Ketofril - instructions for use, reviews, analogs and formulations (10 mg tablets, injections in 1 ml ampoules) for the treatment of toothache, arthrosis, rheumatoid arthritis, neuralgia in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Ketofril. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Ketofril in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Ketofril in the presence of existing structural analogs.Use for the treatment of toothache, postoperative pain, arthrosis, rheumatoid arthritis, joint pain, intercostal neuralgia in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Ketofril - a non-steroidal anti-inflammatory drug (NSAID), a pyrrolizine-carboxylic acid derivative. It has a pronounced analgesic effect, has also an anti-inflammatory and moderate antipyretic effect. The mechanism of action is associated with inhibition of cyclooxygenase (COX) activity, the main enzyme of arachidonic acid metabolism, which is a precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever.

Composition

Ketorolac trometamol + auxiliary substances.

Pharmacokinetics

When ingested absorbed from the gastrointestinal tract. The maximum concentration in the blood plasma is achieved after 40-50 minutes both after ingestion and after intramuscular injection. Eating does not affect absorption. Binding to plasma proteins is more than 99%.

The half-life is 4-6 hours, both after ingestion and after intramuscular injection.More than 90% of the dose is excreted in the urine, in unchanged form - 60%, the rest - through the intestine. In patients with impaired renal function and senile age, the elimination rate decreases, the elimination half-life increases.

Indications

For short-term relief of moderate and severe pain of various origins.

Forms of release

The tablets covered with a cover of 10 mg.

Injections in ampoules for injection 1 ml.

The medicinal form in the form of an ointment at the time of publication of the drug in the Directory did not exist.

Instructions for use and dosing regimen

Adults with oral administration - 10 mg every 4-6 hours, if necessary - 20 mg 3-4 times a day.

With intramuscular injection, a single dose of 10-30 mg, the interval between administrations is 4-6 hours. The maximum duration of application is 2 days.

Maximum doses: when ingestion or intramuscular injection - 90 mg per day. For patients with a body weight of up to 50 kg, with violations of kidney function, as well as for people over 65 years - 60 mg per day.

Side effect

• nausea, vomiting;
• stomach ache;
• diarrhea, constipation;
• flatulence (swelling);
• feeling of overflow of the stomach and intestines;
• dry mouth;
• stomatitis (inflammation of the oral mucosa);
• thirst;
• gastritis (inflammation of the gastric mucosa);
• erosive and ulcerative lesions of the gastrointestinal tract;
• impaired liver function;
• bradycardia (decrease in heart rate);
• changes in blood pressure;
• palpitation;
• fainting;
• headache;
• drowsiness;
• anxiety;
• depression;
• euphoria;
• paresthesia (sensation of tingling, burning, creeping "goosebumps");
• sleep disorders;
• dizziness;
• change in taste;
• visual impairment;
• motor disorders;
• breathing disorders;
• attacks of suffocation;
• increased frequency of urination;
• oliguria (decrease in the amount of urine released by the kidneys);
• polyuria (increased urine formation);
• proteinuria (urinary excretion of protein in excess of normal values);
• hematuria (presence of blood in the urine);
• azotemia (high content of nitrogenous metabolic products in the blood, excreted by the kidneys);
• acute renal insufficiency;
• nasal bleeding;
• anemia (low concentration of hemoglobin);
• thrombocytopenia (decrease in the number of platelets);
• eosinophilia (increase in the number of eosinophils in the blood);
• bleeding from postoperative wounds;
• increased sweating;
• edema;
• itching;
• hemorrhagic rash;
• bronchospasm (acute respiratory failure);
• anaphylactic shock (allergic reaction of immediate type);
• Myalgia (pain in the muscles);
• fever;
• pain at the injection site.

Contraindications

• erosive and ulcerative lesions of the gastrointestinal tract in the phase of exacerbation;
• presence or suspicion of gastrointestinal bleeding or craniocerebral hemorrhage;
• blood clotting disorders in the anamnesis;
• a condition with a high risk of bleeding or incomplete hemostasis;
• hemorrhagic diathesis;
• moderate and severe renal dysfunction (serum creatinine content more than 50 mg per liter);
• risk of developing renal failure in hypovolemia and dehydration;
• intolerance to aspirin;
• bronchial asthma;
• polyps of the nasal cavity;
• angioedema in history;
• preventive anesthesia before surgery and during surgery;
• children and adolescents under 16;
• pregnancy, childbirth, lactation;
• increased sensitivity to ketorolac, acetylsalicylic acid and other NSAIDs.

Application in pregnancy and lactation

Contraindicated in pregnancy, during labor and during lactation (breastfeeding).

Ketofril is contraindicated for use as a means for premedication,supporting anesthesia and for anesthesia in obstetric practice, since under its influence it is possible to increase the duration of the first period of labor. In addition, Ketorolac can inhibit uterine contractility and fetal circulation.

Use in children

Contraindicated in children and adolescents under 16 years.

Application in elderly patients

Caitrifil should be used with caution in patients of senile age, as the half-life of ketorolac is prolonged, and plasma clearance may decrease. In these patients it is recommended to use ketorolac at doses close to the lower limit of the therapeutic range.

special instructions

They are used with caution in patients with impaired liver and kidney function, chronic heart failure, arterial hypertension, in patients with erosive and ulcerative gastrointestinal lesions and bleeding from the gastrointestinal tract in anamnesis.

Caethofril should be used with caution in the postoperative period in cases when particularly careful haemostasis is required (including after resection of the prostate, tonsillectomy, cosmetic surgery), as well as in senile patients.If there are symptoms of liver damage, skin rash, eosinophilia, ketorolac should be discarded. Ketofril is not indicated for use in chronic pain syndrome.

Impact on the ability to drive vehicles and manage mechanisms

If drowsiness, dizziness, insomnia or depression occurs during the treatment with Ketofril, special care must be taken during occupations with potentially dangerous activities requiring increased attention and speed of psychomotor reactions.

Drug Interactions

With the simultaneous use of Ketofril with other NSAIDs, it is possible to develop additive side effects; with pentoksifillinom, anticoagulants (including Heparin in low doses) - may increase the risk of bleeding; with ACE inhibitors - there may be an increased risk of kidney dysfunction; with probenecid - the concentration of ketorolac in the plasma and its half-life increase; with lithium preparations - it is possible to reduce renal clearance of lithium and increase its concentration in plasma; with Furosemide - a decrease in its diuretic effect.

When ketorolac is used, the need for opioid analgesics for analgesia is reduced.

Analogues of the drug Ketofril

Structural analogs for the active substance:

• Adolor;
• Akyular;
• Vatorlak;
• Dolak;
• Dolomin;
• Cetadrope;
• Ketalgin;
• Ketanov;
• Ketokam;
• Ketolac;
• Ketorol;
• Ketorolac;
• Matrolgin;
• Thoradol;
• Torolac.

Analogues on the curative effect (means for relief of acute pain):

• Arthrosylen;
• Bupranal;
• Diclofenac;
• Dinastat;
• Dolak;
• Durogesic;
• Ibuklin;
• Ibuprofen;
• Indomethacin;
• Catadolone;
• Ketonal;
• Ketoprofen;
• Markain;
• MST Continuum;
• Nalbuphine;
• Naropin;
• Neurodolone;
• Nemux;
• Nimesil;
• Nurofen;
• Ketoprofen;
• Oxadol;
• Promedol;
• Protradon;
• Rapent;
• Ropivacaine;
• Stad;
• Tramadol;
• Tramal;
• Tremolin;
• Tramundine;
• Faspik;
• Febrofide;
• Flamadex;
• Flamax;
• Fleksen;
• Hyrumat;
• Cefephecon.

Response of a rheumatologist

Ketofril is an effective medicine. Its active substance ketorolac well relieves pain syndrome with exacerbation of various degenerative-dystrophic pathologies of the joints. I often prescribe it to patients who have an exacerbation of rheumatoid arthritis.The drug, like other non-steroidal anti-inflammatory drugs, has a large list of side effects, so it should only be taken as prescribed by the doctor, while strictly adhering to the prescribed dosages. It is important to understand that Ketofril does not treat the underlying disease, but simply relieves pain, making it easier for the patient to be in a state of therapy.

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