Ketoprofen

Nonsteroidal Anti-inflammatory Drug (NSAID) Propionic acid derivative

Dosage & Administration Guidelines

Species Route Dose Frequency Duration & Clinical Notes
Dog PO 1-2 mg/kg q24h Duration: Up to 5 days (postoperative) or as directed for chronic conditions
Notes: Administer with food to reduce GI upset. Use lowest effective dose for shortest duration.
Dog IV 1-2 mg/kg q24h Duration: Up to 3 days
Notes: For perioperative pain management.
Cat PO 1-2 mg/kg q24h Duration: Up to 3-5 days
Notes: Use with caution in cats due to renal sensitivity. Administer with food.
Cat IV 1-2 mg/kg q24h Duration: Up to 3 days
Notes: For perioperative pain management.
Horse IV 2.2 mg/kg q24h Duration: Up to 5 days
Notes: Administer slowly IV. For colic, use as adjunctive therapy.
Horse PO 2.2 mg/kg q24h Duration: Up to 5 days
Notes: Oral paste or granules. Administer with feed.
Cattle IV 3 mg/kg q24h Duration: Up to 3 days
Notes: For respiratory disease and mastitis adjunctive therapy.
Cattle SC 3 mg/kg q24h Duration: Up to 3 days
Notes: Subcutaneous injection is approved in some countries.
Small Ruminants (Sheep/Goats) IV 2-3 mg/kg q24h Duration: Up to 3 days
Notes: Extra-label use; use with caution.
Rabbit PO 1-2 mg/kg q24h Duration: Up to 3 days
Notes: Extra-label use; monitor renal function.
Rabbit SC 1-2 mg/kg q24h Duration: Up to 3 days
Notes: Extra-label use.
Bird/Poultry PO 2-5 mg/kg q12-24h Duration: Up to 3 days
Notes: Extra-label use; limited data.

Clinical Indications & Species Uses

General Indications
  • Pain and inflammation associated with musculoskeletal disorders
  • Postoperative pain
  • Pyrexia
Dog (Canine)
  • Postoperative pain and inflammation
  • Musculoskeletal pain (e.g., osteoarthritis)
  • Soft tissue inflammation
  • Pyrexia
Cat (Feline)
  • Postoperative pain and inflammation
  • Musculoskeletal pain (e.g., osteoarthritis)
  • Soft tissue inflammation
  • Pyrexia
Horse (Equine)
  • Musculoskeletal pain (e.g., lameness, laminitis)
  • Postoperative pain and inflammation
  • Colic pain (as adjunctive therapy)
  • Soft tissue inflammation
Cattle (Bovine)
  • Musculoskeletal pain and inflammation
  • Respiratory disease (as adjunctive therapy)
  • Mastitis (as adjunctive therapy)
  • Pyrexia
  • Postoperative pain
Small Ruminants (Sheep / Goat)
  • Musculoskeletal pain and inflammation
  • Postoperative pain
  • Pyrexia
Rabbit & Small Mammals
  • Postoperative pain
  • Musculoskeletal pain
  • Inflammation
Avian & Poultry
  • Pain and inflammation (off-label use)
  • Pyrexia
Exotic & Other Species
  • Pain and inflammation in small mammals (off-label use)

Pharmacology & Mechanism of Action

Drug Class: Nonsteroidal Anti-inflammatory Drug (NSAID) | Pharmacological Group: Propionic acid derivative

Mechanism of Action: Ketoprofen is a non-selective inhibitor of cyclooxygenase (COX-1 and COX-2) enzymes, thereby blocking the conversion of arachidonic acid to prostaglandins and thromboxanes. This reduces inflammation, pain, and fever. Additionally, ketoprofen has inhibitory effects on lipoxygenase (LOX) pathways, which may contribute to its anti-inflammatory activity by reducing leukotriene production. It also stabilizes lysosomal membranes and inhibits neutrophil migration, further modulating the inflammatory response.

Pharmacodynamics: Ketoprofen produces analgesic, anti-inflammatory, and antipyretic effects. Its analgesic potency is comparable to or greater than that of other NSAIDs such as phenylbutazone and flunixin meglumine. The anti-inflammatory effect is mediated through reduction of prostaglandin synthesis, while the analgesic effect may also involve central and peripheral mechanisms. Onset of action is rapid, with peak effects typically seen within 1-2 hours after administration. Duration of action varies by species and formulation, but generally lasts 12-24 hours.

⚡ Pharmacokinetics Summary

Absorption: Ketoprofen is well absorbed after oral, intramuscular, and subcutaneous administration. In dogs, oral bioavailability is approximately 90%. Peak plasma concentrations occur within 0.5-2 hours after oral dosing. In horses, oral absorption is slower, with peak levels at 1-2 hours. In cattle, subcutaneous administration results in rapid absorption with peak levels at 1-2 hours.
Distribution: Ketoprofen is highly protein-bound (approximately 90-99% in most species). It distributes widely into tissues, with high concentrations in synovial fluid, which is important for treating joint inflammation. It crosses the blood-brain barrier to a limited extent and crosses the placenta. Volume of distribution is relatively small, consistent with its high protein binding.
Metabolism: Ketoprofen undergoes hepatic metabolism primarily via conjugation (glucuronidation) and oxidation. The major metabolic pathway involves hydroxylation and conjugation to form inactive metabolites. In dogs, metabolism is primarily hepatic, with some enterohepatic recirculation. In horses, metabolism is also hepatic, with a shorter half-life compared to other species.
Excretion: Ketoprofen and its metabolites are excreted primarily in the urine (approximately 80%) and to a lesser extent in feces. In ruminants, biliary excretion and enterohepatic recirculation may occur. Renal excretion involves both glomerular filtration and active tubular secretion.
Half-Life: Dog: 2-4 hours; Cat: 1-2 hours; Horse: 1-2 hours; Cattle: 0.5-1 hour; Rabbit: 1-2 hours; Poultry: 1-2 hours (estimated).
Bioavailability: Oral: ~90% in dogs, ~80% in cats, ~70-80% in horses. IM/SC: nearly 100%.
Protein Binding: Approximately 90-99% in most species, with higher binding in dogs and cats.

Available Formulations & Strengths

Oral Tablet 5 mg, 10 mg, 20 mg, 50 mg, 100 mg (PO)
Oral Capsule 50 mg, 75 mg (PO)
Injectable Solution 100 mg/mL (10% solution) (IV, IM, SC)
Oral Paste 100 mg/mL (PO)
Granules 10% w/w (PO)

Contraindications & Clinical Warnings

Contraindications:
  • Known hypersensitivity to ketoprofen or other NSAIDs
  • Active gastrointestinal ulceration or bleeding
  • Renal or hepatic impairment (severe)
  • Coagulopathies or bleeding disorders
  • Dehydration or hypovolemia
  • Concurrent use of other NSAIDs or corticosteroids
  • Pregnancy (especially late gestation) unless benefit outweighs risk
  • Lactating animals (unless specifically indicated and withdrawal times observed)
Warnings & Clinical Precautions:
  • Use with caution in animals with pre-existing renal, hepatic, or cardiac disease.
  • Monitor for gastrointestinal adverse effects, especially in dogs and cats.
  • Avoid use in animals with suspected or confirmed GI ulceration.
  • Use lowest effective dose for shortest duration.
  • In horses, do not use in cases of colitis or diarrhea.
  • In cattle, do not administer intra-arterially.
  • In cats, use with extreme caution due to long half-life and renal sensitivity.
  • Do not use in animals that are dehydrated, hypotensive, or in shock.
  • Concurrent use with other NSAIDs or corticosteroids is contraindicated.
  • In food animals, observe withdrawal times.
  • Use in young animals (<6 weeks) with caution.

Adverse Effects & Reactions

Common:

  • Gastrointestinal upset (vomiting, diarrhea, anorexia)
  • Elevated liver enzymes
  • Renal effects (increased BUN/creatinine)

Serious / Severe:

  • Gastrointestinal ulceration or perforation
  • Acute renal failure
  • Hepatotoxicity
  • Bone marrow suppression (rare)
  • Anaphylaxis (rare)

Rare:

  • Blood dyscrasias
  • Neurological signs (ataxia, seizures)
  • Dermatological reactions (rash, pruritus)

Key Drug Interactions

Interacting Drug / Class Clinical Effect & Mechanism Severity
Other NSAIDs (e.g., flunixin, carprofen, meloxicam) Additive risk of GI ulceration and renal toxicity High
Corticosteroids (e.g., dexamethasone, prednisone) Increased risk of GI ulceration and renal toxicity High
Anticoagulants (e.g., warfarin, heparin) Increased risk of bleeding due to platelet inhibition High
Diuretics (e.g., furosemide) Reduced diuretic efficacy and increased risk of renal toxicity Moderate
ACE inhibitors (e.g., enalapril) Reduced antihypertensive effect and increased risk of renal dysfunction Moderate
Aminoglycoside antibiotics (e.g., gentamicin) Increased risk of nephrotoxicity Moderate
Methotrexate Increased methotrexate toxicity due to reduced renal clearance Moderate

Overdose & Toxicity Management

Signs of Toxicity:

  • Vomiting
  • Diarrhea (possibly bloody)
  • Lethargy
  • Depression
  • Ataxia
  • Seizures (in severe cases)
  • Acute renal failure
  • Hepatotoxicity
  • Gastrointestinal ulceration or perforation

Emergency Treatment Protocol: Treatment is primarily supportive. Induce emesis if recent ingestion (within 2 hours) and animal is conscious. Administer activated charcoal to reduce absorption. Provide intravenous fluids to maintain renal perfusion and correct dehydration. Use gastroprotective agents (e.g., sucralfate, H2 antagonists, proton pump inhibitors) to manage GI effects. Monitor renal and hepatic function. In severe cases, consider hemodialysis or peritoneal dialysis. There is no specific antidote for ketoprofen overdose.

Food Animal Withdrawal Times

🥩 Meat: 7 days🥛 Milk: 4 days

Withdrawal times vary by country and formulation. In the US, ketoprofen is not approved for food animals, so extra-label use requires extended withdrawal times (e.g., meat 30 days, milk 7 days) as per FARAD guidelines. In the EU, approved formulations have meat withdrawal of 7 days and milk withdrawal of 4 days. Always consult local regulations.

Storage, Handling & Regulatory Information

Storage Temperature: Store at controlled room temperature 20-25°C (68-77°F), with excursions permitted between 15-30°C (59-86°F).

Light Sensitivity: Light-sensitive — protect from direct exposure.

Handling & Special Conditions: Protect from light. Keep container tightly closed. Do not freeze injectable solutions. Store oral formulations in a dry place.

Dispensing Status: Prescription Required (Rx Only)

Approval Status: Ketoprofen is not FDA-approved for veterinary use in the US. It is approved in some other countries for veterinary use (e.g., Europe, Canada). In the US, it is available as a human prescription drug and used extra-label.

Extra-Label (Off-Label) Use: In the US, ketoprofen is not approved for veterinary use in food animals. Extra-label use in food animals is permitted under AMDUCA with a valid veterinarian-client-patient relationship and extended withdrawal times. For companion animals, extra-label use is common. In the EU, ketoprofen is approved for use in cattle, pigs, and horses in some countries. Always follow label directions and consult regulatory authorities.

Clinical Pearls & Practice Notes

💡 Clinical Insights: Ketoprofen is a potent NSAID with both COX and LOX inhibitory activity, providing effective analgesia and anti-inflammatory effects. It is commonly used for postoperative pain, musculoskeletal conditions, and as an adjunct in colic and respiratory disease. Due to its potential for GI and renal adverse effects, it should be used with caution, especially in cats and animals with pre-existing conditions. In food animals, strict adherence to withdrawal times is essential. For perioperative use, administer preemptively to maximize analgesic benefit. Monitor renal and hepatic function during prolonged therapy. Consider alternative NSAIDs with better safety profiles in cats (e.g., meloxicam) if available.

References & Literature

  • 📚 Plumb's Veterinary Drug Handbook
  • 📚 Papich Veterinary Pharmacology and Therapeutics
  • 📚 Compendium of Veterinary Products (CVP)