Ketonal. Instructions for use ointment, price, reviews, analogues

Ketonal used in pathologies of the musculoskeletal system. The drug relieves pain and inflammation of various origins. Later in the article provides detailed instructions for use of the drug Ketonal.

Shape and composition of the drug release

As a therapeutic agent Ketonal comprising ketoprofen.

The medicament is manufactured in the following dosage forms:

• Gel, which is a clear, colorless, homogeneous mass. In 1 g contains 25 mg of active substance. The gel may be packaged-50 and 100 g of an aluminum tube. Her neck is closed by a membrane. The aluminum tube closed truncated screw cap, which has an acute cone-shaped device which allows to pierce the membrane.
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• Cream, which is a homogenous white or almost white mass. In 1 g of preparation 50 mg of active substance. The cream is on sale for 30, 50 and 100 g He is packaged in an aluminum tube, which is sealed membrane and covered with a screw cap.
• Rectal suppositories or candlesThat go to 12 pieces per pack. They are white, smooth, homogeneous. The suppository contains 100 mg of ketoprofen.
• Pills can be from 100 mg and 150 mg. The former have a rounded, convex shape on both sides, on top they are covered with a film of pale-blue envelope. 100 mg tablets can be packaged into vials of amber glass or packaged in blisters. Tablets of 150 mg of white, round, convex on both sides. They Packaged in bottles of dark glass.
• capsules have a white body and a blue cap. Inside they found a white-yellowish powder is compacted or crumbly. Each capsule contains 50 mg ketoprofen.
• Injection produced in 2 ml ampoules, each containing 100 mg of active ingredient. He is a clear, colorless or slightly yellowish.

In the gel, excipients include the following:

• lavender oil;
• water;
• carbopol;
• trolamine;
• E-1510.

The cream contains the following inactive ingredients:

• isopropyl;
• elfakos ST 9;
• water;
• E-216;
• E-218;
• E-1520;
• E-905b;
• E-518;
• propylene glycol, glyceryl oleate.

The composition of rectal suppositories include solid fat and glyceryl kaprilokaprat.

Tablets of 100 mg containing the following excipients:

• E-553b;
• E-171;
• E-464;
• E-132;
• E-1521;
• E-903;
• E-572;
• milk sugar;
• maize starch;
• aerosil;
• polyvinylpyrrolidone.

The composition of the tablets of 150 mg consists of the following additional components:

• E-572;
• E-464;
• aerosil;
• MCC;
• polyvinylpyrrolidone.

The following inactive ingredients are included in the composition of the capsule:

• milk sugar;
• gelatin;
• E-572;
• E-551;
• E-171;
• E-131.

Injections as indifferent components comprise:

• E-1510;
• E-1520;
• E-1519;
• water.

pharmacological properties

Ketonal refers to the group of nonsteroidal anti-inflammatory drugs.
Pharmacodynamics and Pharmacokinetics

Ketoprofen relates to inhibitors of cyclo-oxygenase. He relieves pain and inflammation, eliminates puffiness. The drug inhibits the activity of bradykinin, which is responsible for pain sensitivity. It blocks the release of enzymes involved in inflammation.

The drug has no negative impact on the condition of the articular cartilage.

When using the gel and cream, ketoprofen is absorbed slowly and almost does not accumulate in the body. Bioavailability of external medicinal forms is 5%. The injections it 100%, in other forms of release - 90%. Dabout 99% of the dose binds to blood proteins. The drug penetrates into the synovium where it reaches the therapeutic dosage.

Passing through the liver, the drug biotransformation. Displayed preparation as conjugates via the kidneys and 80% to 10% - in the bile. The half-life of less than 2 hours. In older patients the medication biotransformed and excreted more slowly, but it is important for individuals who have compromised renal function.

When using a gel and a cream analgesic effect in trauma of the musculoskeletal system starts after half an hour.

Indications

Ketonal irrespective release form is used in musculoskeletal pathologiesmusculoskeletal system, accompanied by pain and inflammation, such as:

• rheumatoid arthritis;
• inflammation of the periarticular tissues;
• psoriatic arthropathy (joint disease that emerged against the background of psoriasis);
• Spondylitis and Reiter's disease;
• radiculopathy;
• inflammation of the tendons and periarticular bag;
• muscle pain;
• neuralgia;
• arthrosis;
• injuries of the locomotor system of various origins.

Additionally, a rectal suppository, tablet, capsule, solution for injection is used in the following pathologies:

• gout;
• chondrocalcinosis;
• pain after trauma, surgery, bone cancer, menstruation;
• headache;
• pelvic infection, including inflammation of the ovaries and Fallopian tubes.

Ketonal not slow the progression of the disease, and only relieves the symptoms.

Contraindications

Ketonal contraindicated if the patient has been diagnosed following pathologies:

• idiosyncrasy composition of medicines and other NSAIDs;
• allergic to fragrances, UV blockers;
• bronchial asthma and allergic rhinitis, resulting in the treatment of non-steroidal anti-inflammatory drugs;
• photoallergy in history;
• UV exposure during treatment and for 14 days after its completion.

The medicine can not be applied to women, supporting breastfeeding.

Cream and Gel should not be applied to areas where the integrity of the skin is broken.

Suppositories, tablets, capsules and injections are contraindicated in patients who have been found:

• recurrence of digestive tract ulcers;
• ulcerative colitis;
• ileitis transmural;
• problems with blood clotting;
• heart failure decompensation;
• severe liver dysfunction and kidney glomerular filtration rate when less than 30 ml per minute;
• the period of rehabilitation after bypass surgery of coronary vessels;
• hemorrhage of various genesis;
• suspected internal bleeding;
• chronic diarrheal reaction;
• high content of potassium in the blood, confirmed by laboratory methods;
• progressive renal and liver pathology;
• colitis;
• protrusion of the intestinal wall outward.

Capsules and tablets can not drink in violation of absorption of dextrose and galactose, lactose intolerance, lactase shortage. Candles, never insert, if there is bleeding from the anus and lower intestinal tract inflammation.

Ketonal (instructions for use for pregnant women should be strictly observed) is contraindicated in the last trimester pregnancy, at an earlier stage can only be used when the benefit to the woman outweighs the potential harm to child.

drug treatment in the last 3 months of gestation can cause oligohydramnios, renal dysfunction, blood loss, premature closure of the arterial duct, weak labor.

Be wary Ketonal irrespective release form should be used if the patient is diagnosed with the following diseases:

• dysfunction of the liver and kidneys;
• heart failure in chronic phase;
• ulcer disease of the digestive tract;
• Pathology of blood;
• bronchial asthma.

Precautions suppository, solution for injection, capsules and tablets to be applied to elderly patients and in the presence of the following pathologies:

• increase in blood pressure, lipids and bilirubin in the blood;
• diabetes;
• dehydration;
• cardiovascular disease;
• cirrhosis of the liver caused by alcohol intake;
• nicotine dependence.

At what age can use the drug

Ketonal can be used in patients older than 15 years.

Instructions for use, the dosage of the drug

Ketonal (instructions for use of external forms spelled separate point) should be applied to diseased sites 1 or 2 times per day. A single dose of them can vary from 3 to 5 cm.

In combination with external medicinal forms can be taken Ketonal inside, insert suppositories or injections, but so that the daily dose was not higher than 200 mg. When using a gel and a cream can not be on top of them to impose tight bandage, to be treated by them without consulting a doctor is allowed no more than 2 weeks. Candles insert 1 piece 1 or 2 times a day.

Capsules and tablets should be taken orally with a meal or after it with a glass of at least 1/2 glass of water or milk in the following dosages:

dosage form	Dosage
100 mg Tablets	1 piece twice a day.
Capsules of 50 mg	1 or 2 instance 2-3 times per day.
Tablets of 150 mg	1 tablet once a day.

You can in the morning and in the afternoon to drink Ketonal in capsules of 50 mg, and insert the suppository before bedtime. Acceptable morning to take anti-inflammatory agent in tablets of 100 mg, and bedtime administered anus candle. It is important that at the same daily dose of ketoprofen should not exceed 200 mg.

That reduce the likelihood of negative reactions on the part of the digestive system, patients, who are at risk in conjunction with Ketonalom desirable to take proton inhibitors pump.

The drug injections administered either in a muscle or a vein. That reduce the likelihood of negative effects from the injection, the medication needs to be done in the lowest effective dose. Only after weighing the harm and benefit of drug can be administered by injection of 200 mg per day.

The drug is a muscle to do 1 ampoule at a time. Multiplicity of administration once or twice a day. Ketonal as infusion, in accordance with instructions for use, may be administered depending on the patient and the prescribing physician varying dosage.

In this procedure the length can vary from hour to 8 clock:

Type of intravenous infusion	Diluent	The duration of infusion
A short infusion	1 or 2 ampoules Ketonala diluted in 100 ml saline.	Administer the drug from an hour to an hour.
Continuous infusion	1-2 ampoules anti-inflammatory agent to dissolve in 500 ml of 5% glucose, saline and Ringer's solution.	Introduces the drug over 8 hours. If required, after 8 h Ketonal administered again.

In the vein of the drug can be administered no longer than 2 days. Ketonal in injections may be combined with a centrally acting analgesics. It can be administered generally vial with opioids, such as morphine, but incompatible with ketoprofen tramadol if mixed, then a precipitate formed.

Side effects

Ketonal, instructions for use which should be respected in all circumstances, regardless of the form of release, may cause the following adverse reactions:

• allergies, which can manifest anaphylaxis, angioedema, urticaria, Stevens-Johnson syndrome and toxic epidermal necrolysis, bronchospasm;
• photosensitivity;
• the progression of chronic renal failure, tubulointerstitial nephritis;
• digestive ulcers, bleeding from the gastrointestinal tract, diarrhea.

Furthermore, suppositories, pills, capsules and injections can trigger the following side effects:

• lowering hemoglobin, reduction in the number of leukocytes and platelets;
• depressed mood;
• headaches, dizziness, sensitivity, seizures;
• lack of appetite or conversely its strengthening;
• drowsiness;
• dysgeusia;
• noise in ears;
• blurred vision, inflammation of the conjunctiva;
• heart failure, heart palpitations, increased pressure, vasodilation;
• asthma;
• dyspepsia, nausea, abdominal pain, vomiting, dry mouth, delayed stool, bloating, inflammation of the mucous digestive tract bleeding of its parts, stomatitis, erosive and ulcerative gastrointestinal injury relapse regional enteritis and colitis, wall gap the stomach and intestines;
• inflammation of the liver, the increase in liver enzymes and bilirubin;
• hair loss;
• acute renal failure, nephrotic syndrome, the change in the results of kidney tests;
• weakness;
• weight gain.

Candles can cause a burning sensation in the anus, irritation of the rectum. External dosage forms can cause itching, burning, redness of the skin caused by vasodilatation, eczema.

The gel can cause severe contact dermatitis, if during the therapy they do not comply with the hygiene and the skin is exposed to ultraviolet rays.

Because of shots possible pain and dryness in the eyes, inflammation of the optic nerve, the bladder and the urethra, blood in the urine and the stool, increasing the level of potassium in the blood, hemoptysis, uterine bleeding, breathlessness, muscle twitching, thirst.

Overdose

With an overdose of external medicinal forms can be irritation, itching and redness. When they appear the medicine, it is necessary to wash off with water as soon as possible.

In case of overdose of other forms of release may be nausea, vomiting, including blood, abdominal pain, tarry stools, delirium, renal dysfunction, convulsions, respiratory depression. Antidote for poisoning Ketonalom unknown, the victim is recommended gastric lavage and give drink enterosorbent, for example, neosmectin, Enterosgel.

The negative effect of ketoprofen on the digestive tract can be reduced drugs that reduce the formation of prostaglandins and hydrochloric acid of the stomach, for example, proton pump inhibitors.

special instructions

During the application of gel and cream need to make sure that they do not fall in the eyes or on mucous membranes and periorbital area, if this happened, they should be rinsed with plenty of water. After using the external medicinal forms tube should be tightly closed and wash your hands well.

To reduce the likelihood of photoallergy when using the cream and gel, place the drug coating should be covered by the UV-rays during therapy, and further 14 days after its completion.

Ketonalom treatment may mask signs of infection. If the therapy the patient developed symptoms of infectious and inflammatory diseases or his health has deteriorated, you should consult a doctor.

Women planning to conceive, it is not recommended to use the oral, rectal and injectable forms ketoprofen, as an antiinflammatory agent may interfere with the implantation of a fertilized egg in the wall uterus.

Using Ketonala (except external forms) must be stopped before surgery. Prolonged treatment of NSAID necessary periodically to donate blood for testsIn time to track the changes in its pattern. You also need to check the condition of the liver and kidneys, explore the fecal occult blood test.

Especially these tests must be passed to patients older age group, persons with abnormalities of the kidneys and liver, as they have a high probability of complications from treatment ketoprofen.

Check the blood count when using NSAIDs need to once every 7 days, if a person receives a weekly 15 mg methotrexate. In appointing Ketonala patients with hypertension and other cardiovascular pathologies they often need to measure your blood pressure.

If the patient is receiving treatment with diuretics, especially when he had been dehydrated, some of the decrease renal blood flow caused by the inhibition of formation of prostaglandins, there is a high probability of occurrence of renal failure.

Therefore, in these patients prior to initiating therapy Ketonalom need to eliminate the signs of dehydration. And during the treatment they need to monitor the state of the kidneys.

drug interactions

You can not simultaneously gel or cream Ketonal deals with other outdoor products containing ketoprofen and other NSAIDs. Ketoprofen may inhibit the excretion of methotrexate that will cause a negative impact of the latter on the blood, the time interval between treatment they should be 12 hours.

Non-steroidal anti-inflammatory agent may attenuate the effects of diuretic drugs and medicines used to treat hypertension. It may enhance the effect of hypoglycemic drugs ingested and some anticonvulsants, for example, fetinoina.

Appointment to the background of pentoxifylline therapy, anticoagulants, antiplatelet agents, fibrinolytic agents increases the likelihood of bleeding.

Ketonalom treatment in conjunction with other NSAIDs, salicylates, corticosteroids, SSRIs, and use on the background therapy ketoprofen ethyl alcohol increases the likelihood of complications from the digestive tract.

When administered in combination with NSAIDs diuretics or ACE inhibitors increases the probability of renal dysfunction. Ketonal increases in blood levels of calcium antagonists, cyclosporine, digoxin, drugs lithium.

Ketoprofen may weaken the effect of mifepristone, so apply Ketonal only after 8-12 days after the cessation of steroid treatment antigestagens means. Probenecid may reduce the rate of excretion of the NSAID from the plasma.

The use of ketotifen in a complex with and ACE-inhibitors and angiotensin II receptor antagonists in patients with renal dysfunction may result in its progression.

analogs

On sale are complete analogues Ketonala that as a main component containing ketoprofen:

• Fastum gel. This Italian drug that 100 g of the medicament comprises 2.5 g ketoprofen. Unlike Ketonala Fastum gel loses its therapeutic properties, if stored at temperatures up to 30 degrees, and it is allowed adolescents over 12 years. But the Italian agent is contraindicated during pregnancy.
• Bystrumgel. This domestic drugs produced in the form of a gel, which is approved for children older than 6 years. Unlike Ketonala Bystrumgel should be stored at a temperature of 15-25 degrees for 24 months.
• Artrum. This domestic medicament which is commercially available in the form of a gel, tablets, rectal suppositories, injections for administration into the vein and muscle. From Ketonala different drug composition of inactive ingredients and a shorter shelf life (ampoules are suitable for 36 months, the remaining dosage forms - 24 months). In addition, the gel can be for children older than 6 years, pills and injections are allowed to 15, and candles are only for adults.

Terms, conditions of sale and storage

Ketonal (instruction manual provides prescription) should be stored in a place where the medicine will be inaccessible to children at temperature up to 25 degrees.

The shelf life of the drug is dependent on the release form:

dosage form	Shelf life
The gel, 100 mg tablets packaged into blisters.	36 months
Cream, tablets of 150 mg and 100 mg packaged in dark glass vials, capsules, suppositories.	60 months

Gel, cream, candles, 100 mg tablets are dispensed without a prescription. The other drugs are sold by prescription.

Price in drugstores of Moscow, St. Petersburg, regions

Ketonala cost depends on the form of release and the specific pharmacy:

City	Gel 100 g	Cream 100 g	Tablets of 100 mg № 20	capsules	Tablets of 150 mg	suppositories	ampoule
Moscow	435 rubles.	544 rubles.	189 rubles.	106 rubles.	227 rubles.	240 rubles.	230 rubles.
St. Petersburg	427.60 rubles.	538.50 rubles.	217.30 rubles.	98.40 rubles.	220.10 rubles.	233.20 rubles.	222.70 rubles.
Ufa	434 rubles.	545.60 rubles.	183.30 rubles.	102.70 rubles.	222 rubles.	235.80 rubles.	223.90 rubles.
Novosibirsk	438.80 rubles.	549.30 rubles.	188.60 rubles.	98.4 rubles.	228, 40 rubles.	240.70 rubles.	229.30 rubles.

not enough to read the instructions for use before using Ketonala, be sure to consult a doctor as soon as he can find a suitable individual schemes therapy.

Registration of the article: Mila Friedan

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