Dexketoprofen

# Overview
Dexketoprofen is a non-steroidal anti-inflammatory drug.  It is manufactured by Menarini, under the tradename Keral.  It is available in the UK, as dexketoprofen trometamol, as a prescription-only drug and in Latin America as Enantyum, produced by Menarini. Also, in Italy and Spain it is available as an over the counter-drug under the tradename respectively Enantyum, Ketesgel. Both in Lithuania and Estonia it is available as over the counter-drug under tradename Dolmen. In Mexico it is available in tablet form as "Stadium" made by Menarini in Luxemburg.

# Indications
Short-term treatment of mild to moderate pain, including dysmenorrhoea.

# Pharmacology
Dexketoprofen belongs to a class of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). It works by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in the production of chemicals in the body called prostaglandins. Prostaglandins are produced in response to injury or certain diseases and would otherwise go on to cause swelling, inflammation and pain. By blocking cyclo-oxygenase, dexketoprofen prevents the production of prostaglandins and therefore reduces inflammation and pain. Along with Peripheral analgesic action it possesses central analgesic action.

# Warning
- This medicine may cause dizziness and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
- This medicine is not for long term use

# Use with caution in
- Decreased heart function
- Disorders involving the formation of blood cells (haematopoietic disorders)
- Elderly people
- Excess retention of water in the body tissues (fluid retention)
- History of allergies
- Long-term inflammation of skin and some internal organs (systemic lupus erythematosus)
- Low volume of circulating blood (hypovolaemia)
- Mild to moderately decreased liver function
- Mildly decreased kidney function
- Syndrome with symptoms of systemic lupus erythematosus, scleroderma, polymyositis, and Raynaud's phenomenon (mixed connective tissue disease)

# Not to be used in
- Active bleeding
- Allergy to any of its ingredients
- Allergy to aspirin or other medicines in this class
- Asthma or history of asthma
- Bleeding disorders
- Bleeding from the stomach or intestines
- Breastfeeding
- Children
- Crohn's disease
- History of stomach or duodenal ulcers or indigestion
- Inflammation of the bowel and back passage
- Inherited tendency to bleed (haemorrhagic diathesis)
- Moderate to severely decreased kidney function
- Peptic ulcers
- Pregnancy
- Severe heart failure
- Severely decreased liver function

# Dose
In the USA:
Adult: 12.5 mg of ketoprofen  every 46 hours as needed, or 25 mg every 8 hours as needed; max 75 mg daily.  Elderly: initially max 50 mg daily as needed.  Child: not recommended.
In Europe:
As prescribed, the dosage is variable being consistent with the nature, severity and duration of the pain episode. Currently the prescribed amount is 25 mg every 8 hours, although the daily dosage should not exceed 75 mg. In elderly patients, light to moderate liver and renal failure, the maximum dosage is set at a maximum of 50 mg/24h. Dexketoprofen is currently not prescribed to children under the age of 18.

# Citations