Intramuscular injections "Ketonal": instructions for use, price and responses. Ketonal in the form of ampoules - instructions for use Injections, tablets, capsules, suppositories Ketonal, Ketonal Duo and Ketonal Uno - indications for use

Ethanol, lavender essential oil, sterile water.

Cream - ketoprofen, isopropyl myristate, methyl hydroxybenzoate, propylene glycol, propyl hydroxybenzoate, 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 caprilocaprate.

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 box No. 10.2
• Gel 2.5% - for external use, colorless, transparent, homogeneous in an aluminum tube of 50, 100 g in a cardboard box.
• Cream 5% - for external use, uniform, white in an aluminum tube of 30, 50 g in a carton box.
• Ketonal tablets 50 mg - biconvex round, coated in glass dark bottles of 20 pcs. in a cardboard box.
• Capsules 50 mg with modified release - blue in a blister in a carton box No. 20, 30.
• Rectal suppositories - smooth, white, homogeneous in a blister of 6 suppositories in a carton box No. 12.

pharmachologic effect

Anti-inflammatory, decongestant, analgesic, antipyretic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Ketoprofen suppresses activity cyclooxygenase , 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 does not have a negative effect on the condition of the articular cartilage.

Pharmacokinetics

Suction process ketoprofen it is very slow in the body and practically does not accumulate in the body. Bioavailability - 5%. The drug penetrates well and reaches therapeutic concentrations in the synovial fluid, muscles, ligaments, subcutaneous tissue. Its concentration in blood plasma is insignificant. It is metabolized in the liver to form conjugates. It is excreted in the urine. Slow.

Indications for use

The indications for the use of various forms of the drug are identical. The choice of the form of release of the drug is based on 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 ( of various genesis, , , , articular and non-articular , myalgia , tendinitis , , , shoulder-scapular syndrome, musculoskeletal injuries - sprains and ruptures of ligaments, muscle bruises)
• Relief of pain syndrome with myalgia, bursitis, tendinitis, neuralgia, radiculitis, , headache, algodismenorrhea , renal colic, post-traumatic pain syndrome, oncological diseases, , lumbago , and lymphangitis , phlebitis .

Contraindications

Individual hypersensitivity to the drug and other NSAIDs, bleeding disorders, childhood, hepatic / renal failure , , aggravation , , period after surgery, lactation period and during pregnancy in the 3rd trimester.

Prescribe carefully if there is a history , peptic ulcer; , arterial hypertension , simultaneous reception anticoagulants , cardiovascular diseases, long-term treatment with NSAIDs, in old age.

Side effects

Side effects of the drug can be manifested by disorders on the part of 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 , , laryngeal edema;
• nausea, dyspepsia , soreness in the abdomen, , , ;
• hepatitis ;
• itching and rash, photosensitivity;
• , , hematuria ;
• peripheral edema, fatigue;
• weight gain, thirst, .

Instructions for use of Ketonal (Way and dosage)

Ketonal tablets, instructions for use

Take 1 tablet Ketonal (50 mg) twice a day or Ketonal Forte (100 mg) by mouth, 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 extended-release tablets (Ketonal Retard) - once a day, 150 mg (1 tablet).

Ketonal cream, instructions for use

Apply a little 5% cream (3-5 cm) on 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 must consult a specialist. Sometimes, patients on the cream 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 gel corresponds to 100 mg of Ketonal.

Ketonal capsules, instructions for use

Take for arthritis, dysmenorrhea, osteoarthritis and mild to moderate pain syndrome by mouth, one capsule with food, washed down with milk or water every six hours. It can be combined with a solution for injection, suppositories, taking into account the maximum daily dose. Simultaneous reception with antacids .

Ketonal's injections, instructions for use

For parenteral administration, the drug is administered as an IM injection in an amount of 100 mg 1-2 times a day. IV infusion: the procedure is carried out in a hospital setting. 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, re-introduction no earlier than eight hours later. With continuous 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 central analgesics .

Candles Ketonal, instructions for use

Rectal suppositories are introduced 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, renal failure.

Interaction

Ketoprofen lowers 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. Reception of 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 the risk of developing hyperkalemia .

Terms of sale

Without recipe.

Storage conditions

At temperatures up to 25 ° C.

Shelf life

Ketonal's analogs

Matching ATX level 4 code:

Ketonal's analogs pills and capsules - , Ketoprofen , , , Osteoartisi Active Plus , , Flamax Forte , Ketoprofen MV , Hondra-Sila , , Bystrumcaps , Oruvel , Profenide other.

Ketonal's analogs in the form solution - , , Denebol , OKI , Emodol , Oruvel , , , other.

Analogs cream and gel ketonal - Artrosilene , Ketoprofen , , , , F-gel , , Ketoprom , Oruvel , Ketum gel , Resuscitator Thermo-gel , Valusal , Arthropod , Ultrafastin , Fort gel , Profenide , .

Ketonal's analogs in the form suppositories - Artrum , Oruvel , 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 in tablets and injections:

• “… I had a kidney stone, hellish pain, neither baralgin nor other analgesics helped. The ambulance doctor gave Ketonal injections and the pain was relieved almost immediately. An excellent pain reliever, not a drug and affordable ".
• “... I removed a tooth. When the tooth was removed, it crumbled and when the roots began to be pulled out, there was a hell of a pain. But after Ketonal's injection, 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 a long time for arthrosis. The drug relieves pain in knee joints well and quickly. It is not the cheapest drug, but very effective. ".

There are also negative reviews: “… I ride a horse. After the fall, the ankle joint began to hurt. I used the cream for a month. It did not help, the joint continued to hurt. We got “horse balsam” 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 the ointment be used for? Local 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 faster, leaving no marks on the skin and clothes, the use of the gel is more economical.

There are also numerous positive reviews about suppositories in gynecology: “… At the beginning of my menstrual cycle, it is almost always accompanied by severe pain. That I just didn't drink. The ambulance doctor advised Ketonal candles and the pain subsided. 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. Excellent remedy ".

Ketonal's price where to buy

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

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

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

The cost Ketonala capsules 50 mg No. 25 is 105 - 115 rubles.

Price ketonal cream 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 100 g tube ranges from 338 to 466 rubles per package.

Price Ketonala in candlelight No. 12 pieces vary from 283 to 345 rubles.

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

• Online pharmacies in RussiaRussia
• Online pharmacies of UkraineUkraine
• Internet pharmacies in KazakhstanKazakhstan

ZdravCity

Ketonal solution for intravenous and intramuscular injection 50mg / ml 2ml 10 pcs.Lek d.d.

Ketonal tablets p.p. 100mg 20 pcs.Lek d.d.

Ketonal gel 2.5% 100gSalutas Pharma GmbH

Ketonal cream 5% 50gLek d.d./Salutas Pharma GmbH

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

Pharmacy Dialog

Ketonal (caps. 50mg No. 25)Lek

Ketonal (tab.p.pl / ob. 100mg No. 10)Lek

Ketonal (supp. 100mg No. 12)Sandoz

Ketonal (supp. 100mg No. 12)Lek

Ketonal cream (tube 5% 50g)Salutas Pharma GmbH

Eurofarm * 4% discount with a promo code medside11

Ketonal gel 2.5% 50 gSandoz dd / Salyutas Pharma GmbH

Ketonal cream 5% 100 gSalutas Pharma GmbH

Pain is something that every person has to face from time to time. And in some cases, pain relievers are essential. Ketonal (injections) is considered quite effective today. The instructions for use indicate that the medicine is really capable of eliminating pain and inflammation. What is the composition of the drug? How effective is it? Are there any complications and side effects? What do doctors say about this tool? The answers to these questions will be useful to many readers.

Release form and composition of the drug

In the pharmacy you can buy the drug "Ketonal" in dark glass ampoules with a volume of 2 ml. The medicine itself is a colorless solution, sometimes with a slight yellowish tinge. The main active ingredient is ketoprofen (one milliliter of solution contains 1 mg of this component).

The preparation also contains some auxiliary substances, in particular, ethanol, propylene glycol, benzyl alcohol and purified water for injection. Ampoules are packed in plastic blisters of five pieces (there are packages of 5 or 10 bottles). Ketonal in ampoules can be purchased without a doctor's prescription. Nevertheless, in no case should you use this tool without first consulting a specialist.

What are the properties of the medicine?

Today, in various branches of medicine, the medicine "Ketonal" (injections) is often used. Instructions for use classifies this drug as a non-steroidal anti-inflammatory drug. Ketoprofen blocks the activity of the enzymes COX-1 and COX-2, resulting in a decrease in the amount of prostaglandins produced during inflammation. This medicine has a pronounced analgesic effect.

The bioavailability of the drug is 90%. When ingested, ketoprofen is 99% bound to plasma proteins. The maximum concentration of this substance in the blood is observed 15-30 minutes after injection. That is why Ketonal pain injections are so popular - they really eliminate discomfort in a matter of minutes.

Ketoprofen penetrates into the synovial fluid, but does not adversely affect the articular cartilage. The metabolism of this substance occurs in the liver tissues with the participation of microsomal enzymes. The half-life is two hours. The drug is excreted from the body through the kidneys along with urine in the form of inactive metabolites.

Main indications for use

In what cases do doctors prescribe Ketonal (injections) to patients? The use of this tool is wide enough - it is used to eliminate pain syndrome of almost any origin.

For example, injections are most often prescribed for people suffering from degenerative and inflammatory diseases of the musculoskeletal system. In particular, the drug is effective for rheumatoid arthritis, Reiter's syndrome, ankylosing apondylitis, psoriatic joint lesions, as well as gout, osteoarthritis and pseudogout.

The drug is also recommended for severe and severe pain accompanied by sciatica, myalgia, tendonitis, neuralgia, bursitis. Injections effectively relieve pain after injuries and previous surgical interventions. The indication for admission is pain syndrome, which appears against the background of cancer. Also, the solution helps to alleviate the condition of patients with severe migraines, adnexitis, algodysminorrhea, inflammatory diseases of the pelvic organs.

The drug "Ketonal" (injections): instructions for use

Before using the drug, it is imperative to consult a doctor. Only a specialist can correctly determine the dose and regimen of taking the drug "Ketonal" (injections). The instruction contains only general recommendations.

The maximum daily dose is 200 mg of ketoprofen per day. How to apply Ketonal injection solution correctly? Intramuscular injections can be given at home. As a rule, with severe pain, doctors recommend using 1-2 ampoules per day.

In addition, intravenous administration of the drug is also possible, but only in a hospital under the constant supervision of medical workers. For short-term infusion, 1-2 ampoules of the drug are diluted in 100 ml of 0.9% sodium chloride solution. The administration time is 30-60 minutes. If necessary, the procedure can be repeated, but not earlier than after eight hours.

Sometimes patients need a continuous intravenous infusion. In such cases, 1-2 ampoules of the drug are diluted with 500 ml of saline (can be replaced with lactate-containing Ringer's solution or 5% dextrose composition). The drug is administered for 8 hours.

It should be noted that in some cases, intravenous or intramuscular administration is combined with the intake of tablets or suppositories "Ketonal". Also, the drug can be combined with some other analgesics, as well as opioids.

Can the medicine be used during pregnancy?

It's no secret that not all medications can be used to treat expectant mothers. "Ketonal" during pregnancy is allowed only in cases where the benefits to the mother's body significantly outweigh the possible harm to the growing fetus. According to studies, in the first trimester of pregnancy, such therapy increases the likelihood of spontaneous abortion by 1-2%, as well as the formation of heart defects in the child. But in the third trimester, this medicine is strictly prohibited.

More about contraindications

Not all patients can take this medicine. "Ketonal" has a number of contraindications, which you should definitely familiarize yourself with:

• pregnancy and lactation (you need to stop breastfeeding during therapy);
• children's age (the drug can be used to treat patients over 15 years old);
• severe kidney disease, including kidney failure;
• bleeding disorders, including hemophilia;
• liver failure;
• uncompensated heart failure;
• hypersensitivity to ketoprofen, salicylates and other non-steroidal anti-inflammatory drugs;
• bleeding, including gastrointestinal;
• postoperative period with coronary artery bypass grafting;
• chronic dyspepsia.

Possible side effects during treatment

This medicine can cause unwanted side effects in some cases. Their list is quite impressive, but it should be said that they are rarely registered in medical practice and, as a rule, are associated with misuse.

• The drug can affect the nervous system, causing headaches, increased drowsiness, and dizziness. Paresthesias, convulsions and distortion of taste sensations are much less common. Sometimes patients also complain of tinnitus and blurred vision.
• Possible side effects from the digestive system, including nausea, vomiting, stool disturbances, and bloating. Much less often, therapy leads to the development of gastritis, exacerbation of Crohn's disease, as well as the appearance of gastrointestinal bleeding.
• Side effects include allergic reactions, which are manifested by hives, skin rashes, itching, and edema. Anaphylactic shock develops much less frequently.
• During therapy, disturbances in the functioning of the respiratory system may occur, including nosebleeds, bronchospasm, severe rhinitis, asthmatic attacks, and laryngeal edema.
• Sometimes there is an increase in the level of liver enzymes and bilirubin.
• Possible impaired renal function up to renal failure.
• Other side effects include fatigue, edema, weight gain, hypertension, and hemorrhagic anemia.

If any worsening occurs, you should immediately stop therapy and report the symptoms to your doctor.

Overdose, symptoms and methods of its treatment

Is an overdose of Ketonal (injections) possible? Instructions for use indicate that the use of too large doses of the drug can lead to complications. The most common symptoms of overdose are nausea, vomiting (sometimes with blood), severe abdominal pain, minor intestinal bleeding. Less commonly, patients experience impaired consciousness, convulsions, respiratory depression. The most dangerous consequences include impaired renal function up to the development of renal failure.

In case of an overdose, symptomatic treatment is performed. To weaken the effect of ketoprofen, you can use prostaglandins and proton pump inhibitors.

The drug "Ketonal" (injections): price

For many people, the cost of a particular drug is one of the top priorities. So how much will Ketonal (injections) cost? The price, of course, will depend on many factors. Here you need to take into account the number of ampoules, the manufacturer and distributor of this product, as well as the features of the pharmacy's pricing policy, etc.

Despite this, the cost of the drug is quite affordable. A pack of ten ampoules will cost you about 250-300 rubles, which, you see, is not so much, given the really quick effect.

Are there effective drug analogues?

Sometimes the drug chosen by the doctor is not suitable for patients for one reason or another. Is it possible to replace the Ketonal pain reliever with something? There are, of course, analogs with similar therapeutic effects.

The pharmacy will probably offer you such drugs as "Arketal", "Artrum", "Flamax", "Flexen". As a substitute, you can use "Ketoprofen" (here the same active ingredient) or "Artrosilene". By the way, all of the above drugs are available not only in the form of injectable solutions, but also in tablets, rectal suppositories and even in creams for external use.

But you should not refuse to use the drug "Ketonal" without the knowledge of the doctor. Analogs should be selected by a specialist, based on the patient's condition, type of disease and individual characteristics of the organism.

What do doctors and patients say about this product?

In modern medical practice, the drug "Ketonal" (injections) is often used. The doctors' comments on this remedy are mostly positive. The drug does give almost immediate effect, while rarely causing serious side effects. But experts warn against drug abuse, as it can cause addiction, overdose and various complications. In addition, it should be understood that this is just a pain reliever, so it cannot replace complete therapy.

What do patients say about Ketonal (injections)? Reviews of patients confirm that the drug relieves pain after a few minutes after application. The injections are not too painful. The undoubted advantage of the drug is its low cost. On the other hand, the drug causes drowsiness in many patients. In any case, such medications cannot be used arbitrarily - only a doctor can prescribe them.

Pain often comes on suddenly and is extremely difficult to tolerate. Some pills are simply not able to cope, because their effect is much lower than that of injectable drugs. This is due to the fact that the pills are absorbed by only 5-10% and do not sufficiently affect the source of pain. There is no such problem with injections. One of the best pain relievers is Ketonal.

What is this drug?

Ketonal in the form of injections contains the active substance ketoprofen, which relieves pain quickly enough. One ampoule in 2 ml accounts for 100 mg of this substance. It will dilute ketoprofen in injection water and additionally contains alcohols (benzyl, ethanol), propylene glycol is also contained. The entire composition is in ampoules made of darkened glass, the finished product itself is transparent, but it may have a yellowish tint. For use, injections are classified as non-steroidal anti-inflammatory drugs.

Injections act rather quickly on the body. After intramuscular injection, a noticeable reduction in pain occurs in half an hour. This effect is explained by a special pharmacological action - the suppression of enzymes that provoke inflammatory processes in the body. Ketonal is excreted in the urine and the main disintegration of the drug occurs in the liver. The activity of ketoprofen for the body is 90%, which indicates its incredibly high compatibility with plasma proteins and a very high effect on pain.

Who is Ketonal suitable for?

For use, Ketonal has a separate set of indications, but can be used to suppress any pain. The list of contraindications should be carefully studied. The instructions for the use of Ketonal injections include the following list of contraindications:

• Any disorders with blood clotting;
• Any bleeding;
• Acute conditions of ulcers in the stomach and duodenum;
• Digestive disorders;
• Any acute inflammatory bowel processes;
• Pathological conditions of the kidneys;
• Insufficiency of hepatic or renal, cardiac;
• When performing coronary artery bypass grafting less than 2 months ago.

Separately, it is necessary to highlight pregnancy and young age up to 15 years. If a nursing mother needs treatment, she will need to stop breastfeeding. Additionally, check the personal portability of the components. Never inject yourself with the drug if there are any violations from the list of contraindications!

The intramuscular solution for injection Ketonal itself is prescribed in cases of any disorders of the musculoskeletal system. It is prescribed by many doctors for:

• Arthrosis;
• Reactive, rheumatoid, psoriatic and other arthritis;
• Periarthritis;
• Polyarthritis;
• Compound and non-articular rheumatisms;
• Osteochondrosis;
• Radiculitis;
• Gout and pseudogout;
• Shoulder-brachial syndrome;
• Arthrosynovitis.

It is also often prescribed for headaches, neuralgia, tendinitis, bursitis, myalgia, renal colic, lumbago. Ketonal very well relieves pain during menstruation, it is used even in the postoperative period and with injuries to alleviate the patient's condition. Severe cancer pain can also be indications.

Application features

It is enough to inject Ketonal 1-2 times a day, one ampoule. Intravenous use in the form of droppers is allowed. For this, the daily dosage is diluted in an injection solution of 100 ml and dripped from half an hour to an hour. Droppers can be done every 8 hours as needed. It is necessary to ensure that the daily dose never exceeds 200 mg of ketoprofen.

Ketonal is injected intramuscularly in the places where the skin is closest to the muscles. It is best if it is the thigh or the top of the shoulder. The fatty layer can reduce the absorption of the active substance and reduce its effect.

Ketonal should not be combined with other non-steroidal anti-inflammatory drugs, glucocorticosteroid medications and alcohol, as there is a risk of bleeding in the gastrointestinal tract. During treatment with Ketonal, you should not use any drugs against blood clots, as bleeding may occur. The effect of drugs containing lithium, calcium blockers, cardiac glycosides, hypoglycemic drugs, and methotrexatin is enhanced. Some drugs are suppressed: aimed at lowering blood pressure, diuretics, mifepristone. Combination with ACE inhibitors and diuretics is acceptable.

Side effects

In practice, side effects were seen infrequently. They were mainly associated with an independent increase in the dosage calculated for a day or in violation of the Ketonal injection technique. They can also arise with personal hypersensitivity to the composition of which the patient did not know. However, it is necessary to combine everything with caution and be sure to consult with the doctor supervising you. Do not decide for yourself which drugs you need.

Adverse reactions can be expressed in the form:

• Headaches;
• Dizziness;
• Increased sleepiness;
• Blurred vision;
• Noise in the ears;
• Nausea;
• Incorrect taste sensations;
• Vomiting;
• Bloating;
• Stool disorder;
• The onset of gastritis;
• Gastrointestinal bleeding;
• Convulsions;
• Exacerbation of Crohn's disease;
• Allergies on the skin (swelling, itching, rash);
• Blood from the nose;
• Nasal congestion;
• Laryngeal edema;
• Breathing disorders;
• Asthmatic attacks;
• Anaphylactic shock.

Any non-standard reaction of the body must be recorded. Treatment for negative reactions can only be stationary and will be the same as in case of overdoses. Overdose symptoms are usually accompanied by vomiting and nausea, abdominal pain. Impaired consciousness, difficulty breathing, and seizures may occur.

It is treated with medication in order to eliminate negative symptoms and remove ketoprofen from the body. The withdrawal occurs with special inhibitor drugs and prostaglandins.

Storage

Ketonal ampoules do not require special storage conditions. Make sure that the temperature is not higher than 25 degrees and that the medicine is not exposed to direct sunlight. Ketonal can be stored for 3 years. Be sure to keep the kids safe so they don't find Ketonal.

Additional instructions

Ketonal is not intended for long-term injection. The remedy only relieves pain, but does not treat the underlying cause of its occurrence. Treatment should be continued with other special medications. In addition, Ketonal affects the kidneys and liver, therefore, changes in their condition should be monitored.

Active substance

Release form, composition and packaging

Solution for i / v and i / m administration colorless or slightly yellowish, transparent.

Excipients: propylene glycol - 800 mg, ethanol - 200 mg, benzyl alcohol - 40 mg, water d / i - up to 2 ml.

2 ml - dark glass ampoules (5) - blisters (2) - cardboard packs.
2 ml - dark glass ampoules (5) - blisters (5) - cardboard packs

pharmachologic effect

NSAIDs. It has analgesic, anti-inflammatory and antipyretic effects. Ketoprofen blocks the action of the enzymes COX-1 and COX-2 and, in part, lipoxygenase, which leads to suppression of the synthesis of prostaglandins (including in the central nervous system, most likely in the hypothalamus).

Stabilizes liposomal membranes in vitro and in vivo; at high concentrations in vitro, ketoprofen inhibits the synthesis of bradykinin and leukotrienes.

Ketoprofen does not adversely affect the condition of the articular cartilage.

Pharmacokinetics

Suction

With intravenous administration of ketoprofen, the average plasma concentration after 5 minutes from the start of the infusion and up to 4 minutes after its termination is 26.4 ± 5.4 μg / ml. Bioavailability is 90%.

With a single intramuscular injection of ketoprofen at a dose of 100 mg, the drug is detected in the blood after 15 minutes, and C max (1.3 μg / ml) is reached after 2 hours.

Distribution

The binding of ketoprofen to blood plasma proteins is 99%, mainly to the albumin fraction. V d is 0.1-0.2 l / kg.

Ketoprofen penetrates into the synovial fluid and when administered intravenously at a dose of 100 mg, after 3 hours its concentration reaches 1.5 μg / ml, which is 50% of the concentration in blood plasma (about 3 μg / ml). After 9 hours, the concentration in the synovial fluid is 0.8 μg / ml, and in the blood plasma - 0.3 μg / ml, which means that ketoprofen penetrates into the synovial fluid more slowly and is excreted from it more slowly. Plasma C ss are determined even 24 hours after taking it.

After a single intramuscular injection of ketoprofen at a dose of 100 mg, the drug is found in the cerebrospinal fluid, as well as in the blood plasma after 15 minutes.

Metabolism

Ketoprofen undergoes intensive metabolism with the participation of liver microsomal enzymes. Ketoprofen binds to glucuronic acid and is excreted from the body as glucuronide. There are no active metabolites of ketoprofen.

Withdrawal

T 1/2 is 2 hours. Up to 80% of ketoprofen is excreted by the kidneys within 24 hours, mainly (\u003e 90%) in the form of ketoprofen glucuronide and about 10% through the intestines.

When using ketoprofen at a dose of 100 mg or more, excretion by the kidneys may be difficult.

Pharmacokinetics in special clinical situations

In patients with renal insufficiency, ketoprofen is excreted more slowly, its T 1/2 increases by 1 hour.

In patients with hepatic insufficiency, T 1/2 increases, therefore, the accumulation of ketoprofen in the tissues is possible.

In elderly patients, the metabolism and excretion of ketoprofen are slower, which is of clinical importance only for patients with severe renal failure.

Indications

Symptomatic therapy of pain syndrome, incl. with inflammatory processes of various origins:

• rheumatoid arthritis,
• seronegative arthritis (ankylosing spondylitis / ankylosing spondylitis /, psoriatic arthritis, reactive arthritis / Reiter's syndrome /);
• gout, pseudogout;
• degenerative diseases of the musculoskeletal system, incl. osteoarthritis;
• weak, moderate and severe pain syndrome with headache, migraine, tendinitis, bursitis, myalgia, neuralgia, radiculitis;
• post-traumatic and postoperative pain syndrome, incl. accompanied by inflammation and fever;
• pain syndrome in cancer;
• algodismenorrhea.

The drug is intended for symptomatic therapy to reduce pain and inflammation at the time of use; it does not affect the progression of the disease.

Contraindications

• hypersensitivity to ketoprofen or other components of the drug, as well as salicylates, tiaprofenic acid or other NSAIDs;
• complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance or other NSAIDs (including a history);
• peptic ulcer of the stomach or duodenum in the acute phase;
• ulcerative colitis, Crohn's disease;
• hemophilia and other blood clotting disorders;
• severe liver failure;
• severe renal failure: severe renal failure (CC less than 30 ml / min), confirmed hyperkalemia, progressive kidney disease;
• decompensated insufficiency;
• postoperative period after coronary artery bypass grafting;
• gastrointestinal, cerebrovascular and other bleeding (or suspected bleeding);
• chronic dyspepsia;
• children under 15 years old;
• III trimester of pregnancy;
• period of breastfeeding.

Carefully the drug should be prescribed for a history of peptic ulcer disease, the presence of Helicobacter pylori infection, a history of bronchial asthma, clinically expressed cardiovascular, cerebrovascular and peripheral arterial diseases, dyslipidemia, liver failure, hyperbilirubinemia, alcoholic cirrhosis of the liver, chronic -60 ml / min), chronic heart failure, arterial hypertension, blood diseases, dehydration, diabetes mellitus, with prolonged use of NSAIDs, concomitant use (including warfarin), antiplatelet agents (including acetylsalicylic acid), oral GCS (including prednisolone), selective serotonin reuptake inhibitors (including fluoxentin, parksetin, citalopram, sertraline), in elderly patients, when smoking.

Dosage

To reduce the incidence of adverse reactions, it is recommended to use the minimum effective dose of the drug. The maximum daily dose is 200 mg.

It is necessary to carefully assess the ratio of the intended benefits and risks before starting the use of ketoprofen at a dose of 200 mg / day.

V / m introduction:100 mg (1 ampoule) 1-2 times / day

IV infusionketoprofen should only be administered in a hospital setting. The duration of the infusion should be from 0.5 h to 1 h. The intravenous route of administration should be used no more than 48 hours.

Short intravenous infusion:100-200 mg (1-2 ampoules) of ketoprofen, diluted in 100 ml of 0.9% solution, is injected over 0.5-1 hours.

Continuous IV infusion: 100-200 mg (1-2 ampoules) of ketoprofen, diluted in 500 ml of infusion solution (0.9% sodium chloride solution, lactate-containing, 5% dextrose solution), is administered over 8 hours; re-introduction is possible after 8 hours.

The maximum daily dose is 200 mg.

Ketoprofen can be combined with central analgesics; it can be mixed with opioids (eg morphine) in the same bottle, it cannot be mixed in the same bottle with tramadol due to precipitation.

Parenteral administration of Ketonal can be combined with the use of oral forms (tablets, capsules) or rectal suppositories.

Side effects

Definition of categories of frequency of adverse effects (in accordance with WHO): very often (≥1 / 10), often (≥1 / 100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10 000, <1/1000) и очень редко (<1/10 000); частота неизвестна (частоту возникновения нежелательных явлений нельзя определить на основании имеющихся данных).

From the hematopoietic and lymphatic system:rarely - hemorrhagic anemia, hemolytic anemia, leukopenia; the frequency is unknown - agranulocytosis, thrombocytopenia, impaired bone marrow hematopoiesis.

From the immune system:frequency unknown - anaphylactic reactions (including anaphylactic shock).

From the nervous system:often - insomnia, depression, asthenia; infrequently - headache, dizziness, drowsiness; rarely - paresthesias, confusion or loss of consciousness, peripheral polyneuropathy; the frequency is unknown - convulsions, impaired taste, emotional lability.

From the senses:rarely - blurred vision, tinnitus, conjunctivitis, dryness of the mucous membrane of the eye, pain in the eyes, hearing loss; frequency unknown - optic neuritis.

On the part of the cardiovascular system:infrequently - tachycardia; frequency unknown - heart failure, arterial hypertension, vasodilation.

From the respiratory system:rarely - exacerbation of bronchial asthma, nosebleeds, laryngeal edema; frequency unknown - bronchospasm (especially in patients with hypersensitivity to NSAIDs), rhinitis.

From the digestive system: often - nausea, vomiting, dyspepsia, abdominal pain NSAID-gastropathy; infrequently - constipation, diarrhea, bloating, gastritis; rarely - peptic ulcer, stomatitis; very rarely - exacerbation of NUC of Crohn's disease, gingival, gastrointestinal, hemorrhoidal bleeding, melena, perforation of the digestive tract; frequency unknown - gastrointestinal discomfort, stomach pain.

From the liver and biliary tract:rarely - hepatitis, increased activity of liver enzymes and the concentration of bilirubin.

From the side of the skin:infrequently - skin rash, itching; frequency unknown - photosensitization, alopecia, urticaria, exacerbation of chronic urticaria, angioedema, erythema, bullous rash, including Stevens-Johnson syndrome, toxic epidermal necrolysis, purpura.

From the urinary system: rarely - cystitis, urethritis, hematuria; very rarely - acute renal failure, interstitial nephritis, nephrotic syndrome, abnormalities in the values \u200b\u200bof renal function indicators; the frequency is unknown - fluid retention in the body and, as a result, an increase in body weight, hyperkalemia.

Other:infrequently - peripheral edema, fatigue; rarely - hemoptysis, menometrorrhagia, shortness of breath, thirst, muscle twitching.

Overdose

Symptoms:in case of an overdose, headache, nausea, vomiting, abdominal pain, vomiting of blood, melena, impaired consciousness, respiratory depression, convulsions, renal dysfunction, renal failure may occur.

Treatment: in case of ingestion - gastric lavage, the use of activated carbon. Conducting symptomatic and supportive therapy; the effect of ketoprofen on the gastrointestinal tract can be weakened with the help of agents that reduce the secretion of gastric glands (for example, proton pump inhibitors) and prostaglandins; monitoring of the respiratory system and cardiovascular system is shown. No specific antidote was found. Hemodialysis is ineffective.

Drug interactions

Undesirable combinationsdrugs

The combined use of ketoprofen with others is not recommended NSAIDs (including selective COX-2 inhibitors) , salicylates in high doses,due to an increased risk of gastrointestinal bleeding and ulceration of the gastrointestinal mucosa.

Simultaneous use with anticoagulants(heparin, warfarin), antiplatelet agents(ticlopidine, clopidogrel) increases the risk of bleeding. If the use of such a combination is unavoidable, the patient's condition should be carefully monitored.

lithium preparationsit is possible to increase the concentration of lithium in the blood plasma up to toxic values. It is necessary to carefully monitor the concentration of lithium in the blood plasma and promptly adjust the dose of lithium preparations during and after treatment with NSAIDs.

Increases hematological toxicity methotrexate,especially when used in high doses (more than 15 mg per week). The time interval between stopping or starting therapy with ketoprofen and taking methotrexate should be at least 12 hours.

Combinations to be used with caution

During therapy with ketoprofen, patients taking diuretics,especially with the development of dehydration, have a higher risk of developing renal failure due to a decrease in renal blood flow caused by inhibition of prostaglandin synthesis. Before using ketoprofen in such patients, rehydration measures should be taken.

After starting treatment, it is necessary to monitor kidney function.

Combined use of the drug with aCE inhibitors and angiotensin II receptor blockersin patients with impaired renal function (with dehydration, elderly patients) can lead to worsening of deterioration in renal function, incl. to the development of acute renal failure.

During the first weeks of the simultaneous use of ketoprofen and methotrexatein a dose not exceeding 15 mg / week,
blood tests should be monitored weekly. In elderly patients or if any signs of impaired renal function occur, the study should be performed more often.

Combinations to be taken into account

Ketoprofen may reduce the effect antihypertensive drugs (beta-blockers, inhibitors ACE, diuretics).

Simultaneous use with selective inhibitorsserotonin reuptake (SSRI)increases the risk of developing gastrointestinal bleeding.

Simultaneous use with thrombolyticsincreases the risk of bleeding.

Simultaneous use with potassium salts, potassium-sparingdiuretics, ACE inhibitors, receptor blockersangiotensin II, NSAIDs,low molecular weight heparins, cyclosporin, tacrolimus and trimethoprimincreases the risk of developing hyperkalemia.

When used simultaneously with cyclosporine, tacrolimusthe risk of developing an additive nephrotoxic effect is possible, especially in elderly patients.

Application of multiple antiplatelet drugs(tirofiban, eptifibatid,abciximab, iloprost)increases the risk of bleeding. Increases concentration in blood plasma cardiac glycosides, slow calcium channel blockers, cyclosporine,methotrexate and digoxin.

Ketoprofen may enhance the effect oralhypoglycemic and someanticonvulsants (phenytoin).

Simultaneous use with probenecidsignificantly reduces the clearance of ketoprofen in blood plasma.

NSAIDs may decrease effectiveness mifepristone.The use of NSAIDs should be started no earlier than 8-12 days after discontinuation of mifepristone.

Pharmaceutical interactions

Pharmaceutically incompatible with tramadol solution due to precipitation.

special instructions

With long-term use of NSAIDs, it is necessary to periodically evaluate the clinical blood test, as well as monitor the function of the kidneys and liver, especially in elderly patients (over 65 years old), conduct a fecal occult blood test.

Care must be taken and blood pressure should be monitored more often when using ketoprofen for the treatment of patients suffering from arterial hypertension, cardiovascular diseases that lead to fluid retention in the body.

In the event of violations of the organs of vision, treatment should be stopped immediately.

Like other NSAIDs, ketoprofen can mask the symptoms of infectious and inflammatory diseases. In case of detection of signs of infection or deterioration of health while using the drug, you should immediately consult a doctor.

If there is a history of contraindications from the gastrointestinal tract (bleeding, perforation, peptic ulcer), long-term therapy and the use of high doses of ketoprofen, the patient should be under close medical supervision.

Because of the important role of prostaglandins in maintaining renal blood flow, special care should be taken when prescribing ketoprofen to patients with heart or renal failure, as well as when treating elderly patients taking diuretics and patients who, for any reason, have a decrease in BCC ( for example, after surgery).

The use of ketoprofen can affect female fertility, therefore, patients with infertility (including those undergoing examination) are not recommended to use the drug.

Influence on the ability to drive vehicles and mechanisms

During the period of use of the drug, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions, because the drug may cause dizziness and other side effects that may interfere with these abilities.

Pregnancy and lactation

Inhibition of prostaglandin synthesis can have undesirable effects on pregnancy and / or embryonic development. Data obtained in the course of epidemiological studies with the use of inhibitors of prostaglandin synthesis in early pregnancy confirm an increased risk of spontaneous abortion and the formation of heart defects (up to 1.5%) and congenital defects of the anterior abdominal wall. The risk increases with dose and duration of treatment.

Prescribing the drug to pregnant women in the first and second trimesters of pregnancy is possible only if the benefits to the mother justify the possible risk to the fetus. In this case, it is necessary to apply the minimum effective dose in the shortest possible course.

The use of ketoprofen in pregnant women during the third trimester of pregnancy is contraindicated due to the possibility of developing weakness of labor activity of the uterus, and / or premature closure of the ductus arteriosus, a possible increase in bleeding time, oligohydramnios and renal failure.

To date, there are no data on the release of ketoprofen in breast milk, therefore, if it is necessary to prescribe ketoprofen to a nursing mother, the question of stopping breastfeeding should be decided.

Childhood use

The drug is available by prescription.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature not exceeding 25 ° C. The shelf life is 3 years.

Ketonal - injections with anti-inflammatory effect. The active ingredient of this drug is ketoprofen, so this medicine also has antipyretic and analgesic effects. In the blood, the maximum concentration of the drug is reached in just 5 minutes (with intravenous administration).

Indications for the use of Ketonal injections

Anesthetic injections Ketonal are used in the symptomatic treatment of various diseases of the musculoskeletal system (degenerative and inflammatory). Basically, they are used to eliminate even the strongest pain syndrome of any origin. The use of Ketonal injections is indicated for:

• - when the joints of the limbs (large or small) are affected;
• osteoarthritis;
• psoriatic arthritis;
• gouty arthritis;
• bechterew's disease - when the mobility of the spine is limited.

This drug is also used as an analgesic (mainly for postoperative pain syndrome), even if there is an inflammatory process. In some cases, Ketonal injections are used at home to treat lesions of the peripheral nervous system (if they are accompanied by bouts of pain), tendonitis, severe pain in joints and muscles, bursitis, radiculitis and severe toothache.

Method of using Ketonal injections

Ketonal is used in 1 ampoule three times a day. Typically, the injection is given intramuscularly. This drug is used intravenously only in a hospital. In such cases, the drug is administered:

• intermittently (the contents of the ampoules are diluted with saline and injected for 30-60 minutes);
• in a continuous way (the contents of the ampoules are diluted in saline or glucose solution and injected over 8 hours).

After Ketonal injections, you should not drink alcohol and you should not drive a vehicle if dizziness or drowsiness appears. For severe pain, this drug is combined with various narcotic analgesics. With Tramadol, it is administered separately, and with Morphine, it can be mixed in one container. Ketonal is also used together with vitamins, dietary supplements and various central anesthetics.

Contraindications to the use of Ketonal

Ketonal injections have contraindications. Such injections are strictly forbidden to use if the patient has:

• acute or chronic peptic ulcer of the stomach and duodenum;
• severe renal failure;
• intolerance to any components of the drug;
• recurring asthma attacks.

Use such a drug with caution during pregnancy or lactation. In patients with arterial hypertension, Ketonal can provoke the development of peripheral edema.

You should not give injections to those who have:

• internal bleeding;
• chronic dyspepsia;
• uncompensated heart failure.