From the Guidelines
Dexketoprofen trometamol should be used with caution due to its potential gastrointestinal risks, and its use should be limited to the acute phase of pain, with a maximum treatment duration of 3-5 days, as recommended by recent studies 1.
Indications and Dosage
Dexketoprofen trometamol is a non-steroidal anti-inflammatory drug (NSAID) used to treat acute pain of mild to moderate intensity. It's typically prescribed at a dose of 25 mg every 8 hours, with a maximum daily dose of 75 mg.
Mechanism of Action and Side Effects
This medication works by inhibiting the cyclooxygenase enzyme, which reduces prostaglandin production and thereby decreases inflammation and pain. Dexketoprofen is the active S-enantiomer of ketoprofen, making it more potent and potentially faster-acting than traditional ketoprofen. Common side effects include gastrointestinal issues like nausea, vomiting, and stomach pain.
Precautions and Contraindications
It should be taken with food to minimize stomach irritation and is contraindicated in patients with active peptic ulcers, gastrointestinal bleeding, severe heart failure, or kidney dysfunction. Caution is advised when using this medication in elderly patients or those with cardiovascular risk factors, as NSAIDs can increase the risk of cardiovascular events with prolonged use, as reported in a study published in the Clinical Gastroenterology and Hepatology journal 1.
Risk Factors and Prevention
Some patients are at greater risk for the development of GI complications, including those with a history of previous peptic ulcer, history of NSAID-related GI complications, advanced age, concomitant use of corticosteroids, anticoagulants, and the use of high-dose NSAIDs, or combinations of NSAIDs including ASA, coxibs, and over-the-counter products 1. To minimize the risk of GI complications, patients should be advised to take the lowest effective dose for the shortest duration necessary, and to use prophylactic measures such as proton-pump inhibitors (PPIs) or histamine H2 blockers, as recommended by the American family physician journal 1.
From the Research
Efficacy of Dexketoprofen Trometamol
- Dexketoprofen trometamol is a modified non-selective COX inhibitor with a rapid onset of action, providing effective analgesia in the treatment of acute pain, such as postoperative pain, renal colic, acute musculoskeletal disorders, and dysmenorrhea 2.
- Single-dose dexketoprofen trometamol has been shown to be effective in reducing opioid consumption in the postoperative setting and has a rapid onset of action within 30 minutes 2.
- Dexketoprofen trometamol has been compared to other painkilling medications, including COX-2 inhibitors, and has been found to have similar analgesic efficacy 2, 3.
Comparison with Other Painkillers
- Dexketoprofen has been compared to ketorolac in the treatment of bone cancer pain and was found to have a good analgesic therapy with a good tolerability profile 4.
- Dexketoprofen trometamol has been compared to ibuprofen in the treatment of postoperative pain after oral surgery and was found to have greater analgesic efficacy in the first hour after administration 5.
- Dexketoprofen has also been compared to other nonsteroidal anti-inflammatory drugs (NSAIDs) and has been found to be at least as effective as other NSAIDs and paracetamol/opioid combinations 6.
Safety and Tolerability
- Dexketoprofen trometamol has been found to be well tolerated during short-term treatment, with low adverse event withdrawal rates in postoperative pain and somewhat higher rates in trials of longer duration 2, 6.
- Serious adverse events, such as gastrointestinal bleeding or cardiovascular events, have been reported, but the exposure was limited, and no conclusions could be drawn about safety in terms of these events 6, 4.