Ketoprofen Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Osteoarthritis

Ketoprofen: 75 mg orally 3 times a day or 50 mg orally 4 times a day.
The recommended maximum is 300 mg/day.

Ketoprofen Extended-release: 200 mg orally once daily.

Usual Adult Dose for Rheumatoid Arthritis

Ketoprofen: 75 mg orally 3 times a day or 50 mg orally 4 times a day.
The recommended maximum is 300 mg/day.

Ketoprofen Extended-release: 200 mg orally once daily.

Usual Adult Dose for Acute Gout

Ketoprofen: 100 mg orally one time, followed by 50 mg every 6 hours until the acute gouty attack has resolved, usually 2 to 3 days.

Usual Adult Dose for Pain

Ketoprofen: 25 to 50 mg orally every 6 to 8 hours. Dose may be increased up to a maximum of 75 mg.

Usual Adult Dose for Fever

Ketoprofen: 12.5 mg orally every 4 to 6 hours. An additional dose may be given if the fever does not improve within 1 hour.

The maximum daily dose should not exceed 75 mg.

Usual Adult Dose for Dysmenorrhea

Ketoprofen: 25 to 50 mg orally every 6 to 8 hours as needed for pain relief. The dose should be titrated to patient response and should not exceed 300 mg/24 hours.

Renal Dose Adjustments

The smallest recommended initial dosage should be used in patients with renal disease.

Liver Dose Adjustments

Cirrhotic patients should receive the smallest recommended initial dosage.

Dose Adjustments

Smaller doses should be used initially in small persons, the elderly, and debilitated.

Titrate the dose based on patient response and tolerance. If the patient is stabilized on a total daily dose of 200 mg, an alternative regimen of extended release ketoprofen 200 mg once a day may be given. The over-the-counter dose is 12.5 mg orally every 4 to 6 hours.

Precautions

Patients with a hypersensitivity (angioedema, bronchospasm, urticaria, or rhinitis) to aspirin or other nonsteroidal anti-inflammatory agents (NSAIDs) may be cross sensitive to ketoprofen. Patients with the "triad" of asthma, nasal polyps, and aspirin or other NSAID hypersensitivity are at particular risk. The use of ketoprofen is considered contraindicated in these patients.

Serious gastrointestinal (GI) toxicity, such as bleeding, ulceration, and perforation, can occur at any time with or without warning symptoms, in patients receiving NSAID therapy chronically. Symptomatic upper GI ulcers, gross bleeding, or perforation appear to occur in approximately 1% of patients treated for 3 to 6 months, and in about 2% to 4% of patients treated for one year. Caution should be exercised when using NSAIDs in the elderly and debilitated, because most of the spontaneous reports of fatal GI adverse events are in this population. Patients that consume 3 or more alcoholic drinks per day may be at a higher risk of stomach bleeding. NSAIDs should be administered with care to patients with a history of inflammatory bowel disease (ulcerative colitis, Crohn's disease) as their condition may be exacerbated.

Patients should be advised about the potential for stomach bleeding if more than the recommended dosage is used.

Ketoprofen has been associated with severe allergic reactions which may include hives, facial swelling, asthma (wheezing), and shock.

In addition, renal function may be further compromised by the use of ketoprofen in patients with renal dysfunction, heart failure, hypovolemia, cirrhosis, nephrotic syndrome, or hypoalbuminemia. Renal blood flow in patients with renal dysfunction, edematous disorders, or hypoalbuminemia states is dependent upon renal prostaglandin synthesis. If ketoprofen must be used, periodic monitoring of renal function is recommended.

Patients on long-term treatment with NSAIDs, including ketoprofen, should have their hemoglobin or hematocrit checked if signs or symptoms of anemia are present. Anemia is commonly observed in rheumatoid arthritis and is sometimes aggravated by nonsteroidal anti-inflammatory drugs.

Patients with chronic liver disease, and reduced serum albumin levels, should be closely monitored, and a reduction in dosage should be anticipated to avoid high blood levels of ketoprofen and/or its metabolites.

Ketoprofen is not a substitute for steroidal drugs. If steroid dosage is reduced or eliminated during therapy, it should be reduced slowly and the patients observed closely for any evidence of adverse effects, including adrenal insufficiency and worsening of symptoms of arthritis.

Peripheral edema has been reported in 2% of patients taking ketoprofen, therefore, caution should be used in patients with fluid retention, hypertension, or heart failure.

Ketoprofen is available in a nonprescription strength of 12.5 mg. Self medication doses should not exceed 25 mg in 6 hours or 75 mg in 24 hours.

Dialysis

Ketoprofen is not dialyzable.

Other Comments

The maximum daily dose should not exceed 300 mg.

If no improvement is seen within 2 to 4 weeks of therapy, an alternative NSAID should be considered.

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