Ketonal (tablets, ointment, cream, injections, suppositories) – instructions for use, analogues, reviews, price

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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Ketonal is a non-narcotic and non-hormonal drug with powerful analgesic, anti-inflammatory and antipyretic effects. Ketonal is used to relieve severe or moderate pain of various origins, for example, in arthritis, spondylitis, osteoarthritis, radiculitis, myalgia, neuralgia, colic, menstruation, trauma and after surgery.

Varieties, names, release forms and composition of Ketonal

Currently, the following varieties of Ketonal are available on the pharmaceutical market:

• Ketonal;
• Ketonal Duo;
• Ketonal Uno.

All of these types of drugs have the same therapeutic effect, but differ from each other in release forms, dosages of the active substance and primary scope of application. For example, some varieties of Ketonal are used topically, others are taken orally, and others are administered intramuscularly, but all of them are used to relieve pain, reduce the severity of the inflammatory process and lower body temperature.

The dosage forms of the Ketonal varieties are different. Thus, each of the drugs Ketonal Duo and Ketonal Uno is available in a single dosage form, and Ketonal - in seven forms. Thus, Ketonal Uno and Ketonal Duo are available in the form of capsules for oral administration, and simply Ketonal in the following dosage forms:

• Long-acting tablets;
• Coated tablets;
• Capsules;
• Solution for intramuscular or intravenous administration;
• Rectal suppositories;
• Cream;
• Gel.

Ketonal cream is often called an ointment, but in both cases the same dosage form is meant. In addition, the cream is called “Ketonal 5”, since the concentration of the active substance in this dosage form is exactly 5%. The solution for intramuscular or intravenous administration is called “Ketonal injections” or “Ketonal ampoules”. And rectal suppositories in everyday speech are almost always called “Ketonal suppositories”.

All varieties and dosage forms of Ketonal contain the same active substance - ketoprofen in the following dosages:

• Ketonal coated tablets – 100 mg;
• Extended-release tablets Ketonal – 150 mg;
• Ketonal capsules – 50 ml;
• Solution for injection Ketonal – 50 mg/ml;
• Rectal suppositories Ketonal – 100 mg;
• Gel Ketonal – 2.5% (2.5 mg per 1 g of gel);
• Ketonal cream – 5% (5 mg per 1 g of cream);
• Ketonal Duo capsules – 150 mg;
• Ketonal Uno capsules – 200 mg.

Thus, it is obvious that most of the release forms and varieties of Ketonal are intended for oral administration (tablets, capsules, solution, suppositories) and only two - cream and gel - for external use. This is due to the fact that oral administration of drugs provides pain relief for a wider range and types of pain syndrome compared to forms for external use.

Therapeutic effects of Ketonal

The therapeutic effects of Ketonal are due to its active component - ketoprofen. This substance and, accordingly, all varieties of Ketonal belong to the group of non-steroidal anti-inflammatory drugs(NSAIDs), which have the following three effects:

• Anesthetic;
• Anti-inflammatory;
• Antipyretic.

Ketonal also has all of the indicated effects, and its varieties have the most pronounced analgesic and anti-inflammatory effect, and the antipyretic effect is somewhat weaker. Therefore, Ketonal is used as an anesthetic drug for pain syndromes of various origins.

All three effects of Ketonal are provided by the ability of the active substance to block the work of enzymes cyclooxygenase And lipoxygenase, as a result of which the formation of special substances - prostaglandins, which provoke the development and support the inflammatory reaction, cause a pain impulse and an increase in body temperature, stops. That is, Ketonal blocks the formation of substances that cause inflammation, temperature and pain.

A distinctive feature of Ketonal is wide range analgesic effect, which consists of influencing both central and peripheral nerve fibers responsible for the perception of pain impulses. That is why Ketonal is highly effective painkiller in the presence of pain in various peripheral tissues and organs, such as joints, skin, ligaments, muscles, veins, lymphatic and blood vessels. By reducing the inflammatory reaction, Ketonal not only relieves pain in joint diseases, but also reduces morning stiffness and swelling, increasing range of motion.

Indications for use

Indications for the use of Ketonal tablets, capsules, injections and suppositories, as well as Ketonal Duo and Ketonal Uno capsules, are exactly the same, and the choice of a specific type of drug and release form can be made based on subjective factors, such as ease of administration, etc. The indications for use for external forms of Ketonal - gel and cream - are somewhat different. Therefore, we will consider separately the indications for the varieties of Ketonal for oral administration and for external use.

Injections, tablets, capsules, suppositories Ketonal, Ketonal Duo and Ketonal Uno - indications for use

All oral forms (tablets and capsules), as well as suppositories and injections, are indicated for use in the treatment of the following conditions:
1. Symptomatic treatment of inflammatory or degenerative diseases of bones, joints, muscles, ligaments and cartilage, for example:

• Rheumatoid arthritis ;
• Psoriatic arthritis;
• Various types of arthritis with absent rheumatic factor in the blood;
• Ankylosing spondylitis;
• Reactive arthritis;
• Polyarthritis;
• Periarthritis;
• Arthrosynovitis;
• Osteoarthritis;
• Pseudogout;
• Articular and non-articular rheumatism;
• Shoulder syndrome.

2. Relief of moderate or severe pain of various locations and origins:

• Muscle pain (myalgia);
• Radiculitis;
• Sciatica;
• Lumbodynia;
• Lumbago;
• Phlebitis;
• Lymphangitis and limadenitis;
• Tendinitis;
• Pain after injury;
• Pain after surgery;
• Pain due to malignant tumors of various locations;

Ointment and gel Ketonal - indications for use

Products for external use Ketonal are indicated for use to relieve pain and reduce the inflammatory response in the following diseases:

• Rheumatoid arthritis;
• Periarthritis;
• Ankylosing spondylitis;
• Psoriatic arthritis;
• Reactive arthritis (Reiter's syndrome);
• Bursitis;
• Neuralgia;
• Radiculitis;
• Injuries to the musculoskeletal system (bruises, sprains, tendons, etc.).

Instructions for use

Let's consider the rules for using Ketonal of various varieties and dosage forms separately to avoid confusion.

Ketonal tablets, Ketonal Duo and Ketonal Uno - instructions for use

Regular or extended-release capsules and tablets must be swallowed whole, without chewing, biting, or crushing in any other way, and with a sufficient amount of water or whole milk (at least one full glass). Capsules and both types of tablets are recommended to be taken with or immediately after meals as this will reduce the risk of developing side effects from the digestive tract, as well as a feeling of discomfort in the stomach. To decrease discomfort in the stomach, milk is also used as a means of swallowing tablets or capsules. However, Ketonal can be taken with milk only for those people who tolerate it normally.

In principle, you can take capsules and tablets before meals, and wash them down with water, not milk, however, in this case, a person may experience pain or an unpleasant painful sensation in the stomach, which goes away on its own within 40 - 60 minutes.

To relieve pain, the drug is taken in the following standard dosages:

• Ketonal capsules – 1 – 2 pieces, 2 – 3 times a day;
• Regular Ketonal coated tablets - 1 piece, 2 times a day;
• Extended-release tablets Ketonal - 1 piece once a day;
• Ketonal Uno capsules – 1 piece once a day;
• Ketonal Duo capsules – 1 piece once a day.

The maximum permissible daily dosage for all varieties of Ketonal is 200 mg.

The duration of therapy with Ketonal is individual and determined by the rate of disappearance of the pain syndrome. That is, the drug is taken as needed when pain occurs and continued until it is relieved. Ketonal is suitable for long-term use for pain syndromes of various localizations.

Tablets and capsules must be taken at approximately equal time intervals between two subsequent doses, which will ensure reliable pain relief and minimal risk of complications. For example, if regular tablets need to be taken twice a day, then it is best to take them within a 10-12 hour interval. Extended-release tablets are best taken at the same time every day.

Ketonal tablets and capsules can be used in combination with rectal suppositories, gel or cream. However, it is necessary to ensure that the total daily dosage of the active substance in all forms used does not exceed 200 mg.

When taking Ketonal, you should remember that the drug does not cure the disease, but only eliminates painful symptoms, allowing the person to work fully and lead a normal lifestyle. Therefore, in combination with Ketonal, it is imperative to carry out the necessary treatment aimed at completely eliminating the disease or changing its course.

Ketonal injections - instructions for use

To produce injections, a ready-made solution of Ketonal is used in 2 ml ampoules with a concentration of the active substance of 50 mg/ml. This means that a full ampoule contains 100 mg of active substance. The solution can be administered intramuscularly and intravenously.

Intramuscular administration of Ketonal 100 mg (1 ampoule) 1 - 2 times a day is indicated in the area of ​​the body where the muscle layer comes close to the skin, for example, in the outer upper third of the thigh, upper shoulder, etc. It is not recommended to inject the solution into the buttock, since the muscles in this area lie very deep, and there is a fat layer directly under the skin. If the solution gets into the fat layer, it will not be absorbed into the blood and the desired effect will not be achieved.

Intramuscular injections can be performed at home on your own if the person is not afraid and knows the manipulation technique. To make an injection, you need to draw the contents of the ampoule into a sterile syringe, then lift it up with a needle and tap your finger on the surface in the direction from the piston to the needle holder so that air bubbles come off the walls and collect at the surface of the liquid. After this, you should press the piston so that a drop of solution appears at the tip of the needle and all the air comes out with it. Then the syringe ready for injection is put aside on some clean place and the place where the injection will be made is prepared.

The selected injection site is wiped with a cotton swab moistened with alcohol or another antiseptic. Then, holding the syringe with your working hand, insert the needle vertically into the tissue, after which, slowly pressing the piston, release the entire solution. The needle is removed from the tissue and the injection site is again wiped with a swab moistened with an antiseptic.

For each injection, it is necessary to choose a place that is at least 1 cm away from the previous one, so that purulent foci do not form under the skin.

Intravenous Ketonal is administered only in the form of an infusion (dropper) in a hospital setting. You cannot use drips with Ketonal on your own. Depending on the duration of administration of the solution, all intravenous infusions are divided into long and short.

For short intravenous infusions, 100–200 mg (1–2 ampoules) of Ketonal should be diluted in 100 ml of saline and administered over 30–90 minutes. Ketonal can be re-administered only after at least 8 hours.

For long-term infusions, 100–200 mg (1–2 ampoules) of Ketonal are diluted in 500 ml of saline and administered over 8 hours. Repeated administration of the solution is also possible no earlier than after 8 hours. Ketonal can also be dissolved in lactated Ringer's solution or 5% dextrose solution.

Since Ketonal solutions are sensitive to light, infusion bottles must be wrapped in foil until the end of drug administration.

Intravenous or intramuscular administration of Ketonal is carried out if it is impossible to take the drug orally or if a quick analgesic effect is necessary. Injections can be combined with simultaneous administration of oral forms of Ketonal (capsules, tablets) or rectal suppositories. The maximum permissible daily dosage when using all forms of Ketonal is 200 mg. The duration of drug use is determined by the speed of pain relief.

Ketonal suppositories - instructions for use

Adults need to insert one suppository into the rectum 1 - 2 times a day. Candles can be used simultaneously with any other dosage forms Ketonal, remembering that the total maximum permissible daily dosage is 200 mg.

Suppositories are used until the condition is normalized and pain relief is sufficient for leading a normal lifestyle.

Suppositories must be inserted into the rectum after bowel movements. If bowel movement does not occur on its own, you should give an enema or take a laxative. After defecation, the anal area and perineal skin are washed with warm water and soap and a suppository is inserted into the rectum.

For minimally traumatic insertion of the suppository, you need to kneel and elbows or squat down, then carefully push the suppository inside with the index finger of your working hand (right for right-handed people and left for left-handed people). The candle should be pushed into the intestine until the finger is immersed in the anus to the middle.

After inserting the suppository, wash your hands again with soap.

Ketonal suppositories should not be used if you have any diseases of the rectum.

Instructions for use Ketonal cream (ointment) and gel

A strip of gel or cream 3 to 5 cm long is squeezed out of the tube and applied to the skin that is located above the source of pain. The cream or gel is gently rubbed into the skin with massage movements until completely absorbed. The preparations can be applied to the skin 1 – 2 times a day. An occlusive (tight, non-breathable and compressive) bandage should not be applied to the area of ​​skin treated with Ketonal. It is better to leave the skin free or apply a dry dressing from a regular sterile bandage.

When applying the cream or gel, it is necessary to avoid contact with mucous membranes, eyes and the skin around the eyes. During the entire period of therapy and two weeks after its completion, it is necessary to avoid exposure to direct sunlight and not be near sources of ultraviolet radiation.

If on skin If irritation occurs or side effects develop, you should stop using Ketonal gel or cream. After irritation has subsided, you can resume using the gel or cream if necessary.

When deciding on the amount of Ketonal gel or cream to use, as well as the frequency of their use, you should remember what the content of active substances is:

• 5 cm of gel or 2.5 cm of cream contain 100 mg of active substance;
• 10 cm of gel or 5 cm of cream contain 200 mg of ketoprofen.

Since the maximum permissible daily dosage of Ketonal is 200 mg, you cannot use more than 10 cm of gel or 5 cm of cream in one day. The duration of continuous use of the gel or cream should not exceed two weeks.

Ketonal cream or gel can be simultaneously used in combination with other dosage forms (tablets, capsules, suppositories and injections), however, it must be remembered that the total dosage of all drug options should not exceed 200 mg per day.

Ketonal during pregnancy and breastfeeding

During the third trimester of pregnancy (from 28 to 49 weeks of gestation inclusive), Ketonal is contraindicated for use in any form or variety, as it can cause post-term pregnancy and complications during childbirth.

In the first and second trimesters of pregnancy (up to the 27th week inclusive), any varieties and forms of Ketonal can be used only if the expected benefit to the woman exceeds all possible risks to the fetus.

If it is necessary to use Ketonal during breastfeeding, the child should be switched to artificial formula.

special instructions

Tablets and capsules can be washed down with milk or antacids (for example, Almagel, Maalox, Phosphalugel, etc.), since these substances do not affect the absorption of the active component of Ketonal and at the same time help reduce the likelihood of complications and side effects from the digestive tract.

With long-term use of Ketonal (more than 1 week), it is necessary to regularly take a general blood test, as well as monitor kidney and liver function indicators. You should especially carefully monitor blood, liver and kidney parameters while taking Ketonal in elderly people over 65 years of age.

Ketonal must be used carefully if a person has hypertension and heart pathologies, which are combined and associated with edema. In these cases, during the entire course of Ketonal use, it is necessary to constantly monitor blood pressure levels.

Impact on the ability to operate machinery

Ketonal does not have a significant effect on the ability to control mechanisms, however, since the drug can provoke side effects from the central nervous system, then it should not be used by people whose activities require high reaction speed and concentration (for example, driving a car, working with machines, conveyors, etc.).

Overdose

No cases of overdose have been reported with the use of Ketonal gel and cream. All other forms and varieties of Ketonal can cause an overdose, which is manifested by the following symptoms:

Ketonal goes well with narcotic analgesics. Ketonal solution can be mixed in one syringe with morphine, but not with tramadol, since in this case a precipitate will form due to chemical interaction.

Side effects of Ketonal

Tablets, capsules, solution and suppositories Ketonal, as well as Ketonal Duo and Ketonal Uno capsules, can provoke exactly the same side effects from various organs and systems, such as:

1. Gastrointestinal tract:

• Nausea;
• Diarrhea or constipation;
• Vomit;
• Increased or decreased appetite;
• Abdominal pain;
• Ulceration of the mucous membrane of the digestive tract;
• Liver dysfunction;
• Perforation of the digestive tract;
• Exacerbation of Crohn's disease;
• Melena (black stool);
• Increased activity of liver enzymes (AST and ALT).

2. Central and peripheral nervous system:

• Headache;
• Nightmares;
• Migraine;
• Disorientation in space;
• Speech impairment.

3. Sense organs:

• Change in taste;
• Blurred vision;

4. The cardiovascular system:

• Tachycardia (palpitations);
• Arterial hypertension ;
• Edema.

5. Blood system:

• Decreased platelet aggregation ability;
• Thrombocytopenia (decrease in the total number of platelets in the blood);
• Agranulocytosis (complete absence of neutrophils, eosinophils and basophils in the blood);
• Purpura.

6. Urinary system:

• Liver dysfunction;
• Nephritis (inflammation of kidney tissue);
• Nephrotic syndrome;
• Hematuria (blood in the urine).

7. Allergic reactions:

• Rhinitis;
• Bronchospasm;
• Angioedema.

8. Local reactions (for suppositories only):

• Burning and irritation of the mucous membrane;

9. Other:

• Hemoptysis;
• Menometrorrhagia (bleeding from the uterus).

The listed side effects usually develop with long-term use of Ketonal. When using any form or type of the drug for 5–7 days, no side effects develop.

Ketonal gel and cream as side effects can only provoke purpura, redness of the skin, exanthema and photosensitivity.

Contraindications to the use of Ketonal

Tablets, solution, capsules and suppositories Ketonal, as well as capsules Ketonal Uno and Ketonal Duo contraindicated for use if a person has the following diseases or conditions:

• History of asthma, rhinitis or urticaria, provoked by taking Aspirin or other NSAIDs (Ibuprofen, Diclofenac, Nimesulide, etc.);
• Exacerbation of gastric or duodenal ulcers;
• Exacerbation of inflammatory bowel diseases (for example, Crohn's disease, ulcerative colitis, enteritis, etc.);
• Hemophilia or any other bleeding disorder;
• Severe renal or liver failure;
• Progressive kidney diseases;
• Heart failure in the stage of decompensation;
• Coronary artery bypass grafting less than 2 months ago;
• Suspicion or presence of bleeding of any location (gastrointestinal, uterine, cerebral, etc.);
• Chronic digestive disorders (flatulence, belching, diarrhea or constipation, etc.);
• Age under 15 years;
• III trimester of pregnancy (from 28 to 40 weeks of gestation inclusive);
• Period breastfeeding;

In addition to the listed absolute contraindications, Ketonal also has relative contraindications, in the presence of which the drug can be used, but with caution and under close medical supervision. Relative contraindications The following conditions or diseases apply to taking Ketonal in tablets, capsules, solution and suppositories:

• Peptic ulcer in past;
• Cardiovascular, cerebrovascular diseases and pathologies of peripheral arteries, occurring with clinical symptoms;
• Dyslipidemia (violation of the ratio of blood lipoprotein fractions - HDL, LDL);
• Progressive liver diseases;
• Hyperbilirubinemia ( increased level bilirubin in the blood);
• Kidney failure;
• Chronic heart failure;
• Blood diseases;

Ketonal gel and cream are contraindicated for use in the following conditions and diseases:

• Previous history of asthma, rhinitis or urticaria, triggered by taking Aspirin or other NSAIDs (Ibuprofen, Diclofenac, Nimesulide, etc.);
• Wounds on the skin (eczema, weeping dermatitis, open wound, etc.);
• III trimester of pregnancy (from 28 to 40 weeks);
• Age under 12 years;
• Hypersensitivity to the components of the drug or other NSAIDs.

Instructions for use of the drug Ketonal: release forms, therapeutic effect, dosage, contraindications - video

Ketonal - analogues

Ketonal has analogues and synonyms on the domestic pharmaceutical market. Synonyms are products that contain the same substance as an active ingredient - ketoprofen. Analogues of Ketonal are drugs from the NSAID group, containing other active components, but having the most similar spectrum of therapeutic effects.
Synonyms for Ketonal tablets, solution, capsules and suppositories, as well as Ketonal Duo and Ketonal Uno capsules are the following drugs:

• Arketal Rompharm solution for injection;
• Artrosilene capsules, rectal suppositories and solution for injection;
• Artrum rectal suppositories, tablets and solution for injection;
• Bystrumcaps capsules;
• Ketoprofen tablets and solution for injection;
• OKI granules and rectal suppositories;
• Flamax capsules and solution for injection;
• Flamax forte tablets;
• Flexen capsules, rectal suppositories and lyophilisate for the preparation of solution for injection.

The following medications are synonyms for Ketonal gel and cream:

• Artrosilene aerosol and gel;
• Artrum gel;
• Bystrumgel gel;
• Valusal gel;
• Ketoprofen gel;
• Febrofid gel;
• Flexen gel.

Analogs of various forms and varieties of Ketonal are shown in the table: ointment and gel

Tablets, suppositories and solution Ketonal and capsules Ketonal Duo and Ketonal Uno	Gel and cream Ketonal
Advil tablets and suspension	Bioran gel
Algesir Ultra tablets	Butadione ointment
ArthroCam tablets	Voltaren Emulgel gel and spray
Bonifen tablets	Diclak gel
Brustan tablets and suspension	Diclobene gel
Burana tablets	Diclovit gel
Deblock tablets	Diclogen gel
Dexalgin solution and tablets	Dicloran gel
Ibuklin tablets	Diclofenac gel and ointment
	Finalgel gel

Ketonal - reviews

In most cases, people used Ketonal gel, tablets or injections to relieve pain. Reviews about all forms of the drug in most cases (from 80% to 90%) are positive, which is due to the high effectiveness of the drug, reliable relief of pain of various locations and causes, long-term effect, as well as ease of use.

People who left positive reviews about the drug, in addition to the advantages, they also pointed out disadvantages, which they included high cost and the relatively slow development of the analgesic effect. However, such disadvantages of the drug cannot overshadow its high effectiveness.

Negative reviews about Ketonal are mainly associated with the appearance of side effects or with the long-term development of analgesic action, when it was necessary to wait and use the drug for 2 to 3 days before the pain was completely relieved.

Ketonal (cream, gel, injections, tablets, suppositories), Ketonal Duo – price

Currently, various forms and varieties of Ketonal are sold in pharmacy chains at the following estimated prices:

• Ketonal 50 mg, 25 capsules – 105 – 115 rubles;
• Ketonal ampoules 100 mg 2 ml, 10 pieces – 230 – 305 rubles;
• Ketonal ampoules 100 mg 2 ml, 50 pieces – 957 – 1490 rubles;
• Ketonal cream 5% 30 g – 230 – 297 rubles;
• Ketonal cream 5% 50 g – 310 – 395 rubles;
• Ketonal gel 2.5% 50 g – 185 – 260 rubles;
• Ketonal gel 2.5% 100 g – 338 – 466 rubles;
• Ketonal rectal suppositories 100 mg 12 pieces – 283 – 345 rubles;
• Ketonal Retard 150 mg, 20 tablets – 235 – 302 rubles;
• Ketonal tablets 100 mg, 20 pieces – 200 – 210 rubles;
• Ketonal Duo capsules 150 mg, 30 pieces – 260 – 302 rubles.

Ketonal - how to buy?

Ketonal cream and gel are sold without a doctor's prescription, and all other varieties are sold only by prescription, so you can only buy the drug at a regular pharmacy. When purchasing, you need to pay attention to the expiration date, which is 2 years for tablets, capsules, solution and suppositories, and 3 years for gel and cream.

Ketonal is an anti-inflammatory drug that is most often used for diseases musculoskeletal system to relieve severe pain. It is worth noting that you cannot get carried away with the drug; it has many contraindications and side effects. Before taking, be sure to consult with your doctor. How effective is Ketonal? How to take the medicine correctly?

Action of Ketonal

The medication helps relieve inflammation, get rid of severe pain, and also reduces temperature. Ketonal contains the active substance - ketoprofen. After taking the tablets orally, the substance is maximally concentrated in the blood after 2 hours, but after injection into a vein, the drug acts after 5 minutes.

How is Ketonal excreted? Within two hours the drug is cleared by the liver. Please note that elimination may be slower in case of renal failure. Therefore, it is necessary to be extremely careful with the dosage of the drug.

Indications for use

The drug is prescribed for pathologies of the musculoskeletal system. Doctors recommend using Ketonal in the following cases:

• Psoriatic arthritis – the medication relieves inflammation in the joints when psoriasis worsens.
• Rheumatoid arthritis – the drug alleviates the condition with destructive damage to various joints (large and small).
• , in which mobility in the spine is impaired and internal organs are affected.
• Osteoarthrosis , which is accompanied by damage to joints and cartilage tissue.
• Gouty arthritis (the pathological process in the joints is provoked by the deposition of a large amount of salts) - the drug helps relieve pain during exacerbation.

• Muscle pain.
• Neuralgia, which is accompanied by severe pain.
• Ossalgia, which affects bone and unbearable pain appears.
• Painful sensations in the joints.
• – inflammatory process in the tendons.
• Radiculitis - when the nerves that extend from the spinal cord are damaged.
• Bursitis is an inflammatory process in the joint capsule.
• Adnexitis - inflammation of the uterine appendages.
• Headache and severe toothache.

Ketonal is recommended for use as the best pain reliever after surgery or trauma, which is accompanied by an inflammatory process. Ketonal also relieves pain from cancer. The drug will be a godsend for women with (stomach pain during menstruation), sometimes the medicine is used during childbirth.

Dosage

The medicine is released in different forms Oh. You can purchase Ketonal in tablets, granules, from which a special suspension is prepared, and also in capsules. If you have been prescribed intramuscular injections, you must purchase Ketonal in solution or in the form of a lyophilisate from which the solution is made.

Attention! Ketonal is administered intravenously as a diluted solution.

There are also Ketonal suppositories that are administered rectally. And for external use they produce cream, spray, gel and solution.

How to take the medicine correctly?

• Ketonal capsules taken three times a day, no more than 50 mg (one piece at a time). Maximum daily dose– 300 mg. In the case of rheumatoid arthritis, osteoarthritis, take one capsule 4 times a day. Do not forget to take the drug with water or milk.
• Ketonal Duo capsules, contain up to 150 mg of the active substance – ketoprofen. They are allowed to be taken no more than once a day. In severe cases, the medicine is prescribed for short-term use twice a day.
• Pills no more than one piece is prescribed once a day - they contain 150 mg of ketoprofen. As a rule, treatment lasts no more than two weeks, then the doctor decides what to do next. It is important to take the tablets with clean water.
• Ketonal suppositories sometimes combined with taking capsules and tablets. Prescribe one piece twice a day. One suppository contains 100 mg of ketoprofen.
• Solution. Intravenous injections are given only in the hospital. When administering an ampoule, the drug must be diluted with a physical solution (100 ml) and administered within one hour. When continuous administration Ketonal medicine is diluted with saline solution (500 ml) or glucose. The drug is administered over 7–8 hours.
• Gel and cream used externally for severe pain in muscles and joints after injury, as well as for inflammation in the tendon. The cream is applied in the morning and evening, and it is enough to lubricate the affected area with the gel once a day.

Side effects of Ketonal

After taking it, sometimes unpleasant symptoms may appear:

• Painful sensations in the abdomen.
• Abnormal stool.
• Severe nausea with vomiting.
• Excessive dry mouth.
• Stomatitis.
• Liver problems.
• Increased fatigue, nervousness.
• Migraine with headache.
• Insomnia.
• Speech impairment.
• Conjunctivitis with pain in the eyes.
• Tachycardia, .
• Edema.
• Agranulocytosis.
• Exacerbation of kidney diseases.
• Blood in urine.

Sometimes the drug leads to allergies, accompanied by bronchospasm, shortness of breath, Quincke's edema, and rhinitis. But the cream, gel provokes swelling, skin rash, urticaria, dermatitis, skin necrosis.

Contraindications to the use of the medicine

You should not take Ketonal if you are intolerant to Aspirin, as well as if you have peptic ulcers, Crohn's disease, or chronic kidney pathologies.

Taking Ketonal during pregnancy and lactation is absolutely contraindicated, and the medicine should not be given to small children. The drug is prescribed with caution for anemia, bronchial asthma, liver cirrhosis, stomatitis, and blood disease.

Therefore, you should not use this medication on your own to avoid serious complications.

Effectively relieves symptoms of fever and inflammation, and also has an analgesic effect.

Indications for taking the drug

As written in the instructions for use of Ketonal, the drug is used to get rid of the following conditions:

• to relieve pain during algodismenorrhea;
• for the treatment of gout;
• for the treatment of bursitis;
• for the treatment of any type of arthritis;
• for the treatment of tendinitis;
• for the treatment of spondyloarthritis;
• after any injuries and surgical period;
• for back pain;
• for quick relief of any other severe pain.

Before taking the drug, you should definitely consult with a specialist who will calculate the correct dosage, individual for each patient. This will protect the treatment process itself and help reduce the risk of side effects.

Release form of the drug

Ketonal is available without a prescription in several forms:

• Ketonal suppositories 0.1 g;
• Solution for intravenous injection in ampoules of 1 m;
• Ketonal ointment, cream or gel for external use;
• Ketonal tablets;
• Capsules, the dose of which is 0.05 g.

Instructions for use of capsules

Capsules are taken orally with a small amount of water (about 100 ml):

1. For severe inflammation: 50 mg (1 capsule) 3 times a day. The maximum daily dose is 300 mg (6 capsules).
2. For arthritis and osteoarthritis: 50 mg (1 capsule) 4 times a day.
3. For algodismenorrhea: 50 mg (1 capsule) 3 times a day.
4. To prevent the development of NSAID gastropathy in patients, the doctor sometimes prescribes in parallel with
5. Taking antacids with Ketonal.
6. Duo Ketonal capsules are taken with meals, with plenty of water, at a dosage of 1 capsule/day. In rare cases, it is prescribed to take two capsules per day with an interval of 12 hours.

Instructions for use of ampoules

Ketonal is also available in the form of injections and a solution for intramuscular injections, so it is important to know how to inject the drug. The drug is prescribed 3 times a day in the amount of 0.1 g (1 ampoule). For more effective treatment, in especially severe cases, it is recommended to take pills and use suppositories along with injections.

Administration of Ketonal intravenously is possible only during hospital treatment. The solution is injected intermittently or continuously to numb the specific area where severe pain occurs.

Intermittent administration carried out using two ampoules of Ketonal, which contain approximately 200 mg of the active substance. The ampoules are diluted into 100 ml of solution, and then the medicine is injected into the patient’s vein. The whole procedure takes no more than an hour. This administration of the drug is repeated after 8 hours.

With a continuous injection process You will need 2 ampoules of Ketonal, diluted per 500 ml of solution. For these purposes, hospitals use a special glucose solution. The effect of the injection lasts about 8 hours. The procedure is repeated after 9 hours. For severe excruciating pain, the patient is prescribed Ketonal injections together with a narcotic analgesic.

Instructions for use of Ketonal tablets

To relieve severe pain, Ketonal painkillers are taken once a day. The maximum daily dose, which is allowed only as a last resort, is 2 tablets. This drug is taken during meals or immediately after meals with plenty of water.

Taking the medicine together with antacids will help prevent the development of NSAID gastropathy. The effect of the drug begins no later than 30 minutes after use.

Instructions for use of rectal suppositories

Rectal suppositories Ketonal are indispensable in complex therapy. They are administered 2 times a day.
In parallel with the use of suppositories, you can take Ketonal tablets or capsules, maintaining a sufficient interval between the use of different forms of the drug - take the tablet in the morning, and insert the suppository at night.

The use of suppositories for elderly patients is allowed only under the supervision of a doctor. Patients at this age are prone to side effects such as occult bleeding without external symptoms. As a result, such treatment can lead to very serious negative consequences.

Ketonal rectal suppositories combine well with other analgesics.

Composition of the drug

Ketonal capsules:

• active ingredient ketoprofen - 150 mg;
• lactose;
• Ketonal suppositories: ketoprofen - 100 mg.

Injection ampoules have the following composition:

• propylene glycol;
• ketoprofen - 50 mg;
• sodium hydroxide;
• alcohol in small quantities;
• pure water.

Ketonal-forte tablets:

• ketoprofen - 100 mg;
• lactose.

The drug Ketonal-retard:

• ketoprofen - 150 mg;
• cellulose.

Side effects of the medicine

Side effects from taking the drug occur rarely and does not provoke serious complications in the body.

But taking the drug "Ketonal 5" can lead to the following possible side effects:

1. strong headache;
2. anemia or thrombocytopenia, but in very rare cases;
3. abdominal pain and stool disturbances;
4. severe dizziness, but quite rare;
5. feeling of nausea;
6. nosebleeds;
7. the appearance of a mild rash on the skin;
8. the appearance of depression and panic;
9. bronchial asthma, which may cause spasms;
10. the appearance of nightmares during sleep or, conversely, frequent insomnia;
11. the appearance of tinnitus;
12. blurred vision;
13. problems with normal liver function;
14. rarely, but uterine bleeding occurs.

Also, after consuming Ketonal, there is a risk of developing thrombosis, mild stroke and myocardial infarction. However, such cases have not been observed in clinical practice. When taken in the dose prescribed by the doctor, the occurrence of side effects from the drug is excluded.

To avoid the development of peptic ulcers, elderly patients taking Ketonal should be under daily medical supervision.

Main contraindications

In the following cases, Ketonal is prohibited for use:

• For diseases of the duodenum and stomach ulcers;
• If you are allergic to the composition of this drug, especially to salicylates;
• When taking the drug by patients with non-ulcer dyspepsia syndrome;
• For various bleedings;
• In severe renal failure;
• If the patient has asthma;
• Children and adolescents under 14 years of age;
• During pregnancy and breastfeeding.

Neglecting Ketonal's contraindications leads not only to serious complications, but even to death. Necessarily read the leaflet and consult your doctor before starting to take the drug.

Interaction with other drugs

Taking several drugs in parallel can lead to unexpected consequences. At best, such a technique will weaken or enhance the therapeutic effect, at worst - the development of complications.

The main interactions of Ketonal with other drugs are as follows:

• Increased effect of antiglycemic drugs;
• The effect of using diuretics is greatly reduced;
• The nephrotoxic effect of ACE inhibitors increases;
• The effect of anticonvulsants increases;
• The toxicity of drugs containing lithium and methotrexate increases.

Drug overdose

Ketonal in quantities much higher than the prescribed dosage leads to negative changes in the body and the manifestation of the following side effects:

1. bleeding in the stomach;
2. confusion;
3. disruption of the stomach;
4. kidney dysfunction;
5. vomit;
6. nausea.

At the first signs of an overdose and the appearance of unpleasant symptoms, you should immediately consult a doctor. The patient will immediately have his stomach washed out, and then the specialist will prescribe sorbents and a course of symptomatic therapy.

Use during pregnancy and lactation

As a result of inhibition of prostaglandin synthesis, undesirable events may occur in embryonic development and during pregnancy itself. Such data are confirmed by special epidemiological studies. As indicated in the instructions for use of Ketonal in various forms (tablets, capsules, solution for injections, ointment), the drug increases the risk of spontaneous abortion and the formation of heart defects in the child.

Pregnant women in the first and second trimesters of pregnancy can be prescribed this drug if the risk to the fetus is less than the benefits of its use for the mother.

Women during pregnancy in the third trimester are contraindicated in using the drug Ketonal. This threatens:

• Premature closure of the ductus arteriosus;
• Development of weakness of labor activity of the uterus;
• Increased bleeding time;
• Kidney failure;
• Low water.

When prescribing the drug during breastfeeding, women need to switch their baby to special formulas. This is due to the fact that the components of Ketonal, entering the child’s body along with mother’s milk, can negatively affect his health.

Proper storage of Ketonal

Ketonal should be stored in a ventilated area at a temperature of 13-18 degrees, protected from direct sunlight. Children should not have access to the medicine.

Taking Ketonal will not cause any complications or dangerous side effects if you strictly follow the prescription prescribed by your doctor.

But at the same time:

1. Patients with kidney and liver disease must be under the supervision of a doctor.
2. Patients with stomach ulcers and bleeding in the past should be prescribed medication very carefully. carefully.
3. In case of arterial hypertension, Ketonal should also be taken as carefully as possible. IN otherwise The patient develops peripheral edema.
4. Smoking and drinking alcohol during treatment with Ketonal prohibited.
5. Blood tests are necessary throughout the entire period of therapy. This will make it easier for the doctor to determine when anemia or thrombocythemia begins to develop.
6. If you feel drowsy or dizzy from the drug you are taking, it is best to For the period of treatment, refrain from driving.

Drug analogues

If the patient is intolerant to the components of the drug Ketonal, the doctor may prescribe another drug with a similar effect and composition.

Among the most common analogues of this medicine are:

• Ultrafastin;
• Fort gel;
• Fastum gel;
• Artrosilene;
• Flexen;
• Ketoprofen;
• Bystrumgel;
• Febrofeed;
• Artrum;

All of these drugs have their own side effects and contraindications. Before taking these medications, it is advisable to consult your doctor and carefully read the instructions.

Ketonal cost

Ketonal in the pharmacy is offered at the following prices:

• Ketonal ampoules for injection, 2 ml - 260-290 rubles for 10 ampoules;
• Ketonal Duo tablets – 260-290 rubles for 30 pieces;
• Ketonal Retard – 250-280 rubles for 20 pieces;
• Rectal suppositories Ketonal 100 mg – 270-300 rubles for 12 pieces;
• Ketonal tablets 100 mg – 200-230 rubles for 20 pieces;
• Ketonal capsules - 120-130 rubles for 25 pieces.

Pharmacodynamics. Ketoprofen is an NSAID that has analgesic, anti-inflammatory and antipyretic effects.
During inflammation, ketoprofen inhibits the synthesis of prostaglandins and leukotrienes, inhibiting the activity of cyclooxygenase and partially lipoxygenase; it also inhibits the synthesis of bradykinin and stabilizes lysosomal membranes. It has an analgesic effect and eliminates the manifestations of symptoms of inflammatory and degenerative diseases of the musculoskeletal system.
Pharmacokinetics. When taken orally, ketoprofen is rapidly absorbed into the gastrointestinal tract. After oral administration (50 mg 4 times a day) with meals, the maximum concentration of ketoprofen in the blood plasma is reached after 1.5 hours and is 3.9 mcg/ml, whereas when taken on an empty stomach it is 2.0 mcg/ml and is achieved after 2 hours; for extended-release tablets, the maximum concentration in the blood plasma is achieved after 4-6 hours. The bioavailability of ketoprofen in oral forms is 90-93% and is directly proportional to the dose that is used.
After rectal administration of 100 mg of ketoprofen, the maximum concentration in blood plasma (10.4 μg/ml) is determined after 1.05-1.22 hours. The bioavailability of ketoprofen is 71-96%.
With IV infusion average level in blood plasma 5 minutes from the start and 4 minutes after completion of administration is 26.4 ± 5.4 μg/ml. Bioavailability is 90%.
The degree of protein binding is 99%. Volume of distribution - 0.1-0.2 l/kg. Ketoprofen penetrates into the synovial fluid. A stable concentration of ketoprofen in the blood plasma is achieved within 24 hours after taking oral forms. The pharmacokinetics of ketoprofen do not differ significantly depending on the age of the patients. Cumulation of ketoprofen in tissues is not observed.
Ketoprofen is extensively metabolized in the liver via microsomal oxidation. It is excreted from the body in the form of a conjugate with glucuronic acid. The half-life is 2 hours. Up to 80% of the administered dose of ketoprofen is excreted in the urine, usually (over 90%) in the form of glucuronide, about 10% in feces.
In patients with renal failure, the elimination of ketoprofen is slowed down, the half-life increases by 1 hour. In patients with liver failure, ketoprofen may accumulate in tissues. In elderly patients, the metabolism and excretion of ketoprofen is slow, but this is of clinical significance only in cases of impaired renal function.

Indications for use of the drug Ketonal

• serologically negative spondyloarthritis (ankylosing spondylitis, psoriatic arthritis, reactive arthritis);
• gout, pseudogout;
• extra-articular rheumatism (tendinitis, bursitis, capsulitis of the shoulder joint);
• pain syndrome (post-traumatic pain; postoperative pain; pain due to tumor metastases);
• primary dysmenorrhea.

Use of the drug Ketonal

Ketonal capsules Doses are selected individually, depending on the patient’s condition and his response to treatment.
The usual daily dose of ketoprofen is 100-300 mg, depending on the condition and nature of the disease.
Ketonal capsules take 1 capsule 3 times a day.
For rheumatoid arthritis and osteoarthritis, take 1 capsule every 6 hours.
For pain during menstruation, the recommended dose is 1 capsule every 6-8 hours. Ketonal capsules can be taken with Ketonal suppositories according to the following scheme: 1 capsule in the morning and afternoon and 1 suppository in the evening.
Capsules are taken during meals with water or milk (at least 100 ml).
To prevent the negative effect of ketoprofen on the mucous membranes of organs gastrointestinal tract You can take antacids at the same time.
Ketonal Duo capsules
The standard dose for adults and children over 15 years of age is 1 capsule (150 mg) per day. For short-term use, the maximum daily dose is 300 mg - 1 capsule every 12 hours. Capsules should be taken with food, swallowed whole and with plenty of water. They can also be washed down with milk or taken along with antacids to reduce the incidence of gastrointestinal disorders; milk and antacids do not affect the adsorption of the drug. The duration of treatment depends on the course and severity of the disease.
Ketonal solution
IM administration: the dose recommended for intramuscular administration is 1 ampoule (100 mg) 1-2 times a day.
The maximum daily dose of ketoprofen for intramuscular administration is 300 mg.
If necessary, intramuscular administration can be supplemented with the administration of oral, rectal or transdermal forms of Ketonal.
The daily dose of Ketonal can be increased to 300 mg or reduced to 100 mg, depending on the severity of the disease and the patient's condition.
IV administration: Ketoprofen infusions should be carried out only in a hospital setting.
The infusion should be carried out over 0.5-1 hour, the course of treatment with intravenous administration should not exceed 48 hours.
The maximum daily dose of ketoprofen for intravenous administration is 300 mg.
Intermittent IV infusion: 100-200 mg of ketoprofen is diluted in 100 ml of sodium chloride solution (0.9%) for injection and administered over 0.5-1 hour; after 8 hours the infusion can be repeated.
Continuous IV infusion: 100-200 mg of ketoprofen are diluted in 500 ml of infusion solution ( sodium solution chloride 0.9% for injection, Ringer's solution with lactate, glucose solution) and administered over 8 hours; after 8 hours the infusion can be repeated.
Ketoprofen can be combined with narcotic analgesics; it can be mixed with morphine in one container: 10-20 mg of morphine and 100-200 mg of ketoprofen are diluted in 500 ml of infusion solution (sodium chloride solution 0.9% for injection, Ringer's solution with lactate); after 8 hours the infusion can be repeated.
The maximum daily dose of ketoprofen is 300 mg.
Caution: Do not mix tramadol and ketoprofen due to sediment formation. The bottle with solution for infusion should be wrapped in dark paper or aluminum foil, since ketoprofen is sensitive to light.
Ketonal Retard tablets
The recommended dose for adults and children over 15 years of age is 1 tablet once a day. To prevent unwanted effects, treatment should be short-term.
The maximum daily dose is 200 mg.
Ketonal Retard tablets should be taken after meals or during meals with a glass of water or milk. At the same time, you need to take antacids to reduce the side effects of ketoprofen on the gastrointestinal tract.
Elderly patients. In elderly patients, the risk of adverse reactions increases. After 4 weeks from the start of treatment, monitoring for manifestations of gastrointestinal bleeding is necessary.
Suppositories Ketonal
Suppositories are inserted into the rectum, 1 suppository 1-2 times a day.
Suppositories can be used in combination with other oral forms of Ketonal capsules or tablets according to the following scheme:
1 capsule (50 mg) in the morning and afternoon and 1 suppository (100 mg) in the evening;
1 forte tablet (100 mg) in the morning (in exceptional cases, you can take an additional 1 forte tablet in the afternoon) and 1 suppository (100 mg) in the evening.
Doses are selected individually, depending on the patient’s condition and his response to treatment.
The maximum daily dose of ketoprofen is 300 mg.
To prevent the negative effect of ketoprofen on the mucous membranes of the gastrointestinal tract, you can simultaneously take antacids.

Contraindications to the use of the drug Ketonal

Hypersensitivity to ketoprofen and other components of the drug, salicylates and other NSAIDs; erosive and ulcerative lesions of the gastrointestinal tract in the acute stage; history of chronic dyspepsia; severe impairment of liver and/or kidney function; tendency to bleed; history of asthmatic attacks after using NSAIDs; rhinitis;
proctitis; During pregnancy and breastfeeding; children under 14 years of age.

Side effects of the drug Ketonal

As usual, transient. Most often, gastrointestinal disorders are observed (digestive disorders, dyspepsia, nausea, vomiting, constipation, diarrhea, heartburn, abdominal pain).
Rarely - headache, dizziness, confusion, hypersomnia, drowsiness, swelling, mental changes, insomnia.
In isolated cases, possible ulcerative stomatitis, ground, hematemesis, peptic ulcer, gastrointestinal hemorrhage or perforation, gastritis, duodenal and stomach ulcers.
From the blood system: rarely - anemia, hemolysis, purpura, thrombocytopenia, agranulocytosis.
High doses of ketoprofen can inhibit platelet aggregation, thereby prolonging bleeding time, and cause epistaxis and hematoma formation.
From the outside immune system: asthma, bronchospasm or shortness of breath (especially in patients with hypersensitivity to acetylsalicylic acid and other NSAIDs); very rarely - angioedema and anaphylaxis.
Mental disorders: common - depression, nervousness, nightmares, drowsiness; rarely - delirium with visual and auditory hallucinations, disorientation, dyslalia.
From the side of the central nervous system: often - headache, asthenia, discomfort, increased fatigue, weakness, dizziness, paresthesia; very rarely - there have been isolated reports of cases of pseudotumor cerebri.
From the side of the organ of vision: often - visual impairment; very rarely - conjunctivitis.
On the part of the hearing organ: common - tinnitus.
From the outside of cardio-vascular system: often - swelling; rarely - heart failure, hypertension (arterial hypertension).
Clinical studies and epidemiological evidence suggest that a small increased risk of arterial thrombotic events (eg, myocardial infarction and stroke) may be associated with the use of some NSAIDs (especially at high doses and long-term use). There is insufficient data to exclude such a risk for ketoprofen.
From the outside respiratory system: uncommon - hemoptysis, shortness of breath, pharyngitis, rhinitis, bronchospasm, laryngeal edema (signs of an anaphylactic reaction); rarely - asthma attacks.
From the gastrointestinal tract: very - dyspepsia; often - nausea, abdominal pain, diarrhea, constipation, flatulence, anorexia, vomiting, stomatitis; very rarely - colitis, intestinal perforation (as complications of diverticula), exacerbation of ulcerative colitis or Crohn's disease, enteropathy with perforation, stenosis. Enteropathy may be accompanied by mild bleeding with loss of protein. There have been case reports of rectal perforation in elderly women. Peptic ulcers, perforation or gastrointestinal bleeding may occur, sometimes fatal, especially in elderly patients.
Ulceration, hemorrhage or perforation may develop in 1% of patients after 3-6 months of treatment or in 2-4% of patients after 1 year of treatment with NSAIDs.
Melena, bloody vomiting, and exacerbations of ulcerative colitis or Crohn's disease have been reported after use. Gastritis was rarely observed.
From the hepatobiliary system: very rarely - severe liver dysfunction, which is accompanied by jaundice and hepatitis.
From the skin: common - skin rash; in isolated cases - alopecia, eczema, purple-like rash, increased sweating, urticaria, exfoliative dermatitis; rarely - photosensitivity, photodermatitis; very rarely - bullous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis.
From the urinary system: very rarely - acute renal failure, interstitial nephritis, nephrotic syndrome, acute pyelonephritis.
From the reproductive system: very rarely - menometrorrhagia.
Laboratory indicators: very often - abnormal liver function indicators; rarely - during treatment with NSAIDs, ALT and AST levels increase significantly.
Ketoprofen reduces platelet aggregation, thereby prolonging bleeding time.

Special instructions for the use of the drug Ketonal

When prescribing Ketonal for systemic use, caution should be exercised in patients with a history of gastric or duodenal ulcers or gastrointestinal bleeding. Perforation or gastrointestinal bleeding may occur without the development of previous symptoms. Caution is recommended in patients with impaired liver or kidney function, as well as in patients taking coumarin anticoagulants. The drug is not recommended for use in porphyria. If renal function is impaired, dose adjustment is necessary. Ketoprofen may worsen the course of hypertension (arterial hypertension) and increase the risk of developing peripheral edema.
Ketoprofen should be prescribed with caution to elderly people due to the increased risk of side effects. As with the treatment of other NSAIDs, with long-term use of ketoprofen it is necessary to monitor the composition of peripheral blood, liver and kidney function, especially in the elderly. Like other NSAIDs, ketoprofen may mask symptoms and signs of infectious diseases.
Smoking and drinking alcohol are not recommended during treatment with Ketonal.
The safety of using ketoprofen during pregnancy and lactation has not been established. Ketoprofen can be used in the first and second trimesters of pregnancy only if the expected therapeutic effect for the expectant mother exceeds the potential risk to the fetus. NSAIDs are not recommended for use during pregnancy beyond 36 weeks. When treating with Ketonal, you must stop breastfeeding.
The drug does not affect the ability to drive vehicles or operate potentially dangerous machinery. However, in rare cases, NSAIDs may cause dizziness or drowsiness. In this case, you should refuse to manage such funds.

Interactions of the drug Ketonal

Ketoprofen, when used systemically, increases the effectiveness of oral hypoglycemic and some antiepileptic drugs, reduces the effectiveness of diuretics and antihypertensive drugs. The simultaneous use of diuretics and NSAIDs increases the risk of developing renal failure. The use of Ketonal with ACE inhibitors increases the risk of nephrotoxicity. Patients taking ketoprofen in combination with warfarin and corticosteroids require regular medical monitoring due to the possibility of bleeding. Treatment of patients with ketoprofen simultaneously with lithium should be carried out under close medical supervision, since the toxicity of lithium increases. When ketoprofen is taken simultaneously with methotrexate and cyclosporine, the toxicity of the latter may increase. Ketoprofen should not be taken in combination with salicylates and other NSAIDs.

Overdose of the drug Ketonal, symptoms and treatment

Possible nausea, vomiting, epigastric pain; very rarely - gastrointestinal bleeding, disturbances of consciousness, respiratory depression, convulsions and renal failure. Gastric lavage and activated charcoal are recommended. The development of disorders of the digestive tract can be prevented by taking antacid and antiulcer drugs.

Storage conditions for the drug Ketonal

At temperatures below 25 °C.

List of pharmacies where you can buy Ketonal:

• Saint Petersburg

Ketonal belongs to a group of drugs with pronounced non-steroidal anti-inflammatory properties. It is used as an analgesic, as an active component in the fight against fever and to suppress foci of post-traumatic inflammation. This complex medical product has the following effects: blocks prostaglandins, inhibits the actions of cyclooxygenase, inhibits the synthesis of bradykinin, stabilizes lysosomal membranes. These processes show the effectiveness of Ketonal in diagnosing such ailments as various forms of arthritis, gout, postoperative pain syndromes, bursitis, and tendinitis.

1. Pharmacological action

An anti-inflammatory drug of a non-steroidal nature, which has pronounced analgesic and antipyretic effects. Does not have a negative effect on the condition of articular cartilage. It has a high ability to penetrate into synovial fluid. Ketonal is excreted in the urine in the form of a complex with glucuronic acid.

2. indications for use

• Elimination of symptoms of various inflammatory and degenerative diseases of the musculoskeletal system;
• Pain syndrome of varying severity.

3. Method of application

Ketonal in capsule form, recommended dosage:

• for the treatment of degenerative and inflammatory diseases of the musculoskeletal system: 1 capsule of the drug four times a day;
• to eliminate pain during menstruation: 1 capsule of the drug up to 4 times a day;
• for all other cases: 1 capsule of the drug three times a day;
• for all other cases: no more than 300 mg of the drug per day;
• DUO: no more than one capsule per day. If the need arises, it is possible to use the drug in this form, observing a 12-hour interval.

The drug in this form is taken regardless of food and washed down with plenty of warm drinking water.

Ketonal in the form of a solution for injection:
Recommended dosage for all cases: 1 ampoule of the drug up to 3 times a day.

The use of Ketonal intravenously is permissible only in medical institutions.

Ketonal in tablet form:

• Recommended single dosage of Ketonal for all cases: 1 tablet per day;
• The recommended maximum dosage of the drug for all cases: no more than 2 tablets per day.

The drug in this form is taken during or immediately after the end of a meal and washed down with plenty of warm drinking water.

Ketonal in the form of rectal suppositories:
Recommended dosage for all cases: no more than one or two suppositories per day.

Combined use with Ketonal in other forms is possible.

Ketonal in the form of a gel or ointment for external use:
The drug is applied in a thin layer to the affected area and rubbed in until it is completely absorbed. The frequency of use and duration of treatment is determined by the attending physician, depending on the severity of the patient’s condition.

Features of using Ketonal:

• Long-term use of Ketonal in any form must be accompanied by periodic monitoring of the activity of the hematopoietic system, liver and kidneys;
• It should be noted that the use may hide the symptoms of progressive infectious diseases;
• Based on the fact that during the use of Ketonal, various disturbances in the normal functioning of the central nervous system may occur, its use by persons whose activities are related to the management of various types vehicles, complex mechanisms or with rapid reaction, must take place after complete abandonment of it.

4. Side effects

Various violations:

• when taking Ketonal, it is possible to have a disorder in the activity of the central nervous system (dizziness, increased fatigue, nightmares, multiple degenerative lesions of peripheral nerves, loss of spatial orientation, headaches, drowsiness, increased nervous excitability, the appearance of hallucinations, various speech disorders);
• normal functioning of the cardiovascular system (increased blood pressure, increased heart rate, the appearance of peripheral edema);
• normal functioning of the urinary system (inflammation of the kidneys, the appearance of blood in the urine, impaired renal function);
• when using Ketonal, local reactions may occur (irritation of the rectal mucosa, burning at the site of application, dilution of stool);
• normal functioning of the organs of the digestive system (pain in the abdomen, a feeling of dry mouth, ulcerative lesions of the mucous membrane of the organs of the digestive system, perforation of the organs of the digestive system, the appearance of tarry stools, increased activity of liver enzymes, various disorders of the digestive processes, inflammation of the oral cavity, functional disorders liver activity, exacerbation of Crohn's disease, bleeding in the digestive system);
• sensory organs (changes in taste perception, inflammation of the conjunctiva of the eyes, the appearance of tinnitus, decreased clarity of vision);
• organs of the hematopoietic system (decrease in the amount of hemoglobin, increase in the number of agranulocytes, decrease in the ability of platelets to form blood clots, decrease in the number of platelets, severe redness of the skin);
• when consuming Ketonal, an allergic reaction may occur (shortness of breath, itching, allergic rhinitis, bronchospasm,);
• normal functioning of the body (the appearance of uterine bleeding during menstruation, cough accompanied by bleeding).

5. Contraindications

• Gastric ulcer in the acute stage;
• Various disorders of the blood coagulation system;
• Severe functional failure of the kidneys;
• Carrying out coronary artery bypass grafting;
• Hypersensitivity to Ketonal or its components;
• Various chronic disorders of the digestive system;
• Pregnancy and lactation;
• Various inflammatory diseases of the rectum;
• The presence of allergic reactions in the medical history associated with the use of non-steroidal anti-inflammatory drugs;
• Individual intolerance to Ketonal or its components;
• Severe functional failure of the liver;
• Uncompensated functional failure of the heart muscle;
• Presence of bleeding internal organs or suspicions about him;
• Patients under 15 years of age.

6. During pregnancy and lactation

Use of Ketonal in the last trimester of pregnancy strictly contraindicated.

Use in the first two trimesters of pregnancy is possible only in exceptional cases.

The use of Ketonal during breastfeeding is possible only after its cessation for the period from the start of treatment until the drug is completely eliminated from the body.

7. Interaction with other drugs

Simultaneous use of Ketonal with:

• diuretics medicines or medicines, reducing blood pressure, leads to a weakening of the therapeutic effect of the latter;
• drugs that reduce the amount of glucose in the blood plasma or some anticonvulsants, leads to an increase in the therapeutic effect of the latter;
• non-steroidal anti-inflammatory drugs, drugs of adrenal cortex hormones, ethyl alcohol, drugs of the salicylates group or alcoholic drinks, leads to the development of bleeding of the digestive system;
• drugs that reduce the ability of blood to clot, drugs that dissolve blood clots or drugs that prevent platelets from sticking together, leading to the development of bleeding;
• diuretics or drugs that have a blocking effect on ACE, leading to the development of toxic effects of Ketonal aimed at the kidneys;
• cardiac glycosides, drugs containing lithium ions, drugs that block calcium channels, Cyclosporine or Methotrexate, leads to an increase in the concentration of the latter and the development of corresponding side effects;
• The simultaneous use of Ketonal with centrally acting painkillers is permissible.

8. Overdose

Various disorders from Ketonal:

• normal functioning of the digestive system (abdominal pain, nausea, bleeding of organs, vomiting);
• normal activity of the central nervous system (general weakness, confusion);
• functional disorders of the kidneys.

To eliminate these conditions, it is recommended to perform gastric lavage, taking Activated carbon in an overestimated dosage and drug treatment for symptoms.

9. Release form

Long-acting tablets, 150 mg - 20 pcs.
Capsules with varying amounts of active substance, 50 mg - 25 pcs.
Film-coated tablets, 100 mg - 20 pcs.
Solution for injection, 50 mg/1 ml - amp. 2 ml 10, 25 or 50 pcs.
Rectal suppositories, 100 mg - 12 pcs.
Gel, 2.5% - tubes 50 g or 100 g.
Cream, 5% - tubes 30 g or 50 g.

10. Storage conditions

Ketonal must be stored in a cool, dry place.

11. Composition

1 suppository:

• ketoprofen - 100 mg;
• Excipients: solid fat, glyceryl caprylocaprate (miglyol 812).

1 g cream:

• ketoprofen - 50 mg;
• Excipients in Ketonal: methyl parahydroxybenzoate, propyl parahydroxybenzoate, propylene glycol, isopropyl myristate, white, elphacos ST9, propylene glycol glyceryl oleate, magnesium sulfate, purified water.

1 g gel:

• ketoprofen - 25 mg;
• Excipients: (carbomer, trolamine (triethanolamine), ethanol 96%, lavender oil (lavender essential oil), water.

1 tablet Ketonal:

• ketoprofen - 100 mg;
• Excipients: magnesium stearate, colloidal silicon dioxide, corn starch, povidone, talc, lactose.

12. Conditions for dispensing from pharmacies

The drug is dispensed according to the prescription of the attending physician.

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* Instructions for medical use of the drug Ketonal are published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USE, YOU MUST CONSULT WITH A SPECIALIST