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Fenoprofen

Class
Nonsteroidal anti-inflammatory drugs
Subclass
Propionates
Substance name
Fenoprofen
Common formulations
Film-coated tablet
Dosage and administration
Adults patients
Osteoarthritis
•
400-600 mg PO q6-8h
Pain
•
200 mg PO q4-6h
Other off-label uses
•
Prevention of migraine attacks
Indications for use
Labeled indications
Adults
•
Symptomatic relief of osteoarthritis
•
Symptomatic relief of pain
•
Symptomatic relief of rheumatoid arthritis
Off-label indications
Adults
•
Prevention of migraine attacks
Safety risks
Boxed warnings
Exacerbation of anemia
•
Use extreme caution who have initial hemoglobin values of 10 g/dl or less and who are to receive long-term NSAID therapy.
Myocardial infarction
•
Use extreme caution with a history of hypertension or serious cardiovascular thrombotic events.
Contraindications
A recent history of CABG surgery
Aspirin-sensitive asthma
Chronic use of fenoprofen or with a history of or active gastrointestinal disease including peptic ulcer disease, ulcerative colitis, or gastrointestinal bleeding
Salicylate hypersensitivity or NSAID hypersensitivity
Warnings and precautions
Abnormal LFTs
•
Use caution with hepatic impairment.
Thrombocytopenia
•
Use caution with immunosuppression or a history of hematological disease.
Specific populations
Renal impairment
eGFR 20-50 mL/min/1.73 m²
•
Avoid use as much as possible. Reduce starting dose. Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis and hyperkalemia. Contraindicated in patients with history of significantly impaired renal function.
eGFR 10-20 mL/min/1.73 m²
•
Avoid use as much as possible. Reduce starting dose. Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis and hyperkalemia.
eGFR < 10 mL/min/1.73 m²
•
Avoid use as much as possible. Reduce starting dose. Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis and hyperkalemia.
Renal replacement therapy
Continuous renal replacement
•
Avoid use as much as possible. Dose as in eGFR 10-20 mL/min/1.73 m². Titrate to response.
Intermittent hemodialysis
•
Reduce starting dose. Titrate to response.
Peritoneal dialysis
•
Reduce starting dose. Titrate to response.
Hepatic impairment
Any severity
•
Use with caution.
Substantial chronic alcohol consumption
•
Use with caution.
Pregnancy and breastfeeding
Breastfeeding
Little information available on breastfeeding safety.
•
Consider alternative agents that may be safer.
Unknown drug levels in breastfed infants.
Adverse reactions
Very common > 10%
•
Dyspepsia
Common 1-10%
•
AF, AT, acute cystitis, acute pancreatitis, acute pharyngitis, agranulocytosis, alopecia, angioedema, anuria, aplastic anemia, ↓ platelet count, diaphoresis, exfoliative dermatitis, gastritis, gastrointestinal bleeding, gastrointestinal perforation, hemolytic anemia, ↑ BUN, ↑ liver enzymes, interstitial nephritis, lymphadenopathy, optic neuritis, pancytopenia, peptic ulcer disease, peripheral edema, pulmonary edema, purpura, renal failure, renal papillary necrosis, abdominal pain, asthenia, blurred vision, confusion, constipation, depression, diarrhea, diplopia, dizziness, dry mouth, dyspnea, dysuria, fatigue, fever, flatulence, headache, hearing loss, hematuria, insomnia, itching, loss of appetite, low urine output, malaise, mastalgia, melena, metallic taste, nausea, palpitations, seizure, skin rash, somnolence, tinnitus, vomiting, sinus tachycardia, Stevens-Johnson syndrome, toxic epidermal necrolysis, tremor, urticaria
Unknown frequency
•
Acute liver failure, anemia, aseptic meningitis, DRESS syndrome, ↓ serum sodium, esophageal stricture, esophagitis, heart failure, hepatic necrosis, hepatitis, hypertension, jaundice, myocardial infarction, platelet dysfunction, ↑bleeding time, dysphagia, heartburn, odynophagia, stroke, thromboembolism
Interactions
Drug(s)
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