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Nalfon (Fenoprofen Calcium) Uses, Dosage, Side Effects

Fenoprofen Calcium - (fen-oh-proe′fen) Nalfon

Classifications: ANALGESIC, NONSTEROIDAL ANTI-INFLAMMATORY DRUG (NSAID)

Therapeutic: ANALGESIC; NSAID; ANTIARTHRITIC; ANTIPYRETIC

Prototype: Ibuprofen

Pregnancy Category: C before 30 wk gestation; D 30 wk gestation

AVAILABILITY

Tablet; capsule

ACTION & THERAPEUTIC EFFECT

Exhibits anti-inflammatory, analgesic, and antipyretic properties of an NSAID. Fenoprofen competitively inhibits both cyclooxygenase COX- 1 and COX-2 enzymes by blocking arachidonate binding to prostaglandin G2 resulting in its pharmacologic effects. Has nonsteroidal, anti-inflammatory, antipyretic, antiarthritic properties that provide relief from mild to severe pain.

USES

Rheumatoid arthritis and osteoarthritis; relief of mild to moderate pain.

UNLABELED USES

Juvenile rheumatoid arthritis, acute gouty arthritis, ankylosing spondylitis.

CONTRAINDICATION

Hypersensitivity to fenoprofen or other NSAIDs; salicylate; history of nephritic syndrome associated with aspirin or other NSAIDs; patient in whom urticaria, severe rhinitis, bronchospasm, angioedema, nasal polyps are precipitated by aspirin or other NSAIDs; severe renal or hepatic dysfunction; GI bleeding, ulceration, or perforation; perioperative pain associated in CABG; pregnancy (category D 30 wk gestation).

CAUTIOUS USE

History of GI tract disorders; lupus; renal failure; renal impairment; hemophilia or other bleeding tendencies; compromised cardiac function, risk factors for CAD; CHF; hypertension; fluid retention; impaired hearing; older adults; pregnancy (category C before 30 wk gestation); lactation. Safety in children not established.

ROUTE & DOSAGE

RA/OA

Adult: PO 400–600 mg t.i.d. or q.i.d. (max: 3200 mg/day)

Mild to Moderate Pain

Adult: PO 200 mg q4–6h prn

ADMINISTRATION

Oral

Give on an empty stomach 30–60 min before or 2 h after meals. Give with meals, milk, or antacid (prescribed) if patient experiences GI disturbances.
May crush tablets or empty capsule and mix with fluid or mix with food.
Store capsules and tablets in tightly closed containers at 15°–30° C (59°–86° F); avoid freezing.

ADVERSE EFFECTS (≥1%)

CNS: Headache, drowsiness, dizziness, asthenia, fatigue, lassitude, tremor, confusion, insomnia, nervousness, depression. Special Senses: Tinnitus, decreased hearing, deafness; blurred vision. GI: Indigestion, nausea, vomiting, anorexia, constipation, diarrhea, flatulence, abdominal pain, dry mouth; infrequent: Gastritis, peptic ulcer, GI bleeding. Urogenital: Dysuria, cystitis, hematuria, oliguria, azotemia, anuria, allergic nephritis, papillary necrosis, nephrotoxicity (rare). Hematologic: (Infrequent) Thrombocytopenia, hemolytic anemia, agranulocytosis, pancytopenia. CV: Palpitations, atrial fibrillation. Skin: (May or may not be hypersensitivity reaction) Pruritus, rash, purpura, increased sweating, urticaria. Body as a Whole: Dyspnea, malaise, anaphylaxis, edema.

Nalfon (Fenoprofen Calcium) Uses, Dosage, Side Effects

Related for Nursing Implications and Drugs Guide Information

INTERACTIONS

Drug: Fenoprofen may prolong bleeding time; should not be given with ORAL ANTICOAGULANTS, heparin; action and side effects of phenytoin, SULFONYLUREAS, SULFONAMIDES, and fenoprofen may be potentiated. Herbal: Feverfew, garlic, ginger, gingko may increase bleeding potential.

DIAGNOSTIC TEST INTERFERENCE

May elevate Amerlex-M assay values for thyroid tests.

PHARMACOKINETICS

Absorption: 80% from GI tract. Onset: 2 h. Peak: 2 h. Duration: 4–6 h. Distribution: Small amounts distributed into breast milk. Metabolism: In liver. Elimination: Primarily in urine; some biliary excretion. Half-Life: 3 h.

NURSING IMPLICATIONS

Black Box Warning Etodolac has been associated with increased risk of serious, potentially fatal GI bleeding and cardiovascular events (e.g., MI & CVA); risk may increase with duration of use and may be greater in the older adult and those with risk factors for CV disease.

Assessment & Drug Effects

Baseline and periodic auditory and ophthalmic examinations are recommended in patients receiving prolonged or high-dose therapy.
Monitor for S&S of GI bleeding. Significant GI bleeding may occur without prior warning.
Monitor for and report promptly S&S of CV thrombotic events (i.e., angina, MI, TIA, or stroke).
Monitor lab tests: Baseline Hct and Hgb, kidney function tests and LFTs.

Patient & Family Education

Do not drive or engage in potentially hazardous activities until response to drug is known; fenoprofen may cause dizziness and drowsiness.
Report immediately the onset of unexplained fever, rash, arthralgia, oliguria, edema, weight gain to prescriber. Possible symptoms of nephrotic syndrome are rapidly reversible if drug is promptly withdrawn.
Understand that alcohol and aspirin may increase risk of GI ulceration and bleeding tendencies; avoid both unless otherwise advised by prescriber.

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