Ketonal Duo (Ketoprofen)

Ketoprofen is employed to manage pain and inflammation within the musculoskeletal and rheumatic disease spectrum.

• Mild to moderate pain: provides analgesic relief for acute conditions such as dental procedures, postoperative discomfort, or injury‑related pain.
• Osteoarthritis: reduces joint pain and improves functional mobility in patients with degenerative joint disease of the knee, hip or hand.
• Rheumatoid arthritis: alleviates inflammatory joint pain, swelling and stiffness, supporting disease‑modifying therapy in autoimmune arthritis.
• Ankylosing spondylitis: helps control chronic spinal pain and stiffness associated with inflammatory back disease.

• Ketoprofen exerts its anti‑inflammatory and analgesic actions by non‑selectively inhibiting cyclo‑oxygenase enzymes COX‑1 and COX‑2. This blockade reduces the conversion of arachidonic acid to prostaglandins, decreasing the synthesis of mediators that promote pain, fever and inflammation at peripheral tissues and the central nervous system. By limiting prostaglandin levels, ketoprofen also diminishes vascular permeability and leukocyte infiltration, contributing to its therapeutic effect in inflamed tissues.

Ketoprofen may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia or abdominal pain.
• Headache: mild to moderate headache episodes.
• Dizziness: transient sensation of light‑headedness.
• Skin rash: mild erythema or pruritus.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding: potentially life‑threatening hemorrhage.
• Renal impairment: acute kidney injury or worsening of chronic kidney disease.
• Severe hypersensitivity reactions: anaphylaxis, Stevens‑Johnson syndrome or toxic epidermal necrolysis.

When prescribing ketoprofen, clinicians should consider several precautionary measures to minimize risk.

• Assess gastrointestinal risk: evaluate history of ulcers, bleeding or concurrent NSAID use.
• Monitor renal function: check baseline creatinine and adjust in patients with kidney disease.
• Evaluate cardiovascular status: use cautiously in patients with hypertension or heart failure.
• Review concomitant medications: avoid use with anticoagulants, corticosteroids or other NSAIDs without supervision.
• Pregnancy and lactation: contraindicated or use only if benefits outweigh risks, based on clinical judgment.
• Store at ambient temperature: keep below 25 °C in the original packaging, protect from moisture and light.

Ketoprofen can interact with other medicines, altering efficacy or increasing toxicity.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Selective COX‑2 inhibitors: additive gastrointestinal toxicity.
• Lithium: reduced renal clearance leading to lithium toxicity.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may diminish antihypertensive effect and affect renal function.
• Diuretics: heightened risk of renal impairment, especially in dehydrated patients.
• Methotrexate: decreased renal elimination, potentially raising methotrexate levels.