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fenoprofen (Rx)Brand and Other Names:Nalfon

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 200mg
  • 400mg

tablets

  • 600mg
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Pain

200 mg PO q4-6hr; not to exceed 3200 mg/day

Rheumatoid Arthritis

300-600 mg PO q6-8hr

Maximum recommended dose is 3200 mg/day

Osteoarthritis

300-600 mg PO q6-8hr

Maximum recommended dose is 3200 mg/day

Renal Impairment

Advanced renal disease: Not recommended

Administration

Take with food or 8-12 oz water to avoid GI effects

Other Indications

Off-label: vascular headache, gout

<12 years: Safety and efficacy not established

Pain

200 mg PO q4-6hr; not to exceed 3200 mg/day

Rheumatoid Arthritis, Osteoarthritis

300-600 mg PO q6-8hr

Maximum recommended dose is 3200 mg/day

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Interactions

Interaction Checker

fenoprofen and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Dyspepsia (10.3%)

            Somnolence

            Increased LFT

            1-10%

            Abdominal pain

            Anemia

            Diarrhea

            Dizziness

            Edema

            Headache

            Constipation

            Confusion

            Tremor

            Sweating

            Tinnitus

            Blurred vision

            Palpitations

            Nervousness

            Fatigue

            Rash

            Nausea

            Vomiting

            GI bleeding, ulceration, perforation

            Frequency Not Defined

            Insomnia

            Asthenia

            Paresthesia

            Muscle weakness

            Decreased hearing

            Purpura, bruising, hemorrhage

            Thrombocytopenia, hemolytic anemia, aplastic anemia, agranulocytosis, pancytopenia, slight decreases in hemoglobin concentration & hematocrit

            Dysuria, cystitis, hematuria

            Nephrotic syndrome, renal failure, oliguria, anuria, azotemia, allergic nephritis, nephrosis, papillary necrosis

            Jaundice

            Cholestatic hepatitis

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            Warnings

            Black Box Warnings

            Cardiovascular Risk

            • NSAIDs may increase risk of serious cardiovascular thrombotic events, myocardial infarction (MI), & stroke, which can be fatal
            • Risk may increase with duration of use
            • Patients with risk factors for or existing cardiovascular disease may be at greater risk
            • NSAIDs are contraindicated for perioperative pain in the setting of coronary artery bypass graft (CABG) surgery (increased risk of MI & stroke)

            Gastrointestinal Risk

            • NSAIDs increase risk of serious GI adverse events including bleeding, ulceration, & perforation of the stomach or intestines, which can be fatal
            • GI adverse events may occur at any time during use & without warning symptoms
            • Elderly patients are at greater risk for serious GI events

            Contraindications

            Absolute: ASA allergy

            Relative: bleeding disorders, duodenal/gastric/peptic ulcer, renal impairment, stomatitis, SLE, ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of ductus arteriosus)

            Cautions

            Asthma (bronchial), cardiac disease, CHF, hepatic impairment, HTN

            Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs

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            Pregnancy & Lactation

            Pregnancy Category: C; avoid during third trimester, may cause premature closure of the ductus arteriosus

            The Quebec Pregnancy Registry identified 4705 women who had spontaneous abortions by 20 weeks' gestation; each case was matched to 10 control subjects (n=47,050) who had not had spontaneous abortions; exposure to nonaspirin NSAIDs during pregnancy was documented in approximately 7.5% of cases of spontaneous abortions and in approximately 2.6% of controls. (CMAJ, September 6, 2011; DOI:10.1503/cmaj.110454)

            Lactation: excretion in milk unknown/not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclooxygenase isoenzymes, cyclooxygenase-1 (COX-1) and -2 (COX-2)

            May inhibit chemotaxis, may alter lymphocyte activity, decrease proinflammatory cytokine activity, and may inhibit neutrophil aggregation. These effects may contribute to its anti-inflammatory activity

            Pharmacokinetics

            Onset: 2-4hr

            Duration: 4-6 hr

            Peak Plasma Time: 2 hr

            Peak Plasma Concentration: 50 mcg/mL

            Protein Bound: 99% (albumin)

            Metabolism: Liver

            Metabolites: 4'-hydroxyfenoprofen, glucuronic acid conjugates

            Enzymes inhibited: cyclooxygenase-1 (COX-1) & -2 (COX-2), prostaglandin synthesis

            Half-life: 2.5-3 hr

            Clearance: within 24 hr

            Excretion: urine (primarily); feces

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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