Dexketoprofen

Non-steroidal anti-inflammatory drugs, propionic acid derivatives

ATC code: M01AE17 (Dexketoprofen)

Brand names

Enantyum

Mechanism of action

Dexketoprofen is the dextrorotatory enantiomer of ketoprofen (S-(+)-ketoprofen), the active form. It non-selectively inhibits cyclooxygenases COX-1 and COX-2, blocking prostaglandin and thromboxane synthesis. Analgesic and anti-inflammatory effect develops within 30 minutes after oral administration, peak at 30-60 minutes. Half-life 1.65 hours – substantially shorter than racemic ketoprofen. Efficacy is comparable to diclofenac 50 mg and ibuprofen 400 mg at lower dose and with faster onset.

Indications

Acute mild-to-moderate pain

First line

Dexketoprofen 25 mg orally or 50 mg IM/IV is first-line therapy for acute mild-to-moderate pain: postoperative pain, dental pain, primary dysmenorrhea, musculoskeletal pain. Cochrane review Barden 2009 (10 RCTs, n=2155) showed NNT=3.2 for 20-25 mg in postoperative pain – comparable to other NSAIDs. Advantage of dexketoprofen is faster onset (30 minutes vs 60 minutes for ibuprofen and paracetamol). Maximum daily dose 75 mg (three 25 mg doses). Treatment course should not exceed 7 days.

Sources

AEMPS: Ficha técnica de Dexketoprofeno (2024)

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Memory and concentration enhancement

Not recommended

Dexketoprofen is a nonsteroidal anti-inflammatory drug (NSAID). It is prescribed for short-term symptomatic treatment of acute pain (AEMPS Ficha Técnica). For unconfirmed migraine, any headache, or vigor in fatigue, dexketoprofen is not used: for migraine, triptans and other proven options work; for fatigue, NSAIDs do not help (they are not an anti-fatigue drug). Regular dexketoprofen use creates risks of severe gastrointestinal bleeding, perforation, cardiovascular events, and acute kidney injury. If dexketoprofen was prescribed for migraine or vigor, consider seeking a second opinion.

Sources

Practical notes

Russian practice note

In Russia, dexketoprofen (Dexalgin, generics) is available as 25 mg tablets and 50 mg/2 mL injectable solutions. Cost of 10 tablets is 250-450 ₽. Take with food or after meals to reduce GI side effects. In patients at risk of NSAID gastropathy (age 65+, peptic ulcer history, anticoagulant use), combine with a proton pump inhibitor (omeprazole 20 mg/day).

Drug interactions

Standard NSAID profile. Enhances anticoagulant effect of warfarin, direct oral anticoagulants, and UFH – bleeding risk. Reduces antihypertensive effect of ACE inhibitors, ARBs, diuretics. With methotrexate, lithium, digoxin – their concentrations rise (renal clearance interaction). Combining with other NSAIDs is irrational – additive bleeding and gastropathy risk without analgesic enhancement.

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Official sources

Direct links to regulator labels. Open in a new tab.

AEMPS / CIMA

Spanish Medicines Information Centre (CIMA)

Label dated: 04/14/2026

Safety

Contraindications

Hypersensitivity to NSAIDs
Active peptic ulcer disease
GI bleeding
Severe hepatic or renal impairment
Severe heart failure (NYHA IV)
Third trimester pregnancy
Breastfeeding
Age under 18 (tablets – use cautiously in adolescents)
Aspirin-induced asthma

Serious adverse effects

GI bleeding and perforation
Acute kidney injury
Severe skin reactions (Stevens-Johnson syndrome)
Bronchospasm in aspirin-sensitive asthma
Acute cardiovascular events (increased risk with long-term high doses)

Common adverse effects

Nausea, heartburn, abdominal discomfort
Diarrhoea
Headache, dizziness
Rash
Transaminase elevation

PregnancyFDA C

Use cautiously in trimesters 1-2; contraindicated in trimester 3 (risk of premature closure of the ductus arteriosus and impaired fetal renal function).

Breastfeeding

Contraindicated during breastfeeding: drug is excreted in breast milk.

Frequently asked

What is Dexketoprofen used for?

Dexketoprofen is evaluated for the following indications with varying evidence strength: Acute mild-to-moderate pain (evidence tier A), Memory and concentration enhancement (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Dexketoprofen?

Common side effects of Dexketoprofen (≥ 1 in 100): Nausea, heartburn, abdominal discomfort, Diarrhoea, Headache, dizziness, Rash, Transaminase elevation. See the Safety section for uncommon and serious reactions.

Is Dexketoprofen safe during pregnancy?

FDA category C. Use cautiously in trimesters 1-2; contraindicated in trimester 3 (risk of premature closure of the ductus arteriosus and impaired fetal renal function).

Is Dexketoprofen compatible with breastfeeding?

Contraindicated during breastfeeding: drug is excreted in breast milk.

Who should not take Dexketoprofen?

Dexketoprofen is contraindicated in: Hypersensitivity to NSAIDs; Active peptic ulcer disease; GI bleeding; Severe hepatic or renal impairment; Severe heart failure (NYHA IV). Full list in the Safety section.