Ketanov®

Pharmachologic effect:

analgesic, anti-inflammatory, antipyretic
Ketanov is a NSAID. It has a strong analgesic effect and also has a moderate anti-inflammatory antipyretic action. The mechanism of action of Ketanov is associated with nonselective inhibition of activity of COX1 and COX2, which play an important role in the pathogenesis of pain, inflammation and fever. The power of the analgesic effect of Ketanov is comparable to morphine, greatly exceeds the other NSAIDs.
After oral administration the analgesic effect of Ketanov is marked after 1 h, the maximum effect is achieved in 2-3 hours.

Indications:

Treatment of acute pain of mild to moderate severity:
injury, pain in the postpartum and postoperative, dental pain, cancer, myalgia, arthralgia, neuralgia, sprains, sciatica, sprains, rheumatic diseases.

Contraindications:

Hypersensitivity to Ketanov, "Aspirin" triad (a combination of asthma, recurrent nasal polyposis, and paranasal sinuses and intolerances to ASA , also to drugs of pirazolon group), hypovolemia (irrespective the cause), erosive and ulcerative lesions of the gastrointestinal tract in the acute stage, anticoagulation (including hemophilia), bleeding or a high risk of their development, severe renal insufficiency (plasma creatinine greater than 50 mg / l), liver failure, lactation, childbirth, children's age (up to 16 years - the safety and efficacy have not been established).

Use with caution:

hypersensitivity to other NSAIDs, asthma, the presence of factors that increase the GI-toxicity: smoking, alcoholism, and cholecystitis; postoperative period, heart failure, edematous syndrome, hypertension, renal dysfunction (plasma creatinine below 50 mg / l), cholestasis, sepsis, active hepatitis, SLE, simultaneous with others. NSAIDs, advanced age (over 65 years), pregnancy.

Side effects:

Digestive system: diarrhea, gastralgia; Rarely : stomatitis, constipation, flatulence, vomiting, feeling of fullness, loss of appetite, nausea, erosive and ulcerative lesions of the gastrointestinal tract (including perforation and / or bleeding - abdominal pain, spasm or a burning sensation in the epigastric region, blood in the stool or melena, vomiting blood or "coffee type grounds ", nausea, heartburn, etc.), hepatitis, cholestatic jaundice, hepatomegaly, acute pancreatitis.
Urinary system: rarely : acute renal failure, back pain, hematuria, azotemia, renal failure, hemolytic anemia, thrombocytopenia purpura, increased frequency of urination, increased or decreased amount of urine, nephritis, edema of renal origin
Senses: Rare: tinnitus, hearing loss, visual disturbances (including blurred visual perception).
Respiratory system: rarely - bronchospasm or dyspnea, rhinitis, pulmonary edema, laryngeal edema (shortness of breath, difficulty breathing).
CNS: headache, dizziness, drowsiness, Rarely: aseptic meningitis (fever, severe headache, cramps, stiffness in the neck muscles and / or back), hyperactivity (mood changes, anxiety), hallucinations, depression, psychosis, fainting state.
Cardio vascular system: increased blood pressure
Hematopoiesis: rarely: eosinophilia, anemia, leucopenia
Hemostasis: rarely: bleeding from surgical wounds, nosebleeds, rectal bleeding
Skin: rarely : skin rash (including maculopapular rash), purpura, rarely - exfoliative dermatitis (fever with chills or without redness, induration or peeling of the skin, enlargement and / or tenderness of the tonsils), urticaria, malignant exudative erythema (syndrome Stevens-Johnson), toxic epidermal necrolysis (Lyell's syndrome).
Allergic reactions: rarely: anaphylaxis or anaphylactoid reactions (urticaria, changes in skin color, skin rash, itchy skin, tachypnea or dyspnea, edema of the eyelids, periorbital edema, shortness of breath, difficulty breathing, heaviness in the chest, wheezing)
Other: edema (finger, face, legs, ankles, feet, increased body weight); rarely : sweating, swelling of the tongue, fever.

Interaction:

Co-administration with paracetamol increases the nephrotoxicity of Ketanov.
Reception with other NSAIDs, corticosteroids, ethanol, corticotropin increases the risk of gastrointestinal ulceration of the mucous membranes and the development of gastrointestinal bleeding.
Simultaneous taking with anticoagulant drugs - derivatives of coumarin and indandiona, heparin, thrombolytics (alteplase, streptokinase, urokinase), antiplatelet drugs, cephalosporins, valproic acid and ASA increases the risk of bleeding.
Ketanov reduces the effect of antihypertensive and diuretic drugs (reduces the synthesis of Pg in the kidneys).
Appointment of the drug together with methotrexate increases the hepato-and nephrotoxicity (sharing their purpose is only possible when using low doses of the methotrexate and the control of its concentration in plasma).
In the appointment of other nephrotoxic drugs Ketanov increases the risk of nephrotoxicity.
Drugs that block tubular secretion - reduce the clearance of Ketanov and increase its concentration in plasma.
Ketanov increases the effect of narcotic analgesics.
Myelotoxic drugs increase the expression of hemato-toxity of Ketanov.

Dosing and Administration:

To patients 16 to 64 years old with a body weight exceeding 50 kg - the recommended dose is 20 mg for the first reception, further 10 mg four times a day but not more than 40 mg / day.
Adult patients weighing less than 50 kg or with renal insufficiency - 10 mg in the first reception, further 10 mg four times a day.
The maximum daily dose for oral administration is 40 mg.
Tablets are taken not more than 5-7 days.

Special instructions:
Used with caution in patients with impaired liver and kidney function, chronic heart failure, arterial hypertension, in patients with erosive and ulcerative lesions of the gastrointestinal tract and bleeding from the gastrointestinal tract in history.
Ketorolac should be used with caution postoperatively in cases that require particularly careful hemostasis (including after resection of the prostate, tonsillectomy, cosmetic surgery), as well as in elderly patients, because the half-life of ketorolac is prolonged and plasma clearance may be reduced. In this category of patients Ketorolac is recommended at a dose close to the lower limit of the therapeutic range. When the symptoms of liver disease, skin rash, eosinophilia ketorolac should be abolished. Ketorolac is not indicated for use in chronic pain syndrome.
If during treatment with ketorolac appear drowsiness, dizziness, insomnia or depression, you need to take special care during the classes of potentially hazardous activities that require increased attention and psychomotor speed reactions.

Storage:

The temperature is not above 25 °C (77 °F)

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