | Artrinid | Artrosil | Bicerto | Ceftfenpro lp | Ceprofen | Cetofenid | Cetoprofeno | Fenbip | Flamador | Ketop | Profenid | Rhalunid | Triploa;
  • (CH) Switzerland: Fastum | Ketoprofen Bayer | Profenid;
  • (CI) Côte d'Ivoire: Ketoflex | Ketonal | Ketoprof | Ketoprofene | Koten | Profemigr;
  • (CL) Chile: Bonil | Dolofar | Dolostat | Dolostat bi | Fastum | Flogofin | Flogofin TU LCH | Keprodol | Ketoprofeno | Profenid | Relatene | Talflex | Talflex bi;
  • (CN) China: Ao ding ni | Bu shi | Fastum | Oruvail | Profenid | Remason | Ricfen | San si teng | Shu li ang | Wei kang li;
  • (CO) Colombia: Dolomax | Ketoflex | Ketoprofeno | Ketoprofeno Genfar | Ketum | Lyndak | Profenid | Rhonicap;
  • (CZ) Czech Republic: Fastum | Ketobene | Ketonal | Profenid;
  • (DE) Germany: Advel Schmerzgel | Alrheumun | Dolormin mit ketoprofen | Effekton Ketoprofen | Gabrilen | Ketolist | Ketoprofen CT | Orudis | Phardol ketoprofen schmerzgel | Spondylon | Togal mobil-gel ketoprofen;
  • (DK) Denmark: Ketoprofen nm;
  • (DO) Dominican Republic: Artrogel | Biprofenid | Dolofast | Fastum | Kefentech | Kepron | Ketoprofeno Genfar | Noflan | Profenid;
  • (EC) Ecuador: Bi profenid | Dolofast | Fastum | Kebanon | Ketofinol | Ketoprofeno | Profenid | Talflex | Talflex bi;
  • (EE) Estonia: Begsan | Bi profenid | Fastum | Keto | Ketonal | Ketoprofen Ratiopharm | Ketorin | Profenid;
  • (EG) Egypt: Alcofan | Baskinta | Bi Alcofan | Bi profenid | Doloket | Emiprofen | Fastum | Flamibru | Flamidose | Flamoguard | Gesifast | Gesiket | Kefentech | Ketalgipan | Ketofan | Ketofen | Ketogesic | Ketolgin | Ketoprek | Ketoprof | Ketoxanil | Kiti | Kupan | Mepacofen | Orudis | Profenid;
  • (ES) Spain: Arcental | Extraplus | Fastum | Ketoprofeno ratiopharm | Ketosolan | Orudis;
  • (FI) Finland: Alrhumat | Keto | Ketocal | Ketofen | Ketomex | Ketorin | Orudis | Zon;
  • (FR) France: Bi profenid | Ketoprofene Arrow | Ketoprofene Biogaran | Ketoprofene EG | Ketoprofene Ethypharm | Ketoprofene g gam | Ketoprofene gnr | Ketoprofene irex | Ketoprofene ivax | Ketoprofene merck | Ketoprofene Pharmy II | Ketoprofene Qualimed | Ketoprofene Ranbaxy | Ketoprofene Ratiopharm | Ketoprofene rpg | Ketoprofene sandoz | Ketoprofene teva | Ketum | Profemigr | Profenid | Topfena | Toprec;
  • (GB) United Kingdom: Alrheumat | Fenoket | Jomethid xl | Ketocid | Ketonal | Ketoprofen Almus | Ketoprofen cox | Ketoprofen kent | Ketoprofen sandoz | Ketovail | Ketozip | Ketpron | Larafen | Orudis | Oruvail | Powergel | Tiloket | Valket;
  • (GR) Greece: Farbovil | Menaril | Okitask | Oruvail;
  • (HK) Hong Kong: Cetoclean pain relieving plaster | Fastum | Harufen | Kefenrin | Kefentech | Kenhancer | Kepax | Ketoclean | Ketoclin | Ketofen | Ketokura | Mohrus | Orudis | Oruvail | Wah tat;
  • (HR) Croatia: Fastum | Ketogel | Ketonal | Ketonal Akut | Ketoprofen Farmal | Knavon | Knavon forte;
  • (HU) Hungary: Fastum | Keplat | Profenid;
  • (ID) Indonesia: Altofen | Anrema | Fetik | Flamed | Kaltrofen | Ketros | Lantiflam | Molaflam | Nasaflam | Nazovel | Noflam | Ovurila | Ovurila e | Profenid | Profika e | Pronalges | Protofen | Remapro | Rematof | Retrofen | Rhetoflam | Rofiden | Sanbeflam;
  • (IE) Ireland: Fastum | Orudis | Orugesic | Oruvail;
  • (IL) Israel: Oruvail | Profenid;
  • (IN) India: Fastum | Infen plaster | Ketopatch | Ketoplast | Rhofenid;
  • (IT) Italy: Alket | Artrosilene | Dolgosin | Euketos | Fastum | Flexen | Ibifen | Isofenal | Kefenid | Keplat | Ketartrium | Ketoplus | Ketoprofene | Ketoprofene Alm | Ketoprofene Almus | Ketoprofene doc | Ketoprofene EG | Ketoprofene Fnm | Ketoprofene union health | Ketoret | Ketoselect | Lasonil c.m | Liotondol | Meprofen | Oki | Okitask | Orudis | Reuprofen | Steofen | Toprek | Zepelindue;
  • (JO) Jordan: Fastum | Keflam | Ketofast | Profenid;
  • (JP) Japan: Aneol | Antofenon | Capisten | Epatec | Epatec aventis | Epatec fuji | Epatec zeria | Frestol | Glucose c2 test wao | Inflen | Keprofen | Ketamelin | Ketobun kp | Ketok | Ketoners | Ketopral | Ketoprofen kyorin | Ketoprofen Nichiiko | Ketoprofen nisshin kyorin sei | Ketoprofen teikoku | Ketoprofen xr teikoku | Ketopuro | Ketosten | Ketotax | Lemphen | Megeide | Megeide amel | Menamin | Mohrus | Orudis | Patell | Pestec | Rave | Raynanon | Raynanon chemiphar | Raynanon merck hoei | Rheila | Rheila harasawa | Riferon | Romal | Romal fuji | Romal takata | Sayakinen | Sector | Synprofen | Tohberick | Touchron | Treosin | Vindus s;
  • (KE) Kenya: Fastum | Flexen | Kop | Lolita | Topact;
  • (KR) Korea, Republic of: Alrheumat | Amapro | Amaprogel | Antiphlamine keto | Antiphlamine roll | Anycare 24 | Choa Strong joint | Conacort | Coolgreen | Cutfen one | Cyprogel | Dapro | Fastum | Fenpro | Gelofen | Gettwo | Harufen | Harufen-L | K cataplasma | Kebanon | Kebanox | Kedalpon | Kefen | Kefentec | Kefentech | KefenTech-L | Kefu | Kellon | Kely | Kenhancer | Kenofen | Kenon l | Kenon s | Kepax | Kepem | Kepron | Keprotek | Keropin | Kesfen-L | Kestra | Keterfen | Keterfen s | Keto s | Ketoclin | Ketofain | Ketofam | Ketofen | Ketofilm | Ketopop | Ketopro | Ketoprofen kuhnil | Ketoro | Ketotop | Ketotop el | Ketotop l | Medis | Mendamketo | Newfen | Odis | Orafen | Orapain | Oruvail | Painil | Powerstap skinny | Profenid | Rapen | Rheuma | Rheuma gold | Rheuma rx | Rheumaken | Rheumaprofen | Rheutin | S-gel | Saksinpen | Sapmann | Sarafen | Spo-k | Topren | Torex | Trasen | Trast finger | Zenol gold | Zenoltop s;
  • (KW) Kuwait: Fastum | Oruvail | Profenid;
  • (LB) Lebanon: Bi profenid | Fastum | Flexen | Humfine | Ketartrium | Ketolgin | Oruvail | Profemigr | Profenid | Toprec | Trovex | Trovex MR;
  • (LT) Lithuania: Begsan | Fastum | Flexen | Keto | Ketonal | Ketoprofen sopharma | Profenid | Valusal;
  • (LU) Luxembourg: Fastum | Rofenid | Rofenid e;
  • (LV) Latvia: Begsan | Bi profenid | Fastum | Gabrilen | Keto | Ketonal | Profenid | Spinax | Valusal;
  • (MA) Morocco: Bi profenid | Flexen | Ketoflex | Ketum | Nofene | Oruvail | Profenid;
  • (MX) Mexico: Arthrill | Bibix | Efiken | Fastufrem | Ferandrom | K profen | Kefentech | Ketoflex | Ketoprofeno | Ketoprofeno gi | Menariprem | Neobengue | Notifin | Oki 3a | Painsik | Profenid | Profenid retard;
  • (MY) Malaysia: Apo-keto | Deprofen | Fastum | Kefentech | Kenhancer | Kenofen | Ketoclean | Ketodis | Ketofen | Ketopro | Ketoprofen YSP | Ketotop | Kop | Orudis | Oruvail | Proxen | Sanbeflam;
  • (NG) Nigeria: Fastum;
  • (NL) Netherlands: Orudis | Oscorel | Rilies;
  • (NO) Norway: Orudis | Zon;
  • (NZ) New Zealand: Orudis | Oruvail;
  • (PE) Peru: Bi profenid | Devren | Di profeket | Di-kefeprof | Diprofen | Dolofast | Doloketazon | Dolosciens | Flogofin TU LCH | Halprelin | Kenoplast kefentech | Ketofor | Ketopan | Ketoprofeno | Ketoprox | Ketragesico | Ketragesico forte | Kortal | Profeket | Profenid | Talflex bi;
  • (PH) Philippines: Ketofen | Ketoplast | Ketotop | Lafayette ketoprofen | Orudis | Oruvail;
  • (PK) Pakistan: Artrocol | Dowfen | Etopar | Fastum | Fusinorm H | Kefentech | Ketfren | Ketoflex | Ketogesic | Ketonal | Ketonorfen | Ketotop | Ketpro | Mobifen | Mykit | Orudis | Oruvail | Painflamed | Prefen | Profen | Profenid | Proket | Stayfen | Ticon | Topketo | Toprofin;
  • (PL) Poland: Bi profenid | Fastum | Febrofen | Ketokaps max | Ketokaps Med | Ketolek | Ketonal | Ketonal active | Ketonal forte | Ketoprofen lgo | Ketoprofen SF | Ketoprofen Ziaja | Ketoprofenum fastum | Ketoprom | Ketopronil | Ketores | Oki | Opokan keto | Orudis | Oruvail | Profenid | Refastin | Ultrafastin;
  • (PR) Puerto Rico: Orudis | Oruvail;
  • (PT) Portugal: Artrofene | Cetoprofeno | Deflogix | Kepin | Keplat | Profenid;
  • (PY) Paraguay: Doloketazon | Flogostone;
  • (QA) Qatar: Fastum | KefenTech Plaster | Ketofan | Ketofan SR | Profenid;
  • (RO) Romania: Fastum | Flexen | Ketalgon | Ketard | Ketomag | Ketonal | Ketoprofen fiterman | Ketoprofen hyperion | Ketoprofen ozone | Ketoprofen slavia | Ketoprofen SR | Ketoprofen tis | Ketoproxin;
  • (RU) Russian Federation: Artrosilene | Artrum | Bystrumcaps | Bystrumgel | Fast fort | Fastum | Febrofid | Flamax | Flamax forte | Flexen | Keplat | Ketoactin | Ketonal | Ketoprofen organica | Ketoprofen teva | Ketoprofen verte | Ketoprofen vertex | Ketoprofen vp | Ketoprofen vramed | Ketoprovel | Knavon | Oruvail | Pentalgin extra gel | Profenid | Spazgel | Triosmart | Valusal;
  • (SA) Saudi Arabia: Fastum | Fenajet | Ketofan | Oruvail | Profenid;
  • (SE) Sweden: Orudis | Prodon | Siduro | Zon;
  • (SG) Singapore: Alketo | Apo-keto | Fastum | Kefentech | Kefentech air | Kenhancer | Orudis | Oruvail;
  • (SI) Slovenia: Fastum | Ketonal | Ketoprofen vitabalans;
  • (SK) Slovakia: Fastum | Ketonal | Profenid;
  • (TH) Thailand: Fastum | Flexen | Kaprofen | Ketoprofen Ratiopharm | Lolita | Orudis | Oruvail | Profenid | Rhumafen | Rofepain;
  • (TN) Tunisia: Flexen | Ketalgic | Ketofen | Ketomed | Ketoprof | Ketoprogel | Ketum | Profenid;
  • (TR) Turkey: Artrocol | Bi profenid | Fastjel | Keto jel | Ketofen | Profenid | Vaniket;
  • (TW) Taiwan: Ansiton | Antonin | Chie tung ning | Dar tong pyng | Dofen | Fastum | Febin | Flexen | Isihtonnin | Kee an yan | Kefentech | Kenhancer | Kepinton | Kepro | Keto | Keto pap | Ketoen | Ketofan | Ketofen | Ketofen-h | Ketofen-s | Ketofpan | Keton pap | Ketophen | Ketoprofen Update | Ketoprofene | Ketor | Ketotop | Kutong | Mero | Oruvail | Ping Tung Ning | Proben | Profenadd | Profenid | Sepronin | Soften | Suilanton | Sukeyen | Sutofen | Tofen | Torofen;
  • (UA) Ukraine: Artrocol | F gel | Fastofen | Fastum | Ketonal | Ketonal retard | Nobi gel;
  • (UG) Uganda: Fastum | Ketofen;
  • (UY) Uruguay: Kefentech | Ketofen | Ketofen LP | Ketomax lp | Ketoprofeno | Novobealgia | Orudis | Orudis E | Profenid | Ruprof | Sindol | Sindol E;
  • (VE) Venezuela, Bolivarian Republic of: Bioketof | Dolomax | Fastum | Kefentech | Kelfen | Keproret | Keto | Ketodac | Ketogesic | Ketoprof | Ketoprofeno | Keydol | Lindilan | Orofeno | Profenid | Profenol;
  • (VN) Viet Nam: Flexen | Keflafen;
  • (ZA) South Africa: Fastum | Ketoflam | Myproflam | Orucote | Orugel | Oruject | Oruvail
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