Ketonal Forte (Ketoprofen)

Ketonal Forte, a ketoprofen‑based NSAID, is indicated for several pain‑related and inflammatory conditions.

• Mild to moderate pain: provides analgesic relief for acute or chronic pain such as dental or postoperative discomfort.
• Osteoarthritis: reduces joint inflammation and improves mobility in degenerative joint disease.
• Rheumatoid arthritis: alleviates inflammatory joint pain and swelling in autoimmune arthritis.
• Musculoskeletal pain: eases strain, sprain and back pain associated with soft‑tissue injuries.

• Ketoprofen exerts its anti‑inflammatory and analgesic actions by non‑selectively inhibiting cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes. This inhibition blocks the conversion of arachidonic acid to prostaglandins, thereby decreasing prostaglandin synthesis at sites of inflammation. The reduced prostaglandin levels lower peripheral sensitisation of nociceptors, leading to diminished pain perception and swelling. The effect is systemic, providing relief throughout the body, and the drug’s relatively rapid absorption contributes to its onset of action within hours after oral administration.

Ketonal Forte 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 intensity.
• Dizziness or vertigo: transient sensations of light‑headedness.
• Skin rash: mild erythema or pruritus.

Serious or Rare Side Effects

• Peptic ulcer or gastrointestinal bleeding: severe abdominal pain or blood in stool.
• Renal impairment: reduced urine output or swelling.
• Hepatotoxicity: jaundice or elevated liver enzymes.
• Severe hypersensitivity: anaphylaxis, angioedema or bronchospasm.

When prescribing Ketonal Forte, clinicians should consider several precautionary measures to minimise risk.

• Assess renal function: avoid use in patients with severe renal impairment.
• Evaluate gastrointestinal risk: use with caution in those with history of ulcers or bleeding.
• Monitor hepatic status: periodic liver function tests are advised for long‑term therapy.
• Use cautiously in cardiovascular disease: NSAIDs may increase risk of thrombotic events.
• Avoid in known hypersensitivity: discontinue if allergic reactions occur.
• Store at ambient temperature: keep below 25 °C, in original packaging, protected from moisture.

Ketonal Forte can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Other NSAIDs or aspirin: heightened gastrointestinal toxicity.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may reduce renal function.
• Diuretics (especially loop diuretics): risk of renal impairment.
• Lithium: NSAIDs can raise lithium levels, leading to toxicity.
• Methotrexate: reduced clearance may cause toxicity.