Ketonal in the form of ampoules - instructions for use. Ketonal for injection - instructions for use Side effects and actions

The medicine "Ketonal" (injections) is defined by the instructions for use as a remedy with anti-inflammatory, antipyretic, analgesic properties. The active ingredient is ketoprofen, which is an NSAID.

Pharmacological activity

The drug blocks prostaglandins E2, slows down the synthesis of bradykinin, inhibits the action of cyclooxygenase, and normalizes lysosomal membranes. Due to this, a high anti-inflammatory activity is achieved, which consists in reducing the manifestations of inflammatory pathologies and ensuring a persistent analgesic effect.

Indications for the appointment of Ketonal

Injections (instructions for use indicate this) are prescribed during the treatment of arthritis (reactive, rheumatoid, psoriatic), gout, bursitis, tendinitis, spondyloarthritis. Also, injections of the drug are done with algodismenorrhea in case of pain syndrome, after injuries, operations.

Composition and form of release of the drug "Ketonal" (injections)

The instructions for use contain information on the composition of the medication. Solution for injection is produced in ampoules of 2 ml. In 1 ml, the active ingredient - ketoprofen - is contained in an amount of 50 mg. Auxiliary components of the solution are benzyl alcohol, water, sodium hydroxide, propylene glycol.

Mode of application

The medication should be used 1-2 times a day, one ampoule (100 mg). Along with injections, if necessary, the drug "Ketonal" can be prescribed in other forms. Injections, instructions for use advise supplementing with taking pills or suppositories. The drug is administered intravenously only under stationary conditions, while the infusion can be continuous or intermittent. In the first case, 100-200 mg (1-2 ampoules) of the drug are diluted in 500 ml of saline or glucose solution. The introduction is carried out for 8 hours, then the infusion can be repeated. Intermittent - carried out within 0.5-1 hours. Previously, 100-200 mg of Ketonal (1-2 ampoules) are diluted in 100 ml of saline. After 8 hours, the administration can also be repeated. If there is severe pain, you can use the drug in conjunction with narcotic analgesics.

Side effects

The drug "Ketonal" (injections) rarely causes negative phenomena. Reviews assure that if side effects occur, they pass very quickly. Patients sometimes experience dyspeptic disorders (stool disturbance, nausea, pain in the epigastric region). Some have headaches, dizziness. In rare cases, thrombocytopenia and anemia may develop. In turn, thrombocytopenia can provoke nosebleeds, petechial rash, and bruising.

Contraindications to the use of Ketonal (injections). Drug price

In case of intolerance to ketoprofen or other components present in the composition, in case of intolerance to salicylates, it is prohibited to prescribe the medication "Ketonal". Do not use the medicine during periods of gestation and breastfeeding. Also, the remedy is not prescribed to patients under the age of fourteen. The price of the drug in different pharmacies varies on average from 200 to 240 rubles.

Instructions
on the use of a medicinal product for medical use

Please keep these instructions as you may need them again.
If you have any questions, see your doctor.

Registration number:

Trade name of the drug:

Ketonal ®.

International non-proprietary name:

ketoprofen.

Dosage form:

solution for intravenous and intramuscular administration.

Compound

1 ampoule contains:
active substance: ketoprofen - 100 mg;
Excipients: propylene glycol - 800 mg; ethanol - 200 mg; benzyl alcohol - 40 mg; water for injection - up to 2 ml.

Description:

Transparent, colorless or slightly yellowish solution.

Pharmacotherapeutic group:

Non-steroidal anti-inflammatory drug (NSAID).

ATX code: MO1AE03 - ketoprofen.

Pharmacological properties

Pharmacodynamics
Ketoprofen is a non-steroidal anti-inflammatory drug.
Ketoprofen has anti-inflammatory, analgesic and antipyretic effects.
Ketoprofen blocks the action of the enzyme cyclooxygenase 1 and 2 (COX1 and COX2) and, in part, lipoxygenase, which leads to suppression of prostaglandin synthesis (including in the central nervous system, most likely in the hypothalamus).
Stabilizes in vitro and in vivo liposomal membranes, 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
At 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 100 mg of ketoprofen, the drug is found in the blood plasma 15 minutes after the start of the infusion, and the peak concentration (1.3 μg / ml) is reached after 2 hours. The bioavailability of the drug increases linearly with increasing dose.
Distribution
Ketoprofen is 99% bound to plasma proteins, mainly to the albumin fraction. The volume of distribution in tissues is 0.1-0.2 l / kg.
Ketoprofen penetrates into the synovial fluid, and when intravenous administration 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. Stationary plasma concentrations of ketoprofen are determined even 24 hours after its administration.
After a single intramuscular injection 100 mg of ketoprofen, the drug is found in the cerebrospinal fluid, as well as in the blood serum, after 15 minutes.
Metabolism
Ketoprofen undergoes intensive metabolism with the participation of liver microsomal enzymes. It binds to glucuronic acid and is excreted from the body as glucuronide. There are no active metabolites of ketoprofen.
Withdrawal
The half-life (T1 / 2) of ketoprofen is 2 hours. Up to 80% of ketoprofen is excreted by the kidneys within 24 hours, mainly (> 90%) in the form of ketoprofen glucuronide, and about 10% through the intestines.
In patients with renal impairment ketoprofen is excreted more slowly, its T1 / 2 increases by 1 hour.
In patients with hepatic impairment T1 / 2 increases, therefore, the accumulation of ketoprofen in the tissues is possible.
In elderly patients metabolism and excretion of ketoprofen are slower, which is of clinical importance only for patients with severe renal failure.

Indications for use

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, including accompanied by inflammation and fever;
pain syndrome in cancer;
algodismenorrhea.
The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use, does not affect the progression of the disease.

Contraindications

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

Carefully

A history of peptic ulcer disease, the presence of Helicobacter pylori infection;
history of bronchial asthma;
clinically significant cardiovascular, cerebrovascular and peripheral arterial disease;
dyslipidemia, liver failure, hyperbilirubinemia, alcoholic cirrhosis of the liver;
chronic renal failure (CC 30-60 ml / min);
chronic heart failure, arterial hypertension, blood diseases;
dehydration, diabetes mellitus;
smoking;
elderly age;
long-term use of NSAIDs, concomitant use of anticoagulants (including warfarin), antiplatelet agents (including clopidogrel), oral glucocorticosteroids (including prednisolone), selective serotonin reuptake inhibitors (including fluoxetine, paroxetine, citalopram, sertraline) (see the section "Interaction with other medicinal products").

Application during pregnancy and during breastfeeding

Inhibition of prostaglandin synthesis can have an undesirable effect on the course of pregnancy and / or on 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.
It is possible to prescribe the drug to pregnant women in the first and second trimesters of pregnancy 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 possible development of weakness in labor of the uterus, an increase in bleeding time, an antiplatelet effect (even when taken in small doses), as well as the effect on the fetus (cardiopulmonary toxicity, incl. including premature closure of the ductus arteriosus and pulmonary hypertension, renal dysfunction, which can progress to renal failure with the development of oligohydramnios).
To date, there are no data on the release of ketoprofen into breast milk, therefore, if it is necessary to prescribe ketoprofen to a nursing mother, the question of stopping breastfeeding should be decided.

Method of administration and dosage

Intravenous, intramuscular.
To reduce the frequency 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 ketoprofen at a dose of 200 mg / day.
Intramuscular injection: 100 mg (1 ampoule) 1-2 times a day.
Intravenous infusion of ketoprofen should be carried out only in a hospital setting. The duration of the infusion should be between 0.5 and 1 hour.
The intravenous route of administration should be used for no more than 48 hours.
Short intravenous infusion: from 100 (to 200) mg (1-2 ampoules) of ketoprofen, diluted in 100 ml of 0.9% sodium chloride solution, is administered over 0.5-1 hours.
Continuous intravenous infusion: from 100 (to 200) mg (1-2 ampoules) of ketoprofen, diluted in 500 ml of infusion solution (0.9% sodium chloride solution, lactate-containing Ringer's solution, 5% dextrose solution), is injected within 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 one vial, it is pharmaceutically incompatible with tramadol solution due to precipitation.
Parenteral administration of Ketonal ® can be combined with the use of oral forms (tablets, capsules) or rectal suppositories.

Side effect

According to the World Health Organization (WHO), unwanted effects are classified according to their frequency of development as follows: very often (≥1 / 10), often (≥1 / 100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10000, <1/1000) и очень редко (<1/10000); частота неизвестна (частоту возникновения явлений нельзя определить на основании имеющихся данных).
On the part of the hematopoietic and lymphatic system:
rarely: hemorrhagic anemia, hemolytic anemia, leukopenia;
frequency unknown: agranulocytosis, thrombocytopenia, bone marrow dysfunction.
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;
frequency 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, increased blood pressure, 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 gastrointestinal tract:
often: nausea, vomiting, dyspepsia, abdominal pain, NSAID gastropathy;
infrequently: constipation, diarrhea, bloating, gastritis;
rarely: peptic ulcer, stomatitis;
rarely: exacerbation of ulcerative colitis, Crohn's disease, gingival, gastrointestinal, hemorrhoidal bleeding, melena, perforation of the gastrointestinal tract.
frequency unknown: gastrointestinal discomfort, stomach pain.
From the liver and biliary tract:
rarely: hepatitis, increased activity of "liver" enzymes and bilirubin.
From the side of the skin:
infrequently: skin rash, itchy skin;
frequency unknown: photosensitivity, 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;
rarely: acute renal failure, interstitial nephritis, nephrotic syndrome, abnormal values of indicators of renal function;
frequency 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

In case of an overdose of ketoprofen, headache, nausea, vomiting, abdominal pain, vomiting of blood, melena, impaired consciousness, respiratory depression, convulsions, impaired renal function and renal failure may occur.
In case of an overdose, gastric lavage and the use of activated charcoal are indicated. Treatment - symptomatic and supportive therapy; the effect of ketoprofen on the gastrointestinal tract can be weakened by means that reduce the secretion of gastric glands (for example, proton pump inhibitors) and prostaglandins, monitoring of respiratory and cardiovascular activity, no specific antidote has been found, hemodialysis is ineffective.

Interaction with other medicinal products

Unwanted drug combinations
The combined use of ketoprofen with others is not recommended. NSAIDs (including selective cyclooxygenase-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 preparations it 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 starting the use of 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 blockers in patients with impaired renal function (with dehydration, in elderly patients), it can lead to an aggravation of the deterioration of renal function, including the development of acute renal failure.
During the first weeks of the simultaneous use of ketoprofen and methotrexate at a dose not exceeding 15 mg / week, a blood test 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, angiotensin-converting enzyme inhibitors, diuretics).
Simultaneous use with selective serotonin reuptake inhibitors (SSRIs) increases the risk of gastrointestinal bleeding.
Simultaneous use with thrombolytics
Simultaneous use with potassium salts, potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor blockers, NSAIDs, low molecular weight heparins, cyclosporin, tacrolimus and trimethoprim increases the risk of developing hyperkalemia.
When used simultaneously with cyclosporine, tacrolimus the risk of developing an additive nephrotoxic effect is possible, especially in elderly patients.
Application of multiple antiplatelet drugs (tirofiban, eptifibarid, abciximab, iloprost) increases the risk of bleeding.
Increases concentration in blood plasma cardiac glycosides, blockers of "slow" calcium channels, cyclosporine, methotrexate and digoxin.
Ketoprofen may enhance the effect oral hypoglycemic and some anticonvulsants (phenytoin).
Simultaneous use with probenecid significantly reduces the clearance of ketoprofen in blood plasma.
Non-steroidal anti-inflammatory drugs may decrease effectiveness mifepristone. NSAIDs should be started no earlier than 8-12 days after discontinuation of mifepristone.
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 to treat patients with 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 circulating volume. blood (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, 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 an increased concentration of attention and speed of psychomotor reactions, since the drug can cause dizziness and other side effects that can affect these abilities.

Release form

Solution for intravenous and intramuscular administration of 50 mg / ml. 2 ml of the preparation are placed in ampoules of amber glass of I hydrolytic class with a red breaking point. On the top of the ampoule there is a yellow ring.
A label is attached to the ampoule.
5 or 10 ampoules are placed in a transparent open blister or in a transparent blister covered with a white polymer film.
2 or 5 blisters (5 ampoules) are placed in a cardboard box along with instructions for medical use.
5 blisters (10 ampoules) are placed in a cardboard box together with instructions for medical use (for hospitals).

Storage conditions

Store at a temperature not exceeding 25 ° C.
Keep out of the reach of children.

Best before date

3 years.
Do not use the drug after the expiration date.

Vacation conditions

Dispensed by prescription.

Manufacturer

Lek dd,
Verovshkova 57, 1526 Ljubljana, Slovenia
Consumer claims should be sent to Sandoz CJSC:
125315, Moscow, Leningradsky prospect, 72, bldg. 3.

Instructions for use:

Ketonal is a non-steroidal anti-inflammatory agent used in the symptomatic treatment of diseases of the musculoskeletal system, as well as to eliminate pain syndrome of various origins.

Pharmacological action of Ketonal

Ketonal has anti-inflammatory, analgesic and antipyretic properties.

The action of ketoprofen, the active substance of Ketonal, is due to the ability of the drug to increase the pain threshold by suppressing the synthesis of bradykinin, stabilize lysosomal membranes and delay the release of enzymes from them, which, in chronic inflammation, contribute to tissue destruction.

The maximum concentration of ketoprofen in the blood can be observed within 1.5-2 hours after using Ketonal tablets, 65-80 minutes after using rectal suppositories and after 5 minutes with intravenous administration.

About 90% of Ketonal is excreted by the liver, the half-life is about 2 hours. Delayed elimination of Ketonal in renal failure requires dose adjustment for patients with this disease.

Indications for use

psoriatic arthritis (joint inflammation during psoriasis);
rheumatoid arthritis (inflammatory and destructive lesion of large and small joints of the extremities);
ankylosing spondylitis (persistent limitation of the mobility of the spine with possible involvement in the inflammatory process of internal organs);
osteoarthritis (joint disease provoked by damage to their cartilage tissue);
gouty arthritis (joint disease caused by the deposition of uric acid salts in various tissues).

The use of Ketonal is also advisable when:

muscle pain;
neuralgia (damage to peripheral nerves, accompanied by attacks of pain);
ossalgia (pain resulting from damage to bone tissue);
joint pain;
tendinitis (inflammation around or inside a tendon);
radiculitis (damage to the bundles of nerve fibers extending from the spinal cord);
bursitis (inflammation of the joint capsules);
adnexitis (inflammation of the uterine appendages);
toothache and headache.

Ketonal is used as an analgesic for post-traumatic and postoperative pain syndrome, accompanied by inflammation, cancer, algodismenorrhea (soreness of menstruation), childbirth.

Instructions for the use of Ketonal

Ketonal is available in forms intended for oral administration: capsules, tablets, granules for suspension preparation.

For intramuscular injections, Ketonal is used in the form of a solution or lyophilisate to prepare a solution. Only solution is injected intravenously. For external use, Ketonal is available in the form of a gel, cream, spray and solution. Ketonal suppositories are intended for rectal use.

The instruction recommends taking Ketonal capsules three times a day, 1 pc. (50 mg), not exceeding a daily dose of 300 mg. For osteoarthritis and rheumatoid arthritis, 50 mg of the drug is taken four times a day. Drink Ketonal with a sufficient amount of milk or water, it is recommended to take the drug with meals. Ketonal Duo capsules containing 150 mg of ketoprofen are usually taken 1 pc. once a day, and if it is necessary to prescribe large doses of the drug for a short time, it is possible to increase the number of doses up to twice a day.

Ketonal tablets are usually prescribed 1-2 times a day, 1 pc. (150 mg), not exceeding a daily dose of 300 mg. The duration of treatment is two weeks, if necessary, the duration of the drug can be increased by the doctor. Ketonal tablets should be taken during or immediately after a meal with plenty of water.

Ketonal suppositories, the use of which can be combined with taking tablets or capsules, are usually prescribed 1 pc. (With 100 mg) morning and evening.

Intramuscular Ketonal injections are usually prescribed 1-3 times a day, 1 ampoule (100 mg). Intravenous Ketonal injections should be given only in a hospital setting. With intermittent administration, 1-2 ampoules of the drug are diluted with 100 ml of "saline" and administered within half an hour or an hour. With continuous administration, the same amount of Ketonal is diluted in 500 ml of "saline" or glucose and administered over 8 hours. Repeated intravenous Ketonal injections are given after 8 hours.

Ketonal gel and cream are intended for external topical use. These forms of the drug are used for pain in joints and muscles that were caused by damage or injury, as well as for tendovaginitis (inflammation of the tendon and its sheath). Ketonal cream should be applied to the affected areas 2 times a day, and the gel - 1 or 2 times. The use of an occlusive dressing is not recommended. The maximum daily dose is 200 mg (10 cm of Ketonal cream). The duration of treatment is 7-10 days.

Side effects

According to the instructions, Ketonal can cause the following undesirable phenomena:

abdominal pain, stool disorders, vomiting, nausea, dry mouth, stomatitis, liver dysfunction, gastrointestinal bleeding;
nervousness, fatigue, headache, migraine, sleep disturbance, dizziness, speech disorder;
change in taste, tinnitus, conjunctivitis, blurred vision, pain in the eyes;
arterial hypertension, tachycardia, peripheral edema;
anemia, agranulocytosis, thrombocytopenia;
nephrotic syndrome, impaired renal function, the presence of blood in the urine in excess of the norm;
allergic skin reactions, shortness of breath, bronchospasm, rhinitis, angioedema.

Ketonal cream and gel can provoke vascular edema, urticaria, skin rash, skin necrosis, dermatitis.

Contraindications to the use of Ketonal

The use of Ketonal is prohibited for hypersensitivity, "aspirin" asthma, peptic ulcer disease, ulcerative colitis, peptic ulcer, diverticulitis (protrusion of the intestinal wall), Crohn's disease (inflammation of the digestive tract, which can affect all its parts), blood clotting disorders, chronic kidney disease ...

According to the instructions, Ketonal is contraindicated in children under 14 years old, pregnant and breastfeeding women.

Ketonal is prescribed with caution to patients suffering from bronchial asthma, anemia, alcoholism, alcoholic cirrhosis of the liver, liver failure, sepsis, diabetes mellitus, arterial hypertension, edema, stomatitis, blood diseases. The use of Ketonal by elderly patients should take place as directed and under the supervision of a physician.

Additional Information

Ketonal should be stored in a dark, dry place where the air temperature does not exceed 25 ° C.

Available in the form of a transparent solution, 2 ml in each ampoule. The drug is administered intravenously or intramuscularly. The medicine is poured into special ampoules made of thick and dark glass, with a break line.

The ampoule has a label with the characteristics and dose of the product. Ampoules are located in transparent blisters of 5 or 10 pieces each. The composition of the drug includes the main substance 100 mg and 50 mg.

Refers to the group of non-steroidal antirheumatic drugs. The shelf life of the medicine is three years from the date of manufacture. After the expiration of the sale period, it is prohibited to use the medicine.

What are the properties of the medicine?

It belongs to the group of non-steroidal drugs.

Doesn't have a bad effect on articular cartilage:

stabilizes lysosomal membranes;
reduces the symptoms of dysmenorrhea;
the drug has an antipyretic effect;
relieves inflammation at the site of the lesion;
eliminates pain and swelling.

The drug Ketonal in injections: instructions for use

If the drug is administered intravenously, then after five minutes its average plasma concentration is observed. The bioavailability of the drug is almost one hundred percent.

When the drug is administered intramuscularly, the plasma concentration occurs within 20 minutes and is maximally achieved two hours after the start of the infusion. Bioavailability increases with increasing dose.

The main substance of the medicine, Ketoprofen, is one hundred percent bound to blood proteins. It is metabolized in the liver, in the same place it binds to glucuronic acid and is excreted from the body in the form of glucuronide.

There are no active metabolites of ketoprofen. It is displayed in half after two hours. Up to 80% is excreted by the kidneys in a day and a small part through the intestines. The elimination process is associated with the individual characteristics of the organism, age and the presence of chronic diseases.

Indications:

pain after surgery;
painful sensations during critical days;
pain in patients with bone metastases;
pain after injury;
rheumatoid arthritis;
spondylitis;
osteoarthritis;
gout;
rheumatism outside the joint.

Contraindications:

individual intolerance to the main and auxiliary substances in the composition of the drug;
bronchial asthma;
a history of an allergic reaction to a group of non-steroidal drugs;
severe heart failure;
pain management during and after surgery;
shunting;
acute ulcer of the stomach and duodenum;
gastrointestinal bleeding;
chronic dyspepsia;
pathology of the liver and kidneys;
age up to 15 years;
pregnancy in the last three months;
diseases of the hematopoietic organs.

Side effects:

thrombocytopenia;
posthemorrhagic anemia;
anaphylactic shock;
mood swings;
migraine;
increased sleepiness;
dizziness;
convulsions;
visual impairment;
noise in ears;
heart failure;
increased pressure;
bronchospasm;
nausea, vomiting;
diarrhea;
allergic reactions;
acute renal failure;
swelling and pain at the injection site;
very rarely arterial thrombosis.

Overdose. Symptoms and treatments:

dizziness;
lethargy and drowsiness;
pain in the epigastric region;
feeling of nausea;
vomiting reflex;
violation of the stool;
in more severe cases, the pressure drops sharply;
breathing is depressed;

In this case, the patient must be immediately hospitalized and symptomatic treatment carried out. In case of overdose, there is no antidote.

Can the medicine be used during pregnancy?

In the first half of pregnancy, it is not recommended to use the drug without special purpose. A woman who is about to become pregnant or is already pregnant in the first and second trimester should take a dose of the medication half as much and limit herself to the minimum course of treatment.

This is due to the fact that the inhibition of prostaglandin synthesis has a negative effect on pregnancy and fetal development. The use of Ketonal in the third trimester of pregnancy is prohibited. There is no data on the penetration of the drug into milk. It is better not to use the drug while breastfeeding.

Dosage and course of treatment

The drug is administered parenterally. Adults and children under 15 years of age, the permissible dose per day is 200 mg. It is not advisable to inject injections for more than 3 days. If the effect is positive, you can switch to pills for further treatment.

The drug is injected intramuscularly at a single dose of 100 mg once or twice a day. You can take injections together with other forms of ketoprofen.

Ketonal can be administered in combination with analgesics and narcotics. Before starting treatment, you should know all the side properties of the drug and contraindications for admission .. Do not exceed the permissible dose, so as not to cause an overdose of the drug.

Interaction with other groups of funds:

it is not recommended to jointly use other drugs that belong to non-steroidal drugs;
with large doses of salicylates;
antigregants;
anticoagulants;
lithium preparations;
methotrexates;
ATP inhibitors;
diuretics;
thrombolytics;
antihypertensive drugs;
tramadol;
cardiac glycosides.

General instructions

If you take the drug for a long time, then periodically it is necessary to monitor the blood, urine, and feces for occult blood, especially in elderly patients and with severe renal and hepatic insufficiency.

You should also focus on the treatment of patients with high blood pressure, other vascular and cardiac pathologies.

The drug Ketonal can cause the retention of excess fluid in the body and thereby provoke an increase in pressure.

If visual impairment is observed, then the medicine should be excluded.

Also, the use of non-steroidal drugs can reduce or even mask the symptoms and signs of infectious and inflammatory diseases.

Therefore, at the slightest discomfort, you should contact a specialist for help.

All patients who have a history of chronic processes in the stomach or intestines should be observed by a doctor during treatment with Ketonal.

All patients suffering from diseases of the kidneys, blood vessels, taking diuretics, the elderly, there is a decrease in blood volume.

The drug also affects the female reproductive system, therefore, patients with signs of infertility are not recommended to take this drug.

When treating with Ketanol, you should not drive a vehicle and perform work associated with increased danger. The drug can cause side effects and dizziness, which is fraught with a great risk to the patient's health and life.

You need to store the medicine away from children at a temperature of no more than 25 degrees.

The cost of the drug in injections

Ketonal is manufactured by the pharmaceutical firm Sandoz in Switzerland. The cost of a package of 10 ampoules of 50 mg of ketoprofen each is 266 rubles. The price for 50 ampoules is 851 rubles.

Are there any effective analogues?

In the pharmacy, you can buy analogues of the drug Ketonal, which have an identical composition and effect. Prices do not actually differ.

List of analogues:

Artrum;
Ketoprofen;
Flamax;
Valusal.

Analogs of the Ketonal drug have the same indications, contraindications, side effects as the Ketonal drug. Only a doctor can prescribe a remedy, you cannot self-medicate, this can lead to serious consequences and pathologies.

Flavamax is an analogue of Ketonal

Refers to non-steroidal, anti-inflammatory drugs. The main substance in the composition of the drug is Ketoprofen.

Available in the form of a clear or slightly brown solution for intravenous and intramuscular injections. One ampoule contains 100 mg of Ketoprofen.

Derived from propionic acid.

Has the following effects on the patient's body:

analgesic;
anti-inflammatory;
antipyretic;
reduces platelet aggregation;
inhibits the synthesis of prostaglandins;
restores lysosomal membranes.

Indications for use:

diseases of the musculoskeletal system;
rheumatoid arthritis;
gout;
osteoarthritis;
migraine;
dysmenorrhea;
removal of pain in the postoperative period.

Contraindications:

hypersensitivity to a group of non-steroidal drugs;
bronchial asthma;
diseases of the stomach and intestines;
pathology of the liver and kidneys;
diseases of the hematopoietic system;
lactation;
pregnancy in the third trimester.

Flavamax is perfect as an analogue to Ketonal. They have the same composition, indications for use, contraindications and action. In the pharmacy, the drug is dispensed with a prescription.

Before starting treatment, you need to familiarize yourself with all the side effects in order to eliminate the development of serious complications from other organs and systems.

Often the pain comes on suddenly and is extremely difficult to endure. Some of the tablets 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 may have a yellowish tint. For use, injections are classified as non-steroidal anti-inflammatory drugs.

Injections act on the body quite quickly. 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 it 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 blood clotting disorders;
Any bleeding;
Acute conditions of ulcers in the stomach and duodenum 12;
Digestive disorders;
Any acute inflammatory bowel processes;
Pathological conditions of the kidneys;
Insufficiency of hepatic or renal, cardiac;
When carrying out coronary artery bypass grafting less than 2 months ago.

Separately, it is necessary to highlight pregnancy and young age up to 15 years. If treatment is necessary for a nursing mother, then she will need to suspend 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 injection solution 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 an indication.

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 a 100 ml injection solution 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 into 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 drugs 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, methotrexatin is increasing. Some drugs are suppressed: aimed at lowering blood pressure, diuretics, mifepristone. Combination with ACE inhibitors and diuretics is permissible.

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;
Bleeding of the gastrointestinal tract;
Convulsions;
Exacerbation of Crohn's disease;
Allergies on the skin (edema, 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 overdose. 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 root cause of its occurrence. The treatment must be continued with other special medications. In addition, Ketonal affects the kidneys and liver, therefore, changes in their condition should be monitored.