Ketoprofen Patch: Safety in Children

• Oral ketoprofen is effective and well tolerated in children for the control of post-surgical pain and for the control of pain and fever in inflammatory conditions.¹
• From BNF for children there is no data showed for the ketoprofen used in children
• From Frank Shann Drug Doses, the dose of Ketoprofen for paediatrics is 1-2mg/kg (max 4mg/kg or 200mg in 24hr).

Manufacturer’s recommendation

• From the product leaflet of keplat 20mg medicated patch, it is not recommended for the patient age below than 12 years old.³
• From the product leaflet Kefentech 30mg Plaster (used in HKGU), it is not recommended since the safety for children has not been established yet.

Pharmacokinetic and pharmacodynamic of ketoprofen patch

• From the pharmacokinetic data, the total systemic bioavailability of ketoprofen 100 mg administered via a patch is no more than 10% of that reported for ketoprofen 100 mg administered orally.²
• By using extrapolation, children seems reasonable to be given the patch based on several factors:⁴
• the pharmacodynamic response to most medications including local anesthetics, opioids, and NSAIDs are substantially mature by the age of 2 years,
• the degree of systemic absorption of these topical medications is low
• local skin effects  for the most part of body is minimal and short-lived

References:

1. http://link.springer.com/article/10.2165/11534910-000000000-00000
2. http://www.ncbi.nlm.nih.gov/pubmed/16274258
3. http://mri.medagencies.org/download/IT_H_0120_001_FinalPI_1of3.pdf
4. http://dolor.org.co/articulos/Analgesia%20topia%20dolor%20nueropatico%20osteomuscular.pdf
5. BNF for children
6. Frank Shann Drug Doses