Ketoprofen

Aka: Ketoprofen, Orudis

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II. Indications

  1. See NSAID
  2. FDA approved indications
    1. Rheumatoid Arthritis
    2. Osteoarthritis
    3. Mild to moderate pain
    4. Primary Dysmenorrhea
  3. Off-Label (Non-FDA approved) Indications
    1. Juvenile Rheumatoid Arthritis

III. Contraindications

  1. See NSAID

IV. Mechanism

  1. See NSAID
  2. NSAID in the propionic acid class
    1. Other NSAIDS in propionic acid class include Ibuprofen and Naproxen

V. Medications

  1. Ketoprofen (Orudis) Immediate Release Capsules: 25 mg, 50 mg, 75 mg
  2. Ketoprofen (Orudis) Extended Release Capsules: 200 mg

VI. Dosing: Adult

  1. Immediate Release
    1. Arthritis (RA, OA): 75 mg orally three times daily (or 50 mg orally every 6 hours)
    2. Mild to moderate pain (including Dysmenorrhea): 25 to 50 mg orally every 6 to 8 hours
  2. Extended-Release
    1. Arthritis (RA, OA): 200 mg orally daily

VII. Dosing: Child

  1. Juvenile Rheumatoid Arthritis (not FDA approved)
    1. Start 100 to 200 mg/m2/day in divided doses 3 to 4 times daily
    2. Maximum: 320 mg/day

VIII. Adverse Effects

  1. See NSAID

IX. Safety

  1. See NSAID
  2. Avoid in Lactation
  3. Avoid NSAIDs in pregnancy outside the first part of the second trimester (13 to 20 weeks)
    1. Teratogenic in first trimester
    2. Risk of premature ductus arteriosus closure in the fetus in third trimester
    3. Most NSAIDs carry a legacy system Pregnancy Category B or C designation (aside from third trimester)
      1. However, many obstetricians avoid NSAIDs entirely in pregnancy (even in second trimester)

X. Efficacy

  1. Ketoprofen 25 mg comparable to Ibuprofen 400 mg
  2. Ketoprofen 50 mg more potent than Tylenol #3

XI. Resources

  1. Ketoprofen Immediate Release (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=d0f47ab6-29ff-df07-e053-2a95a90a2b51
  2. Ketoprofen Extended Release (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=198a4140-f4c0-4478-9157-ee1d68d0bb96

XII. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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