Ketonal Duo is a non-steroidal anti-inflammatory drug that is intended for use in the treatment of muscle and joint pain. Consider the instructions for using this medicine, find out what indications and analogues it has.
Composition of the medicine
One capsule contains 50 milligrams of the active substance, which is ketoprofen. The excipients are lactose along with magnesium stearate and silicon dioxide. The composition of the drug capsule shell is made of gelatin, titanium dioxide and a blue proprietary dye.
What does the instruction to Ketonal Duo tell us?
Pharmacological effects
This drug is a non-steroidal anti-inflammatory drug derived from propionic acid. It can have an analgesic, and at the same time, an anti-inflammatory and antipyretic effect. "Ketonal Duo" can block the action of "COX-1" enzymes, and in addition, "COX-2", and partially affects lipoxygenase, which leads to suppression of the process of prostaglandin synthesis.
This drug maystabilize lysosomal membranes, and at the highest concentrations, ketoprofen leads to suppression of the synthesis of leukotrienes and bradykinin. The active ingredient, ketoprofen, does not have any negative effect on the state of articular cartilage.
Drug pharmacokinetics
"Ketonal Duo" is a dosage form that differs from the already familiar capsules in the way the main component is released. Modified release capsules include two pellet options: white and yellow. The active substance (ketoprofen) can be released very quickly from white pellets, and from yellow ones, on the contrary, slowly. This results in a combination of rapid and prolonged exposure.
In terms of the strength of its effect, "Ketonal Duo" is not inferior to injections.
The presented drug is well absorbed immediately after ingestion. The bioavailability of ketoprofen in the form of standard capsules and those with modified release is 90%.
Reception of products does not affect the bioavailability of ketoprofen, but reduces the rate of absorption. After ingestion of the active substance at a dose of 150 milligrams in the form of modified-release capsules, the maximum concentration is 9036 nanograms per milligram within one and a half hours. This is confirmed by the instructions for Ketonal Duo.
Drug distribution and metabolism
Ketoprofen binding to plasma protein (i.e. albumin) is approximately 99%. Ketoprofen easily penetrates into the composition of the synovial fluid, where it reaches a 30% plasma concentration. Significant concentrations of the active substance in the synovial fluid are stable and last up to 30 hours, as a result of which the presence of pain and stiffness in the joints decreases for a long period of time.
Ketoprofen may be extensively metabolized by a liver microsomal enzyme that can bind to glucuronic acid and is then excreted as a glucuronide. There are no active metabolites of ketoprofen.
Approximately 80% of the active ingredient is excreted in the urine, predominantly in the form of ketoprofen glucuronide. 10% leaves the body through the intestines. Against the background of the use of ketoprofen at a dose of 100 milligrams or more, excretion through the kidneys may be difficult.
Does Ketonal Duo help with toothache? We will talk about this at the end of the article.
Other product information
In patients who suffer from severe renal insufficiency, a large proportion of the drug may be excreted through the intestines. Against the background of taking in high dosages, hepatic clearance also increases. Through the intestines, up to 40% of the drug is excreted.
In patients who suffer from liver failure, the plasma concentration of the main component is increased by two times, which is most likely due to hypoalbuminemia, and also due to high levels of unbound ketoprofen. Such patients are recommendedprescribe such medications in minimal therapeutic doses.
In patients suffering from kidney failure, the clearance of ketoprofen is reduced. However, dose adjustment is required only in cases of severe deficiency. In older people, the metabolism with elimination of ketoprofen is much slower, which is of clinical importance only for patients with severe renal insufficiency.
"Ketonal Duo": indications for use
Presented drug doctors usually prescribe as part of the symptomatic therapy of painful, and in addition, inflammatory processes of various origins. Thus, "Ketonal Duo" is appropriate for use in inflammatory and degenerative diseases of the musculoskeletal and motor systems:
- If you have rheumatoid arthritis.
- When seronegative arthritis appears, that is, with ankylosing spondylitis, Bechterew's disease, psoriatic or reactive arthritis and Reiter's syndrome.
- For gout and pseudogout.
- With the development of osteoarthritis.
In addition, Ketonal Duo capsules are also prescribed as part of the treatment of pain, with symptoms such as:
- The appearance of headaches.
- Presence of tendinitis, bursitis, myalgia, neuralgia, sciatica.
- Development of post-traumatic and postoperative pain syndrome.
- The appearance of pain in oncological diseases.
- Presence of algomenorrhea.
How many days to take"Ketonal Duo"? The course of treatment is determined by the doctor.
This drug is used to get the effect. Pain subsided, and the drug is stopped. If the pain syndrome is persistent and the drug has been taken for more than a month, then blood tests (general and biochemistry), urinalysis, and a number of examinations, such as ultrasound of the abdomen and kidneys, should be taken.
Contraindications for use
The presented drug has a wide list of various contraindications:
- Presence of hypersensitivity to the main component - ketoprofen, or other substances of the drug. In addition, this medicinal product should not be used if there is a sensitivity to substances such as salicylates and thiaprofenic acid.
- The presence of a complete or incomplete combination of bronchial asthma with recurrent polyposis of the nose and paranasal sinuses, along with intolerance to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs.
- Presence of erosive and ulcerative lesions of the digestive system, which are in the phase of their exacerbation.
- The appearance of ulcerative colitis and Crohn's disease.
- Presence of hemophilia and other bleeding disorders.
- Presence of severe liver failure.
- Development of active liver disease.
- Development of severe renal failure.
- Presence of progressive kidney disease.
- Development of decompensated heart failure.
- This drug should not be taken during the postoperative period aftercoronary artery bypass grafting.
- The appearance of gastrointestinal, cerebrovascular and other bleeding. And also for any suspicion of possible bleeding.
- Presence of diverticulitis.
- The emergence of inflammatory bowel disease.
- Presence of confirmed hyperkalemia.
- Development of chronic dyspepsia.
- Children under 15 years of age, and in addition, in the third trimester of pregnancy due to the danger to the fetus.
- While breastfeeding.
- Patient lactose intolerance along with lactase deficiency and glucose-galactose malabsorption syndrome.
When should a drug be used with caution?
With caution, Ketonal Duo injections and capsules are prescribed in the following cases:
- Peptic ulcer history.
- Asthma.
- Clinically expressed cerebrovascular pathologies, as well as vascular and heart diseases.
- Peripheral arterial disease along with dyslipidemia and advanced liver disease.
- Liver failure, hyperbilirubinemia and alcoholic cirrhosis.
- Renal and chronic heart failure along with arterial hypertension.
- Blood diseases, dehydration and diabetes.
- Ulcerative lesion of the digestive system in combination with the presence of Helicobacter pylori infection.
- Severe somatic diseases along with smoking.
- Concomitant anticoagulant therapy, for example,"Warfarin".
- Treatment with antiplatelet agents, such as acetylsalicylic acid.
- Using oral glucocorticosteroids, such as Prednisolone.
- Concomitant use of selective inhibitors, for example, Sertraline, Citalopram.
What helps Ketonal Duo, now we know.
Drug dosing
This medicine should be taken by mouth. The standard dose for adults and children over 15 years of age is 150 milligrams. This amount of active substance contains one capsule.
Capsules can be taken during or after meals. Wash down the drug with water, you can also use milk. In this case, the total volume of liquid must be at least 100 milliliters. The maximum daily dose of ketoprofen is 200 milligrams.
Side effects
This drug may cause side effects. So, the blood and lymphatic system in rare cases responds with hemorrhagic anemia, purpura, agranulocytosis, thrombocytopenia and disorders of bone marrow hematopoiesis. The immune system may react with an anaphylactic reaction.
The work of the nervous system against the background of the use of "Ketonal Duo" may be accompanied by headaches, dizziness, drowsiness, paresthesia, convulsions, impaired taste sensations and emotional lability. The senses react with blurred vision and tinnitus.
Patients may also have heart failurealong with increased pressure and vasodilation. The respiratory system reacts with an exacerbation of bronchial asthma, the appearance of bronchospasm and rhinitis. It must be said that bronchospasms are predominantly observed in patients who have hypersensitivity to non-steroidal anti-inflammatory drugs.
The digestive system may experience nausea, vomiting, dyspepsia, abdominal pain, constipation, diarrhea, bloating, gastritis, peptic ulcers, and stomatitis with this drug. Rarely, exacerbation of colitis with Crohn's disease, intestinal bleeding and perforation is observed. The liver and biliary tract react with hepatitis, an increase in the level of transaminases, and in addition, bilirubin.
Rash and itching may appear on the skin. Photosensitivity may also occur along with alopecia, urticaria, angioedema, erythema, bullous rash, and toxic epidermal necrolysis.
The urinary system may respond with acute renal failure, interstitial nephritis, nephritic syndrome, and abnormal kidney function.
Other side effects include edema with increased fatigue, weight gain in patients, and so on.
Overdose
Symptoms of an overdose of Ketonal Duo painkillers, like other cases with an excess of ketoprofen, may be marked by the appearance of nausea, vomiting, abdominal pain, melena, impaired consciousness, respiratory depression, convulsions andkidney failure.
In case of overdose, gastric lavage and the required amount of activated charcoal should be taken. It is advisable to perform symptomatic treatment. The effect of ketoprofen on the digestive system is weakened by means that reduce the secretion of the gastric glands, for example, proton pump inhibitors and prostaglandins. In cases of kidney failure, hemodialysis is recommended.
Drug Interactions
Ketoprofen tablets - "Ketonal Duo", can weaken the effects of diuretics and antihypertensive drugs. In addition, it enhances the work of oral medications of the hypoglycemic and anticonvulsant type. Concomitant use with other non-steroidal anti-inflammatory drugs, salicylates, and in addition with ethanol may increase the risk of adverse effects on the digestive system.
Simultaneous use with such groups of drugs as anticoagulants, thrombolytics and antiplatelet agents increases the risk of bleeding. Simultaneous use with potassium, potassium-sparing diuretic, low molecular weight heparin and cyclosporins may increase the risk of hyperkalemia.
The presented drug increases the concentration of cardiac glycosides in plasma. It also contributes to an increase in slow calcium channel blockers, cyclosporins and methotrexates. Against its background, the toxicity of methotrexates and the nephrotoxicity of cyclosporins increase. The simultaneous use of the drug "Ketonal Duo" with probenecides significantly reduces the clearanceKetoprofen in the blood.
Special instructions for the use of the medication
Against the background of long-term use of non-steroidal anti-inflammatory drugs, it is necessary to monitor the state of the blood, as well as the function of the kidneys and liver, especially in elderly patients (over 65 years old).
In addition, care must be taken and blood pressure control when using ketoprofen in the treatment of patients with arterial hypertension and heart and vascular diseases. These pathologies can lead to fluid retention in the body. Like other non-steroidal anti-inflammatory drugs, ketoprofen may mask the symptoms of infectious diseases.
How long does Ketonal Duo last? The drug relieves pain for about 5-6 hours. The use of the drug in the recommended dosage does not affect the ability to drive a car. But, nevertheless, patients who notice non-standard effects while taking Ketonal Duo are advised to be careful when engaging in hazardous activities. This applies to those that require increased attention and speed of psychomotor reaction.
Ketonal Duo and alcohol
Concomitant use of alcohol and this drug may aggravate the therapeutic effect, increasing the risk of bleeding. There is also a high percentage of poisoning and liver damage.
Use in Pregnancy
The process of inhibition of prostaglandin synthesis can haveundesirable effects on the course of pregnancy, as well as on embryonic development. Data from an epidemiological study with the use of synthesis inhibitors in the early stages confirm an increase in the risk of spontaneous abortions and the development of heart disease.
Prescribing this drug to pregnant women during the first two trimesters is allowed only in situations where the benefits to the woman's he alth justify the likely risk to the fetus.
Ketoprofen is completely contraindicated for pregnant women in the third trimester due to the possibility of developing weakness in the activity of the uterus during childbirth. It can also cause premature closure of the ductus arteriosus, increased bleeding time, oligohydramnios, and kidney failure.
At the moment, there is no information on the allocation of ketoprofen with milk. Thus, if there is a need for taking ketoprofen by a nursing woman, it is required to stop breastfeeding.
What are the analogues of the drug "Ketonal Duo"? Let's consider in detail how it can be replaced.
Analogues of the drug
Among the most popular analogues of the drug "Ketonal Duo" can be called such drugs as "Fastum Gel" along with the usual "Ketonal", "Bystrumgel", "Artrosilene", "Flexen", "Flamax forte", " Arketal and Artrum.
Reviews about the drug
Doctors call the presented remedy an interesting non-steroidal anti-inflammatory drug that combines a high speed of achieving an effect with a long duration of action. On the backgroundsevere inflammatory diseases, the effect of this medicine, according to the observations of specialists, can last up to 20 hours.
As for moderate inflammation, against their background, the total duration of the effect is equal to the declared 24 hours. Like other drugs with ketoprofen, the analgesic effect of the drug predominates somewhat over the anti-inflammatory effect.
Directly, patients write in their reviews of Ketonal Duo that it is an excellent medicine that perfectly relieves pain with inflammation. It is often prescribed to people for symptoms of renal colic, acute cystitis, prostatitis and urethritis, which is done as part of complex therapy.
Among the minuses, patients in the reviews of "Ketonal Duo" note the too strong effect of the drug on the digestive system. In addition, it is not suitable for patients with peptic ulcer disease and generally has a large number of certain contraindications. Not infrequently, patients complain of the appearance of dyspeptic disorders. Consumers are also not satisfied with the high cost of the medicine, which starts from 400 rubles per package.
Nevertheless, the drug presented is quite popular and frequently purchased remedy. People note its powerful analgesic effect, and also say that it acts very gently and quickly, already 10 minutes after taking it, relieves, for example, toothache. Patients also enjoy its convenient dosage.
