Fenoprofen

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DRUGS
Fenoprofen

Fenoprofen is a nonsteroidal anti-inflammatory drug (NSAID). It may block certain substances in the body that are linked to inflammation. It is used for treating various inflammatory conditions like rheumatoid arthritis, osteoarthritis and also used for treating mild to moderate pain.

Introduction

Fenoprofen is a nonsteroidal anti-inflammatory drug (NSAID). It may block certain substances in the body that are linked to inflammation. It is used for treating various inflammatory conditions like rheumatoid arthritis, osteoarthritis and also used for treating mild to moderate pain.

Pharmacological class: NSAID

Indications

  • Osteoarthritis
  • Rheumatoid arthritis
  • Mild to moderate pain

Pharamcological Action

Fenoprofen, a propionic acid derivative, reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes resulting in decreased formation of prostaglandin precursors. 

Dosage

Osteoarthritis, Rheumatoid arthritis

Adult: 300-600 mg, 3-4 times daily. Max: 3.2 g/day.

 

Mild to moderate pain

Adult: 200 mg 4-6 hourly as needed. Max: 3.2 g/ day.

Pharmacokinetics

Fenoprofen is rapidly and almost completely absorbed from the GI tract and shows 85% bioavailability. It takes 1-2 hours to achieve peak plasma concentration. It exhibits plasma protein binding of 99%. Fenoprofen undergoes hepatic metabolism to 4'-hydroxyfenoprofen and is excreted via urine as glucuronide and glucuronide of hydroxylated fenoprofen and feces. Plasma half-life is approximately 3 hours.

Contraindications

  • Contraindicated in patients with hypersensitivity to aspirin or other NSAIDs
  • Contraindicated in patients receiving treatment of perioperative pain in the setting of CABG surgery
  • Contraindicated in patients with severe renal impairment
  • Contraindicated in 3rd trimester of pregnancy.

Drug Interactions

  • Increased risk of GI bleeding with anticoagulants, bisphosphonates, clopidogrel, oral corticosteroids, dabigatran, rivaroxaban, salicylates and SSRIs.
  • May reduce antihypertensive effect of ACE inhibitors.
  • Increased nephrotoxicity with ciclosporin.
  • Decrease in plasma half-life with phenobarbital.
  • May reduce the natriuretic effects of loop and thiazide diuretics.
  • May increase toxicity of lithium and methotrexate. Increased risk of CNS stimulation and seizures with quinolones.

Side effects

Common (affecting between 1 in10 to 1 in 100)

  • Headache
  • Abdominal Pain
  • Blurred vision

Uncommon (affecting 1 in 100 to 1 in 1000)

  • Difficult breathing
  • Hearing loss
  • Itching on skin
  • Rapid weight gain
  • Rash
  • Shortness of breath
  • Tightness in chest
  • Tingling of hands or feet
  • Unusual weight gain or loss
  • Wheezing

Very rare (affecting less than 1 in 10,000)

  • Back, leg, or stomach pains
  • Black or red, tarry stools
  • Bloody stools
  • Burning feel in chest or stomach
  • Coughing up blood
  • Dark urine
  • Dry mouth
  • Fever with or without chills
  • Hoarseness
  • Increased blood pressure
  • Nosebleeds
  • Redness of skin
  • Swelling of hands, legs, and feet
  • Swollen or painful glands
  • Yellow eyes or skin

Precautions

  • Avoid in patients with known CV disease or risk factors for CV disease
  • Avoid in patients with history of upper GI disease
  • Avoid in patients with renal or hepatic impairment.

Clinic Evidence

In a double-blind crossover study involving the treatment of soft-tissue rheumatism in 50 patients, fenoprofen calcium 600 mg, four times daily, and ibuprofen 400 mg, four times daily, were compared. After 7 days, there was no significant difference between the efficacy of the two drugs with respect to 'pain at rest', 'pain on movement', 'tenderness' or 'sleep disturbance' but fenoprofen was significantly better when considering 'limitation of movement' and 'the physician's assessment of the severity of the condition'. Combining data from weeks 1 and 2 of treatment, 14 days fenoprofen treatment brought about significant improvements in all of the above parameters. Ibuprofen did not significantly improve 'pain at rest', but did improve the other parameters.1

References

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