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Severe heart failure.

Severe liver failure

Severe kidney failure

Pain before and after surgery in coronary artery surgery (CABG).

Caution when using

Using the lowest dose effectively in the shortest time helps minimize unwanted effects.

Because of the risk of bleeding, not using ketoprofen to treat pain associated with discreet bleeding (pain after the accident) or pain associated with trauma in the central nervous system.

impaired cardiovascular, kidney and liver function

When starting to treat, closely monitor kidney function in patients with heart failure, abnormalities of liver function, cirrhosis and kidney damage, patients are taking diuretics, patients with chronic renal insufficiency, especially in the patient who is the elderly. In these patients, using ketoprofen can reduce blood to the kidneys due to prostaglandin inhibition and lead to kidney decomposition.

NSAID drugs have also been reported to toxicity in many different forms and this can lead to interstitial nephritis, nephrotic syndrome and kidney failure.

In patients with abnormal liver function tests or a history of liver disease, it is advisable to evaluate the periodic transaminase level, especially when long -term treatment. Jaundice and rare hepatitis have been described when using ketoprofen.

Effects on cardiovascular and cerebrovascular

Need to monitor and advise appropriately for patients with a history of hypertension and/or have mild congestive heart failure to medium because the water retention and edema have been reported when the therapy coordinates with NSAID.

Clinical and epidemiological testing data shows that the use of some NSAIDs (especially when taking high doses in a long time) may be related to an increase in the risk of arterial thrombosis (such as myocardial infarction, stroke). There is no enough data to eliminate the risk due to ketoprofen.

Patients with hypertension, congestive heart failure, ischemia, untreated peripheral vascular disease and/or brain blood vessels should only be treated with ketoprofen after careful consideration. Similarly, it is advisable to consider before starting long -term treatment in patients at risk of cardiovascular disease (e.g. hypertension, increased blood fat, diabetes, smoking).

Respiratory disorders

Patients with asthma with chronic rhinitis, chronic sinusitis, and/or nasal polyps are at risk of allergies to aspirin and/or higher NSAID drugs. When using this medication can cause asthma attacks or bronchospasm, especially in people who are allergic to aspirin or nsAID drugs.

Bleeding, ulcers and digestive puncture

Hemorrhage, ulcers and digestive perforation can lead to deaths that have been reported to all NSAID drugs at any time of the treatment process, with or without warning symptoms or a history of serious events in the digestive tract.

Some evidence of epidemiology shows that Ketoprofen may be related to a high risk of serious digestion, as well as other NSAID drugs, especially in high doses.

The risk of bleeding, ulcers and digestive perforation when increasing the dose of NSAID drugs, in patients with a history of ulcer, especially when bleeding or perforation, and in the elderly.

Older patients start treatment with the lowest possible dose. Treatment in combination with digestive protection drugs (such as Misoprostol or proton pump inhibitors) should be considered in these patients, and for patients to use simultaneously with low -dose aspirin, or other drugs that increase the risk for the digestive tract. Ketoprofen should not be used for patients with a history of gastrointestinal ulcer.

Use NSAID caution in patients with a history of digestive disease (such as ulcerative colon, Crohn's disease) because it can cause disease outbreaks.

Patients with a history of gastrointestinal toxicity, especially when older, should report abdominal abdominal signs (especially digestive bleeding), in the first stage of treatment.

Be cautious when used for patients who use simultaneous drugs at risk of ulcers or other bleeding such as oral corticosteroids, or anticoagulants such as warfarin, selective inhibitors of Serotonin reabsorption or platelet anti -platelet -like anti -platelet -like drugs.

When bleeding or gastrointestinal ulcers in patients using ketoprofen, drugs should be discontinued.

used for children

Safety and effectiveness in children have not been recorded.

Used for older people

As with any type of NSAID, should be careful when treating the elderly (65 years or older).

The ability to drive and operate machines

using ketoprofen can make patients feel dizzy, drowsiness and affect vision. Therefore, patients should not drive or operate the machine, unless the patient assesses the effect of the drug on their bodies, as well as the patient can perform those activities safely.

Pregnancy

Prostaglandin synthesis inhibitors can adversely affect pregnancy and/or embryo/fetal development. Data from epidemiological studies shows an increase in the risk of miscarriage, heart defects and abdominal cracks (gastroschisis) after using Prostaglandin synthetic inhibitors at the beginning of pregnancy.

The absolute risk of cardiovascular defects increases from less than 1% to about 1.5%. This risk is thought to be due to increased dose and treatment time. In the first three months and three months between pregnancy, ketoprofen should not be used if not needed. If you have to use ketoprofen for women who are trying to conceive or in the first three months and three months in the middle of pregnancy, the dose should be kept low and the treatment time is as short as possible.

During the last three months of pregnancy, all Prostaglandin synthetic inhibitors can cause the fetus: