Ketonal forte – use and side effects. Can Ketonal forte be taken with other medications?

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Ketonal forte is a very potent non-steroidal anti-inflammatory drug. Due to its action, it is available on prescription from a doctor’s prescription, but in a small dose it is also available without a prescription. However, there is a lot of information about Ketonal both about its great effects and the side effects it can cause. How is it really?

Ketonal forte – properties

Ketonal forte has anti-inflammatory, analgesic and antipyretic properties, as the active ingredient in this drug is ketoprofen. Ketonal is classified as a non-steroidal anti-inflammatory drug and is derived from the propionic acid group. By taking Ketonal forte, you counteract the synthesis of prostaglandin, which is responsible for the development of inflammation. In addition, ketoprofen inhibits the activity of cyclooxygenases, i.e. enzymes that lead to the formation of protaglandins from the lipids of cell membranes, i.e. it prevents the formation of a substance that triggers inflammation in the body.

In addition, ketoprofen reduces swelling, lowers fever, relieves pain and reduces joint stiffness. Therefore, it can be used as an analgesic in severe pain and to treat inflammation, especially in rheumatic diseases and injuries. Ketonal forte starts working very quickly and the maximum concentration in the blood is achieved after 90 minutes after administration. It has great penetrating abilities, therefore it reaches the synovial fluid and joint spaces. But thanks to this, it also penetrates the placenta or into the breastfeeding milk, so it cannot always be used.

Ketonal forte – reviews

Ketonal forte has the reputation of being a very potent drugwhich is administered in serious degenerative diseases, inflammations, rheumatic diseases and in pain syndromes. It is not a first line drug. If, for example, ibuprofenum does not have the desired effect, then a more potent drug from the same group of non-steroidal anti-inflammatory drugs is used.

However, Ketonal forte has the best opinions as a drug indicated for the treatment of rheumatoid arthritis, in degenerative diseases such as osteoarthritis, as well as in pain conditions, including severe menstrual pain. A lot of women recommend Ketonal Forte because It brings great relief in painful menstruation and reduces unpleasant pain symptoms to zero.

Ketonal forte – contraindications

Ketonal forte has many contraindications to use. The main contraindications for taking Ketonal forte are pregnancy and the breastfeeding period. It also cannot be given to children under 15 years of age. Even if you are allergic to the ingredients of the preparation or if you are allergic, you should stop using it despite the lack of knowledge about the allergy to the ingredients. In addition, it cannot be used by people with gastric or duodenal ulcer disease, bleeding, after gastrointestinal perforation, and people with renal or hepatic or heart failure.

Ketonal forte – dosage and warnings

Ketanol forte is in the form of coated tablets and is administered by oral administration. The tablets should be taken with a meal, which is very important, if you swallow them, you should not chew them. To help you swallow ketanol, you should use at least 100 ml of liquid, such as water or milk. Ketanol forte can cause harmful effects in our stomachTherefore, it is good to take medications to neutralize gastric juices along with the preparation.

The maximum dose should never exceed 200 mg per day. For adults and adolescents up to 15 years of age, the usual dose is 1 tablet (100 mg) 1-2 times a day. Elderly people should be extremely careful because ketanol forte may cause them to develop adverse body reactions such as gastrointestinal bleeding, therefore in the elderly, the lowest dose should be used.

Ketanol forte – use with other drugs

In some diseases, as well as due to various other circumstances, there may be a situation in which we will be forced to stop taking ketanol forte or reduce its dose. It is important to remember that the lower the dose of the preparation we use, the lower the chance of side effects.

You should also know that using ketoprofen, like some other NSAIDs (non-steroidal anti-inflammatory drugs), can be associated with a significant risk of gastrointestinal side effects. The use of such preparations may be associated with the occurrence of gastrointestinal haemorrhage, ulceration or perforation, which may be fatal and may not be preceded by warning symptoms.

Symptoms can occur at any time during treatment, also in people without previous gastrointestinal disturbances. These complications are especially dangerous in the elderly. If this happens, tell your doctor as soon as possible (especially if there is bleeding). If gastrointestinal bleeding occurs, the preparation must be discontinued immediately.

People who have had gastrointestinal diseases cannot use the preparation without close medical supervision, but it will be necessary for such people to use lower doses and start treatment with them. High doses and advanced age increase the risk of gastrointestinal bleeding.

Be careful and consult your doctor if you are taking other medications that increase the risk of gastrointestinal side effects, including peptic ulcer disease or bleeding (e.g. systemic corticosteroids, anticoagulants, e.g. warfarin, etc.). your doctor may sometimes recommend the use of protective drugs (e.g. misoprostol, proton pump inhibitors).

People should exercise particular caution:

1. with gastrointestinal diseases, including chronic inflammatory bowel diseases such as ulcerative colitis, Crohn’s disease (high chance of disease exacerbation)
2. with heart failure, with liver cirrhosis, with impaired liver function, with nephrotic syndrome, using diuretics, with impaired renal function, dehydration, after major surgery, especially in the elderly (risk of worsening of renal function; regular monitoring of renal function is recommended and controlling the amount of urine you pass)
3. with hypertension, congestive heart failure, with fluid retention, with edema (the use of NSAIDs may cause fluid retention and edema)
4. with bronchial asthma, with rhinitis, with sinusitis, with polyps and in people allergic to any allergens (the use of the preparation in this group of patients is associated with an increased risk of bronchospasm causing breathing difficulties and / or angioedema that may impede breathing and be life-threatening; it is necessary to ensure the possibility of quick access to medical assistance)
5. with blood coagulation disorders, renal failure, haemophilia, von Willebrand’s disease, severe thrombocytopenia, with haemostatic or liver disorders, and using anticoagulants (increased risk of bleeding; ketoprofen inhibits platelet aggregation and prolongs bleeding time; medical supervision is necessary during the period of using the preparation)
6. with alcoholism
7. in the elderly (increased risk of side effects; be especially careful and use the lowest effective dose for the shortest possible time; long-term use only possible under strict medical supervision).

People with hypertension, congestive heart failure, ischemic heart disease, peripheral arterial disease or cerebrovascular disease, and people with risk factors for cardiovascular diseases (diabetes, smoking, hyperlipidemia) require special care and close medical supervision. . It is also worth remembering that long-term use of ketoprofen in high doses may increase the risk of a heart attack or stroke.

The preparation, like other non-steroidal anti-inflammatory drugs, may cause severe skin reactions, sometimes leading to death.such as Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis. These reactions, however, occur very rarely and most often appear in the first month of using the preparation.

In the event of the first symptoms of skin lesions (rash, mucosal lesions) or any symptoms of hypersensitivity, discontinue use of the preparation immediately and consult a physician. If visual disturbances occur (e.g. blurred vision), discontinue use of the preparation and consult an ophthalmologist.

Use of the preparation should be discontinued before major surgery. The use of the preparation may cause fertility problems in women and is not recommended in women planning pregnancy. This effect is transient and disappears after the end of the treatment. Importantly, the drug contains lactose, so people with galactose intolerance, lactase deficiency or malabsorption of glucose-galactose should not use this preparation.

Ketanol forte and pregnancy and breastfeeding

Ketanol forte, like any other drug, should not be used during pregnancy and breastfeeding without consulting a specialist doctor first. The use of Ketanol forte by women in the third trimester of pregnancy may carry a risk of premature closure of the ductus arteriosus in the fetus, inhibition of uterine contractions or damage to the fetal kidneys.

During the first and second trimesters of pregnancy, the physician in a special case, i.e. when the benefits for the mother from the use of the drug outweigh the risk for the fetus, may allow the patient to take ketanol.

Ketanol forte – interactions with other substances

Ketanol forte should not be used with such preparations as:

1. acetylsalicylic acid (more commonly known as aspirin) when taken in high doses; salicylates or other non-steroidal anti-inflammatory drugs, including COX-2 inhibitors, such as e.g. celecoxib, etoricoxib (they may increase the risk of side effects such as e.g. gastrointestinal bleeding);
2. anticoagulants such as warfarin, heparin;
3. drugs that inhibit platelet aggregation, such as, for example, ticlopidine, clopidogrel (possible chance to intensify the effect and increase the risk of haemorrhage. Parallel use of such drugs must be under strict medical supervision);
4. lithium (possible increase in the concentration of lithium and intensification of its toxic effects; it is recommended to control the concentration of lithium in the blood);
5. methotrexate used in doses greater than 15 mg per week (the concentration of methotrexate may increase and its toxic effects may increase. In extreme cases, the chance of severe intoxication leading to death. ketoprofen treatment at least 15 hours before taking methotrexate (ketoprofen may be restarted 12 hours after stopping methotrexate).

We should also be especially careful when taking ketaprofen with:

1. diuretics such as furosemide (they can reduce their effectiveness, increase the risk of an effect which may lead to kidney damage. In this case, ensure adequate hydration of the patient and monitor kidney function);
2. antihypertensive drugs, including the so-called angiotensin converting enzyme inhibitors, angiotensin antagonists and beta-blockers such as, for example, propranolol (it is very possible that their effectiveness will be reduced and the risk of damaging the kidneys will increase)
3. corticosteroids or serotonin reuptake inhibitors (this increases the risk of side effects, especially gastrointestinal bleeding)
4. pentoxifylline (increased risk of bleeding);
5. thrombolytic drugs (increased risk of bleeding);
6. probenecid and sulfinpyrazone (intensification and prolongation of the effect of ketoprofen);
7. cyclosporin and tacrolimus (increased risk of damaging the kidneys) phenytoin (risk of increasing its effect);
8. oral antidiabetic drugs, sulfonylureas (risk of intensifying their effects);
9. cardiac glycosides, e.g. digoxin (risk of increasing heart failure and increasing the concentration of cardiac glycosides in the blood);
10. quinolone antibiotics (increased risk of convulsions).

Ketoprofen is able to interact with anticoagulants, hydantoins, sulfonamides and increase their effect. In such situations, it may be necessary to change and adjust the dosage by your doctor.

Ketanol forte – side effects

When using Ketanol forte as with any other drug, unfortunately, undesirable side effects may occur. However, it is worth remembering that they do not have to appear in everyone, but the benefits of taking ketanol forte are usually much greater than the damage associated with the occurrence of side effects.

The most common undesirable effects are those affecting the gastrointestinal tract, including dyspepsia, abdominal pain, nausea, diarrhea, constipation, flatulence, anorexia, vomiting, and stomatitis.

Very rarely, dysgeusia, gastrointestinal bleeding, tarry stools, bloody vomiting, peptic ulcer disease, sometimes with perforation, colitis, recurrence and exacerbation of colitis, recurrence and exacerbation of Crohn’s disease, intestinal perforation (as a complication of diverticulosis ), enteropathy with perforation, ulceration, narrowing, sometimes with bleeding or loss of protein, severe liver dysfunction, hepatitis, jaundice.

Common: headache and dizziness, asthenia, malaise, fatigue, asthenia, paraesthesia, possible somnolence and convulsions, visual disturbances, tinnitus, depression, nervousness, nightmares, somnolence. Common: edema. Uncommon: haemoptysis, dyspnoea, pharyngitis, rhinitis, bronchospasm, heart failure, hypertension, menstrual disorders, increased liver enzymes, hyperkalemia, haematological disorders (anemia, agranulocytosis, leukopenia, thrombocytopenia, prolonged bleeding time; if symptoms such as: fever, sore throat, flu-like symptoms, superficial ulceration of the oral mucosa, fatigue, nosebleeds, bruises, ecchymosis or purpura, you should immediately consult your doctor as these may be the first symptoms of hematological disorders).

Rare bone marrow suppression, delirium with hallucinations visual and auditory, disorientation, speech disorders, asthma attack.

Very rarely impaired renal function, acute renal failure, interstitial nephritis, nephrotic syndrome, acute pyelonephritis.

Hypersensitivity reactions (rash, hives, itching, photosensitivity, alopecia, sweating, exfoliative dermatitis) and anaphylactic reactions, including life threatening anaphylactic shock (sudden fall in blood pressure, arrhythmias), angioedema ( swelling of the face, larynx, tongue, throat which may obstruct breathing), bronchospasm, asthma attack and severe skin reactions: toxic epidermal necrolysis, Stevens-Johnson syndrome.

Long-term use of ketoprofen in high doses may increase the risk of a heart attack or stroke.