Profenid Gel

Indications

Profenid is a medication that reduces pain. It is used to treat acute strains, sprains, and soft tissue injuries to reduce pain. Inflammation and other painful muscle or bone problems are also treated with it. Profenid should only be used externally and according to your doctor's instructions exclusively.

Pharmacology

Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) that has analgesic and antipyretic effects. In addition to inhibiting prostaglandin synthesis, it also stabilizes lysosomal membranes inside and outside the body, inhibits leukotriene synthesis at high concentrations in vitro, and also exhibits anti-bradykinin activity in vivo. Ketoprofen produces analgesic effects by inhibiting the synthesis of central and peripheral prostaglandins. Ketoprofen is also believed to inhibit prostaglandin synthesis in the central nervous system (possibly in the hypothalamus), leading to its antipyretic effect.

Ketoprofen can be absorbed rapidly and almost completely from the gastrointestinal tract. Approximately 99% is bound to plasma proteins, mainly albumin. The average elimination half-life of the drug is 1.14 hours after single or multiple oral administration to healthy adults. It is rapidly and extensively metabolized in the liver, primarily by binding to glucuronic acid. After a single oral administration of ketoprofen in healthy adults, about 50-90% of the drug is excreted in the urine within 15 days and about 18% is excreted in the feces; most urine excretion occurs within 12 to 24 hours, and most fecal excretion occurs within 15 days. 2448 In a matter of hours. In the case of IM injection, a maximum concentration of approximately 10 mg / L is reached approximately 0.50.75 hours after the 100 mg dose. The elimination half-life is approximately 1.88 hours.

Dosage & Administration

Anti-inflammatory dosage: The recommended starting dose is 150 to 300 mg/day in 3 divided doses. Once the maintenance dosage has been established (usually 100 to 200 mg/day), the patient may be tried on a twice-daily dose regimen. Alternatively, switching to the once-daily form at the same dosage may be considered. The recommended maximum daily dose is 300 mg.

With clean, dry hands, massage a thin layer of the medication into the afflicted areas. Avoid getting it in your eyes, nose, or mouth, and stay away from applying it to skin that is already injured or damaged. You should immediately rinse it with cold water if you come into contact with these places by accident. It normally has little to no negative effects and is safe. But in some people, it could result in a burning sensation and skin irritation where it's applied. These are typically transient and disappear with time. You should let your doctor know if they don't get better on their own or get worse.

Management of pain and primary dysmenorrhea: The usual recommended dose is 25 to 50 mg, every 6 to 8 hours as necessary. The total daily dose should not exceed 300 mg. 

Interaction

Not recommended drug associations Other NSAIDs (including cyclooxygenase-2 selective inhibitors) and high-dose salicylates: Increased risk of gastrointestinal ulceration and bleeding. Anticoagulants Increased the risk of bleeding.

Heparin

Vitamin K antagonists.

Platelet aggregation inhibitor.

Thrombin inhibitors.

Direct factor Xa inhibitors.

If coadministration is unavoidable, the patient should be closely monitored.

Lithium: Risk of elevation of lithium plasma levels, sometimes reaching toxic levels due to decreased lithium renal excretion. Where necessary, plasma lithium levels should be closely monitored and the lithium dosage levels adjusted during and after NSAID therapy.

Methotrexate at doses greater than 15mg/week: Increased risk of haematologic toxicity of methotrexate, particularly if administered at high doses (>15 mg/week), possibly related to the displacement of protein-bound methotrexate and to its decreased renal clearance.

Drug associations requiring precautions for the use of Medicinal products and therapeutic categories that can promote hyperkalemia (i.e. potassium salts, potassium-sparing diuretics, ACE inhibitors and angiotensin II antagonists, NSAIDs, heparins (low molecular-weight or unfractioned), cyclosporin, tacrolimus, and trimethoprim): The risk of hyperkalemia can be enhanced when the drugs mentioned above are administered concomitantly.

Corticosteroids: increased risk of gastrointestinal ulceration or bleeding.

Diuretics: Patients and particularly dehydrated patients taking diuretics are at a greater risk of developing renal failure secondary to a decrease in renal blood flow caused by prostaglandin inhibition. Such patients should be rehydrated before initiating co-administration therapy and renal function monitored when the treatment is started.

ACE inhibitors and Angiotensin II Antagonists: In patients with compromised renal function (e.g. dehydrated patients or elderly patients the co-administration of an ACE inhibitor or Angiotensin II antagonist and agents that inhibit cyclooxygenase may result in further deterioration of renal function, including possible acute renal failure.

Nicorandil: In patients concomitantly receiving nicorandil and NSAIDs, there is an increased risk for severe complications such as gastrointestinal ulceration, perforation, and hemorrhage.

Cardiac glycosides: A pharmacokinetic interaction between ketoprofen and digoxin has not been demonstrated. However, caution is advised, in particular in patients with renal impairment, since NSAIDs may reduce renal function and decrease the renal clearance of cardiac glycosides.

Cyclosporin: Increased risk of nephrotoxicity.

Tacrolimus: Increased risk of nephrotoxicity.

Methotrexate at doses lower than 15mg/week: During the first weeks of combination treatment, full blood count should be monitored weekly. If there is any alteration of the renal function or if the patient is elderly, monitoring should be done more frequently.

Contraindications

Ketoprofen is contraindicated in patients who have a history of hypersensitivity reactions such as asthmatic attacks or other allergic-type reactions to ketoprofen, ASA, or other NSAIDs. Severe, rarely fatal, anaphylactic reactions have been reported in such patients. Ketoprofen is also contraindicated in the following cases:

Severe heart failure

Active or history of peptic ulcer/hemorrhage

History of gastrointestinal bleeding or perforation, related to previous NSAIDs therapy

Severe hepatic insufficiency

Severe renal insufficiency

The third trimester of pregnancy

Rectitis or history of proctorrhagia

Side Effects

Blood and lymphatic system disorders- Rare: hemorrhagic anemia; Unknown: agranulocytosis, thrombocytopenia, bone marrow failure, hemolytic anemia, leucopenia

Immune system disorders- Unknown: anaphylactic reactions (including shock) Psychiatric disorders; Unknown: depression, hallucinations, confusion, mood altered

Nervous system disorders- Uncommon: headache, dizziness, somnolence, Rare: paraesthesia; Unknown: aseptic meningitis, convulsions, dysgeusia, vertigo

Eye disorders- Rare: vision blurred

Ear and labyrinth disorders- Rare: tinnitus

Cardiac disorders- Unknown: exacerbation of heart failure, atrial fibrillation

Vascular disorders- Unknown: hypertension, vasodilatation, vasculitis.

Respiratory, thoracic, and mediastinal disorders- Rare: asthma; Unknown: bronchospasm

Gastrointestinal disorders- Common: dyspepsia, nausea, abdominal pain, vomiting; Uncommon: constipation, diarrhea, flatulence, gastritis; Rare: stomatitis, peptic ulcer; Unknown: exacerbation of colitis and Crohn’s disease, gastrointestinal hemorrhage and perforation, pancreatitis

Hepatobiliary disorders- Rare: hepatitis, transaminases increased

Skin and subcutaneous disorders- Uncommon: rash, pruritis; Unknown: photosensitivity reaction, alopecia, urticaria, angioedema, bullous eruption including Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis Renal and urinary disorders- Unknown: renal failure acute, tubulointerstitial nephritis, nephritic syndrome, renal function tests abnormal

General disorders and administration site conditions- Uncommon: oedema Metabolism and nutritional disorders; Unknown: hyponatremia, hyperkalemia Investigations; Rare: weight increased.

Pregnancy & Lactation

During the first and second trimesters of pregnancy: Because the safety of ketoprofen in pregnant women has not been established, it should be avoided during the first and second trimesters of pregnancy. During the third trimester of pregnancy: Prodenid is not recommended during the third trimester. Ketoprofen should not be used by nursing moms.

 Precautions & Warnings

Oral dosage form: Patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease) should use NSAIDs with caution because their condition may worsen. At the beginning of treatment, the renal function of patients with heart failure, cirrhosis, and kidney disease, patients receiving diuretic therapy, and patients with chronic renal failure, especially in elderly patients, should be carefully monitored. In these patients, the administration of ketoprofen can cause a decrease in renal blood flow caused by the inhibition of prostaglandins and cause renal degradation.

Patients with a history of mild to moderate hypertension and/or congestive heart failure should be cautious due to reports of fluid retention and edema associated with NSAID treatment.

It has been reported that there is an increased risk of atrial fibrillation associated with the use of NSAIDs. Hyperkalemia may occur, especially in patients with underlying diabetes, renal failure, and/or concurrent treatment with promoters of hyperkalemia. In these cases, the potassium content must be controlled.

Like other non-steroidal anti-inflammatory drugs, in the presence of infectious diseases, it should be noted that the anti-inflammatory, analgesic, and antipyretic properties of ketoprofen can mask common signs of infection progression, such as fever.

For patients with abnormal liver function tests or a history of liver disease, transaminase levels should be assessed regularly, especially during long-term treatment. Rare cases of jaundice and hepatitis have been described as the use of ketoprofen.

If vision disorders such as blurred vision occur, treatment should be stopped. The use of non-steroidal anti-inflammatory drugs can affect female fertility and is not recommended for women who are trying to become pregnant. For women who have difficulty conceiving or are undergoing infertility testing, NSAIDs should be considered to be discontinued. 

Therapeutic Class

Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs.

Storage Conditions

Protect from light. Store below 30°C. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.