dexketoprofen trometamol: clinical use

Prescribing considerations

• Assess gastrointestinal, renal, hepatic and cardiovascular risk, hydration, allergy history and interacting medicines before prescribing.
• Older people and patients with mild renal or hepatic impairment require particular caution and close review.
• Consider gastroprotection where gastrointestinal risk is increased.
• Dexketoprofen can mask infection symptoms; reassess persistent or worsening fever and pain.

Contraindications and cautions

• Hypersensitivity to dexketoprofen, another NSAID or an excipient, including previous NSAID-triggered asthma, bronchospasm, urticaria or angioedema
• Active or previous gastrointestinal bleeding, ulceration or perforation, chronic dyspepsia, Crohn's disease or ulcerative colitis
• Active bleeding, bleeding disorders or haemorrhagic diathesis
• Severe heart failure, moderate-to-severe renal impairment, or severe hepatic impairment
• Severe dehydration
• Previous ketoprofen- or fibrate-associated photoallergic or phototoxic reaction
• Third trimester of pregnancy and breastfeeding

Monitoring

• Use clinical judgement to monitor blood pressure, renal function, full blood count and liver function according to risk factors and treatment context.
• Monitor for gastrointestinal bleeding, oedema, worsening heart failure, renal impairment, hypersensitivity and severe skin reactions.
• With relevant interacting medicines, monitor renal function, blood counts, anticoagulation or medicine concentrations as appropriate.

Clinical pharmacology

Dexketoprofen is the pharmacologically active S-(+) enantiomer of ketoprofen, supplied as the trometamol salt. It inhibits COX-1 and COX-2, is highly protein bound, undergoes glucuronide conjugation and is mainly eliminated renally.

Formulation and product differences

• The selected UK product is a white, round, scored film-coated tablet that can be divided into equal halves.
• Food delays the rate of absorption without changing overall exposure.
• The tablet is essentially sodium-free.

Tablet

Route: Oral

Strengths: 25 mg