Dexketoprofen

How it works

It non-selectively inhibits cyclo-oxygenase (COX-1 and COX-2), reducing prostaglandin synthesis and thereby producing analgesic, anti-inflammatory and antipyretic effects.

Prescribing in practice

• Like other NSAIDs it carries risks of gastrointestinal ulceration and bleeding, cardiovascular and renal adverse effects, so it should be used at the lowest effective dose for the shortest duration.
• Contraindicated in active or previous peptic ulceration/GI bleeding, severe heart failure, significant renal impairment and in late pregnancy.
• Use caution with other NSAIDs, anticoagulants, antiplatelets, and drugs affecting renal function, and consider gastroprotection in at-risk patients per current prescribing references.

Monitoring

Assess renal function, blood pressure and for gastrointestinal symptoms, particularly in older or at-risk patients and with longer use.

Counselling the patient

• Take with or after food and use it only for short-term pain relief.
• Stop and seek advice if you develop indigestion, black stools or signs of gastrointestinal bleeding.
• Avoid taking other anti-inflammatory painkillers (including over-the-counter ones) at the same time.

Evidence & guidelines

NSAID gastrointestinal, cardiovascular and renal risks are well established and reflected in MHRA advice and the SPC.