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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Dexketoprofen is a propionic acid derivative and nonsteroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory, and antipyretic properties. It is the (S)-enantiomer and active isomer of ketoprofen and works by blocking the action of cyclooxygenase. Dexketoprofen is indicated for short-term treatment of mild to moderate pain, including dysmenorrhea, musculoskeletal pain and toothache. It is available in topical and oral formulations (1).
Routes of administration
Published in Pamela E Macintyre, Suellen M Walker, David J Rowbotham, Clinical Pain Management, 2008
In surgical patients, oral ibuprofen arginine has a similar efficacy profile to intramuscular ketorolac, both being superior to placebo, 6[II] whilst in postcesarian section pain, the time to maximum analgesia of ibuprofen arginine is similar to intramuscular ketorolac.7[II] Feldene “melt,” a matrix of freeze-dried piroxicam in a fast dissolving excipient, rapidly dissolves in saliva and is swallowed as a solution. In a double-blind, randomized, double-dummy study, Feldene “melt” provided equivalent analgesia to rectal diclofenac when given 1 hour before surgery.8[II] Speed of absorption is also increased using a single isomer compared with a racemic mixture of the same NSAID. Median values for tmax are shorter (30 versus 75 minutes) and for Cmax are higher and less variable with dexketoprofen trometamol than for racemic ketoprofen.9[III] At least one clinical study has confirmed a rapid onset of analgesic action of dexketoprofen. Following removal of impacted third molars, the time to reduce pain by at least 50 percent was shorter in patients treated with oral dexketoprofen trometamol than in patients who had received oral ibuprofen (mean 0.9 versus 2.1 hours).10[II] There are a limited number of trials of the few coxibs that are licensed for postoperative pain relief. A Cochrane review has concluded that single-dose oral celecoxib is at least as effective as paracetamol for relieving postoperative pain, despite finding only two trials of celecoxib that met their inclusion criteria.11[I] A subsequent larger systematic review of 22 trials (2246 patients) concluded that preoperative oral coxibs (mainly celecoxib and rofecoxib) were effective in reducing postoperative pain, but were unable to draw any conclusions from three trials comparing coxibs with traditional NSAIDs.12[I]
Combined site-specific release retardant mini-matrix tablets (C-SSRRMT) for extended oral delivery of dexketoprofen trometamol: in vitro evaluation and single versus multiple doses pharmacokinetic study in human volunteers
Published in Drug Development and Industrial Pharmacy, 2019
Nabila M. Sweed, Emad B. Basalious, Samia A. Nour
Racemic ketoprofen is used as an analgesic and an anti-inflammatory agent, and is one of the most potent in vitro inhibitors of prostaglandin synthesis. The analgesic effect is due to the S (+)-enantiomer (dexketoprofen), while the R (–)-enantiomer has no analgesic activity. It was found that the separation of the R (–)-enantiomer from the racemic mixture results in doubling of the analgesic effect of dexketoprofen [1]. Dexketoprofen trometamol (DT), a water soluble salt of (S)-(+)-2-(3-benzoylphenyl)propionic acid, is well absorbed orally throughout the gastrointestinal tract [2]. The usual dose of dexketoprofen is 25 mg (equivalent to 36.9 mg of DT) every 8 h or 12.5 mg every 4–6 h. A maximum daily dose of 75 mg (equivalent to 110.7 mg of DT) may be applicable [3]. DT peak plasma levels are reached within 0.25–0.75 h. The current oral dexketoprofen tablets present two main drawbacks. The first is rapid elimination which necessitates three times daily administration due to the short elimination half-life of the drug (1.2–2.5 h) [3,4]. The second is gastrointestinal disturbances, such as gastrointestinal discomfort, nausea, diarrhea, and gastrointestinal bleeding [5]. The oral dosage form is the most widely accepted route of administration [6]. Therefore, a once-daily sustained-release oral formulation of DT can reduce the frequency of administration, adverse effects, and improve patient compliance.
A review of dexketoprofen trometamol in acute pain
Published in Current Medical Research and Opinion, 2019
Few studies of parenteral dexketoprofen trometamol for the treatment of acute pain reported adverse event data versus placebo (and all involved multiple doses); the findings were consistent with those for the oral formulation45,47. In studies of parenteral dexketoprofen trometamol in patients with renal colic (none of which had a placebo group) the authors rated tolerability as good and no new safety signals were reported. A systematic review of short-duration studies of oral and parenteral dexketoprofen trometamol in dental and postoperative pain, which included single- and multiple-dose studies (generally <2 days’ duration) found that 2.5% of dexketoprofen trometamol recipients were withdrawn due to adverse events compared with 1.8% of those given placebo86. The most common adverse events reported for dexketoprofen trometamol in acute pain studies were generally gastrointestinal (e.g. nausea, vomiting, constipation) or related to the central nervous system (e.g. drowsiness/tiredness, headache and dizziness)17–20,25,37,42,45,47.
Less painful ESWL with ultrasound-guided quadratus lumborum block: a prospective randomized controlled study
Published in Scandinavian Journal of Urology, 2019
Ahmet Murat Yayik, Ali Ahiskalioglu, Haci Ahmet Alici, Erkan Cem Celik, Sevim Cesur, Elif Oral Ahiskalioglu, Saban Oguz Demirdogen, Omer Karaca, Senol Adanur
Visual analogue scales (VAS) were described before pre-medication. Both groups received 50 mg of dexketoprofen intravenously 30 min before the procedure. The patients were then placed on the ESWL table and monitored. The patients were started with 2–4 L/min O2 and received 1 mg midazolam and 50 mcg fentanyl intravenously. During the procedure, VAS scores were investigated at the 5th, 10th, 15th, 20th, and 25th min, and 25 mcg fentanyl was administered for VAS scores of 4 and higher. Any perioperative side-effects (such as nausea, vomiting, itching and desaturation) were recorded and patient satisfaction was evaluated after the procedure.