Кетонал Актив Гранулы, пакеты, 12 шт, 40 мг, для приготовления раствора

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Обладает антибрадикининовой активностью, стабилизирует\nлизосомальные мембраны и задерживает высвобождение из них ферментов,\nспособствующих разрушению тканей при хроническом воспалении. Снижает выделение\nцитокинов, тормозит активность нейтрофилов."}},{"type":"paragraph","data":{"text":"Уменьшает утреннюю скованность\nи припухлость суставов, увеличивает объем движений. "}},{"type":"paragraph","data":{"text":"Кетопрофена лизиновая соль, в\nотличие от кетопрофена, является быстрорастворимой молекулой с нейтральным рН и\nпочти не вызывает раздражение желудочно-кишечного тракта (ЖКТ)."}},{"type":"paragraph","data":{"text":"\u003ca\u003e\u003ci\u003eФармакокинетика\u003c/i\u003e\u003c/a\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eВсасывание\u003c/i\u003e "}},{"type":"paragraph","data":{"text":"Кетопрофен при\nприеме внутрь быстро и достаточно полно всасывается из ЖКТ, его биодоступность\nсоставляет около 80 %. Максимальная концентрация в плазме крови при приеме\nвнутрь отмечается через 0,5-2 ч и прямо зависит от принятой дозы. Равновесная\nконцентрация кетопрофена достигается через 24 ч после начала его регулярного\nприема."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРаспределение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"До 99 % адсорбировавшегося\nкетопрофена связывается с белками плазмы, преимущественно с альбумином. Объем\nраспределения – 0,1-0,2 л/кг. Легко проходит через гистогематические барьеры и\nраспределяется в тканях и органах. Кетопрофен хорошо проникает в синовиальную\nжидкость и соединительные ткани. Хотя концентрация кетопрофена в синовиальной\nжидкости несколько ниже, чем в плазме крови, она более\nстабильна (сохраняется до 30 ч)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетаболизм\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Кетопрофен в\nосновном метаболизируется в печени, где он подвергается глюкуронидации с\nобразованием сложных эфиров с глюкуроновой кислотой."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВыведение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Метаболиты\nвыводятся почками. Препарат не кумулируется."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Воспалительные\nи дегенеративные заболевания опорно-двигательного аппарата: "}},{"type":"paragraph","data":{"text":"-     \nревматоидный артрит; "}},{"type":"paragraph","data":{"text":"-     \nсеронегативные артриты:\nанкилозирующий спондилит (болезнь Бехтерева), псориатический артрит, реактивный\nартрит (болезнь Рейтера); "}},{"type":"paragraph","data":{"text":"-     \nподагра, псевдоподагра;"}},{"type":"paragraph","data":{"text":"-     \nостеоартроз; "}},{"type":"paragraph","data":{"text":"-     \nтендинит, бурсит, миалгия,\nневралгия, радикулит."}},{"type":"paragraph","data":{"text":"Болевой\nсиндром, в том числе слабый, умеренный и выраженный: "}},{"type":"paragraph","data":{"text":"-     \nголовная боль; "}},{"type":"paragraph","data":{"text":"-     \nзубная боль;"}},{"type":"paragraph","data":{"text":"-     \nпосттравматический и\nпослеоперационный болевой синдром;"}},{"type":"paragraph","data":{"text":"-     \nболевой синдром при онкологических\nзаболеваниях;"}},{"type":"paragraph","data":{"text":"-     \nальгодисменорея."}},{"type":"paragraph","data":{"text":"Детям (старше 6 лет): кратковременное\nсимптоматическое лечение воспалительных процессов, сопровождающихся болевым\nсиндромом в сочетании с жаром или без него при заболеваниях опорно-двигательного\nаппарата, отите. "}},{"type":"paragraph","data":{"text":"Купирование послеоперационных болей."}},{"type":"paragraph","data":{"text":"Препарат предназначен для симптоматической\nтерапии, уменьшения боли и воспаления на момент\nиспользования, на прогрессирование заболевания не влияет. "}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"·   \nГиперчувствительность к действующему\nвеществу и другим компонентам препарата, а также к другим НПВП;"}},{"type":"paragraph","data":{"text":"·   \nполное или неполное сочетание бронхиальной\nастмы, рецидивирующего полипоза носа и околоносовых пазух и непереносимости\nацетилсалициловой кислоты или других НПВП (в том числе в анамнезе);"}},{"type":"paragraph","data":{"text":"·   \nэрозивно-язвенные поражения желудка\nи двенадцатиперстной кишки в стадии обострения;"}},{"type":"paragraph","data":{"text":"·   \n активное желудочно-кишечное,\nцереброваскулярное или иное кровотечение;"}},{"type":"paragraph","data":{"text":"·   \nвоспалительные заболевания кишечника\n(язвенный колит, болезнь Крона) в стадии обострения;"}},{"type":"paragraph","data":{"text":"·   \nгемофилия и другие нарушения\nсвертываемости крови;"}},{"type":"paragraph","data":{"text":"·   \nдекомпенсированная сердечная\nнедостаточность;"}},{"type":"paragraph","data":{"text":"·   \nпериод после проведения аортокоронарного\nшунтирования;"}},{"type":"paragraph","data":{"text":"·   \nтяжелая печеночная недостаточность\nили активное заболевание печени;"}},{"type":"paragraph","data":{"text":"·   \nтяжелая почечная недостаточность (клиренс креатинина (КК) < 30 мл/мин),\nпрогрессирующие заболевания почек;"}},{"type":"paragraph","data":{"text":"·   \nподтвержденная гиперкалиемия;"}},{"type":"paragraph","data":{"text":"·   \nдетский возраст (до 6 лет);"}},{"type":"paragraph","data":{"text":"·   \nбеременность в сроке более 20 недель\nи период грудного вскармливания. "}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Язвенная\nболезнь желудка и двенадцатиперстной кишки, язвенный колит, болезнь Крона, заболевания\nпечени (в анамнезе), печеночная порфирия, хроническая почечная недостаточность\n(КК 30-60 мл/мин), хроническая сердечная недостаточность, артериальная\nгипертензия, значительное снижение объема циркулирующей крови (в том числе\nпосле хирургического вмешательства), пожилые пациенты (в том числе получающие\nдиуретики, ослабленные пациенты и с низкой массой тела), бронхиальная астма, одновременный\nприем глюкокортикостероидов (в том числе преднизолона), антикоагулянтов (в том\nчисле варфарина), антиагрегантов (в том числе ацетилсалициловой кислоты,\nклопидогрела), селективных ингибиторов обратного захвата серотонина  (в том числе циталопрама, флуоксетина,\nпароксетина, сертралина), ишемическая болезнь сердца, цереброваскулярные\nзаболевания, дислипидемия/гиперлипидемия, сахарный диабет, заболевания\nпериферических артерий, курение, наличие инфекции \u003ci\u003eHelicobacter pylori, \u003c/i\u003eдлительное применение НПВП, туберкулез,\nвыраженный остеопороз, алкоголизм, тяжелые соматические заболевания,\nбеременность (I, II триместр).\u003cb\u003e\u003c/b\u003e"}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Не следует применять НПВП женщинам с 20-й недели\nбеременности в связи с возможным развитием маловодия и/или патологии почек у\nноворожденных (неонатальная почечная дисфункция)."}},{"type":"paragraph","data":{"text":"При беременности сроком более 20 недель применение\nкетопрофена противопоказано. "}},{"type":"paragraph","data":{"text":"При беременности сроком до 20 недель назначение препарата\nвозможно только в случае, если предполагаемая польза для матери превышает\nпотенциальный риск для плода."}},{"type":"paragraph","data":{"text":"Препарат не следует применять во время грудного\nвскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Взрослым:"}},{"type":"paragraph","data":{"text":"Содержимое двух пакетиков растворить в\nполовине стакана питьевой воды и принимать внутрь до 3-х раз в день во время\nеды."}},{"type":"paragraph","data":{"text":"Пожилым пациентам дозу устанавливает врач,\nжелательно уменьшение дозировки в 2 раза."}},{"type":"paragraph","data":{"text":"Детям (от 6 до 14 лет):"}},{"type":"paragraph","data":{"text":"Содержимое одного пакетика растворить в\nполовине стакана питьевой воды и принимать внутрь до 3-х раз в день во время\nеды."}},{"type":"paragraph","data":{"text":"Детям (от 14 до 18 лет):"}},{"type":"paragraph","data":{"text":"Дозировки препарата соответствуют таковым\nу взрослых."}},{"type":"paragraph","data":{"text":"Для снижения риска развития нежелательных\nявлений со стороны желудочно-кишечного тракта следует использовать минимальную\nэффективную дозу максимально возможным коротким курсом."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"По данным Всемирной организации\nздравоохранения (ВОЗ) нежелательные реакции классифицированы в соответствии с\nих частотой развития следующим образом: очень часто (≥ 1 / 10), часто (≥ 1 / 100,\n< 1 / 10), нечасто (≥ 1 / 1000, < 1 / 100), редко (≥ 1 / 10000, < 1 / 1000) и очень\nредко (< 1 / 10000); частота неизвестна (частоту возникновения явлений нельзя\nопределить на основании имеющихся данных)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со\nстороны крови и лимфатической системы \u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко:\u003c/i\u003e геморрагическая анемия;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e тромбоцитопения,\nтромбоцитопеническая пурпура, агранулоцитоз, нарушение функции костного мозга,\nлейкоцитопения, лейкоцитоз, воспаление лимфатических сосудов, лейкопения,\nгемолитическая анемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e анафилактические реакции\n(включая анафилактический шок)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со\nстороны обмена веществ и питания\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко: \u003c/i\u003eувеличение массы тела;\u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна: \u003c/i\u003eгипонатриемия, гиперкалиемия (см. раздел «Особые указания»).\u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения психики\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e спутанность сознания, изменение настроения, раздражительность."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны нервной системы \u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eнечасто: \u003c/i\u003eголовная боль, головокружение, сонливость;\u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко: \u003c/i\u003eпарестезии;\u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна: \u003c/i\u003eсудороги, дисгевзия, бессонница.\u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со\nстороны органа зрения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко: \u003c/i\u003eнечеткость зрения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со\nстороны органа слуха и лабиринтные нарушения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко: \u003c/i\u003eшум в ушах."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со\nстороны сердца\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e сердечная недостаточность,\nтахикардия, учащенное сердцебиение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со\nстороны сосудов\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e гипертензия, гипотензия, вазодилатация, васкулит (включая\nлейкоцитокластический васкулит)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны дыхательной\nсистемы, органов грудной клетки средостения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко:\u003c/i\u003e бронхиальная астма;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e\nбронхоспазм (особенно у пациентов с подтвержденной гиперчувствительностью к\nацетилсалициловой кислоте и другим НПВП), ринит, одышка, отек и спазм гортани."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчасто:\u003c/i\u003e тошнота, рвота,\nдиспепсия, боль в области живота;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eнечасто:\u003c/i\u003e\nзапор, диарея, вздутие живота, гастрит;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко:\u003c/i\u003e стоматит, язва желудка\nи двенадцатиперстной кишки;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e\nобострение язвенного колита и болезни Крона, желудочно-кишечное кровотечение,\nперфорация, изжога, панкреатит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны печени и желчевыводящих путей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eредко:\u003c/i\u003e гепатит, повышение\nактивности «печеночных» трансаминаз и повышение концентрации билирубина в\nсыворотке крови, вызванные нарушениями функции печени."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны кожи и подкожных тканей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eнечасто:\u003c/i\u003e\nкожная сыпь, кожный зуд;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e\nреакции фотосенсибилизации, алопеция, крапивница, ангионевротический отек,\nбуллезные реакции со стороны кожи, включая синдром Стивенса-Джонсона и\nтоксический эпидермальный некролиз (синдром Лайелла), эритема и экзантема,\nмакулопапулезная сыпь, дерматит, острый генерализованный экзантематозный\nпустулез."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны почек и мочевыводящих путей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e\nострая почечная недостаточность, тубулоинтерстициальный нефрит и нефритический\nсиндром, аномальные значения показателей функции почек."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбщие расстройства и нарушения в месте введения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eнечасто:\u003c/i\u003e\nотеки, усталость;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eчастота неизвестна:\u003c/i\u003e отек\nслизистой оболочки полости рта, периорбитальный отек."}},{"type":"paragraph","data":{"text":"В случае возникновения\nкакого-либо побочного действия следует немедленно прекратить прием препарата и\nобратиться к врачу."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Были зарегистрированы\nслучаи передозировки при приеме дозы до 2,5 г кетопрофена. В большинстве\nслучаев симптомы ограничивались вялостью, сонливостью, тошнотой, рвотой и болью\nв эпигастральной области."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМеры при оказании помощи при передозировке\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Специфический антидот неизвестен. В\nкачестве симптоматических мер при обеспечении жизненно важных функций\n(стабилизация кровообращения, дыхания, устранение ацидоза) показаны препараты и\nпроцедуры, снижающие резорбцию и ускоряющие элиминацию (медицинский уголь,\nфорсированный диурез). "}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСочетания, которых необходимо избегать \u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eКортикостероиды:\u003c/i\u003e повышается риск изъязвления слизистой оболочки ЖКТ и\nжелудочно-кишечного кровотечения. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eАнтикоагулянты (парентеральный гепарин, варфарин, ингибиторы тромбина\n(такие, как дабигатран), прямые ингибиторы фактора свертывания Xa (такие, как\nапиксабан, ривароксабан, эдоксабан):\u003c/i\u003e повышается риск кровотечения, вызванного ингибированием функции\nтромбоцитов и повреждением слизистой оболочки ЖКТ. НПВП могут усиливать эффекты\nантикоагулянтов, таких как варфарин. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eАнтиагреганты (клопидогрел, тиклопидин) и селективные ингибиторы\nобратного захвата серотонина: \u003c/i\u003eповышается риск кровотечения, вызванного ингибированием агрегации\nтромбоцитов и повреждением слизистой оболочки ЖКТ. Пациенты должны находиться\nпод наблюдением, если совместного применения нельзя избежать."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДругие НПВП, включая высокие дозы салицилатов (>3 г/день):\u003c/i\u003e сопутствующий прием нескольких НПВП может\nповышать риск изъязвления слизистой оболочки ЖКТ и желудочно-кишечного\nкровотечения, что обусловлено синергическим эффектом."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛитий:\u003c/i\u003e\nНПВП повышают плазменный уровень лития (снижается экскреция лития в почках),\nкоторый может достичь токсичного уровня. Данный параметр необходимо\nконтролировать в начале лечения, при регуляции дозы и после прекращения лечения\nкетопрофеном. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетотрексат в высоких дозах (более 15 мг в неделю):\u003c/i\u003e повышается гематотоксичность метотрексата,\nтак как снижается его выведение почками при приеме противовоспалительных\nпрепаратов. При совместном применении \u003ci\u003eс метотрексатом в низких дозах (менее 15 мг в неделю)\u003c/i\u003e необходимо проводить общий анализ крови один\nраз в неделю на протяжении первых нескольких недель лечения. Обязательно\nпроведение более частного мониторирования клинического состояния пациента при\nналичии даже незначительного ухудшения функции почек, а также у пожилых\nпациентов. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eГидантоин и сульфамиды:\u003c/i\u003e токсические эффекты данных веществ могут усиливаться."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСочетания, которые требуют мер предосторожности\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛекарственные препараты и вещества, способные приводить к развитию\nгиперкалиемии (соли калия, калийсберегающие диуретики, ингибиторы АПФ и\nантагонисты рецепторов ангиотензина II, НПВП, гепарины (низкомолекулярный и\nнефракционированный), циклоспорин, такролимус и триметоприм\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Возможно\nповышение риска развития гиперкалиемии при совместном применении с\nвышеуказанными препаратами."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДиуретики, ингибиторы (АПФ) и антагонисты рецепторов ангиотензина II:\u003c/i\u003e НПВП могут снижать их эффективность. У\nпациентов с нарушением функции почек (например, пациенты с обезвоживанием или\nпожилые пациенты) сопутствующий прием ингибиторов АПФ или антагонистов\nрецепторов ангиотензина II с препаратами, ингибирующими систему\nциклооксигеназы, может вызвать дополнительные нарушения функции почек, в том\nчисле острую почечную недостаточность, обычно обратимую. Пациенты должны быть\nдостаточно гидратированы до начала сопутствующей терапии, после начала терапии\nнеобходимо проводить мониторинг функции почек."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПентоксифиллин:\u003c/i\u003e\nповышается риск кровотечений. Обязательно проводить более частое\nмониторирование клинического состояния пациента и контролировать время\nсвертывания крови."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТенофовир:\u003c/i\u003e\nсовместное применение тенофовира дизопроксила фумарата и НПВП может повышать\nриск развития почечной недостаточности."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНикорандил:\u003c/i\u003e\nсовместное применение никорандила и НПВП может повышать риск развития серьезных\nосложнений, таких как изъязвление, перфорация и кровотечение из органов ЖКТ."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСердечные гликозиды:\u003c/i\u003e фармакокинетическое взаимодействие между кетопрофеном и дигоксином не\nподтверждено. Однако следует соблюдать осторожность при их совместном\nприменении, особенно у пациентов с почечной недостаточностью, поскольку НПВП\nмогут снижать функцию почек и замедлять почечный клиренс сердечных гликозидов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЗидовудин:\u003c/i\u003e\nповышается риск токсичности в отношении эритроцитов посредством влияния на\nретикулоциты с развитием тяжелой анемии через неделю после начала лечения НПВП.\nНеобходимо проводить общий анализ крови и контролировать количество\nретикулоцитов 1-2 раза в неделю после начала лечения НПВП."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСульфонилмочевина:\u003c/i\u003e НПВП могут усиливать гипогликемический эффект сульфонилмочевины,\nуменьшая ее связь с белками плазмы. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСочетания, которые необходимо принимать во внимание\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eБета-адреноблокаторы:\u003c/i\u003e НПВП могут снижать гипотензивный эффект бета-адреноблокаторов из-за\nингибирования синтеза простагландинов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЦиклоспорин и такролимус:\u003c/i\u003e НПВП могут увеличивать нефротоксичность из-за эффектов, связанных с\nпростагландинами почек. При совместном применении необходимо контролировать\nфункцию почек."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТромболитики:\u003c/i\u003e\nповышается риск кровотечений."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПробенецид:\u003c/i\u003e\nконцентрация кетопрофена в плазме крови может повышаться. Это повышение может\nбыть обусловлено ингибирующим механизмом в месте почечной канальцевой секреции\nи глюкуроноконъюгации и требует корректировки дозы кетопрофена."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"В начале лечения\nнеобходим контроль картины периферической крови и функционального состояния\nпечени и почек."}},{"type":"paragraph","data":{"text":"После 2-х недель\nприменения препарата необходим контроль показателей функции печени (уровень\nтрансаминаз)."}},{"type":"paragraph","data":{"text":"Пациенты с бронхиальной\nастмой в сочетании с хроническим ринитом, хроническим синуситом и/или\nназальными полипами имеют более высокий риск развития аллергических реакций при\nприменении ацетилсалициловой кислоты и/или НПВП. Применение кетопрофена у\nпациентов с бронхиальной астмой может привести к развитию приступа бронхиальной\nастмы."}},{"type":"paragraph","data":{"text":"При применении\nкетопрофена возможно развитие гиперкалиемии, в особенности у пациентов с\nсахарным диабетом, почечной недостаточностью, и/или при совместном применении\nпрепаратов, приводящих к развитию гиперкалиемии. У данных групп пациентов\nследует контролировать уровень калия в плазме крови."}},{"type":"paragraph","data":{"text":"При\nнеобходимости определения 17-кетостероидов препарат следует отменить за 48 ч до\nисследования."}},{"type":"paragraph","data":{"text":"Препарат может\nизменять свойства тромбоцитов, однако не заменяет профилактические действия\nацетилсалициловой кислоты при сердечно-сосудистых заболеваниях."}},{"type":"paragraph","data":{"text":"Применение\nпрепарата может маскировать признаки инфекционных заболеваний, что может привести\nк удлинению сроков постановки правильного диагноза, отсроченному началу\nсоответствующего лечения и ухудшению исхода инфекционного заболевания. Данное\nявление наблюдалось при бактериальной внебольничной пневмонии и бактериальных\nосложнениях ветряной оспы. Если кетопрофен применяют для снижения температуры\nили обезболивания при инфекции, то рекомендуется отслеживать развитие этой\nинфекции. В амбулаторных условиях пациенту следует проконсультироваться с\nврачом, если симптомы не исчезают или ухудшаются."}},{"type":"paragraph","data":{"text":"Пожилым\nпациентам, пациентам с язвенной болезнью желудка и двенадцатиперстной кишки в\nанамнезе, а также пациентам, принимающим низкие дозы ацетилсалициловой кислоты\nили других препаратов, которые могут повышать риск реакций со стороны ЖКТ,\nпоказано совместное применение гастропротективных препаратов (мизопростол или\nингибиторы протонной помпы)."}},{"type":"paragraph","data":{"text":"Применение\nпрепарата может отрицательно влиять на женскую фертильность и не рекомендуется\nженщинам, планирующим беременность. Применение препарата необходимо прекратить\nу женщин с проблемами фертильности или проходящих исследование фертильности."}},{"type":"paragraph","data":{"text":"Препарат не\nвлияет на низкокалорийные и контролируемые диеты и может применяться у\nпациентов с сахарным диабетом."}},{"type":"paragraph","data":{"text":"Препарат не\nсодержит глютен, поэтому может применяться у пациентов с целиакией."}},{"type":"paragraph","data":{"text":"Препарат не\nсодержит аспартам, поэтому может применяться у пациентов с фенилкетонурией."}},{"type":"paragraph","data":{"text":"\u003ci\u003eКардиоваскулярные\nи цереброваскулярные эффекты\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Пациентам с\nартериальной гипертензией и/или с сердечной недостаточностью средней степени\nтяжести, сопровождающейся задержкой жидкости и отеками (в анамнезе), связанными\nс приемом НПВП, необходим тщательный мониторинг и консультация врача."}},{"type":"paragraph","data":{"text":"Клинические\nисследования и эпидемиологические данные указывают на то, что использование\nнекоторых НПВП (особенно в высоких дозах в течение длительного времени) может\nбыть связано с небольшим повышением риска артериальных тромботических явлений\n(например, инфаркт миокарда или инсульт). Данных для исключения вышеуказанного\nриска для кетопрофена лизиновой соли недостаточно."}},{"type":"paragraph","data":{"text":"Пациентам с\nнеконтролируемой артериальной гипертензией, сердечной недостаточностью,\nустановленной ишемической болезнью сердца, заболеваниями периферических артерий\nи/или цереброваскулярными заболеваниями следует применять кетопрофена лизиновую\nсоль только после тщательного обследования. Такое же обследование должны\nпроходить пациенты перед началом длительного лечения с факторами риска развития\nкардиоваскулярных заболеваний (например, артериальная гипертензия,\nгиперлипидемия, сахарный диабет, курение)."}},{"type":"paragraph","data":{"text":"Сообщалось о\nповышенном риске развития артериальных тромбозов у пациентов, принимающих  НПВП для купирования периоперационного\nболевого синдрома при выполнении аортокоронарного шунтирования."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат имеет ограниченное и умеренное\nвлияние на способность управлять транспортными средствами или механизмами по\nпричине возможного появления головокружения и сонливости."}},{"type":"paragraph","data":{"text":"Если после применения препарата отмечается\nсонливость, головокружение или судороги, следует избегать управления\nавтотранспортом и механизмами, а также других видов деятельности, требующих\nконцентрации внимания."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eПервичная упаковка\u003c/i\u003e: по 1 г гранул в пакетик из комбинированного материала\n(бумага/алюминий/полиэтилен)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВторичная упаковка\u003c/i\u003e: по 12, 15, 18 или 30 пакетиков помещают в пачку картонную\nвместе с инструкцией по применению."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать препарат после истечения\nсрока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eДержатель РУ:\u003c/i\u003e Сандоз д.д. Веровшкова 57, 1000 Любляна, Словения;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eПроизведено:\u003c/i\u003e Файн Фудc энд Фармасьютикалз Н.Т.М. С.П.А., Виа-Гриньяно, 43, 24041 – Брембате (Бергамо), Италия."}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"АО «Сандоз», 125315, г. Москва,\nЛенинградский проспект, д.70;"}},{"type":"paragraph","data":{"text":"телефон:\n(495) 660 75 09; факс: (495) 660 75 10."}}]}],"source":null},"description_toggle":false,"short_description":"ФармакодинамикаОказывает противовоспалительное, анальгезирующее и жаропонижающее действие. Ингибируя циклооксигеназу I и II типа, угнетает синтез простагландинов. Обладает антибрадикининовой активностью, стабилизирует лизосомальные мембраны и задерживает высвобождение из них ферментов, способствующих разрушению тканей при хроническом воспалении. Снижает выделение цитокинов, тормозит активность нейтрофилов. Уменьшает утреннюю скованность и припухлость суставов, увеличивает объем движений. Кетопрофена лизиновая соль, в отличие от кетопрофена, является быстрорастворимой молекулой с нейтральным рН и почти не вызывает раздражение желудочно-кишечного тракта (ЖКТ).ФармакокинетикаВсасываниеКетопрофен при приеме внутрь быстро и достаточно полно всасывается из ЖКТ, его биодоступность составляет около 80 %. Максимальная концентрация в плазме крови при приеме внутрь отмечается через 0,5-2 ч и прямо зависит от принятой дозы. Равновесная концентрация кетопрофена достигается через 24 ч после начала его регулярного приема.РаспределениеДо 99 % адсорбировавшегося кетопрофена связывается с белками плазмы, преимущественно с альбумином. Объем распределения – 0,1-0,2 л/кг. Легко проходит через гистогематические барьеры и распределяется в тканях и органах. Кетопрофен хорошо проникает в синовиальную жидкость и соединительные ткани. Хотя концентрация кетопрофена в синовиальной жидкости несколько ниже, чем в плазме крови, она более стабильна (сохраняется до 30 ч).МетаболизмКетопрофен в основном метаболизируется в печени, где он подвергается глюкуронидации с образованием сложных эфиров с глюкуроновой кислотой.ВыведениеМетаболиты выводятся почками. Препарат не кумулируется.","substance":[{"id":94,"title":"Кетопрофен","title_latin":"Ketoprophenum","slug":"ketoprofen_94"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Кетонал Актив - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/87253/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/87253/share_default/"}},"diseases":[],"other_packages":[],"other_product_forms":[],"related_products":{"title":"Аналоги","type":"analogs","products":[{"id":96122,"title":"ОКИ","subtitle":{"full":"Гранулы, саше, 12 шт, 80 мг, для раствора для приема внутрь","short":"Гранулы, 12 шт, 80 мг","package":"12 шт, 80 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