Ketoprofen

Respiratory

A fatal asthmatic reaction has been described [ ], and severe bronchospasm with respiratory and cardiac arrest has been reported in a young man with a history of mild asthma after he took ketoprofen [ ]. Topical application can provoke asthma in predisposed subjects [ ].

Even topical formulations of NSAIDs should be avoided in patients with a history of analgesic-induced asthma [ ].

• A 74-year-old woman with a history of sinusitis, nasal polyps, and analgesic-induced asthma had a sudden life-threatening attack of asthma 2 hours after the application of a 2% ketoprofen adhesive tape. Asthma had not previously occurred when she had used a 0.3% ketoprofen adhesive patch.

Nervous system

Retention of salt and water, sometimes with reversible pseudotumor cerebri, can occur with ketoprofen [ ].

Gastrointestinal

The overall frequency of adverse reactions was 15–50% in different trials; gastrotoxicity predominated, at a frequency of 6.5–42% [ ], even after rectal administration. In some epidemiological studies, ketoprofen in prescription doses was more gastrotoxic than other NSAIDs [ , ].

There are very few data on the gastrointestinal toxicity of over-the-counter doses of ketoprofen. In an endoscopic short-term study in healthy subjects ketoprofen was associated with significant gastrointestinal toxicity [ ]. Another endoscopic study showed that the R-enantiomer of ketoprofen has less gastrointestinal toxicity than the racemic mixture or the S-enantiomer while retaining good analgesic activity [ ].

Local symptoms, including rectal bleeding, can accompany treatment with ketoprofen suppositories (8.3% of patients) [ ].