Ketoprofen and Diclofenac review

Pain is the most common reason for seeking medical attention. Injuries, surgeries, bone and joint diseases, and diseases of internal organs can all lead to discomfort. Acute pain that is not controlled in time develops into chronic pain. It reduces quality of life, impairs performance, causes insomnia, depression, and other related conditions.

The problem of adequate pain relief is one of the key problems in modern medicine. Various techniques are used to reduce discomfort, and nonsteroidal anti-inflammatory drugs are most commonly prescribed. In combination with the methods of osteopathy, acupuncture and physiotherapy NSAIDs give good results – relieve pain and improve quality of life.

In the group of NSAIDs of particular interest are strong drugs – Ketoprofen and Diclofenac. They are traditionally prescribed to relieve pain and inflammation in diseases of the musculoskeletal system, are used in surgery, dermatology, gynecology and many other areas of medicine. For a detailed review of each medication, see this article.

Important to remember: Many people take nonsteroidal anti-inflammatory drugs without a prescription. They help to relieve pain and relieve other symptoms of inflammation. However, do not take NSAIDs for more than three consecutive days without medical supervision. If there is no effect in three days, you need to seek help.

What’s inside: the composition and release form of the drugs

Ketoprofen and Diclofenac have the same scope of use and are therefore very similar. But there are differences between them – they are drugs with different composition, formulation and features of production. Read more about each drug in the table below.

How drugs work

All nonsteroidal anti-inflammatory drugs act according to the same scheme. They inhibit the production of the enzyme cyclooxygenase (COX), which is responsible for the development of inflammation, pain and fever. In the human body, COXs are represented in three variants:

1. COX-1 is synthesized normally and affects the digestive tract and other organs.

2. COX-2 is produced by inflammation. It is assumed that this enzyme is also involved in some physiological processes.

3. COX-3 acts in the development of fever. Its existence has not yet been proven.

All non-steroidal anti-inflammatory drugs in relation to COX are divided into two groups:

1. Non-selective NSAIDs. They affect not only COX-2, but also COX-1 – that is, they affect pathological and physiological processes. Such drugs work effectively, but they have a large number of adverse reactions, precisely because of their non-selective effect on “normal” COX. The heroes of our article – Ketoprofen and Diclofenac belong to this group.

2. Selective NSAIDs. They only affect COX-2 production. Considered weaker drugs, but less likely to cause adverse reactions.

Ketoprofen and Diclofenac have a triple action:

1. Analgesic: relieves acute and chronic pain. Drugs act quickly, so they are prescribed to relieve acute attacks.

2. Antipyretic: reduce body temperature, relieve symptoms of fever. This is not the main effect of the drugs – they are not used as antipyretics for the flu and cold.

3. Anti-inflammatory: relieve manifestations of the inflammatory process, inhibit further reactions.

Ketoprofen acts quickly – reaches maximum concentration in the blood after 15-30 minutes when administered parenterally. Diclofenac is slightly delayed – estimated time is 20-40 minutes. When administered orally, the drugs are absorbed more slowly – up to 1-2 hours. They do not accumulate in the body and are excreted by the kidneys.

Effectiveness Assessment

Numerous articles in Russian and foreign literature are devoted to the comparative analysis of NSAIDs. In one study, the authors compare the effects of ketoprofen and diclofenac in vitro. Analysis showed: ketoprofen accumulates mainly in muscles, adipose tissue and adrenal glands. Chemotropic study revealed additional effects of the drugs: antiaggregant, vasodilator and antitumor.

The Cochrane Library database has an overview of the drugs of interest. The authors conducted an analysis of clinical studies on the subject. The studies involved people over the age of 40 with knee arthritis. Found that with ketoprofen and diclofenac, 60% of patients had significantly less pain after 6-12 weeks. Adverse skin reactions developed more often with diclofenac. Serious side effects have occurred infrequently.

In recent years, ketoprofen has increasingly fallen under the attention of scientists. In a review article on NSAIDs, ketoprofen is stated as the drug of choice. Its peculiarity of action is the ability to inhibit not only the production of COX, but also other enzymes involved in the development of inflammation. Many researchers attribute the strong analgesic effect of the drug to a central effect through the horns of the spinal cord.

In another study, the authors again favored ketoprofen over other NSAIDs. The meta-analysis showed: the drug is most effective as a remedy for topical use. This is due not only to the structure of the molecule, but also to the good ability of the drug to penetrate into the joint cavity and periarticular tissues. The drug is well tolerated – rarely causes severe adverse reactions.

Diclofenac is also not forgotten by scientists. This is a fairly old drug, so many articles on its use are already in the archives. A review of modern literature shows: diclofenac sodium successfully copes with pain in osteochondrosis, arthritis, arthrosis and other diseases of the musculoskeletal system. The drug is effective both when used systemically and when used topically. In a Cochrane Library review article on various NSAIDs, researchers found the effects of diclofenac to be comparable to other drugs – including ketoprofen.

Regimen of use

The indications for prescribing the drugs are similar:

1. Inflammatory and degenerative diseases of the musculoskeletal system: rheumatoid arthritis, psoriatic arthritis, osteoarthritis, Bechterew disease, etc.

2. Pain syndrome of different localization: muscles, joints, bones, ligaments, toothache and headache.

3. Pain relief in post-surgery, cancer.

4. Algodysmenorrhea – painful menstruation.

Ketoprofen and Diclofenac only relieve pain and alleviate the general condition of the person. They do not affect the progression of the disease, its mechanisms of development, or its causes. Therefore, NSAIDs are usually prescribed in combination with other drugs that affect the development of the disease.

The dosage of drugs is selected by the doctor taking into account the severity of the patient’s condition, age, the presence of concomitant pathology and other factors. The course of therapy usually does not last long – 5-10 days. If there is no effect, you need to see a doctor – to change the treatment tactic.

Precautions

NSAIDs are known for their side effects. Most often, non-selective COX inhibitors hit the digestive tract. They cause nausea and vomiting, heartburn, epigastric pain, interfere with food digestion, lead to constipation or diarrhea. In predisposed people provoke the development of gastric ulcers and bleeding.

Ketoprofen and Diclofenac often cause allergic reactions. Cross-reaction is also possible, when a person reacts to several drugs from this group at once. If skin itching or rashes occur, stop taking the drug and consult a physician.

Non-selective NSAIDs often cause headaches, nervousness, insomnia. Sometimes drowsiness is noted. When such reactions occur, you can not drive a car and work with mechanisms that require extreme concentration.

Ketoprofen and Diclofenac can disrupt liver and kidney function. With chronic lesions of these organs we must be especially careful not to exceed the recommended dosage of the drugs.

Ketoprofen and Diclofenac are not prescribed in such situations:

1. intolerance to NSAIDs in people with bronchial asthma and other allergic diseases;

2. Severe liver and kidney pathology;

3. Exacerbation of gastric and duodenal ulcers, ulcerative colitis;

4. Hemophilia and other clotting disorders;

5. Hyperkalemia.

6. NSAIDs are not recommended in the first trimester of pregnancy and are prohibited in the third trimester. The drugs are not prescribed during lactation.

Conclusions

To summarize:

1. Diclofenac and Ketoprofen are nonsteroidal anti-inflammatory drugs. They relieve acute and chronic pain. Primarily used for diseases of the musculoskeletal system and skin, but can be used in other areas of medicine.

2. A comparison of the effectiveness of the two drugs provides contradictory data. Some researchers believe that Ketoprofen acts faster and stronger, and has a high safety profile. Other scientists find no significant differences between Ketoprofen and Diclofenac.

3. Diclofenac and Ketoprofen are well tolerated, but can be harmful if used improperly. NSAIDs should only be taken under the supervision of a doctor.