Synthetic substances are the basis of many drugs. They are divided into different groups and have different effects on the human body, although many of them are used in the treatment of the same diseases or conditions. One commonly prescribed drug is Ketonal Forte (tablets). Instructions for use, analogues, composition, indications are considered in the article.
Which pharmacological group does the medicine include?
All drugs are divided into a certain number of groups according to the type and principle of functionality. The group of non-steroidal anti-inflammatory drugs includes the drug "Ketonal Forte" (tablets). The instruction to it contains all the relevant information for both the specialist and the patient. Nonsteroidal drugs that help cope with inflammatory processes, fever, fever, their name is opposed to glucocorticoids - a subclass of steroid hormones that are also used in the treatment of many diseases and can have a large number of undesirable side effects on the patient's body.
NSAIDs are a fairly extensive pharmacological group. As chemical elements, these medicinal components are divided into acids and their derivatives and non-acidic substances. The main focus of non-steroidal anti-inflammatory drugs is the suppression of the enzymes cyclooxygenase-1 and cyclooxygenase-2, which serves as a way to combat inflammatory processes, fever, pain. In the preparation "Ketonal Forte" (100 mg), one of such substances, the derivative of propionic acid ketoprofen, acts as an active component.
Active component of the drug
Nonsteroidal anti-inflammatory drugs are popular in the treatment of many diseases. Their choice is sufficient to help solve many health problems (temperature, pain, chills). As with all medicines, the instructions for use tell about the Ketonal Forte preparation. Tablets in their composition have one active component - ketoprofen.
In Latin, this substance is written like this: Ketoprophenum. The structure of this substance is very interesting - it is an equimolar mixture of two enantiomers, the so-called racemate. What does it mean? Ketoprofen contains two compounds, denoted by the symbols S and R, which are a mirror image of each other and not compatible in space. For ketoprofen, pharmacological activity is expressed by the enantiomer with index S.
The physical properties of the drug substance are as follows: fine-grained or granular powder of white or almost white color. It is odorless and does not absorb water. Ketoprofen is highly soluble in acetone, benzene, strong alkalis, chloroform, ethanol, but practically insoluble in water at room temperature. The molecular weight of the chemical compound is 254.28. The scientific name for this substance is: 3-benzoyl-alpha-methylbenzeneacetic acid.
Pharmaceutical form
Ketoprofen is a widely used pharmaceutical substance used as a component of non-steroidal anti-inflammatory drugs. Under the name "Ketonal" in pharmacies you can find a wide range of medicines. But not so long ago, the pharmaceutical company Sandoz (Sandoz) began production of the enhanced preparation Ketonal Forte (100 mg).
This medicine is produced only in tablet form. The tablets are rounded in shape. They are biconvex, without scratches and additional engravings and have almost white color without inclusions. Ketonal Forte tablets are packed in a glass bottle of twenty pieces, each bottle is closed with a screw cap and put together in a cardboard box with instructions for use.
How does the active component work?
One of the popular anti-inflammatory and analgesic drugs is Ketonal Forte 100. Instructions for its use, developed by the manufacturer, indicate that ketoprofen is used as the active ingredient - a substance that belongs to the group of non-steroidal anti-inflammatory drugs used in medicine. It is used in the form of a fumarate. Once inside the human body, this active substance has an analgesic, anti-aggregation, antipyretic, anti-inflammatory effect.
This functionality is due to the inhibition of cyclooxygenase type 1 and 2. These enzymes have a direct effect on the occurrence of the main symptoms of inflammation - pain and heat. Ketonal Forte also inhibits the production of the following biologically active substances produced by the human body:
- prostaglandins, which are not mediators of pain, but increase the sensitivity of nociceptive receptors to histamine and bradykinin, which prevents the development of the inflammatory process and helps to reduce the intensity of pain;
- leukotrienes, the main result of which is bronchospasm, stimulation of the smooth muscle tone of the gastrointestinal tract, mediation of plasma exudation and chemotaxis.
Instructions "Ketonal Forte" (100 mg) indicates that the active component of the drug has anti-bradykinin activity, which can affect blood pressure. Also, the drug has a stabilizing effect on lysosome membranes, which delays the release of enzymes inside the organoid. This helps to prevent tissue destruction during chronic inflammation and intoxication of the body by their decomposition products.
The non-steroidal anti-inflammatory substance ketoprofen reduces the production of cytokines, which are involved in the regulation of growth, differentiation and duration of the cell's life cycle. Also, this drug inhibits the activity of neutrophils - one of the subspecies of agranulocytic leukocytes, which negatively affects the protective properties of the body against fungi and bacteria. Tests of the substance ketoprofen and its lysine salt did not reveal their carcinogenicity and no significant effect on fertility.
What path does the medicine take in the human body?
The non-steroidal anti-inflammatory drug Ketonal Forte (100 mg tablets) is taken orally. Once in the gastrointestinal tract, the drug is absorbed into the systemic circulation quickly and almost in full - its bioavailability is about 90%. The maximum concentration of the active component in the blood is achieved after one and a half to two hours. Although for the retarded form, to which Ketonal Forte can be attributed, the maximum drug content is fixed after 2-3 hours and lasts up to 6-7 hours.
The effectiveness of the drug does not depend on food intake, because its general bioavailability does not change from this, adsorption only slows down. According to the instruction, “Ketonal Forte” (100 mg tablets), more precisely, its active component, entering the gastrointestinal tract, passes through the liver, where part of it undergoes natural biotransformation, interacting with a whole complex of enzymes, and some passes further into the bloodstream unchanged. 99% of ketoprofen binds to blood proteins, mainly with albumin. It is distributed throughout the body, penetrating into tissues and organs, as well as passing through histohematological barriers.
At the same time, the amount of the active component in the synovial fluid is recorded lower than in the blood, but for a longer time - up to 6-8 hours. In the synovial fluid - the biomass filling the joint cavity - the therapeutic concentration of the drug is slightly lower than that recorded in blood plasma, but the drug works there for a longer time - up to twenty hours. The metabolic process in the human body, ketoprofen passes through glucuronidation (the process of detoxification of harmful or foreign substances to the body, occurring in the tissues of the liver).
As stated in the instructions for use of "Ketonal Forte", tablets release the active ingredient in the intestines. Ketoprofen, doing its job, is excreted mainly by the kidneys - about 80%, moreover, in the form of a hepatic metabolite of a glucuronic compound. This process occurs within a day after taking a drug dose. The half-life of a retarded dose of the drug is about seven hours. If the patient suffers from renal failure, then the release of the body from the active component of the drug slows down.
The same factor is present in elderly patients who are recommended therapy with the drug "Ketonal Forte" (tablets 100 mg). Instructions and reviews in this case recommend taking into account age-related features for dosage adjustment or the use of additional means of therapy for a particular disease.
In what cases is the drug prescribed?
All the important information is told about the drug "Ketonal Forte" (100 mg tablets) instructions. A non-steroidal anti-inflammatory drug is used in the treatment of many diseases to eliminate pain, heat, inflammation:
- arthritis gouty;
- rheumatoid arthritis;
- bursitis;
- primary dysmenorrhea;
- sciatica;
- capsulitis;
- renal colic;
- myalgia;
- osteoarthrosis;
- pseudogout;
- radiculitis;
- muscle strain;
- extra-articular rheumatism;
- spondylitis ankylosing;
- psoriatic spondylitis;
- tenosynovitis;
- soft tissue bruises.
Ketonal Forte tablets have the ability to stop pain syndrome of various origins, including pain after operations and injuries. The drug effectively suppresses pain in gynecological, neurological, dental, oncological practice. Only the attending physician can recommend this medicine for use.
When is medicine forbidden?
Details on the non-steroidal anti-inflammatory drug "Ketonal Forte" instructions for use. It indicates the diseases and conditions that serve as a ban on its use in treatment:
- asthma;
- Crohn's disease;
- hemophilia;
- hypersensitivity to both ketoprofen and other non-steroidal anti-inflammatory substances;
- diverticulitis;
- ulcerative colitis;
- disorders of the blood coagulation system;
- renal and hepatic insufficiency;
- peptic ulcer;
- peptic ulcer of the stomach and duodenum.
This drug is not recommended for use by children under the age of eighteen years, as well as pregnant women in the third trimester. Only a specialist can recommend Ketonal Forte for use after collecting an anamnesis and making a diagnosis, taking into account the existing characteristics of the patient’s state of health.
Caution will not hurt
As the instruction says for the retarded preparation "Ketonal Forte", its appointment should be due to the diagnosis, and the patient should not have strict contraindications to treatment with this remedy. Pharmacologists have identified conditions requiring the careful use of this medication. Thus, pregnancy and lactation serve as an occasion for a thorough analysis of the benefits for the mother and the potential danger to the fetus.
Moreover, the third trimester of pregnancy is the reason for the categorical prohibition for the treatment of painful conditions with this medicine. Caution must also be exercised in those patients who have kidney and / or liver disease. Their well-being should be constantly monitored by the specialist who prescribed the treatment, monitoring the work of these organs. The started deterioration in well-being or a violation of blood counts require the abolition of Ketonal Forte drug therapy.
Undesirable effect of the drug
According to the instructions for use, Ketonal Forte may cause the following undesirable side effects:
- abdominal pain;
- anorexia;
- headache;
- dizziness;
- dyspepsia;
- dyspnea;
- flatulence;
- general malaise;
- nosebleeds;
- belching;
- increase in blood pressure;
- vomiting
- rhinitis;
- palpitations
- urinary tract irritation;
- drowsiness;
- tachycardia;
- nausea;
- pharyngitis.
Medical observations have recorded isolated cases of other side effects that appear during therapy with drugs with ketoprofen. You must tell your doctor about all undesirable deviations in well-being during treatment with this medicine.
Overdose
Any drug is prescribed by a specialist for use in a certain mode and dosage. So for the drug "Ketonal Forte" (tablets) has its own characteristics of therapy. Since one unit of this non-steroidal anti-inflammatory drug contains an increased dose of the active component, it must be taken differently than tablets with the usual dosage. One tablet contains 100 mg of the active ingredient, this corresponds to a single dose.
It should be noted that the drug "Ketonal Forte" can not take more than two tablets per day. This drug can be combined with other dosage forms containing ketoprofen, for example with suppositories. In this case, the daily dose of the active component should not be more than 200 mg, that is, if a tablet of 100 mg was taken in the morning, then in the evening you can put a suppository.
How to take the medicine?
Like many medicines, Ketonal Forte tablets must be taken strictly according to the recommendation of a specialist, following the indicated regimen and dosage. Tablets are taken with food or immediately after a meal with a sufficient amount of water or milk, not less than 100 ml. This does not affect the bioavailability of the drug, but helps to reduce the possible negative effect of ketoprofen on the gastrointestinal tract. The tablets do not need to be chewed, they should be swallowed whole. If the patient cannot swallow a whole tablet, then the specialist will change the dosage form of the drug, for example, recommend injections.
Some features of therapy
The medicinal substance Ketoprofen contained in the Ketonal Forte tablets is actively bound to plasma proteins. This factor must be considered if the patient is taking anticoagulants, warfarin, sulfonylamides, hydantoins because of the potential risk of increasing the concentration of these drugs and their competition in blood plasma. The drug in question is not recommended to be taken simultaneously with other drugs of the pharmacological group of non-steroidal anti-inflammatory drugs, as well as with drugs of the salicylate group.
The risk of developing ulcerative lesions of the gastrointestinal tract mucosa increases dramatically if Ketoprofen is combined with corticosteroids. Drugs related to antiplatelet agents and selective serotonin reuptake inhibitors, in combination with ketoprofen, provoke the development of gastrointestinal bleeding. Ketonal Forte reduces the effectiveness of antihypertensive drugs and diuretics. Due to the decrease in the activity of diuretics, the nephrotoxicity of NSAID therapy increases. Especially patients who receive drugs from the group of angiotensin converting enzyme (ACE) inhibitors can suffer from this action.
Also, signs of kidney damage appear in patients receiving simultaneous therapy with ketoprofen and cyclosporine. Hyperkalemia can develop against the background of the simultaneous use in the treatment of ketoprofen and potassium salts, potassium-sparing diuretics, low molecular weight or unfractionated heparins, cyclosporine, tacrolimus, trimethoprim. Hypoglycemic drugs, as well as some antiepileptic drugs, such as phenytoin, under the influence of ketoprofen, contribute to the deterioration of the heart during heart failure, reduce the glomerular filtration rate, but increase the concentration of cardiac glycosides in plasma.
Ketonal Forte, like other drugs based on ketoprofen, reduces the excretion of lithium through the kidneys, which can cause toxic damage to lithium. Therefore, patients receiving lithium therapy should be constantly monitored if they need to take ketoprofen. Toxic damage to the whole organism up to death was recorded during treatment with drugs with ketoprofen and methotrexate.
Such therapy is unacceptable due to an increase in the number and duration of methotrexate in the blood plasma. The treatment with mifepristone allows the patient to receive treatment with a drug with ketoprofen only after 10-12 days. All the nuances of complex therapy should be considered by a specialist when prescribing Ketonal Forte to a patient.
The opinion of experts
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One of the frequently asked painkillers in pharmacies is Ketonal Forte tablets. Patient reviews about them are mostly only grateful, because ketoprofen as an active component is an effective means of relieving pain. People who took the drug on an outpatient basis note a convenient regimen, because tablets should be taken only twice a day, during or immediately after a meal, and therefore it is impossible to miss the next dose.
Some patients note the cost of the drug as some drawback - about 200 rubles will have to pay for Ketonal Forte tablets. Analogues of the drug can be purchased somewhat cheaper. Side effects of the drug are also noted. Basically, patients complain of dyspeptic disorders - constipation or diarrhea, belching and flatulence. Some talk about headaches and weakness that appeared during use.
Are there any similar medicines?
Ketoprofen is a drug in the group of non-steroidal anti-inflammatory drugs. It is it that is contained in the Ketonal Forte preparation. In pharmacies, you can buy both different forms of drugs called "Ketonal", as well as synonyms for this drug. These will be such tablets as Flamax Forte, which contains 50 mg of ketoprofen in one capsule, Arthrum, which contains 150 mg of the active substance, Bystrumkaps with 200 mg of ketoprofen.
The analogs and composition are similar, and the dosage form is the same - in the form of tablets. Other non-steroidal anti-inflammatory substances are also widely used in the treatment of various diseases. For example, ibuprofen is contained in the medicines Baralgin, Nurofen, Sedalgin. In the popular Dexalgin 25 pain tablets, Dexketoprofen is present as the active ingredient.
But it should be remembered that it is impossible to take any pain medication without an expert examination, clarifying the cause and making a diagnosis, as well as prescribing a specific drug by a doctor. Many nuances should be considered in the treatment of drugs such as Ketonal Forte. Therefore, first visit a specialist.
How to buy and store the drug?
The drug "Ketonal Forte" should be dispensed from the pharmacy network only according to the prescription prescribed by a specialist. The drug must be stored in its original packaging - in a bottle of dark glass, put in a cardboard box. This will protect the medicine from exposure to sunlight. The temperature at the storage location should not exceed 25 degrees Celsius. The medicine can be used in therapy within five years of the release date. After this time, unused tablets should not be taken, they should be disposed of as household waste.
Conclusion
So, you have read the instructions for use of "Ketonal Forte" (tablets). The analogs of the composition are the same as that of the drug considered in the article: they contain the substance ketoprofen. Both the drug itself and similar drugs should be used in the treatment of pain, heat and inflammation only on the recommendation of the attending physician. NSAID drugs are well-known among both specialists and patients due to their effectiveness.