Fenoprofen Capsules

Generic name:

Fenoprofen

Drug class:

Nonsteroidal anti-inflammatory drug (NSAID), propionic acid derivative

Dosage form:

Capsules: 200 mg, 300 mg

Route of administration:

Oral

Dose:

• Osteoarthritis/Rheumatoid arthritis: 300–600 mg orally every 6–8 hours, not to exceed 2.4 g/day
• Acute pain: 400–600 mg every 4–6 hours as needed (max 2.4 g/day)
• Primary dysmenorrhea: 600 mg initially, then 200–400 mg every 4–6 hours (max 2.4 g/day)
• Elderly or renal impairment: use lowest effective dose; adjust based on tolerance

Mechanism of action:

Inhibits cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and COX-2), reducing prostaglandin synthesis to produce anti-inflammatory, analgesic, and antipyretic effects.

Drug usage cases:

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Primary dysmenorrhea
• Acute musculoskeletal pain
• Off-label: tendonitis, bursitis, gout flares, headache, dental pain

Drug contraindications:

• Hypersensitivity to fenoprofen or other NSAIDs
• Aspirin- or NSAID-induced asthma, urticaria, or allergic reactions
• Active peptic ulcer disease or gastrointestinal bleeding
• Severe heart failure
• Severe hepatic or renal impairment
• Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery
• History of gastrointestinal perforation or ulceration related to previous NSAID therapy

Side effects:

• Gastrointestinal: nausea, vomiting, dyspepsia, abdominal pain, diarrhea, constipation, gastric ulceration, GI bleeding
• Cardiovascular: hypertension, edema, heart failure exacerbation, increased risk of myocardial infarction and stroke
• Renal: acute renal failure, elevated blood urea nitrogen (BUN) and creatinine, interstitial nephritis
• Hepatic: elevated liver enzymes (AST, ALT), hepatitis, jaundice
• CNS: dizziness, headache, drowsiness, lightheadedness
• Hematologic: anemia, thrombocytopenia, prolonged bleeding time
• Hypersensitivity: rash, pruritus, angioedema, anaphylaxis
• Dermatologic: photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis

Warnings:

• Cardiovascular thrombotic events: may increase risk of MI and stroke; use lowest effective dose for shortest duration
• Gastrointestinal toxicity: risk of ulceration, bleeding, perforation—monitor for GI symptoms
• Renal toxicity and hyperkalemia: monitor renal function and electrolytes in long-term use
• Hepatic effects: monitor liver function tests during prolonged therapy
• Hypersensitivity reactions: discontinue immediately if signs of allergic reaction occur
• Fluid retention/edema: use with caution in patients with fluid overload or heart failure
• Masked signs of infection: NSAIDs may hide fever and inflammation
• Photosensitivity: advise sun protection

Use during pregnancy or breastfeeding:

First and second trimesters: Category C. May cause fetal harm in animal studies; use only if benefits justify risks. Third trimester: Category D. Risk of premature closure of ductus arteriosus, pulmonary hypertension, renal dysfunction, and bleeding in fetus/neonate; avoid NSAIDs. Breastfeeding: Excreted in breast milk. Potential for adverse effects in nursing infant; use lowest effective dose and monitor infant for GI and renal adverse reactions.