ketoprofen: clinical use

Prescribing considerations

• Confirm that UV-avoidance measures are practical and understood.
• Consider increased NSAID-hypersensitivity risk with asthma plus chronic rhinitis, sinusitis or nasal polyps.
• Use caution in cardiac, hepatic or renal impairment because systemic and renal reactions can occur despite low absorption.
• Ketoprofen can mask worsening infection; reassess persistent or deteriorating symptoms.

Contraindications and cautions

• Ketoprofen, aspirin or other NSAID hypersensitivity
• Previous photosensitivity or relevant skin allergy, including reactions to ketoprofen, tiaprofenic acid, fenofibrate, UV blockers or perfumes
• Expected sunlight, sunbed or other UV exposure to the treated area
• Third trimester of pregnancy
• Eczema, acne, infected lesions, open wounds or other pathological skin changes at the application site
• Application to eyes, mucous membranes, anal or genital areas, or beneath occlusive dressings

Monitoring

• Check for rash, contact dermatitis and photosensitivity; stop immediately if any skin reaction occurs.
• Review persistent or worsening symptoms, particularly where infection is possible.
• Assess for systemic hypersensitivity or renal effects when exposure is extensive or organ function is impaired.

Clinical pharmacology

A propionic-acid NSAID that inhibits cyclooxygenase-mediated prostaglandin synthesis. Systemic passage from the gel is approximately 5% of that from oral formulations.

Formulation and product differences

• The prescription-only cutaneous gel contains ethanol and lavender essential oil.
• The formulation is flammable and must be kept away from naked flames.
• Topical delivery provides gradual absorption and substantially lower systemic exposure than oral ketoprofen.

Gel

Route: Cutaneous

Strengths: 2.5%, 2.5% w/w