- November 9, 2018
- Other drugs
- Ksenia Fed
Every day, millions of people suffer from headaches, dental, joint or other pain. Of course, to get rid of it, you must first consult a doctor and identify the cause of this unpleasant symptom. But it is not always possible to quickly get an appointment with the necessary specialist. Often people have to endure pain for several days, and sometimes more, which can sometimes be quite difficult. Therefore, patients take painkillers. You can see dozens of different medicines on the pharmaceutical market, but how to choose the right one?
The nonsteroidal anti-inflammatory drug Ketonal DUO is quite popular. Instructions for using this product, its indications and contraindications, as well as patient reviews will be discussed in detail in this article.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Of all NSAIDs, it has the most powerful analgesic effect, comparable to the effect of morphine . The powerful analgesic effect is explained by peripheral and central mechanisms. Inhibits the synthesis of prostaglandins, inhibiting the activity of cyclooxygenase, inhibits the synthesis of bradykinin.
The central action is realized through a direct influence on the pain centers in the thalamus. Its anti-inflammatory activity is comparable to classical NSAIDs. It is quickly eliminated from the body, so it can be recommended to elderly patients without fear. The capsules have two types of pellets (yellow and white). The drug is quickly released from white and slowly from yellow pellets, which gives a quick and prolonged effect (up to 24 hours).
Pharmacokinetics
Well absorbed. The bioavailability of capsules is 90% and is not affected by food intake. The maximum concentration is achieved in 1.76 hours. Penetrates into the synovial fluid and significant concentrations remain in it for 30 hours, which ensures the elimination of pain for a long time. Metabolized in the liver, there are no active metabolites. T 1/2 - 2 hours. Mainly excreted by the kidneys and through the gastrointestinal tract. In case of liver failure, the concentration increases by 2 times, so the drug is prescribed in a minimum dose. In renal failure, clearance is reduced.
Release form and composition
Dosage form of release of Ketonal DUO - capsules with modified release: size No. 1; body – transparent, cap – blue; the capsules contain yellow and white pellets (10 pieces in blisters, 1–3 blisters in a cardboard pack).
Composition of 1 capsule:
- active substance: ketoprofen – 150 mg;
- auxiliary components: lactose monohydrate – 20 mg; croscarmellose sodium – 10 mg; povidone – 5 mg; microcrystalline cellulose – 34 mg; polysorbate-80 – 1 mg;
- capsule shell: titanium dioxide (E 171) – 0.9%; indigo carmine (E 132) – 0.4%; gelatin – up to 100%;
- pellet shell: colloidal silicon dioxide – 0.2 mg; talc – 0.2 and 1.760 mg; Eudragit RL 30 D [copolymer of methyl methacrylate, ethyl acrylate and trimethylammonioethyl methacrylate (2:1:0.2)] – 4.908 mg; Eudragit RS 30 D [copolymer of methyl methacrylate, ethyl acrylate and trimethylammonioethyl methacrylate (2:1:0.1)] – 4.908 mg; iron (III) oxide yellow (E 172) – 0.08 mg; triethyl citrate – 0.88 mg; polysorbate-80 – 0.008 mg.
Indications for use
- psoriatic arthritis;
- ankylosing spondylitis , gout ;
- rheumatoid arthritis;
- osteoarthritis
- Reiter's syndrome;
- post-traumatic pain;
- headache;
- bursitis , tendonitis ;
- neuralgia , radiculitis ;
- postoperative pain;
- pain relief in oncological practice;
- algomenorrhea.
Contraindications
- aspirin-induced bronchial asthma ;
- peptic ulcer in the acute stage;
- bleeding from the gastrointestinal tract;
- exacerbation of Crohn's disease , ulcerative colitis and other inflammatory bowel diseases;
- hemophilia;
- severe liver and kidney failure ;
- decompensated heart failure ;
- age up to 15 years;
- hypersensitivity to salicylates and other NSAIDs;
- pregnancy (III trimester).
Ketonal Duo should be prescribed with caution for severe cardiovascular diseases, arterial hypertension , dyslipidemia , peripheral arterial diseases, liver diseases, alcoholism , diabetes mellitus .
Taking the drug during pregnancy and lactation
Not all patients tolerate Ketonal DOU pain-relieving capsules well. Therefore, doctors do not recommend taking it to children under 15 years of age, as well as to older people. Pregnant women are also at risk. The fetus in the womb of the expectant mother is negatively affected by inhibition of prostaglandin synthesis. Scientists conducted a study proving that taking the drug in the early stages can cause miscarriage. Also, when using the drug during pregnancy, the risk of developing heart disease in the child increases.
Therefore, taking capsules during the first and second trimester is not recommended. They are prescribed only if the likely benefits of taking them will be significantly higher than the possible risks of complications. In the third trimester, the use of capsules is strictly contraindicated. The fact is that their active substance can provoke a weakening of the labor activity of the uterus. In rare cases, it causes premature closure of the ductus arteriosus.
No studies have been conducted to prove the safety of taking Ketonal DUO during breastfeeding. Doctors cannot yet say for sure whether ketoprofen is excreted in mother’s milk. Therefore, during lactation it is recommended to avoid taking capsules. If you nevertheless decide to take the drug, then you need to switch the child to artificial formula.
Side effects
Common adverse reactions:
- nausea, diarrhea or constipation , bloating, abdominal pain, vomiting, dry mouth;
- headache;
- irritability, fatigue, sleep disturbance, nightmares;
- decreased platelet aggregation;
- itching, urticaria .
Rarely found:
- ulceration and perforation of the gastrointestinal mucosa, bleeding (with long-term use of large doses);
- migraine , polyneuropathy ;
- hallucinations , speech disorder;
- tinnitus, blurred vision, change in taste, conjunctivitis ;
- tachycardia , edema, arterial hypertension ;
- anemia , agranulocytosis ;
- interstitial nephritis , hematuria (with long-term use of NSAIDs in combination with diuretics), nephrotic syndrome;
- angioedema , rhinitis , bronchospasm ;
- hemoptysis, metrorrhagia .
special instructions
When carrying out long-term therapy, monitoring of blood status and renal/hepatic function is required, especially in elderly patients.
Against the background of arterial hypertension and cardiovascular diseases, which can lead to fluid retention in the body, taking Ketonal DUO requires caution and more frequent monitoring of blood pressure.
It is necessary to take into account that the drug can mask the signs of infectious diseases.
Impact on the ability to drive vehicles and complex mechanisms
When driving vehicles, it is necessary to take into account the patient’s individual response to the therapy.
Ketonal Duo tablets, instructions for use (Method and dosage)
There are various dosage forms of the drug: coated tablets (50 mg), forte tablets (100 mg), prolonged-release retard tablets (150 mg), Ketonal Duo (150 mg) and Ketonal Uno (200 mg).
Tablets 50 mg are taken one 3-4 times a day, long-acting tablets 1 time a day. The dose of Ketonal Duo and Ketonal Uno for adults is 1 capsule per day. It must be remembered that the maximum dose is 300 mg. For short-term use, it is permissible to take 1 capsule (150 mg) every 12 hours.
The drug is taken after meals with water or milk. To reduce gastrointestinal complications, you can take proton pump blockers ( Omez , Rabeprazole , Lansoprazole ).
Instructions for use of Ketonal Duo contain a warning that during treatment it is necessary to monitor kidney and liver function and blood condition. Some caution must be observed with hypertension, since NSAIDs lead to fluid retention.
Symptoms and treatment of overdose
When taking more than 200 mg of the active substance per day, an overdose may occur. It can be identified by the corresponding symptoms that are characteristic of all NSAIDs. Patients begin to complain of severe nausea, which over time develops into vomiting. However, in especially severe cases it can be bloody. A person begins to experience severe stomach pain, and melena appears - unformed black stool with an unpleasant odor. If you do not seek help from a doctor in time, the symptoms begin to intensify. The patient is diagnosed with impaired consciousness and respiratory depression. Convulsions appear, and subsequently severe renal failure develops, since the organs cannot cope with the removal of large amounts of the active substance from the body.
The instructions for using Ketonal DUO tablets indicate that in case of an accidental overdose, it is necessary to immediately perform a gastric lavage and then give the patient activated charcoal to slow down the absorption of the drug. You should also seek help from a doctor. Specialists will prescribe symptomatic therapy to the patient, usually taking drugs that reduce the secretion of the stomach walls. When diagnosing kidney failure, it is necessary to perform hemodialysis to help the body remove ketoprofen from the body faster.
Interaction
Weakens the effect of diuretics and antihypertensive drugs , enhances the effects of oral hypoglycemic and anticonvulsant drugs .
Increases the blood concentration of methotrexate , lithium preparations , calcium channel blockers , cardiac glycosides , cyclosporine .
Adverse effects from the gastrointestinal tract intensify when used simultaneously with GCS and other NSAIDs .
The risk of bleeding occurs when anticoagulants , thrombolytics , and antiplatelet agents .
When co-administered with diuretics and ACE inhibitors, there is a risk of renal dysfunction.
NSAIDs reduce the effectiveness of estrogens ( Mifepristone ), so NSAIDs are prescribed 12 days after the end of treatment with this drug.
Lethal dose of the drug
It is believed that a daily dose exceeding 300 mg is hazardous to health, and death can occur after a single dose of 800-1000 mg or more - individually, depending on what other medications the patient is taking. The lethal dose will be less if there is impaired liver function, kidney function, low blood pressure, or heart failure.
Such cases are extremely rare, because such an overdose can occur either through accidental, unconscious ingestion of capsules by children, or deliberate use for suicidal purposes.
Analogs
Level 4 ATC code matches:
Artrum
Brustan
Nurofen Plus
Nurofen Express
Nurofen Forte
Nurofen Express Lady
Nurofen for children
Nurofen
Ibuprom
Ibuprofen
Advil
Mig 400
Has
Ketoprofen
Vimovo
Naproxen
Flexen
Nalgesin
Flamax
Novigan
Capsules: Flexen , Ketonal , Artrosilene .
Tablets: Flamax Forte , Ketoprofen Forte , Ketonal Retard .
Reviews about Ketonal Duo
A variety of dosage forms (capsules, ampoules, suppositories, retard tablets, forte) allows you to choose the most effective route of administration and select an adequate dosage.
Ketoprofen is an effective remedy for the treatment of pain (postoperative and oncological), as evidenced by reviews of Ketonal Duo capsules. In oncology, it is highly effective in relieving pain that accompanies bone metastases. It is often used to relieve an acute attack of migraine, various diseases of the musculoskeletal system, and algodismenorrhea. In general, Ketonal Duo was well tolerated; side effects occurred with long-term use. The most common symptoms were diarrhea, abdominal pain, exacerbation of peptic ulcer disease and chronic colitis.
Ketonal and coronavirus
Ketonal has an analgesic, anti-inflammatory and antipyretic effect. The properties of this drug have raised many questions among patients about COVID-19. Coronavirus spreads through airborne droplets. Anyone who comes into contact with an infected person can get sick. A characteristic symptom of the virus is a very high temperature, so many people would like to know whether Ketonal will be effective against coronavirus. The substance contained in it will certainly reduce the temperature, but one cannot be sure that the patient will defeat the pathogen. Does not have typical antiviral activity.
Ketonal Duo price, where to buy
You can buy the drug in Moscow at any pharmacy. The price of Ketonal Duo in capsules 150 mg No. 30 ranges from 234 rubles. up to 261 rub.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Ketonal duo caps.
with mod. free 150 mg No. 30Lek dd/Novartis Neva LLC SI RUB 213 order
Pharmacy Dialogue
- Ketonal Duo (caps. 150 mg No. 30)Lek
RUB 244 order
show more
Pharmacy24
- Ketonal Duo 150 mg No. 20 capsules Lek pharmaceutical company d.d., Slovenia
179 UAH order
PaniPharmacy
- Ketonal duo capsule Ketonal DUO capsules 150 mg No. 20 Slovenia, Lek
192 UAH order
show more
Analogues of the drug according to ATC codes:
ARTHROZILENE ARTHROZILENE BYSTRUMCAPS KETONAL KETONAL KETONAL UNO KETOPROFEN OKI OKI FLAMAX FLEXEN FLEXEN All
Before using KETONAL DUO, you should consult your doctor. These instructions for use are for informational purposes only. For more complete information, please refer to the manufacturer's instructions.
