Ketoprofen

(key-toe-pro-fen)

Trade/other name(s): Actron, Orudis, Oruvail

Why would this drug be used?

Ketoprofen may be used to treat mild to moderate pain from cancer, surgery, or other causes. For severe pain, it is more helpful when used along with other pain-relieving drugs. It is also used to reduce fever and inflammation, as well as for other purposes. You can buy smaller doses of ketoprofen over the counter, without a prescription. Larger doses can only be obtained by prescription.

How does this drug work?

Ketoprofen is a non-opioid pain medicine, meaning that it is not in the same family as morphine or codeine. It belongs to the class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Its action is not fully understood, but it helps block the body from making prostaglandins. (Prostaglandins are substances made by most of the cells in the body. They have a role in many body functions, including pain and inflammation.) Ketoprofen helps prevent pain receptors from passing pain messages to the brain. In addition, ketoprofen reduces inflammation. It also reduces fever by helping enlarge blood vessels near the skin so that heat is lost from the body.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• About any reactions you have had when taking aspirin or other non-steroidal anti-inflammatory medicines in the past. If you have had problems with any of these medicines, you are more likely to have problems taking ketoprofen.
• If you have any medical conditions such as asthma, nasal polyps, allergies, high blood pressure, kidney disease, liver disease (including hepatitis), stroke, high cholesterol, diabetes, or heart disease. These conditions increase the risk of serious side effects from or reactions to ketoprofen, and you may need a different medicine. If you take this drug, you may need to be watched more closely during treatment.
• If you have congestive heart failure or fluid retention (swelling, usually of the legs and feet). Ketoprofen may worsen this problem.
• If you are taking blood pressure medicines. Ketoprofen may cause some blood pressure medicines to stop working properly. In some cases, the combination of medicines may damage the kidneys.
• If you have ever had ulcers in your stomach or intestines, especially if you had bleeding. Ketoprofen can worsen these problems or make them come back.
• If you have hemophilia or any other bleeding problem, or if you are taking blood thinners such as warfarin or heparin. Ketoprofen can increase your risk of bleeding from the stomach or intestine.
• If you are pregnant or trying to get pregnant. Taking ketoprofen, especially later in pregnancy, can harm the baby.
• If you are breast-feeding. It is not known if ketoprofen is excreted in breast milk. If it is, it may affect the baby.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

If you take ketoprofen while you are taking lithium, your lithium level may go up. This can increase your risk of toxic effects from lithium. You may need more frequent monitoring of lithium levels while on ketoprofen.

Taking ketoprofen while using "blood thinners" (such as warfarin and heparin) can increase your risk of serious bleeding.

Probenecid can cause ketoprofen to build up in the body, and generally should not be taken during the time you are taking ketoprofen.

Alcohol may increase your risk of stomach irritation or bleeding, as may aspirin. Corticosteroids that are taken by mouth, such as prednisone, prednisolone, hydrocortisone, betamethasone, budesonide, triamcinolone, can also increase this risk.

Medicines for high blood pressure, such as diuretics (water pills) and ACE inhibitors (such as captopril, lisinopril, enalapril, benazepril, and others) may not work as well if taken during treatment with ketoprofen. You may need more frequent blood pressure checks and possibly a change of medicines.

Methotrexate may have more toxic effects if ketoprofen is taken during the same time.

Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Ketoprofen is a tablet or capsule that can be taken by mouth with milk, food, or antacids. It also comes in extended-release capsules and rectal suppositories. Extended-release capsules must be swallowed whole, not chewed, crushed, broken, opened, or dissolved.

Take this drug exactly as directed by your doctor, or follow the directions on the label for the non-prescription doses. If you do not understand the instructions, ask your doctor or nurse to explain them to you.

Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

Precautions

Avoid aspirin or other anti-inflammatory drugs like ibuprofen while taking ketoprofen. They may increase the risk of overdose, bleeding, or stomach irritation. It is easy to get aspirin or ibuprofen without knowing it, because they are often added to other medicines. Read the ingredient list on any remedies for headache, sinus, cold or flu before taking them, or check with your pharmacist.

Avoid ketoprofen if you have a stomach or duodenal ulcer. Ketoprofen can cause severe bleeding or holes in the intestine.

If you have ever had trouble breathing, rash, itching, or swelling in the mouth or throat after taking aspirin or other anti-inflammatory drugs, do not take ketoprofen.

If your blood counts are low due to chemotherapy or radiation, check with your doctor or nurse before taking ketoprofen. It may increase your chance of bleeding.

Call your doctor or nurse right away if you are vomiting blood, or a coffee-ground material, notice blood in your stools, or stools appear black and tarry. Talk to your doctor if you have pain in your belly or severe indigestion. Stop taking ketoprofen until after you talk with your doctor.

Ketoprofen must be stopped at least a few days before any type of surgery. Make sure you tell your doctor or dentist at least a week before surgery if you are taking ketoprofen.

Your doctor may want to check your lab work and blood pressure more often if you are taking ketoprofen for more than a few weeks. This is to help find problems early, before they worsen.

Call your doctor or nurse right away if your vision is blurred, you don't see colors well, or if you see spots in front of your eyes. Stop taking ketoprofen until you talk to your doctor or nurse.

If you notice any type of itching, rash, or sores in your mouth, especially if you also have a fever and feel sick, stop the ketoprofen and call your doctor right away.

Ketoprofen can cause you to retain fluids and make heart failure worse. If you have unexplained weight gain or swelling, stop the ketoprofen and call your doctor.

Rarely, ketoprofen can cause damage to the liver. If you notice nausea, tiredness, itching, tenderness below the right side of your rib cage, flu-like symptoms, or yellowing of the skin or eyes, stop the medicine and call your doctor or nurse right away.

Ketoprofen can increase your risk of heart attack and stroke. If you develop shortness of breath, chest pain, weakness, or slurred speech, get help right away.

If you have signs of an allergic reaction such as trouble breathing, itchy welts on the skin, or swelling of your mouth, face, or throat, get emergency help.

Smoking or drinking alcohol increases your risk of bleeding from the stomach or intestine.

Most cancer pain can be controlled. If you are taking ketoprofen for cancer pain, keep your doctor or nurse informed about how well your pain medicines are working and any side effects you are having. Your cancer team may need to adjust your medicines several times before they find the medicines that work best for you.

If your doctor prescribes another medicine for pain, ask your doctor or nurse whether you should continue taking ketoprofen along with the new medicine. Severe pain usually requires more than one type of medicine to control it.

If you have chronic cancer pain, take your pain medicines on a regular schedule to keep it from worsening. If you wait until the pain is bad, it takes more medicine to get it under control. If pain gets bad between doses, talk to your cancer team about changing your medicine or adding an extra one for "breakthrough" pain.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• heartburn
• nausea

Less common

• constipation
• belly pain
• vomiting
• diarrhea
• headache
• sores in mouth or on lips*
• increase in blood pressure*
• abnormal blood tests which suggest that the drug is affecting the liver (Your doctor will discuss the importance of this finding, if any)

Rare

• swelling of arms, hands, legs, or feet*
• fluid retention with weight gain*
• peptic (stomach) or intestinal ulcers*
• bleeding in the stomach or intestines (risk greater with longer use)*
• abnormal blood tests which suggest that the drug is affecting the kidneys (Your doctor will discuss the importance of this finding, if any)
• kidney damage (usually gets better after medicine is stopped)
• kidney failure
• damage to liver, which can cause yellow skin or eyes, pain in the upper abdomen*
• unusual bruising or bleeding*
• dizziness
• anemia (low red blood cell count, which can cause symptoms like tiredness)*
• heart attack*
• stroke*
• serious skin rash with itching, redness, blistering, usually with fever*
• worsening of asthma symptoms*
• allergic reaction with trouble breathing, skin welts, itching, feeling faint, or swelling of the face, mouth, or throat*

*See "Precautions" section for more detailed information.

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1986.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.