Why ketans are sold by prescription. Ketanov do I need a prescription. The use of the drug for toothache

Packs 10 and 20 are registered as over-the-counter drugs in some countries. In general, the drug is not registered, so you can easily buy it at any pharmacy without a prescription. Regarding the fact that analgin is safer than ketanov, one can argue. Although lately I have preferred naproxen more.

Ketanov is an anesthetic drug. Although very effective, it is powerful and has many side effects. Therefore, you should not purchase this drug on your own, only with a doctor's prescription, although you can easily purchase it yourself at any pharmacy.

It is believed that Ketanov is sold by prescription only. But, it is noticed that in some smaller pharmacies it can be sold without a prescription. True, they still look at the buyer, who, from the point of view of the seller, will not sell suspicious. The most important thing is to understand that if they were sold to you, then you need to take ketans only as a last resort, and usually use other pain relievers.

Even that year, I had a severe toothache, so in the evening I had to go to the dentist, there she looked at me everything, and said to come in a couple of days, but warned that the tooth might ache at night.

And she advised me to go to the pharmacy and buy Ketans, at first I was very surprised, like, somewhere out of the corner of my ear I heard that this drug is not sold without a prescription, to which the dentist told me that even oh, how they sell it.

So, they really gave me this drug without a prescription, I said that the doctors advised me, no one asked anything, they just sold it and that's it.

So in theory, it seems as if it is impossible without a prescription, but in practice - they sell like cute.

OTC analogs to Ketanov tablets

Nonsteroidal anti-inflammatory drugs have been the sales leaders in the world's pharmacy chains for several years, which is quite natural. Medicines in this group have a wide range of uses, are effective and relatively inexpensive.

The drug Ketanov (ketorolac) is one of the most popular when prescribed to patients, but recently, this drug is dispensed in Russian pharmacies only by prescription. Below, analogs to Ketanov's tablets and options for replacing it with over-the-counter drugs will be described in detail.

Instructions for use

The active ingredient, ketorolac, belongs to non-steroidal anti-inflammatory drugs (NSAIDs). It is produced both in tablet form and in the form of a solution for injection.

It has an anti-inflammatory and pronounced analgesic effect by blocking the mediators (mediators) of inflammation.

The result is a decrease in pain, edema and hyperemia of the affected area of the patient's body.

It is indicated for use in pain syndromes of various origins, including after surgery and in cancer patients.

The price of this medicine: tablets - from 70, ampoule packaging - from 110 rubles.

Drug analogs

In Russian pharmacies, there are many cheap Ketanov analogues of various forms of use. Tablet preparations - Ketorol, Ketorolac (several types of domestic manufacturers and the Belarusian plant "Belmedpreparaty"), Ketokam, Ketofril. They have the same indications for use and a standard dosage of 10 mg. The price starts from 50 rubles per package.

Variety also reigns in injection forms. Ketorolac in ampoules is available for purchase under the trade names Ketorol, Ketorolac, Dolac. A package of 10 ampoules costs from 85 rubles.

For external use under the trade name Ketorol gel (Dr. Reddis firm). The price for a tube of ointment is about 230 rubles.

In the form of eye drops, there is Akular. Used by ophthalmologists in the postoperative period in patients. The price is 350 rubles.

What to replace?

It is not always possible to quickly write a prescription for Ketanov from a doctor. The way out of this situation is to replace it with another drug from its group, which is allowed to be dispensed from pharmacies without a prescription.

Ibuprofen

Properties: NSAIDs for a wide range of purposes. In addition to pain relief, it has a pronounced antipyretic effect. Effective as a substitute for Ketanov, which helps with pain after dental treatment.

Indications for use: pains of various localization, postoperative period, hyperthermic syndrome (increased body temperature).

Method of production: in the form of gels (Ibuprofen Gel, Deep Relief), cream (Dolgit), tablets (Ibufen, MIG 200, MIG 400 and others), as well as suspensions for children (Maxikold, Ibuprofen - Akrikhin).

The price range is very large, the most inexpensive are Russian-made.

Naproxen

In terms of properties, this replacement is similar to Ketanov and Ibuprofen described above. It is used in rheumatology, neurology to relieve prolonged pain syndrome, helps with algodismenorrhea.

Available for purchase in the form of tablets (Naproxen-Acri, Nalgezin), it is also part of the combined analgesics (Pentalgin).

There are also gels and ointments (Naproxen, Naproxen EMO). Prices for tablet forms start at 100 rubles, a tube of gel will cost the buyer about twice as much.

Analgin, aspirin, paracetamol

It is necessary to mention these drugs, which belong to the category of NSAIDs. It should be remembered that they have a less pronounced anti-inflammatory and analgesic effect in comparison with the drug Ketanov. However, they are commonly sold over the counter, making them more accessible to the layman.

Combined drugs

They have a quick and pronounced analgesic effect due to the combination of various components that enhance each other's action. Common trade marks:

Spazmalgon is a combination of an antispasmodic (fenpiverinium bromide), analgin and pitofenone (NSAIDs). Effective for headache, toothache, and algodismenorrhea. Price - 120 Russian rubles per pack of 10 tablets.
Novalgin - in the composition of caffeine (stimulant of the vasomotor center in the brain), paracetamol and propyphenazone (NSAIDs). Reduces fever, relieves joint pain and headache. The cost is about 170 rubles.
Novigan is an Indian drug. It contains a combination of an antispasmodic and two types of NSAIDs (ibuprofen, pitofenone). It is widely prescribed for headaches, arthralgia, after injuries. Relieves pain in renal colic, dysmenorrhea. The unit price is about 160 rubles.

What do you need to remember?

The drugs described above have an extensive list of contraindications, before taking it, you should carefully study the instructions. Most common for NSAIDs:

erosive lesions of the esophagus, stomach and intestines;
the presence of bleeding from the gastrointestinal tract in the patient's history;
severe forms of coronary heart disease (acute and chronic insufficiency, myocardial infarction). NSAIDs, in particular ketorolac and diclofenac, have proven cardiotoxic effects;
bronchial asthma (especially in the presence of the "aspirin form");
pregnancy and early postpartum period;
severe impairment of kidney and liver function (end-stage chronic renal failure, liver cirrhosis);
it is not recommended to prescribe in any condition accompanied by a risk of bleeding (perioperative period, taking anticoagulants).
not prescribed in childhood (with the exception of some forms of paracetamol and ibuprofen, which are used to lower body temperature in children from the first days of life).

Side effects

More often, undesirable manifestations from Ketanov and other non-steroidal anti-inflammatory drugs occur with prolonged and uncontrolled intake.

Acute erosion of the stomach and intestines, leading to bleeding and anemia of varying severity. This complication can be avoided by taking drugs that protect the mucous membrane of the gastrointestinal tract (omeprazole, ranitidine and others);
Exacerbation of gastritis, peptic ulcer disease in a patient;
Diarrhea;
Nausea and vomiting;
Increased blood pressure in patients with hypertension (often requires dose adjustment of antihypertensive drugs);
NSAIDs violate blood clotting, which threatens the appearance of subcutaneous hematomas, petechiae.

Before you start taking any drug of this series, carefully read the instructions, focusing on contraindications and side effects. It is also recommended to discuss the possibility of treatment with a specialist. In this case, it will be possible to help the body without damage.

Ketanov (tablets, injections) - instructions for use, analogs, reviews, price

Names and forms of release

1. Tablets for oral administration.

2. Solution for intramuscular injection.

Ketans - composition

Corn starch;
Microcrystalline cellulose;
Silica;
Magnesium stearate;
Hydroxypropyl methylcellulose;
Macrogol 400;
Purified talcum powder;
Purified water.

Tablets are available in packs of 10, 20 and 100 pieces per pack.

Sodium chloride (table salt);
Edetate disodium;
Ethanol;
Sodium hydroxide;
Water for injections.

The solution is available in 1 ml ampoules, 5 or 10 pieces per pack.

Ketanov - therapeutic action and scope

Compared with Aspirin, the analgesic effect of Ketans is 350 times stronger;
Compared with Indomethacin - 5 times;
Compared with Butadion - 435 times;
Compared with Nalgezin - 50 times.

Among the non-narcotic painkillers available on the pharmaceutical market that do not affect the central nervous system, Ketanov is the most powerful. Due to its powerful peripheral action, Ketanov is an ideal pain reliever for the relief of severe to moderate pain, especially provoked by trauma and surgery.

Does not depress breathing;
Does not cause depression of the central nervous system;
Does not have a pronounced sedative effect;
Does not provoke nausea and vomiting;
Does not cause urinary retention;
Does not weaken intestinal peristalsis;
Doesn't change heart rate;
Does not change blood pressure.

However, Ketanov reduces blood clotting, so the drug should be used with caution if there is a high risk of bleeding, for example, in people suffering from diseases of the gastrointestinal tract.

Ketanov (tablets and injections) - indications for use

1. Relief of pain after surgery (general surgical, gynecological, orthopedic, urological, dental and ENT organs).

2. Relief of pain after traumatic injury to muscles, bones and soft tissues (for example, during sprains, dislocations, fractures, bruises, etc.).

3. Short-term pain relief in the following conditions:

Otitis;
Fibromyalgia (muscle pain);
Radicular syndrome;
Osteochondrosis.

It should be remembered that Ketanov cannot be used to relieve sharp and acute abdominal pains, as this can mask the symptoms of a disease requiring urgent surgical intervention.

Instructions for use

Ketanov tablets - instructions for use

Ketanov injections - instruction

Person under the age of 65- the first and subsequent administrations of 10 - 30 mg (0.3 - 1 ml of solution);
Person over 65 or suffering from renal failure - inject 10 - 15 mg (0.3 - 0.5 ml of solution).

The maximum allowable daily dosage of Ketanov for people under 65 is 90 mg (3 ml of solution), and for patients over 65 or suffering from kidney disease - 60 mg (2 ml of solution). When using the "on demand" regimen, the solution is administered as soon as pain appears. And when using the "on schedule" regimen, Ketanov's solution in the indicated dosages should be injected every 4-6 hours, regardless of whether there is a sensation of pain at the time of the next injection.

Precautionary measures

Influence on the ability to control mechanisms

Overdose

To eliminate an overdose, gastric lavage is performed and sorbents are given (activated carbon, Polysorb, Polyphepan, etc.), after which symptomatic therapy is carried out, aimed at maintaining the normal functioning of vital organs.

Ketanov - compatibility with other drugs

Saline;
5% dextrose solution;
Ringer's solution;
Plasmalite solution;
Aminophylline, Lidocaine, Dopamine, Insulin and Heparin solution.

Ketanov: composition, indications, instructions for use, dosages, precautions - video

The use of the drug for toothache

Application for headache

Ketans for children

Application during pregnancy and breastfeeding

Is Ketanov banned?

Ketanov and alcohol

Side effects

Acute renal failure
Lower back pain;
Blood in the urine
Hemolytic uremic syndrome (anemia + renal failure + purpura + decreased blood platelet count);
Frequent urination
An increase or decrease in the volume of urine;
Nephritis;
Swelling (of the face, legs, ankles, fingers, feet, tongue).

3.Senses:

Anemia;
Leukopenia (decrease in the total number of leukocytes in the blood);
Eosinophilia (an increase in the number of eosinophils in the blood);
Bleeding from a wound;
Epistaxis or rectal bleeding.

8.Skin covering:

Rash;
Purpura;
Exfoliative dermatitis (fever, redness, thickening and peeling of the skin, swelling and tenderness of the tonsils);
Hives;
Stevens-Johnson syndrome;
Lyell's syndrome;
Burning and pain in the area of solution injection (for injection only).

9.Allergic reactions: Anaphylactic shock (swelling of the face, larynx, itching of the skin, difficulty breathing, heaviness in the chest, etc.) 10. Other:

Contraindications to the use of Ketans

Individual sensitivity to Ketanov or other drugs of the NSAID group;
"Aspirin asthma" in the present or past;
Bronchospasm;
Angioedema;
Dehydration (dehydration);
Hypovolemia (small volume of circulating blood);
The period of exacerbation of erosive and ulcerative lesions of the digestive tract;
Peptic ulcers in the acute stage;
Reduced blood clotting (including hemophilia);
Liver failure;
Renal failure with a blood creatinine concentration of more than 50 mg / l;
Hemorrhagic stroke, including the suspect;
Hemorrhagic diathesis;
High risk of bleeding;
Violation of hematopoiesis;
Pregnancy and the period of breastfeeding;
Age under 16;
Chronic pain.

The following conditions or diseases are relative contraindications to the use of tablets and Ketanov solution:

Bronchial asthma;
Cholecystitis;
Hypertonic disease;
Impaired renal function with a plasma creatinine concentration of less than 50 mg / l;
Cholestasis;
Active hepatitis;
Sepsis;
Systemic lupus erythematosus;
Polyps on the mucous membrane of the nose and nasopharynx.

Ketanov - analogues

Adolor tablets;
Dolac solution and tablets;
Dolomin solution;
Ketalgin solution and tablets;
Ketorol solution, tablets and gel;
Ketolac tablets;
Ketorolac solution and tablets;
Ketofril solution and tablets;
Ketokam tablets.

The following drugs are analogs of Ketanov:

Arthrotek tablets;
Asinak tablets;
Aertal tablets;
Bioran solution and tablets;
Voltaren solution, tablets and rectal suppositories;
Diclac solution, rectal suppositories and tablets;
Diklovit rectal suppositories;
Diclogen solution and tablets;
Diclonat P solution, tablets and rectal suppositories;
Dicloran solution and tablets;
Diclofenac solution, tablets, and rectal suppositories;
Indomethacin tablets and rectal suppositories;
Metindol retard tablets;
Naklofen tablets, solution and rectal suppositories;
Naklofen Duo capsules;
Neurodiclovitis capsules;
Ortofen solution and tablets;
Ortofer solution and tablets;
Panoxen tablets;
Rapten Duo and Rapten Rapid tablets;
Rantudil Forte and Rantudil Retard capsules;
Flotak capsules.

What is stronger than Ketanov?

Reviews of the drug

Ketanov (tablets, ampoules) - price

Tablets, 10 pieces - 26 - 33 rubles;
Tablets, 20 pieces - 62 - 70 rubles;
Tablets, 100 pieces - 248 - 275 rubles;
Solution, 10 ampoules –112 - 137 rubles.

Is Ketanov on sale by prescription or not?

Why did ketanov start being sold by prescription?

I don't know about this drug, but I used to be a neighbor, she is an old grandmother, I bought karbolepsin at the pharmacy. He also has a prescription now. I work as a security guard, but sometimes they force me to be on duty in the police. 3 months ago I turned out to be understood - they took a drug dealer. They made counter purchase and he sold them 1 gram of heroin for 1,500 rubles. Carbolepsin contains 0.022 morphine and 0.008 heroin.

Carbolepsin cost 100 gr. RUB 160 Hence, by buying 1 kg of it, you could get 2.2 grams of morphine and 0.8 heroin from it. to do business on this, it seems to have been promoted, but perhaps the reason is the same as with ketanol.

Ketans were banned from free sale, because cases of death increased when taking it. That is, it carries with it a bunch of side effects, it is dangerous when interacting with other substances. The risk of gastrointestinal bleeding and stroke is high. In Europe, because of this, it was generally forbidden to sell it.

Prescription ketans began to be sold because it entered the list of drugs that must be sold strictly by prescription, there is an order from the Ministry of Health about this. Ketanov has many side effects, and there have been deaths after taking it. It is not sold in Europe, it is produced in India.

It had to be sold by prescription before. They just sold it that way. In general, they gave me a recipe for it three years ago. But then no one asked him. And now they don't ask. Only in some pharmacies.

I recently bought myself the medicine Ketorol for toothache and the pharmacist warned me that I should take it strictly in 4 hours if the pain reappears or does not go away. I did so, but 2 tablets were enough for me. Since the medicine is very powerful for 42 rubles. Well In general, my mother's doctor's friend does not recommend taking this medicine more than once, since even from one priming the load and harm on the liver is strong. Personally, after taking this medicine, I developed weakness and mild nausea. But Ketanov's medicine is said to be even stronger, so that. .By the way, I would still ban the antibiotic Klacid, since the side effects are even worse than these drugs.

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And what about ketans - a drug banned for free sale?

And then I went to the pharmacy, they asked me for a prescription. I gru - no, they always sold like that. And they answer me - nifiga, they violate them in those pharmacies, and they hint at length that they say it’s down to it without a prescription.

They let such a fog in and talked so sympathetically, as if I was going to make a drug out of him.

In general, under "You are so young, and so ruining yourself" left with nothing. I went to another - sold without problems.

What was that? Is it the madness of pharmacists and pharmacists taken separately, or are all "others violating"?

Ketanov by prescription.

04/25/10 11:12 PM Reply to the message of the Ketans according to the recipes. by lion

Because he was always there.

04/25/10 11:47 PM Reply to the message Re: Ketanov on recipes. by Zaika555

Failure to comply is a risk that each particular pharmacy and each particular pharmacist assumes. That's all.

From the pharmacist's answer, it follows that now they have become stricter to check. It is logical that they began to release less what is supposed to be done according to the recipes, because the punishment for this is decent.

To see a rainbow, you have to survive the rain. (with)

04/26/10 00:07 Reply to the message Re: Ketanov on recipes. by Zaika555

“We bring laughter and joy to people. " (WITH)

Sperat in adversis

04/26/10 10:07 AM Reply to the message of the Ketans according to the prescriptions. by lion

There are Nise tablets - they help from the tooth well. 5 minutes and that's all.)) I've been choosing a dentist for a month now)) I'm grumpy and nothing hurts)) True, you still need to stomp to the doctor (a lot of wheels are harmful. sensations and. eternal buzz))

So are you from Siberia? They say you have bears on the roads?

Ketanov do I need a prescription

Of course, I am far from the world of pharmacists, pharmacists, and even more so from the Ministry of Health, as a student of a medical college from the head. Research Institute of Cardiovascular Surgery, and nevertheless.

A little over an hour ago, it was my urge to walk to the nearest pharmacy for a banal reason. "Got sick, DIFFERENT AND STARTED MY TOOTH NIGHTMARE."

Me: "Be so kind as a package of KETANES."

P: “You take it as prescribed by a doctor. "

I was a little taken aback. There was a feeling that I was almost asking her for antipsychotics.

Me: “Yes, no. They simply let him go to me anyway. "

Me: “What you have is not on a prescription. "

A powerful and commanding finger points to a shop window, which flaunts colorful packages of analgesic drugs, at the same colorful prices.

Okay, I think this has not happened before, maybe this is just an exception to the rule, I will walk to another first-aid kit.

The situation repeated itself, and for 1.5-2 minutes I was choosing a drug from the display assortment (fortunately, there was only one and there was time to admire the prices "with the expression of a cat in the photo").

As a result, I had to buy an analgesic 3 times (!) More expensive than the requested one.

At home, the Internet prompted me that this type of drug was included by order (h.z what) of the Ministry of Health in the list as with protected contraindications.

I read the list in the purchased one.)))) Not far he ran away from Ketanov (and the rest of the Ketorolac family).

I know that the drug is quite strong, it cannot be abused;

I was not born yesterday, I had a glimpse of the peculiarities of the drug industry (well, not the same);

I know I need to visit the dentist.

What do you say, gentlemen, pharmacists of the peekaboo portal. If there are any. If I am wrong about something, then I tolerate objective criticism normally.

Ketanov tablets: instructions for use

Ketanov is a non-steroidal anti-inflammatory agent with a pronounced analgesic, anti-inflammatory and moderate antipyretic effect, a derivative of pyrrolysine-carboxylic acid.

The drug is used for pain syndromes of various etiologies. Directions for use: oral and parenteral (intramuscular injections). Recommended for short-term use.

On this page you will find all the information about Ketanov: full instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Ketanov. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

NSAIDs, a derivative of pyrrolysine carboxylic acid.

Terms of dispensing from pharmacies

Dispensed by prescription.

How much are Ketans worth? The average price in pharmacies is 70 rubles.

Is Ketanov banned?

In other countries, Ketanov is still used, but it is sold only with a doctor's prescription. Since 2012, Ketanov's prescription leave has been introduced in Russia, but in practice, many pharmacies sell it freely.

Release form and composition

One coated tablet contains:

Active ingredient: ketorolac trometamol - 10.00 mg.
Excipients: corn starch - 44.76 mg, microcrystalline cellulose - 122.41 mg, colloidal silicon dioxide -1.83 mg, magnesium stearate - 1.00 mg.
Film shell: hypromellose - 2.91 mg, macrogol - 400 - 0.68 mg, purified talc - 0.16 mg, titanium dioxide - 1.25 mg.

Round biconvex film-coated tablets of white or almost white color with "KVT" engraving on< одной стороне.

Pharmacological effect

The active substance of the drug is ketorolac, which has a pronounced analgesic, moderate antipyretic and anti-inflammatory effect.

Unlike narcotic analgesics, the use of Ketanov does not affect psychomotor functions and the work of the heart muscle, does not depress the respiratory center and does not cause drug dependence.

In terms of the strength of the analgesic effect, Ketanov is noticeably superior to other NSAIDs and is equivalent to morphine.

Indications for use

As a rule, elimination of painful sensations of any location and nature is considered as the main indication for the use of Ketans. In general, the following applications are considered:

elimination of pain from injuries, fractures, bruises;
elimination of pain after any surgical operations.

For a short time, Ketanov can relieve such conditions as:

Otitis;
Fibromyalgia (muscle pain);
Pain with osteoarthritis or osteoarthritis;
Pain in malignant tumors;
Sciatica (pain along the sciatic nerve);
Radicular syndrome;
Pain after withdrawal of narcotic analgesics;
Toothache in any dental disease (for example, pulpitis, caries, periodontitis, etc.);
Pain during dental procedures;
Biliary or renal colic (in combination with antispasmodic drugs);
Pain after childbirth and episiotomy (perineal incision);
Osteochondrosis.

Ketanov for toothache

When a toothache appears, do not immediately take pills. Try first to thoroughly brush your teeth with a healing paste, and then rinse your mouth with Rotokan every half hour. Effective for Metrogyldent's toothache. If this does not help, and you cannot go to the dentist at the moment, then you can use the drug Ketanov.

You can drink a pill, or you can put it on a sore tooth - so you will forget about the pain for 3-5 hours. When it restarts, take 1 more pill, but no more. Do not overuse this medicine, as it is a powerful analgesic with properties similar to opium drugs. It also has a detrimental effect on the liver and, when combined with alcohol, can lead to liver failure.

Contraindications

Contraindications to the use of Ketanov are:

Treatment of chronic pain;
Simultaneous appointment with other NSAIDs;
Pregnancy, childbirth, breastfeeding period;
Children and adolescents up to 16 years of age, since safety and efficacy have not been established;
Renal and / or hepatic impairment (with plasma creatinine levels above 50 mg / ml);
Pain relief before or during surgery (due to an increased risk of bleeding);
Peptic ulcers, erosive and ulcerative lesions of the gastrointestinal tract in the acute stage, hypocoagulation (including hemophilia);
Hemorrhagic diathesis, hemorrhagic stroke (suspected or confirmed), impaired hematopoiesis, high risk of recurrence or development of bleeding (including after surgery);
Hypersensitivity to ketorolac or other NSAIDs, angioedema, bronchospasm, "aspirin asthma", dehydration and hypovolemia.

Ketanov is prescribed with caution to persons over 65 years of age and to patients with the following diseases:

Sepsis;
Active hepatitis;
Cholestasis;
Systemic lupus erythematosus;
Chronic heart failure;
Bronchial asthma;
Arterial hypertension;
Cholecystitis;
Impaired renal function (with plasma creatinine levels below 50 mg / ml);
Polyps of the nasopharynx and nasal mucosa.

Application during pregnancy and lactation

Ketanov in any form is contraindicated for use during pregnancy and lactation. Its use during pregnancy can only be resorted to for health reasons on the part of the mother. If Ketanov is indicated for a nursing mother, then for the period of its use, the woman should transfer the child to artificial mixtures.

During childbirth, it is also impossible to use Ketans for the purpose of anesthesia, since the drug lengthens the course of the labor act and weakens the contractile activity of the uterus, which can provoke severe complications, including bleeding.

Women forced to use Ketanov during pregnancy should not worry too much, since no negative effects of the drug on the fetus have been revealed in animal experiments. However, in females receiving Ketans, late labor and prolonged pregnancy were observed.

Instructions for use

The instructions for use indicate that Ketanov in the form of tablets is taken orally.

A single dose with a single dose is 10 mg (1 tablet). If necessary, the drug in the same dose can be taken up to 4 times a day (maximum 40 mg per day).

Intramuscularly (deeply) Ketans in the form of a solution for injection should be administered in the lowest effective doses, which the doctor selects individually, depending on the intensity of pain and response to therapy. If necessary, simultaneous use with reduced doses of opioid analgesics is possible.

With a single intramuscular injection, single doses of Ketanov are:

Patients under 65 years of age - mg (determined by the severity of the pain syndrome);
Patients over 65 years of age or patients with functional impairment of the kidneys - mg.

With repeated intramuscular administration, the following are usually used:

Patients up to 65 years old - mg, then every 4-6 hours, pomg;
Patients over 65 years of age or patients with functional impairment of the kidneys - every 4-6 hours a day.

The maximum daily doses for intramuscular administration are:

Patients under 65 years of age - 90 mg;
Patients over 65 years of age or patients with functional impairment of the kidneys - 60 mg.

The same total daily doses should not be exceeded when switching from parenteral administration of Ketanov to taking the drug orally (on the day of the transition, it is permissible to take 30 mg of the drug orally).

The duration of Ketanov's use in any dosage form should not exceed 5 days.

Side effects

The use of Ketans can cause the following side effects:

Central nervous system: often - drowsiness, dizziness and headache; rarely - hyperactivity (anxiety, mood changes), hallucinations, psychosis, depression, aseptic meningitis (severe headache, fever, stiffness of the back and / or neck muscles, convulsions);
Urinary system: rarely - frequent urination, renal edema, nephritis, increase or decrease in urine volume, hemolytic uremic syndrome (hemolytic anemia, purpura, thrombocytopenia, renal failure), back pain (including with hematuria and / or azotemia) , acute renal failure;
Digestive system: often (especially in people over the age of 65 years, in the history of which there are indications of erosive and ulcerative lesions of the gastrointestinal tract) - diarrhea, gastralgia; less often - flatulence, a feeling of fullness in the stomach, vomiting, constipation, stomatitis; rarely - erosive and ulcerative lesions of the gastrointestinal tract (including bleeding and / or perforation - burning or spasm in the epigastric region, abdominal pain, heartburn, nausea, vomiting like "coffee grounds", melena, etc.), nausea, hepatitis, acute pancreatitis, cholestatic jaundice, hepatomegaly;
Cardiovascular system: less often - increased blood pressure; rarely - fainting, pulmonary edema;
Sense organs: rarely - ringing in the ears, hearing loss and visual impairment (including blurred vision);
Hematopoiesis: rarely - eosinophilia, anemia, leukopenia;
Respiratory system: rarely - rhinitis, dyspnea or bronchospasm, laryngeal edema, manifested by shortness of breath and difficulty breathing;
Hemostatic system: rarely - nose or rectal bleeding, bleeding from a postoperative wound;
Allergic reactions: rarely - anaphylaxis or anaphylactoid reactions (itching of the skin, rash, hives, discoloration of the face, swelling of the eyelids, shortness of breath, heaviness in the chest, tachypnea or dyspnea, shortness of breath, periorbital edema, wheezing);
Skin: less often - purpura, skin rash (including maculopapular); rarely - urticaria, exfoliative dermatitis (fever, sometimes with chills, peeling, redness and / or thickening of the skin, soreness and / or swelling of the palatine tonsils), Lyell and Stevens-Johnson syndromes;
Others: often - edema (feet, fingers, ankles, legs, face), weight gain; less often - increased sweating; rarely - fever, swelling of the tongue.

Overdose

Overdose symptoms: nausea, vomiting, abdominal pain, the formation of peptic stomach ulcers, erosive gastritis, metabolic acidosis, renal dysfunction.

Treatment: gastric lavage, the appointment of adsorbents and symptomatic therapy.

special instructions

In the postoperative period, the drug Ketanov should be used with caution, while controlling the blood clotting ability. This is due to the high risk of bleeding in the postoperative period.

The drug is used with extreme caution in patients with depression of liver function and impaired cardiac activity. Patients with erosive gastritis or a history of gastric ulcer can be treated with drugs only with the permission of a specialist after a preliminary examination.

Since during the use of the drug, hypersensitive patients may complain of dizziness, headaches and drowsiness, you should avoid driving a car and controlling complex mechanisms that require increased concentration.

Drug interactions

With the simultaneous use of ketorolac with other NSAIDs, the development of additive side effects is possible; with pentoxifylline, anticoagulants (including heparin in low doses) - the risk of bleeding may increase; with ACE inhibitors - it is possible to increase the risk of developing renal dysfunction; with probenecid - the concentration of ketorolac in plasma and its half-life increase; with lithium preparations - a decrease in the renal clearance of lithium and an increase in its concentration in plasma is possible; with furosemide - a decrease in its diuretic action.

With the use of ketorolac, the need for the use of opioid analgesics for pain relief is reduced.

Alcohol compatibility

This drug is incompatible with alcohol, since the risk of side effects from the gastrointestinal tract in the form of gastralgia, abdominal pain and bleeding from the gastrointestinal tract increases. Alcohol enhances the analgesic effect, so you can skip the moment when you need to urgently see a doctor. In addition, it enhances the depressing effect on the central nervous system, causing drowsiness, lethargy.

thanks

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Ketanov is a non-narcotic analgesic drug ( analgesic) from the group of non-steroidal anti-inflammatory drugs (NSAIDs). In addition to the powerful and rapid analgesic effect, Ketanov has moderate anti-inflammatory and antipyretic effects. However, since the drug has the most pronounced analgesic effect, it is used as an analgesic for pain syndrome of various origins. The optimal field of application of Ketans is to relieve pain of traumatic origin or arising after operations on various organs.

Names and forms of release

Currently, Ketanov is available in the following two dosage forms:
1. Oral tablets.
2. Solution for intramuscular injection.

Ketanov tablets can be of two varieties - in a regular or in a film shell. However, these varieties are exactly the same in terms of clinical effect, so this difference is insignificant for doctors and patients.

For designation in everyday speech, the Ketanov tablets are not called in any special, distinctive way. And the solution for intramuscular injection in everyday speech is usually called "Ketans injections" or "Ketans in ampoules".

Ketans are not available in the form of ointments or suppositories. In forms for external use (gels, ointments), other preparations are produced containing, like Ketanov, ketorolac as an active substance, such as, for example, Ketonal and Ketorol gels.

Ketans - composition

The composition of the solution and tablets of Ketanov as an active substance includes ketorolac in various dosages. So, one tablet contains 10 mg of ketorolac, and in solution - 30 mg per 1 ml.

The following substances are included in Ketanov tablets as auxiliary components:

Corn starch;
Microcrystalline cellulose;
Silica;
Magnesium stearate;
Hydroxypropyl methylcellulose;
Macrogol 400;
Purified talcum powder;

Tablets are available in packs of 10, 20 and 100 pieces per pack.

The composition of the solution for intramuscular injection of Ketanov contains the following substances as auxiliary components:

Sodium chloride (table salt);
Edetate disodium;
Ethanol;
Sodium hydroxide;
Water for injections.

The solution is available in 1 ml ampoules, 5 or 10 pieces per pack.

Ketanov - therapeutic action and scope

Ketanov belongs to non-steroidal anti-inflammatory drugs, therefore, has the following three therapeutic effects:
1. Anesthetic;
2. Anti-inflammatory;
3. Antipyretic.

However, Ketanov has a very pronounced and powerful analgesic effect, a very moderate anti-inflammatory and insignificant antipyretic. The analgesic effect literally "overshadows" the other effects, and therefore the drug is used as a non-narcotic, very strong anesthetic... Compared to other drugs of the NSAID group, the analgesic effect of Ketanov is tens or even hundreds of times stronger, for example:

Compared with Aspirin, the analgesic effect of Ketans is 350 times stronger;
Compared with Indomethacin - 5 times;
Compared with Butadion - 435 times;
Compared with Nalgezin - 50 times.

The therapeutic effect of Ketanov is due to the ability of the active substance to block the work of the enzyme cyclooxygenase which carries out the synthesis prostaglandins- substances that provoke the development of inflammation, fever and pain. That is, under the influence of Ketanov, the production of substances that provoke a sensation of pain stops, which relieves pain syndrome of any origin and localization.

Ketanov is effective for severe pain and has advantages over narcotic analgesics, since it does not cause, unlike opiates, (Morphine, Omnopon, etc.) the following side effects:

Does not depress breathing;
Does not cause depression of the central nervous system;
Does not have a pronounced sedative effect;
Does not provoke nausea and vomiting;
Does not cause urinary retention;
Does not weaken intestinal peristalsis;
Doesn't change heart rate;
Does not change blood pressure.

However, Ketanov reduces blood clotting, so the drug should be used with caution in the presence of a high risk of bleeding, for example, in people suffering from diseases of the gastrointestinal tract.

Ketanov (tablets and injections) - indications for use

The main and general indication for the use of both tablets and injections of Ketans is the relief of pains of various origins and localization. The indications for the use of tablets and injections are exactly the same, and the choice of the dosage form is made based on personal convenience.

Since pain syndrome is very widespread and accompanies many conditions and diseases, then such an official broad interpretation of indications for use, as relief of pain of various origins, is not entirely clear and can raise many questions. Therefore, for a better orientation, under what conditions it is necessary and possible to use the drug, in more detail the indications for the use of tablets and injections of Ketans can be listed as follows:
1. Pain relief after surgical interventions (general surgical, gynecological, orthopedic, urological, dental and ENT organs).
2. Relief of pain after traumatic injury to muscles, bones and soft tissues (for example, in sprains, dislocations, fractures, bruises, etc.).
3. Short-term pain relief in the following conditions:

Pain after withdrawal of narcotic analgesics;
Toothache in any dental disease (for example, pulpitis, caries, periodontitis, etc.);
Pain during dental procedures;
Biliary or renal colic (in combination with antispasmodic drugs);
Pain after childbirth and episiotomy (perineal incision);
Fibromyalgia (muscle pain);
Pain with osteoarthritis or osteoarthritis;
Pain in malignant tumors;
Sciatica (pain along the sciatic nerve);
Radicular syndrome;

It should be remembered that Ketanov cannot be used to relieve sharp and acute abdominal pains, as this can mask the symptoms of a disease requiring urgent surgical intervention.

In addition, it must be remembered that Ketanov only relieves pain, that is, eliminates a painful symptom, but does not cure the disease and does not eliminate the cause that provoked the pain syndrome. Therefore, Ketanov should always be used in combination with other drugs, the action of which is aimed at eliminating the cause of pain.

Instructions for use

Consider the rules for the use of tablets and injections of Ketans separately, since there are certain nuances in the use of these dosage forms that you should know. However, there are no fundamentally different indications for the use of tablets and injections, therefore, the choice of the dosage form of Ketanov in each specific case is based on personal convenience, preferences and the required speed of effect.

Ketanov injections and tablets can be used regularly for several days or as needed. If the option of regular intake is chosen, then pills or injections are given every 5 to 6 hours, regardless of whether there is currently a pain syndrome. When using the option of taking the drug as needed, they take a pill or give another injection only when pain appears. However, when using Ketanov in the "on demand" and "on schedule" regimen, the duration of the course of treatment should not exceed 5 days for adults and 2 days for children.

Ketanov tablets - instructions for use

The tablets should be taken orally, swallowing whole, without biting or chewing, but with a small amount of water (at least 100 ml). It is better to take the tablets after meals, since in this case their negative effect on the mucous membrane of the digestive tract is reduced. However, if the pill is taken after a fatty and plentiful meal, then the therapeutic effect will come a little later, for which one should be mentally prepared. If a person wants to relieve pain as quickly as possible, then the tablets should be taken before meals.

Ketans can be taken as needed, that is, when pain appears. You can also take the drug on schedule, regardless of whether there is pain at the time of the next appointment. When taking Ketanov as needed, every time pain appears, you should drink one tablet. And when taking the drug on schedule, you should take 1 tablet 3-4 times a day at regular intervals (6-8 hours). In cases where the pain is very severe, it is allowed to take Ketanov in an increased dosage of 2 tablets 3-4 times a day.

The total daily dosage of Ketanov when taken, both on schedule and as needed, is 8 tablets. If a person replaces injections with tablets, then on the day of switching from one dosage form to another, more than 30 mg of Ketanov (3 tablets) cannot be taken. People who weigh less than 50 mg, suffer from renal failure or are over 65 years old should take Ketans in half dosages, that is, half a tablet at a time, and not whole.

The duration of continuous use of tablets should be no more than 5 - 7 days, since otherwise the risk of developing severe and severe side effects significantly increases.

Ketanov injections - instruction

The ampoules contain a ready-to-use solution of Ketans, which is injected deeply intramuscularly. For the injection, you should choose those parts of the body on which the muscles come closest to the skin, and the layer of subcutaneous fatty tissue is minimal (for example, the outer surface of the thigh, the upper third of the shoulder, the abdomen in slender people, etc.).

It is not recommended to inject the Ketanov solution into the gluteal muscles, since in this part of the body there is a rather dense and developed subcutaneous fatty tissue. In this regard, the needle of the syringe does not always penetrate the muscle, as a result of which the solution is injected into the fatty tissue, from where it is slowly and poorly absorbed into the blood. After such an injection, when the solution enters the subcutaneous fatty tissue, and not into the muscle, a painful, long-lasting seal can form on the buttock, which worsens the patient's quality of life. In addition, if the solution gets into the fatty layer, then its effect will be much weaker than with the correct intramuscular administration.

Having chosen a site for injection, it is necessary to wipe this area with a cotton swab dipped in an antiseptic (alcohol, Chlorhexidine, etc.). Then open the ampoule and package with a syringe, put the needle on the needle holder and collect the required amount of solution. Since the ampoule contains 1 ml of solution, it is recommended to use a small 0.5 - 1 ml syringe for accurate dosage, but attach a long needle to it for intramuscular injection. After collecting the solution from the ampoule, the syringe is brought into a vertical position with the needle up. Then a finger is tapped on the side of the syringe in the direction from the piston to the needle holder so that air bubbles collect on the surface of the solution. After that, to remove air bubbles, the plunger of the syringe is pressed and a small drop or jet of solution is released into the air.

Only after such preparation is the syringe with the solution considered ready for intramuscular injection. To make an injection into the area treated with an antiseptic, the needle is inserted perpendicular to the skin, deep into the tissue (up to the nozzle, with which the needle is held on the syringe), after which, slowly pressing the plunger, the medicine is released into the muscles. After emptying the syringe, the needle is carefully removed from the tissues, and the injection area is again wiped with an antiseptic.

Intramuscular injections can be made independently at home if the person is proficient enough with the described technique and can maintain clarity of thought and control over the situation.

The dosage of Ketanov in injections is selected individually, depending on the intensity of pain and the person's response to the drug. Moreover, the drug should be used in the minimum effective dosage.

The solution can be administered "on demand" or "on schedule" (as with taking tablets). Moreover, when using any regimen of Ketanov's administration, its dosages are the same, depending on age:

Person under the age of 65 - the first and subsequent administrations of 10 - 30 mg (0.3 - 1 ml of solution);
Person over 65 or suffering from renal failure - inject 10 - 15 mg (0.3 - 0.5 ml of solution).

The maximum allowable daily dosage of Ketanov for people under 65 is 90 mg (3 ml of solution), and for patients over 65 or suffering from kidney disease - 60 mg (2 ml of solution). When using the "on demand" regimen, the solution is administered as soon as pain appears. And when using the "on schedule" regimen, Ketanov's solution in the indicated dosages should be administered every 4-6 hours, regardless of whether there is a sensation of pain at the time of the next injection.

A continuous course of intramuscular injections of Ketanov should not exceed 5 days, since longer use of the drug can provoke severe side effects.

When the need for a quick analgesic effect disappears, Ketan injections can be replaced with tablets. On the day of switching from injections to tablets, the total daily dosage of the drug should not exceed 90 mg for people under 65 and 60 mg for those over 65 or suffering from renal failure. Moreover, on the day of the transition, you cannot take more than 3 Ketanov tablets.

Precautionary measures

Ketans should not be used to relieve abdominal pain, as this can lead to a smoothing of the clinical picture of an acute disease, in which an urgent surgical operation is required.

The effect of reducing blood clotting stops 1 to 2 days after taking or administering the last dose of Ketanov. This should be borne in mind when performing planned surgical interventions and examinations. To avoid bleeding during the operation and distortion of the test results, it is necessary to cancel Ketanov 3 days before the scheduled manipulation.

When used simultaneously with paracetamol, Ketanov should not be used for more than 5 days in adults and 2 days in children.

If a person suffers from bleeding disorders or has undergone surgery, then during the entire period of using Ketanov, the number of platelets in the blood should be carefully monitored. In such cases, it is recommended to use the drug in minimal dosages.

With severe pain, Ketanov can be used in combination with narcotic analgesics.

If, against the background of the use of Ketans, symptoms of liver damage, a rash on the skin and an increased number of eosinophils in the blood appear, then the drug should be discontinued immediately.

Influence on the ability to control mechanisms

Ketanov in tablets and injections is quite often capable of provoking drowsiness and dizziness as side effects, therefore, against the background of the use of the drug, any activity related to the control of mechanisms and the need to maintain a high speed of reactions and attention should be abandoned.

Overdose

An overdose of Ketans is manifested by the following symptoms:

Stomach ache;
Nausea;
Vomit;
Peptic stomach ulcers;
Impaired renal function.

Ketanov - compatibility with other drugs

Ketans should not be used with other drugs of the NSAID group (Aspirin, Paracetamol, Ibuprofen, etc.), calcium compounds (calcium glycerophosphate, calcium gluconate, Calcium-D3 Nycomed, etc.), ethyl alcohol and glucocorticosteroids (Betamethasone, Hydrocortisone , Prednisolone, Dexamethasone, etc.), since such combinations can provoke instant formation of gastrointestinal ulcers and massive internal bleeding.

Ketanov with Paracetamol is toxic to the kidneys, and with Methotrexate, it is toxic to the liver. It is categorically impossible to use the combination of Ketanov + Paracetamol, and Ketanov + Methotrexate only if the dosage of the latter is reduced by at least 2 times.

Probenecid increases the duration of the Ketanov effect. The combined use of Ketans with anticoagulants (Warfarin, Thrombostop, etc.), heparin, thrombolytics, antiplatelet agents, sodium valproate, Cefoperazone, Cefotetan and Pentoxifylline increases the risk of bleeding.

Ketanov in combination with ACE inhibitors (Captopril, Enalapril, Lisinopril, etc.) increases the risk of developing renal dysfunction.

Antacids do not alter the absorption of Ketanov, so they can be taken together and not spread over time.

Solution for intramuscular injection cannot be mixed in one syringe with morphine, Promethazine, Hydroxyzine, Tramadol and lithium preparations. However, the Ketanov solution is compatible and can mix with the following drugs:

Saline;
5% dextrose solution;
Ringer's solution;
Plasmalite solution;
Aminophylline, Lidocaine, Dopamine, Insulin and Heparin solution.

Ketanov: composition, indications, instructions for use, dosages, precautions - video

The use of the drug for toothache

In case of toothache, Ketanov is recommended to be taken in pill form until visiting a dentist, but no longer than 7 days. This means that Ketans should not be taken as an effective medicine that will help get rid of the problem. Ketanov will only eliminate the pain so that the person cannot tolerate it, while waiting for the date of the visit to the dentist.

If the dentist has performed any surgical manipulations in the oral cavity with a diseased tooth (for example, removed a tooth or nerves, etc.), then Ketanov is recommended to be taken within 2 - 3 days to relieve severe pain.

The best option for taking Ketans for toothache is the "on schedule" regimen, when a person drinks 1 tablet every 4 - 5 hours, without waiting for the pain syndrome to develop in full force again after the last dose of the drug ends. During the day for toothache, you can take a maximum of 4 tablets.

Application for headache

Ketans for headaches can be taken, but this drug will not help in all cases. After all, there are more than 100 causes of headache, and for some of them Ketanov is effective, and for others it is completely useless. Therefore, if there is Ketanov, then it can be taken in order to relieve headaches. But if the drug does not work within 40 minutes, you should look for another medicine, and not take another Ketanov pill.

To relieve headaches, it is enough to take 1 Ketanov tablet. If the headache is prolonged, then you can take 1 tablet every 4 to 5 hours for a maximum of 5 days. In general, if the headache returns within 2 to 3 days, then you should consult a doctor, and not try to stop it with Ketanov, since this may be a symptom of a disease that must be adequately treated.

Ketans for children

Ketans, if urgently needed, can be given to children from the age of two in order to relieve pain syndrome of various origins and localization, with the exception of abdominal pain. You can not use Ketanov in courses, constantly, it should be used only periodically, when the child has severe pain that he cannot tolerate (for example, toothache, pain after injury, etc.).

However, before giving Ketans to a child, you should try other medications, since this remedy is too strong and potentially dangerous for children. So, Ketanov is able to provoke the development of nephritis, depression, impaired hearing and vision, pulmonary edema and other serious complications in children. Therefore, the use of Ketans for children should be resorted to only if absolutely necessary, when safer drugs (for example, Nimesulide, Ibuprofen, etc.) are ineffective.

A child under 14 years old should be given Ketans 1 tablet at a time, and a maximum of 2 per day. The duration of use of the drug in children should not exceed 2 days, since with a longer intake of tablets or injections, the risk of developing severe side effects significantly increases.

The dosage of Ketanov's injections for children 2-14 years old is calculated individually by body weight, based on the ratio of 1 mg per 1 kg of body weight. At this initial dosage, the drug is administered for the first time. Re-introduction is also possible every 6 hours, but at a dosage that is half of the initial one.

If a child is older than 10, but under 14 years old, but his body weight is more than 50 kg, then he can be injected and given Ketanov tablets in adult dosages.

Application during pregnancy and breastfeeding

Is Ketanov banned?

In many European countries, Ketanov is banned for use due to more than 100 deaths registered in the 90s of the last century, provoked by severe complications caused by the drug. Since that time, the registration of the drug has been canceled in some countries, and it has ceased to be sold in principle. In other countries, Ketanov is still used, but it is sold only with a doctor's prescription. Since 2012, Ketanov's prescription leave has been introduced in Russia, but in practice, many pharmacies sell it freely.

Ketanov and alcohol

Ketans are incompatible with alcohol, since this combination significantly increases the risk of ulcers and internal bleeding from the gastrointestinal tract. In addition, alcohol enhances the analgesic effect of Ketanov, as a result of which a person may not notice a dangerous increase in pain, which requires immediate medical attention.

Side effects

Ketanov solution tablets provoke the following similar side effects from various organs and systems:
1. Digestive tract:

10.04.2015 10.01.2019 by admin

Ketanov is a powerful analgesic, a synthetic drug that relieves pain symptoms. In terms of the effectiveness of the effect on the nervous system, this drug can compete with most of the known drugs. The active ingredient is ketorolac. Ketanov and alcohol, when used together, give a strong narcotic effect with extremely severe, often irreversible consequences for the body. Fatalities are known.

Unfortunately, drug addicts at the final stage are ready for any sacrifices on the part of the body in order to get at least a little narcotic euphoria. Ketanov with alcohol satisfies these requirements.

In addition, the drug is not expensive and is available even for financially poor people, which include drug addicts who have lost the ability to do any work. Also among the victims were overly naive young people who do not understand the principle of drug action and have no idea about the chemical processes in the human body.

How do I get the medicine now?

In most countries, ketanes and their derivatives are prohibited from production and sale, even in the prescription department. Until recently, this medicine was freely sold in Russia on an over-the-counter basis. At the moment, you can buy this powerful pain reliever only with a doctor's prescription.

Indications for use

Ketanov is a potent medicine and is used to relieve severe headache or toothache, including after surgery.

A special indication is the relief of oncological pain.

It is widely used in sports medicine for traumatic injuries.

It is indicated for postoperative rehabilitation, with severe menstrual pain and in the postpartum period.

There are contraindications

Pregnancy or lactation, under 16 years of age, inflammatory kidney or liver disease.

Drinking alcohol by mistake

Possible consequences if you accidentally take ketans and alcohol at the same time.

Mistakes, by the way, do not happen so rarely. Under the influence of severe pain, a person is often unable to think logically and consistently. Sometimes people take medicine while already intoxicated and without realizing the consequences. Since ethanol nullifies the pain relieving effect of the drug in most cases, drug overdose is also very likely. With the onset of darkened states, a person may not remember that he has already taken the medicine, and will take it until the package is empty, or until a coma occurs.

You can simply wash down the medicine with water, which the jokers replaced with vodka, by the way, this is a real case when the young employees of the company decided to help a colleague suffering from toothache. It is generally accepted that a glass of vodka can dull any pain. And for a joke, they replaced the mineral water in the girl's bottle with undiluted vodka. The employee was admitted to the intensive care unit with alcoholic hepatitis.

Drug action

Ketanov has a strong effect on the liver and urinary system. Therefore, this strong pain reliever is prescribed only in exceptional cases when the pain is unbearable. The drug is not recommended for long-term use, because a habit arises and the therapeutic effect decreases. When combined with alcohol, an uncontrolled reaction occurs, leading to the destruction of the liver and, often, acute renal failure. At the same time, the adrenal glands, in which a fair share of hormones are produced, throw out colossal doses of active substances into the body. Hormonal disruption can lead to both an explosion of activity, like the one that causes ecstasy, and inhibitory reactions, when a person stops responding to the environment, the pupils lose their sensitivity to light and, in the absence of immediate medical attention, they may fall into a coma.

Even a single intake of such a cocktail causes colossal harm to the body, which will have to be treated for more than one year. In addition to renal failure and alcoholic hepatitis, the most common consequence is the instantaneous development of stomach ulcers.

It is precisely because of frequent failures, erroneous techniques and extremely difficult consequences that ketans are prohibited for free sale.

Since June 1, as you know, a ban has been introduced on the free sale of antitussive and analgesic drugs with codeine. You can buy it if it hurts a lot. But only according to a strict accountability recipe - with a red stripe.

The "RG" correspondent went to pharmacies to check what they would offer in return, if, say, an urgent need to relieve a toothache.

"No prescription? No, we won't give you anything with codeine," the nearest pharmacy said sternly. And they explained: prescriptions with a red stripe (form N148), strict accountability, must be kept in the pharmacy for three years. So any inspector will come and check the invoices - how many medicines were received, how many were sold, and if something goes wrong, you will not get into trouble.

"Good. Well, what if, say, a tooth hurts badly?" - I ask the pharmacist Yulia. "There is a choice: spazmalgon - 92 rubles, nalgezin - 170 rubles. These are analgesics. The first is combined, contains three components. Quite strong, even relieves renal colic. The second is a monopreparation. Usually 2-4 tablets are enough, but with very severe pain, daily the dose can be increased to 6. There is also Nurofen - this is another group of drugs, the active ingredient is ibuprofen, "Julia read me a mini-lecture on pharmaceuticals.

"Is it possible to buy something stronger - ketans, nise, for example?" - "No. These drugs, although they do not contain codeine, we sell according to a prescription, however, the usual one. Or, at the very least, the patient must present an extract from the medical history," explains Yulia. "They are unsafe. Wrong with the dose - great risk of gastric bleeding. "

It is clear, for a long time to pretend that a toothache is aching, I did not succeed. She explained why she had come. I ask: have you ever faced the fact that drugs containing codeine were bought almost in bulk?

"No, no, for a long time there has been a restriction - no more than two packs per person," explains Yulia. And her colleague Ksenia, who came to work in Moscow from Samara, said that there has been a strict ban on the sale of such drugs since the end of last year: “You know, it's okay. Those who are on painkillers still regularly visit a doctor. to get used to the fact that a prescription is required. I don’t know how in other regions, but in Samara, all this went quietly. If anyone tried to make a scandal, then it was those who needed these pills for completely different purposes. "

Of course, to go "if something happens" to the clinic, to sit in line to see a doctor - who wants to? But, on the other hand, doctors every year more and more loudly, more and more insistently insist on the dangers of self-medication, that those who like to drink handfuls of pills do not think that "one is curing, and the other is crippling."

“People with chronic pain syndrome have to constantly take something,” says pharmacist Roman in another pharmacy. “But from the entire assortment, with prolonged use, gastropathies arise. According to the quality of analgesia, the salvation is ketorolaks (the same ketans, nise), no wonder their effectiveness is compared Combined drugs help well. The only institute in the world dealing with pain syndrome (USA), throughout the years of its existence, has urged not to dull pain, but to treat its cause. I also try to use analgesics only in the most extreme cases. I would not advise anyone to gulp such medicines with every scratch or other trifle. "

The drug Ketanov (ketorolac) is one of the most popular when prescribed to patients, but recently dispensing in Russian pharmacies of this medicine is carried out only with a prescription. Below, analogs to Ketanov's tablets and options for replacing it with over-the-counter drugs will be described in detail.

Instructions for use

The active ingredient, ketorolac, belongs to non-steroidal anti-inflammatory drugs (NSAIDs). It is produced both in tablet form and in the form of a solution for injection.

It has an anti-inflammatory and pronounced analgesic effect by blocking the mediators (mediators) of inflammation.

The result is a decrease in pain, swelling and hyperemia of the affected area the patient's body.

It is indicated for use in pain syndromes of various origins, including after surgery and in cancer patients.

The price of this medicine: tablets - from 70, ampoule packaging - from 110 rubles.

Drug analogs

Variety also reigns in injection forms. Ketorolac in ampoules is available for purchase under the trade names Ketorol, Ketorolac, Dolac. A package of 10 ampoules costs from 85 rubles.

For external use under the trade name Ketorol gel (Dr. Reddis firm). The price for a tube of ointment is about 230 rubles.

In the form of eye drops, there is Akular. Used by ophthalmologists in the postoperative period in patients. The price is 350 rubles.

What to replace?

Ibuprofen

Properties: NSAIDs for a wide range of purposes. In addition to pain relief, it has a pronounced antipyretic effect. Effective as a substitute for Ketanov, which helps with pain after dental treatment.

Indications for use: pains of various localization, postoperative period, hyperthermic syndrome (increased body temperature).

Release forms: in the form of gels (Ibuprofen Gel, Deep Relief), cream (Dolgit), tablets (Ibufen, MIG 200, MIG 400 and others), as well as suspensions for children (Maxikold, Ibuprofen - Akrihin).

The price range is very large, the most inexpensive are Russian-made.

Naproxen

In terms of properties, this replacement is similar to Ketanov and Ibuprofen described above. It is used in rheumatology, neurology to relieve prolonged pain syndrome, helps with algodismenorrhea.

Available for purchase in the form of tablets (Naproxen-Acri, Nalgezin), it is also part of the combined analgesics (Pentalgin).

There are also gels and ointments (Naproxen, Naproxen EMO). Prices for tablet forms start at 100 rubles, a tube of gel will cost the buyer about twice as much.

Analgin, aspirin, paracetamol

It is necessary to mention these drugs, which belong to the category of NSAIDs. It should be remembered that they have a less pronounced anti-inflammatory and analgesic effect in comparison with the drug Ketanov. However, they are commonly sold over the counter, making them more accessible to the layman.

Combined drugs

They have a quick and pronounced analgesic effect due to the combination of various components that enhance each other's action. Common trade marks:

Spazmalgon- a combination of an antispasmodic (fenpiverinium bromide), analgin and pitofenone (NSAIDs). Effective for headache, toothache, and algodismenorrhea. Price - 120 Russian rubles per pack of 10 tablets.
Novalgin- in the composition of caffeine (stimulant of the vasomotor center in the brain), paracetamol and propiphenazone (NSAIDs). Reduces fever, relieves joint pain and headache. The cost is about 170 rubles.
Novigan- a drug of Indian origin. It contains a combination of an antispasmodic and two types of NSAIDs (ibuprofen, pitofenone). It is widely prescribed for headaches, arthralgia, after injuries. Relieves pain in renal colic, dysmenorrhea. The unit price is about 160 rubles.

What do you need to remember?

The drugs described above have an extensive list of contraindications, before taking it, you should carefully study the instructions. Most common for NSAIDs:

erosive lesions of the esophagus, stomach and intestines;
the presence of bleeding from the gastrointestinal tract in the patient's history;
severe forms of coronary heart disease (acute and chronic insufficiency, myocardial infarction). NSAIDs, in particular ketorolac and diclofenac, have proven cardiotoxic effects;
bronchial asthma (especially in the presence of the "aspirin form");
pregnancy and early postpartum period;
severe impairment of kidney and liver function (end-stage chronic renal failure, liver cirrhosis);
it is not recommended to prescribe in any condition accompanied by a risk of bleeding (perioperative period, taking anticoagulants).
not prescribed in childhood (with the exception of some forms of paracetamol and ibuprofen, which are used to lower body temperature in children from the first days of life).

Side effects

More often, undesirable manifestations from Ketanov and other non-steroidal anti-inflammatory drugs occur with prolonged and uncontrolled intake.