Top 50 | 10pcs

✔️ Dosage & Administration

Anti-inflammatory dosage:

Initial: 150–300 mg daily in 3 divided doses

Maintenance: 100–200 mg daily; may be given twice daily or as a once-daily formulation

Maximum dose: 300 mg/day

Pain & Dysmenorrhea:

25–50 mg every 6–8 hours as needed

Do not exceed 300 mg/day
Take orally with sufficient fluids, preferably with food to minimize gastric irritation.

Elderly: Use lowest effective dose; increased susceptibility to side effects

Hepatic or Renal impairment: Reduce dosage and monitor closely

✔️ Side Effects:

Common and uncommon adverse effects include:

GI: Nausea, dyspepsia, abdominal pain, diarrhea, constipation, or peptic ulcer

CNS: Headache, dizziness, drowsiness, vertigo, paresthesia

Skin: Rash, pruritus, urticaria, photosensitivity

Cardiovascular: Edema, hypertension, exacerbation of heart failure

Hepatic/Renal: Elevated liver enzymes, rare hepatitis, nephritis, acute renal failure

Rare but serious: GI bleeding, anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis

✔️ Drug Interactions:

Avoid concomitant use with:

• Other NSAIDs (including COX-2 inhibitors) and high-dose salicylates → ↑ risk of GI bleeding and ulceration
• Anticoagulants (heparin, warfarin, ticlopidine, clopidogrel, dabigatran, apixaban, rivaroxaban, etc.) → ↑ bleeding risk
• Lithium → ↑ plasma lithium levels (monitor closely)
• Methotrexate (>15 mg/week) → ↑ hematologic toxicity
• Corticosteroids → ↑ GI ulceration/bleeding risk
• Diuretics, ACE inhibitors, or ARBs → ↑ risk of renal impairment
• Cyclosporin, Tacrolimus → ↑ nephrotoxicity
• SSRIs → ↑ risk of GI bleeding

Use with caution with:

• Hyperkalemia-promoting agents (e.g., potassium salts, heparins, trimethoprim)
• Antihypertensives → Possible reduction in efficacy
• Thrombolytics → ↑ bleeding risk
• Probenecid → ↓ Ketoprofen clearance

✔️ Top is contraindicated in patients with:

• Hypersensitivity to Ketoprofen, aspirin, or other NSAIDs
• Severe heart failure
• Active or history of peptic ulcer or GI bleeding/perforation
• Severe hepatic or renal impairment
• During the third trimester of pregnancy
• Rectal administration in patients with rectitis or a history of rectal bleeding

✔️ Pregnancy & Lactation:

First and second trimesters: Use only if clearly necessary; safety not established

Third trimester: Contraindicated due to risk of fetal harm

Lactation: Not recommended; Ketoprofen may pass into breast milk

✔️ Precautions & Warnings:

• Use cautiously in patients with GI disorders (ulcerative colitis, Crohn’s disease)
• Monitor renal function in patients with heart failure, cirrhosis, nephrosis, or dehydration
• May cause fluid retention and edema, particularly in hypertensive or elderly patients
• Can mask infection symptoms (e.g., fever) due to anti-inflammatory effects
• Long-term use requires liver function monitoring
• May impair female fertility; avoid in women attempting conception
• Discontinue if visual disturbances (blurred vision) occur

✔️ Storage:

Store below 30°C, protected from light.
Keep out of reach of children.
Dispense only on prescription of a registered physician.