Main Research Findings

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that has a high analgesic efficacy against inflammatory and nociceptive pain. 9 It is commonly used due to its rapid absorption, simple metabolism, high antinociceptive activity, and fast blood-brain barrier crossing. 9 However, ketoprofen can cause various side effects, which are the major factors affecting its popularity. 9 Dexketoprofen, the active enantiomer of racemic ketoprofen, has similar analgesic efficacy but causes fewer adverse effects than racemic ketoprofen. 8 One of the main limitations for racemic ketoprofen IV administration is venous irritation. 8 It has been claimed that dexketoprofen may cause less frequent and less severe injection pain than racemic ketoprofen. 8 Indeed, a study comparing the injection pain of IV administered racemic ketoprofen and dexketoprofen in elective surgical patients showed that dexketoprofen induced less injection pain than racemic ketoprofen. 8 Ketoprofen, when administered in conjunction with an opioid during pain management, prevents the development of opioid-induced hyperalgesia. 8 Ketoprofen has been approved for OTC use as an analgesic/antipyretic at doses of 75 mg versus the usual dose of < or = 300 mg daily. 4 However, epidemiological studies have consistently shown that ketoprofen at prescription doses has a higher relative risk of gastrointestinal complications than other NSAIDs. 4 Studies have shown that ketoprofen is well tolerated and effective in the treatment of patients with rheumatoid arthritis. 1 Ketoprofen has a significantly superior analgesic effect compared to placebo in patients with rheumatoid arthritis, with a similar incidence of adverse reactions. 1 Moreover, ketoprofen at a dose of 150 mg daily showed similar clinical effects to indomethacin 100 mg daily in 8 out of 10 indices, with indomethacin being slightly more effective in reducing pain severity and rescue drug count. 1 In another study, both 300 mg ketoprofen per day and 150 mg indomethacin per day had similar effects on patients' subjective improvement of pain. 2 Objectively, ketoprofen may be more effective in reducing the articular index, suggesting a superior analgesic effect. 2 Ketoprofen and carprofen given prior to orthopedic surgery were effective for postoperative pain relief in dogs. 5 Ketoprofen was more effective than carprofen in reducing the number of dogs requiring oxymorphone for pain relief and resulted in lower pain scores. 5 However, ketoprofen should not be used when noncompressible bleeding may be a problem due to its potential for prolonged bleeding time. 5 Ketoprofen lysine salt is a potent therapeutic approach to control post-surgery pain in children, and an alternative to other established drug regimens. 7 Ketoprofen lysine salt was more effective than paracetamol in reducing postoperative pain in children, with earlier onset and longer duration of the antinociceptive effect. 7 No adverse effects related to the treatment were observed. 7 Ketorolac, diclofenac, and ketoprofen are equally safe for pain relief after major surgery. 6 Ketoprofen has been shown to be effective in the management of severe postoperative pain. 3 Ketoprofen 100 mg was at least as effective as the combination of acetaminophen and oxycodone in reducing postoperative pain and its effects lasted longer, except for the first hour when the combination was superior. 3 Significantly more patients who took repeated doses of the combination had adverse effects than those who took either dose of ketoprofen. 3

Benefits and Risks

Benefits Summary

Ketoprofen is an effective analgesic for various types of pain, including inflammatory and nociceptive pain. 9 It has a rapid onset of action and a long duration of effect. 9 Ketoprofen has been shown to be effective in the treatment of rheumatoid arthritis, postoperative pain, and pain in children. 1 7 3 It is also effective in preventing opioid-induced hyperalgesia when administered with opioids. 8 Dexketoprofen, the active enantiomer of racemic ketoprofen, has similar analgesic efficacy but causes fewer adverse effects than racemic ketoprofen. 8

Risks Summary

Ketoprofen can cause various side effects, including gastrointestinal problems, such as ulcers and bleeding. 9 It can also cause venous irritation when administered intravenously. 8 Ketoprofen can prolong bleeding time, making it unsuitable for use in patients with noncompressible bleeding. 5

Comparison Between Studies

Commonalities Between Studies

Several studies have demonstrated the effectiveness of ketoprofen in managing pain. These studies have also highlighted the potential risks associated with ketoprofen, such as gastrointestinal complications and prolonged bleeding time.

Differences Between Studies

The studies investigated different aspects of ketoprofen, including its efficacy and safety in various populations (children, adults, dogs), its use in different clinical scenarios (postoperative pain, rheumatoid arthritis), and its effects in comparison to other medications.

Consistency and Contradictions in Results

The results of these studies are generally consistent, supporting the use of ketoprofen for pain management. However, it is important to acknowledge the potential risks associated with ketoprofen, particularly gastrointestinal complications and prolonged bleeding time. 9 5

Considerations for Real-World Application

While ketoprofen is an effective analgesic, its potential for side effects should be considered, especially for patients with gastrointestinal problems or those at risk of bleeding. Consultation with a healthcare professional is essential before using ketoprofen.

Limitations of Current Research

There is limited data on the long-term use of ketoprofen. Furthermore, research on the safety and effectiveness of ketoprofen in specific populations, such as children and pregnant women, is lacking.

Future Research Directions

Further research is needed to assess the long-term safety and efficacy of ketoprofen. Research on the safety and effectiveness of ketoprofen in specific populations is also necessary. Additionally, research on new formulations and administration methods to minimize the side effects of ketoprofen is highly desirable.

Conclusion

Ketoprofen is an effective analgesic for various types of pain, but it is important to be aware of its potential for side effects, such as gastrointestinal problems and prolonged bleeding time. Consultation with a healthcare professional is essential before using ketoprofen. Further research is needed to fully understand the long-term safety and effectiveness of ketoprofen, particularly in specific populations.