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Fenoprofen Calcium

Class: Other Nonsteroidal Anti-inflammatory Agents
VA Class: MS120
Molecular Formula: C30H26CaO6•2H2O
CAS Number: 53746-45-5
Brands: Nalfon

Warning(s)

  • Cardiovascular Risk
  • Possible increased risk of serious (sometimes fatal) cardiovascular thrombotic events (e.g., MI, stroke).137 b Risk may increase with duration of use.137 b Individuals with cardiovascular disease or risk factors for cardiovascular disease may be at increased risk.100 137 b (See Cardiovascular Effects under Cautions.)

  • Contraindicated for the treatment of pain in the setting of CABG surgery.100 137 b

  • GI Risk
  • Increased risk of serious (sometimes fatal) GI events (e.g., bleeding, ulceration, perforation of the stomach or intestine).137 b Serious GI events can occur at any time and may not be preceded by warning signs and symptoms.137 b Geriatric individuals are at greater risk for serious GI events.100 137 b (See GI Effects under Cautions.)

Introduction

Prototypical NSAIA;100 b propionic acid derivative;b structurally and pharmacologically related to flurbiprofen, ibuprofen, ketoprofen, and naproxen.b d

Uses for Fenoprofen Calcium

Consider potential benefits and risks of fenoprofen therapy as well as alternative therapies before initiating therapy with the drug.100 137 b Use lowest possible effective dosage and shortest duration of therapy consistent with patient’s treatment goals.100 137 b

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Pain

Relief of mild to moderate pain in adults.100 b

Inflammatory Diseases

Symptomatic treatment of osteoarthritis and rheumatoid arthritis.100 b d

Has been used in the symptomatic treatment of juvenile rheumatoid arthritis.b c

Also has been used with some success in the treatment of ankylosing spondylitis and acute gouty arthritis.b d

Fenoprofen Calcium Dosage and Administration

General

  • Consider potential benefits and risks of fenoprofen therapy as well as alternative therapies before initiating therapy with the drug.100 137 b

Administration

Oral Administration

Administer orally.100 b

Administration with meals, milk, or antacids may minimize adverse GI effects.100 b d

Dosage

Available as fenoprofen calcium; dosage expressed in terms of fenoprofen.100 b

To minimize the potential risk of adverse cardiovascular and/or GI events, use lowest effective dosage and shortest duration of therapy consistent with the patient’s treatment goals.100 137 b Adjust dosage based on individual requirements and response; attempt to titrate to the lowest effective dosage.100 137 b

Adults

Pain
Oral

For mild to moderate pain, 200 mg every 4–6 hours as needed.100 b

Inflammatory Diseases
Osteoarthritis or Rheumatoid Arthritis
Oral

Initially, 300–600 mg 3 or 4 times daily.100 b d Adjust dose and frequency as necessary based on severity of symptoms and clinical response (maximum 3.2 g daily).100 b

Patients with rheumatoid arthritis may require higher dosages than those with osteoarthritis.100 b

Symptomatic improvement usually begins in a few days, but an additional 2–3 weeks may be needed to determine response.100 b

Prescribing Limits

Adults

Inflammatory Diseases
Osteoarthritis or Rheumatoid Arthritis
Oral

Maximum 3.2 g daily.100 b

Special Populations

Renal Impairment

No dosage adjustments recommended.100

Use not recommended in patients with advanced renal disease.100

Hepatic Impairment

No dosage adjustments recommended.

Cautions for Fenoprofen Calcium

Contraindications

  • Known hypersensitivity to fenoprofen or any ingredient in the formulation.100 d

  • History of asthma, urticaria, or other sensitivity reaction precipitated by aspirin or other NSAIAs.100 137 d

  • Treatment of perioperative pain in the setting of CABG surgery.100 137

  • History of significant renal impairment.100

Warnings/Precautions

Warnings

Cardiovascular Effects

Selective COX-2 inhibitors have been associated with increased risk of cardiovascular events (e.g., MI, stroke) in certain situations.138 Several prototypical NSAIAs also have been associated with increased risk of cardiovascular events.141 142 143 Information not available on risk associated with fenoprofen at this time.141 142 143

Use NSAIAs with caution and careful monitoring (e.g., monitor for development of cardiovascular events) and at the lowest effective dosage for the shortest duration necessary.100 137

Peripheral edema, palpitations, tachycardia (including supraventricular tachycardia), atrial fibrillation, and ECG changes reported.100 b

Short-term use to relieve acute pain, especially at low dosages, does not appear to be associated with increased risk of serious cardiovascular events (except immediately following CABG surgery).138

No consistent evidence that concomitant use of low-dose aspirin mitigates the increased risk of serious adverse cardiovascular events associated with NSAIAs.100 137 138 (See Specific Drugs under Interactions.)

Hypertension and worsening of preexisting hypertension reported; either event may contribute to the increased incidence of cardiovascular events.100 137 Use with caution in patients with hypertension; monitor BP.100 137 Impaired response to certain diuretics may occur.100 137 (See Specific Drugs under Interactions.)

Fluid retention and edema reported.100 137 Caution in patients with fluid retention or heart failure.100 137

GI Effects

Serious GI toxicity (e.g., bleeding, ulceration, perforation) can occur with or without warning symptoms;100 104 105 108 increased risk in those with a history of GI bleeding or ulceration, geriatric patients, smokers, those with alcohol dependence, and those in poor general health.100 124 127 134

For patients at high risk for complications from NSAIA-induced GI ulceration (e.g., bleeding, perforation), consider concomitant use of misoprostol;107 124 125 126 alternatively, consider concomitant use of a proton-pump inhibitor (e.g., omeprazole)107 124 125 or use of an NSAIA that is a selective inhibitor of COX-2 (e.g., celecoxib).125

Renal Effects

Direct renal injury, including renal papillary necrosis, reported in patients receiving long-term NSAIA therapy.100 137

Potential for overt renal decompensation.100 137 Increased risk of renal toxicity in patients with renal or hepatic impairment or heart failure, in geriatric patients, in patients with volume depletion, and in those receiving a diuretic, ACE inhibitor, or angiotensin II receptor antagonist.100 137 140 (See Renal Impairment under Cautions.)

Sensitivity Reactions

Hypersensitivity Reactions

Anaphylactoid reactions reported.100 137

Immediate medical intervention and discontinuance for anaphylaxis.100 137

Avoid in patients with aspirin triad (aspirin sensitivity, asthma, nasal polyps); caution in patients with asthma.100 137 d

Dermatologic Reactions

Serious skin reactions (e.g., exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) reported; can occur without warning.100 137 Discontinue at first appearance of rash or any other signs of hypersensitivity (e.g., blisters, fever, pruritus).100 137

General Precautions

Hepatic Effects

Severe reactions including jaundice, fatal fulminant hepatitis, liver necrosis, and hepatic failure (sometimes fatal) reported rarely with NSAIAs.100

Elevations of serum ALT or AST reported.100

Monitor for symptoms and/or signs suggesting liver dysfunction; monitor abnormal liver function test results.100 Discontinue if signs or symptoms of liver disease or systemic manifestations (e.g., eosinophilia, rash) occur.100

Hematologic Effects

Anemia reported rarely.100 137 Determine hemoglobin concentration or hematocrit in patients receiving long-term therapy if signs or symptoms of anemia occur.100 137 d

May inhibit platelet aggregation and prolong bleeding time.100 137 d

CNS Effects

Drowsiness and dizziness reported; may impair ability to perform activities requiring mental alertness.100 b

Ocular Effects

Adverse ocular effects reported in patients receiving NSAIA therapy; ophthalmologic evaluation recommended if visual disturbances occur.100 b

Otic Effects

Safety not established in patients with hearing impairment; auditory function tests should be performed periodically in these patients during prolonged therapy.100 b

Other Precautions

Not a substitute for corticosteroid therapy; not effective in the management of adrenal insufficiency.100

May mask certain signs of infection.b

Obtain CBC and chemistry profile periodically during long-term use.100

Specific Populations

Pregnancy

Category C.100 Avoid use in third trimester because of possible premature closure of the ductus arteriosus.100

Lactation

Fenoprofen is distributed into milk.b d Discontinue nursing or the drug.100 b

Pediatric Use

Safety and efficacy not established in children <18 years of age.100

Geriatric Use

Use with caution in patients ≥65 years of age.100 Geriatric patients appear to tolerate therapy less well (e.g., possible higher incidence of adverse GI effects, greater risk of developing renal decompensation) than younger individuals.100 b Fatal adverse GI effects reported more frequently in geriatric patients than younger adults.100 b

Renal Impairment

Has not been evaluated in patients with severe renal impairment.100 b Use not recommended in patients with advanced renal disease.100 b

Common Adverse Effects

Dyspepsia,100 d nausea,100 d constipation,100 d headache,100 somnolence,100 dizziness,100 nervousness,100 asthenia,100 and peripheral edema.100

Interactions for Fenoprofen Calcium

Protein-bound Drugs

Possible pharmacokinetic interaction; potential for fenoprofen to be displaced from binding sites by, or to displace from binding sites, other protein-bound drugs (e.g., oral anticoagulants, hydantoins, salicylates, sulfonamides, and sulfonylureas).100 b d Observe for adverse effects if used with other protein-bound drugs.100 b

Specific Drugs

Drug

Interaction

Comments

ACE inhibitors

Reduced BP response to ACE inhibitor possible 100 137 144

Possible deterioration of renal function in individuals with renal impairment144

Monitor BP100 144 b

Angiotensin II receptor antagonists

Reduced BP response to angiotensin II receptor antagonist possible144

Possible deterioration of renal function in individuals with renal impairment144

Monitor BP144 b

Antacids (aluminum- and magnesium-containing)

Did not affect fenoprofen absorption in one study; other antacids not evaluated for possible interactionsa b d

Anticoagulants (e.g., warfarin)

Possible bleeding complications100 137 144

Caution and careful monitoring advised100 144 b

Aspirin

Increased risk of GI ulceration or other complications 100 137

Possible decreased plasma concentrations and half-life of fenoprofen100 b d

No consistent evidence that low-dose aspirin mitigates the increased risk of serious cardiovascular events associated with NSAIAs 100 138

Concomitant use generally not recommended100 d

Diuretics (furosemide and thiazides)

Reduced natriuretic effects100 137

Monitor for diuretic efficacy and renal failure100 137

Lithium

Increased plasma lithium concentrations100 137

Monitor for lithium toxicity 100 137

Methotrexate

Possible toxicity associated with increased plasma methotrexate concentrations during concomitant NSAIA use100 b

Caution advised100 b

Phenobarbital

Possible decreased plasma concentrations and plasma half-life of fenoprofen100 b d

Dosage adjustment may be necessary when phenobarbital is initiated or discontinued100 b d

Fenoprofen Calcium Pharmacokinetics

Absorption

Bioavailability

Rapidly and almost completely absorbed following oral administration.100 b d Peak plasma concentrations usually attained within 2 hours.100 b

Onset

Onset of analgesic activity reportedly occurs within 15–30 minutes following oral administration.b

Duration

Duration of analgesic activity: 4–6 hours.b

Food

Food delays and diminishes peak plasma fenoprofen concentrations.100 a b d

Distribution

Extent

Distributed into milk;b d does not appear to cross the placenta.b d

Plasma Protein Binding

Approximately 99% (mainly to albumin).100 b d

Elimination

Metabolism

Extensively metabolized in the liver.b d Fenoprofen’s major metabolite, 4′-hydroxyfenoprofen, probably is inactive.b

Elimination Route

Eliminated principally in urine as unchanged drug (2–5%), 4′-hydroxyfenoprofen (2–5%), their glucuronide or other conjugates (90%), and unidentified conjugates (2–5%).100 b d

Half-life

2.5–3 hours.100 b d

Special Populations

Not substantially removed by hemodialysis or peritoneal dialysis.100

Stability

Storage

Oral

Capsules and Tablets

Tight containers at 20–25°C.100

Actions

  • Inhibits cyclooxygenase-1 (COX-1) and COX-2.118 119 120 121 122 123 b

  • Pharmacologic actions similar to those of other prototypical NSAIAs; exhibits anti-inflammatory, analgesic, and antipyretic activity.100 118 119 120 121 122 123 b d

Advice to Patients

  • Importance of reading the medication guide for NSAIAs that is provided each time the drug is dispensed.100 137

  • Risk of serious cardiovascular events with long-term use.100 b Importance of notifying clinician if signs and symptoms of a cardiovascular event (chest pain, dyspnea, weakness, slurred speech) occur.100 b

  • Risk of GI bleeding and ulceration.100 111 115 b Importance of notifying a clinician if signs and symptoms of serious adverse GI effects occur.100 b

  • Risk of serious skin reactions.100 b Importance of discontinuing fenoprofen calcium and contacting clinician if rash or other signs of hypersensitivity (blisters, fever, pruritus) develop.100 b

  • Risk of anaphylactoid and other sensitivity reactions.100 b Importance of seeking immediate medical attention if an anaphylactic reaction occurs.100 b

  • Risk of hepatotoxicity.100 b Importance of discontinuing therapy and contacting a clinician immediately if signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, upper right quadrant tenderness, flu-like symptoms) occur.100 b

  • Importance of notifying clinician if signs and symptoms of unexplained weight gain or edema develop.100

  • Risk of dizziness and potential for drug to impair mental alertness; use caution when driving or operating machinery until effects on individual are known.100 b

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.100 Importance of avoiding fenoprofen in late pregnancy (third trimester).100 b

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant diseases.100

  • Importance of informing patients of other important precautionary information.100 (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Fenoprofen Calcium

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules

200 mg (of fenoprofen)*

Nalfon

Pedinol

300 mg (of fenoprofen)*

Fenoprofen Calcium Capsules

Par, Sandoz, Watson

Nalfon

Pedinol

Tablets, film-coated

600 mg (of fenoprofen)*

Fenoprofen Calcium Tablets

Mylan, Purepac, Teva

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2014. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Fenoprofen Calcium 600MG Tablets (MYLAN): 30/$62.69 or 90/$170.47

Nalfon 200MG Capsules (PEDINOL): 100/$90.39 or 300/$262.78

AHFS DI Essentials. © Copyright, 2004-2014, Selected Revisions November 1, 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

100. Pedinol Pharmacal Inc. Nalfon (fenoprofen calcium) capsules prescribing information. Farmingdale, NY; 2006 Jan.

101. Gurney JR, Mills RJ. Assessment of thyroid function: complications after treatment with fenoprofen. BMJ. 1986; 292:1560. [IDIS 217988] [PubMed 3087516]

102. Tillman J, Leask JTS, Logue FC et al. Assessment of thyroid function: complications after treatment with fenoprofen. BMJ. 1986; 293:206. [IDIS 219567] [PubMed 3089454]

103. Thornes HM, Carr D. Fenoprofen and free triiodothyronine measurement. Lancet. 1986; 2:101. [IDIS 219180] [PubMed 2873356]

104. Palmer JF. Letter sent to Talbott MW of Eli Lilly and Company regarding labeling revisions about gastrointestinal adverse reactions to Nalfon (fenoprofen). Rockville, MD: Food and Drug Administration, Division of Oncology and Radiopharmaceutical Drug Products; 1988 Sep.

105. Food and Drug Administration. Labeling revisions for NSAIDs. FDA Drug Bull. 1989; 19:3-4.

106. Searle. Cytotec (misoprostol) prescribing information. 1989 Jan.

107. Anon. Drug for rheumatoid arthritis. Med Lett Drugs Ther. 2000; 42:57-64. [PubMed 10887424]

108. Soll AH, Weinstein WM, Kurata J et al. Nonsteroidal anti-inflammatory drugs and peptic ulcer disease. Ann Intern Med. 1991; 114:307-19. [IDIS 277370] [PubMed 1987878]

109. Kolodzik JM, Eilers MA, Angelos MG. Nonsteroidal anti-inflammatory drugs and coma: a case report of fenoprofen overdose. Ann Emerg Med. 1990; 19:378-81. [PubMed 2321822]

110. Corticosteroid interactions: nonsteroidal anti-inflammatory drugs (NSAIDs). In: Hansten PD, Horn JR. Drug interactions and updates. Vancouver, WA: Applied Therapeutics, Inc; 1993:562.

111. Garcia Rodriguez LA, Jick H. Risk of upper gastrointestinal bleeding and perforation associated with individual non-steroidal anti-inflammatory drugs. Lancet. 1994; 343:769-72. [IDIS 328176] [PubMed 7907735]

112. Hollander D. Gastrointestinal complications of nonsteroidal anti-inflammatory drugs: prophylactic and therapeutic strategies. Am J Med. 1994; 96:274-81. [IDIS 328041] [PubMed 8154516]

113. Schubert TT, Bologna SD, Yawer N et al. Ulcer risk factors: interaction between Helicobacter pylori infection, nonsteroidal use, and age. Am J Med. 1993; 94:413-7. [IDIS 314155] [PubMed 8475935]

114. Piper JM, Ray WA, Daugherty JR et al. Corticosteroid use and peptic ulcer disease: role of nonsteroidal anti-inflammatory drugs. Ann Intern Med. 1991; 114:735-40. [IDIS 280191] [PubMed 2012355]

115. Bateman DN, Kennedy JG. Non-steroidal anti-inflammatory drugs and elderly patients: the medicine may be worse than the disease. BMJ. 1995; 310:817-8. [IDIS 345154] [PubMed 7711609]

116. Ciba Geigy, Ardsley, NY: Personal communication on diclofenac 28:08.04.

117. Reviewers’ comments (personal observation) on diclofenac 28:08.04.

118. Hawkey CJ. COX-2 inhibitors. Lancet. 1999; 353:307-14. [IDIS 418284] [PubMed 9929039]

119. Kurumbail RG, Stevens AM, Gierse JK et al. Structural basis for selective inhibition of cyclooxygenase-2 by anti-inflammatory agents. Nature. 1996; 384:644-8. [PubMed 8967954]

120. Riendeau D, Charleson S, Cromlish W et al. Comparison of the cyclooxygenase-1 inhibitory properties of nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors, using sensitive microsomal and platelet assays. Can J Physiol Pharmacol. 1997; 75:1088-95. [PubMed 9365818]

121. DeWitt DL, Bhattacharyya D, Lecomte M et al. The differential susceptibility of prostaglandin endoperoxide H synthases-1 and -2 to nonsteroidal anti-inflammatory drugs; aspirin derivatives as selective inhibtors. Med Chem Res. 1995; 5:325-43.

122. Cryer B, Dubois A. The advent of highly selective inhibitors of cyclooxygenase—a review. Prostaglandins Other Lipid Mediators. 1998; 56:341-61. [PubMed 9990677]

123. Simon LS. Role and regulation of cyclooxygenase-2 during inflammation. Am J Med. 1999; 106(Suppl 5B):37-42S.

124. Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N Engl J Med. 1999; 340:1888-99. [IDIS 426864] [PubMed 10369853]

125. American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines.. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum. 2002; 46:328-46. [IDIS 476480] [PubMed 11840435]

126. Lanza FL and the members of the Ad Hoc Committee on Practice Parameters of the American College of Gastroenterology. A guideline for the treatment and prevention of NSAID-induced ulcers. Am J Gastroenterol. 1998; 93:2037-46. [IDIS 417402] [PubMed 9820370]

127. Singh G, Triadafilopoulos G. Epidemiology of NSAID induced gastrointestinal complications. J Rheumatol. 1999; 26(suppl 56):18-24.

128. in’t Veld BA, Ruitenberg A, Hofman A et al. Nonsteroidal antiinflammatory drugs and the risk of Alzheimer’s disease. N Engl J Med. 2001; 345:1515-21. [PubMed 11794217]

129. Breitner JCS, Zandi PP. Do nonsteroidal antiinflammatory drugs reduce the risk of Alzheimer’s disease? N Engl J Med. 2001; 345:1567-8. Editorial.

130. McGeer PL, Schulzer M, McGeer EG. Arthritis and anti-inflammatory agents as possible protective factors for Alzheimer’s disease: a review of 17 epidemiologic studies. Neurology. 1996; 47:425-32. [IDIS 371394] [PubMed 8757015]

131. Beard CM, Waring SC, O’sBrien PC et al. Nonsteroidal anti-inflammatory drug use and Alzheimer’s disease : a case-control study in Rochester, Minnesota, 1980 through 1984. Mayo Clin Proc. 1998; 73:951-5. [IDIS 416502] [PubMed 9787743]

132. in’t Veld BA, Launer LJ, Hoes AW et al. NSAIDs and incident Alzheimer’s disease: the Rotterdam Study. Neurobiol Aging. 1998; 19:607-11. [PubMed 10192221]

133. Stewart WF, Kawas C, Corrada M et al. Risk of Alzheimer’s disease and duration of NSAID use. Neurology. 1997; 48:626-32. [IDIS 383303] [PubMed 9065537]

134. Pharmacia. Daypro (oxaprozin) caplets prescribing information. Chicago, IL; 2002 May.

135. Chan FKL, Hung LCT, Suen BY et al. Celecoxib versus diclofenac and omeprazole in reducing the risk of recurrent ulcer bleeding in patients with arthritis. N Engl J Med. 2002; 347:2104-10. [IDIS 490812] [PubMed 12501222]

136. Graham DY. NSAIDs, Helicobacter pylori, and Pandora’s box. N Engl J Med. 2002; 347:2162-4. [IDIS 490815] [PubMed 12501230]

137. US Food and Drug Administration. Proposed NSAID Package Insert Labeling Template 1. From the FDA website (). Accessed 10 Oct 2005.

138. Food and Drug Administration. Analysis and recommendations for agency action regarding non-steroidal anti-inflammatory drugs and cardiovascular risk. 2005 Apr 6.

139. Cush JJ. The safety of COX-2 inhibitors: deliberations from the February 16-18, 2005, FDA meeting. From the American College of Rheumatology website (). Accessed 2005 Oct 12.

140. Novartis Pharmaceuticals. Diovan (valsartan) capsules prescribing information (dated 1997 Apr). In: Physicians’ desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:2013-5.

141. McGettigan P, Henry D. Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA. 2006; 296: 1633-44. [PubMed 16968831]

142. Kearney PM, Baigent C, Godwin J et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ. 2006; 332: 1302-5. [PubMed 16740558]

143. Graham DJ. COX-2 inhibitors, other NSAIDs, and cardiovascular risk; the seduction of common sense. JAMA. 2006; 296:1653-6. [PubMed 16968830]

144. Merck & Co. Clinoril (sulindac) tablets prescribing information. Whitehouse Station, NJ; 2006 Feb.

145. Chou R, Helfand M, Peterson K et al. Comparative effectiveness and safety of analgesics for osteoarthritis. Comparative effectiveness review no. 4. (Prepared by the Oregon evidence-based practice center under contract no. 290-02-0024.) . Rockville, MD: Agency for Healthcare Research and Quality. 2006 Sep. Available at: .

a. Chernish SM, Rubin A, Rodda BE et al. The physiological disposition of fenoprofen in man. IV. The effects of position of subject, food ingestion and antacid ingestion on the plasma levels of orally administered fenoprofen. J Med. 1972; 3: 249-57. [PubMed 4508566]

b. AHFS drug information 2007. McEvoy GK, ed. Fenoprofen. Bethesda, MD: American Society of Health-System Pharmacists; 2007:2054-2058.

c. Brewer EJ, Giannini EH, Baum J et al. Aspirin and fenoprofen (Nalfon) in the treatment of juvenile rheumatoid arthritis results of the double blind-trial: a segment II study. J Rheumatol. 1982; 9: 123-8.

d. Brogden RN, Pinder RM, Speight TM et al. Fenoprofen: a review of its pharmacological properties and therapeutic efficacy in rheumatic diseases. Drugs. 1977; 13: 241-65.

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