Keto-A 100 mg/2 ml (IM Injection)

2 ml ampoule: ৳ 19.64 (2 x 5: ৳ 196.40)

Medicine Details

Category Details
Generic Ketoprofen oral injection
Company Acme laboratories ltd
Also available as
Keto a 50 mg tablet Keto a 100 mg tablet Keto a 100 mg suppository

Indications

  • Rheumatoid arthritis
  • Degenerative joint diseases
  • Musculoskeletal and joint disorders
  • Pain

Pharmacology

  • Non-steroidal anti-inflammatory drug (NSAID)
  • Analgesic
  • Antipyretic
  • Prostaglandin synthesis inhibition
  • Lysosomal membrane stabilization
  • Leukotriene synthesis inhibition
  • Antibradykinin activity
  • Centrally and peripherally acting analgesia
  • CNS prostaglandin synthesis suppression
  • Rapid and complete absorption from GI tract
  • 99% plasma protein binding
  • Extensive liver metabolism
  • Excretion in urine and faeces
  • Peak concentration after IM injection
  • 1.88-hour elimination half-life

Dosage

  • Anti-inflammatory starting dose: 150-300 mg/day
  • Maintenance dosage: 100-200 mg/day
  • Maximum daily dose: 300 mg
  • Pain and primary dysmenorrhea: 25-50 mg every 6-8 hours
  • Total daily dose not to exceed 300 mg

Administration

  • Oral forms to be taken with fluids
  • Preferably with food

Interaction

  • Not recommended drug associations
  • Increased risk of gastrointestinal ulceration and bleeding with other NSAIDs and high dose salicylates
  • Increased risk of bleeding with anticoagulants like heparin, vitamin K antagonists, platelet aggregation inhibitors, thrombin inhibitors, and direct factor Xa inhibitors
  • Risk of elevation of lithium plasma levels with lithium
  • Increased risk of haematologic toxicity of methotrexate
  • Medicinal products and therapeutic categories promoting hyperkalemia
  • Increased risk of gastrointestinal ulceration or bleeding with corticosteroids and diuretics
  • Compromised renal function with ACE inhibitors and Angiotensin II Antagonists
  • Increased risk for severe complications with nicorandil and NSAIDs
  • Possible pharmacokinetic interaction between ketoprofen and digoxin
  • Increased risk of nephrotoxicity with cyclosporin and tacrolimus
  • Full blood count monitoring with methotrexate at lower doses
  • Increased risk of bleeding with pentoxifylline
  • Increased risk of renal failure with tenofovir
  • Risk of decreased antihypertensive potency with antihypertensive agents
  • Increased risk of bleeding with thrombolytics
  • Marked reduction in the plasma clearance of ketoprofen with probenecid
  • Increased risk of gastrointestinal bleeding with selective serotonin reuptake inhibitors (SSRIs)

Contraindications

  • Hypersensitivity reactions
  • Severe heart failure
  • Active or history of peptic ulcer/hemorrhage
  • History of gastrointestinal bleeding or perforation related to previous NSAIDs therapy
  • Severe hepatic insufficiency
  • Severe renal insufficiency
  • Third trimester of pregnancy
  • Rectitis or history of proctorrhagia

Side Effects

  • Haemorrhagic anaemia
  • Agranulocytosis
  • Thrombocytopenia
  • Bone marrow failure
  • Haemolytic anemia
  • Leucopenia
  • Anaphylactic reactions
  • Depression
  • Hallucinations
  • Confusion
  • Headache
  • Dizziness
  • Somnolence
  • Paraesthesia
  • Aseptic meningitis
  • Convulsions
  • Dysgeusia
  • Vertigo
  • Vision blurred
  • Tinnitus
  • Exacerbation of heart failure
  • Atrial fibrillation
  • Hypertension
  • Vasodilatation
  • Vasculitis
  • Asthma
  • Bronchospasm
  • Dyspepsia
  • Nausea
  • Abdominal pain
  • Vomiting
  • Constipation
  • Diarrhoea
  • Flatulence
  • Gastritis
  • Stomatitis
  • Peptic ulcer
  • Exacerbation of colitis and Crohn’s disease
  • Gastrointestinal haemorrhage and perforation
  • Pancreatitis
  • Hepatitis
  • Transaminases increased
  • Rash
  • Pruritus
  • Photosensitivity reaction
  • Alopecia
  • Urticaria
  • Angioedema
  • Bullous eruption
  • Renal failure acute
  • Tubulointerstitial nephritis
  • Nephritic syndrome
  • Oedema
  • Hyponatremia
  • Hyperkalemia
  • Weight increased

Pregnancy & Lactation

  • Avoid use during first and second trimester of pregnancy
  • Contraindicated during the third trimester of pregnancy
  • Not recommended in nursing mothers

Precautions & Warnings

  • Give with care to patients with a history of gastrointestinal disease
  • Monitor renal function at the start of treatment
  • Caution in patients with heart failure, cirrhosis, and nephrosis
  • Caution in patients with infectious disease
  • Evaluate transaminase levels in patients with abnormal liver function
  • Discontinue treatment if visual disturbances occur
  • NSAIDs may impair female fertility
  • Reduce initial dosage in elderly patients
  • Careful monitoring for patients with hepatic impairment
  • Reduce initial dosage in patients with renal impairment

Use in Special Populations

  • Reduce initial dosage in elderly patients
  • Carefully monitor hepatic impairment patients
  • Reduce initial dosage in patients with renal impairment

Overdose Effects

  • Lethargy
  • Drowsiness
  • Nausea
  • Vomiting
  • Epigastric pain
  • No specific antidotes
  • Gastric lavage recommended
  • Symptomatic and supportive treatment

Therapeutic Class

  • Drugs for Osteoarthritis
  • Drugs used for Rheumatoid Arthritis
  • Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Storage Conditions

  • Protect from light
  • Store below 30°C
  • Do not use after expiry date
  • Keep out of the reach of children
  • To be dispensed only on prescription

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