Ketonal (Ketoprofen)

• Ketonal (ketoprofen) is used to manage pain and inflammation across several musculoskeletal and postoperative conditions.
• Mild to moderate pain: provides analgesic relief by reducing prostaglandin‑mediated inflammation, improving patient comfort.
• Rheumatoid arthritis: helps control joint swelling and pain, contributing to improved functional ability.
• Post‑operative pain: decreases postoperative discomfort and edema, facilitating recovery after surgical procedures.
• Musculoskeletal injuries: alleviates pain and inflammation associated with sprains, strains, and soft‑tissue trauma.

• Ketoprofen exerts its effect by non‑selectively inhibiting cyclooxygenase enzymes COX‑1 and COX‑2, which blocks the conversion of arachidonic acid to prostaglandins. The resulting decrease in prostaglandin synthesis reduces inflammation, pain signaling, and fever responses at sites of tissue injury. Additionally, reduced prostaglandin levels diminish vascular permeability and leukocyte infiltration, further contributing to anti‑inflammatory activity. These actions together provide rapid analgesia and swelling control after intramuscular or intravenous administration.

Ketonal may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia, or abdominal pain, often transient.
• Headache: mild to moderate intensity, may respond to simple analgesics.
• Dizziness or vertigo: sensation of light‑headedness, usually short‑lasting.
• Injection site reactions: pain, erythema, or swelling at the administration site.

Serious or Rare Side Effects

• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis, requiring immediate medical attention.
• Gastrointestinal bleeding or ulcer perforation: potentially life‑threatening hemorrhage in the stomach or intestines.
• Renal impairment: acute kidney injury or reduced renal function, especially in patients with pre‑existing kidney disease.
• Hepatic dysfunction: elevated liver enzymes, hepatitis, or jaundice indicating liver injury.
• Anaphylaxis: rapid onset of airway swelling, hypotension, and shock, demanding emergency treatment.

• Before prescribing Ketonal, clinicians should consider several safety precautions to minimize risk.
• Assess renal function: evaluate creatinine clearance in patients with kidney disease.
• Avoid in active peptic ulcer disease: increased risk of gastrointestinal bleeding.
• Use caution with anticoagulants: heightened bleeding tendency when combined with warfarin or similar agents.
• Monitor liver enzymes: potential hepatic effects require periodic testing.
• Check for hypersensitivity: contraindicated in patients with known allergy to ketoprofen or other NSAIDs.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

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

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Selective COX‑2 inhibitors: additive gastrointestinal toxicity.
• ACE inhibitors or ARBs: may impair renal function when combined.

Moderate Interactions (Monitor Closely)

• Diuretics: monitor renal function and electrolytes.
• Corticosteroids: increased risk of ulceration and gastrointestinal complications.