Understanding Keral and Its Primary Use
Keral is a medication classified as a non-steroidal anti-inflammatory drug (NSAID). Its active ingredient, dexketoprofen, functions by inhibiting the production of prostaglandins, which are substances in the body that play a role in causing pain and inflammation. It is utilized by adults for the brief management of symptoms associated with mild to moderate acute pain, such as discomfort in muscles or joints, menstrual cramps, and dental pain. The injectable form is specifically indicated for a limited duration, typically not exceeding two days, after which a transition to an oral pain reliever may be necessary if pain persists.
Recommended Duration of Treatment
The principal guideline for Keral emphasizes its use for short periods. For NSAIDs available without a prescription, continuous use generally should not extend beyond three days for fever or ten days for pain without seeking medical advice. Specifically, the use of injectable Keral should be restricted to the acute symptomatic phase, meaning typically no more than two days. For oral forms of Keral (tablets or granules), the duration of use will be determined by your healthcare provider, but it is typically prescribed as a short course of treatment.
Risks of Exceeding the Recommended Duration
Using Keral for longer than the recommended duration, similar to other NSAIDs, increases the potential for adverse effects. The likelihood of experiencing any risk is generally greater with higher amounts and extended use.
Major Concerns with Prolonged NSAID Use:
- Gastrointestinal (GI) Issues: Adverse effects most frequently involve the GI tract, presenting as stomach pain, indigestion, nausea, and diarrhea. Extended use significantly elevates the potential for more severe complications, including peptic ulcers, bleeding, and perforation of the stomach or intestines. This risk is particularly elevated in older individuals and those with a history of GI issues.
- Cardiovascular (CV) Risks: Regulatory bodies have issued stronger warnings indicating that NSAIDs can increase the likelihood of heart attack and stroke. These events can occur relatively early during treatment and the risk may increase with longer durations of use. These risks are present for individuals both with and without pre-existing heart conditions, although the baseline risk is higher for those with cardiovascular disease.
- Kidney (Renal) Damage: NSAIDs have the potential to reduce blood flow to the kidneys, which can potentially lead to renal impairment or acute renal failure. This risk is amplified in older adults and those with existing kidney disease or dehydration. In many cases, this damage can be reversed by discontinuing the medication, but continued use may contribute to chronic kidney disease.
- Liver (Hepatic) Problems: Although less frequent, NSAIDs can sometimes lead to an increase in liver enzymes and, in rare instances, result in liver dysfunction. Individuals with mild to moderate liver dysfunction may require a lower starting amount and close monitoring.
Comparison: Short-Term vs. Prolonged Keral Use
| Feature | Short-Term Use (Recommended) | Prolonged Use (Discouraged) |
|---|---|---|
| Primary Goal | Management of acute, mild-to-moderate pain (e.g., dental, menstrual, muscular) | Not recommended for long durations; any extended NSAID therapy requires strict medical supervision |
| Efficacy | Effective for intended use; pain relief typically begins about 30 minutes after oral administration | May mask a serious underlying condition; not a suitable approach for managing chronic pain |
| Gastrointestinal Risk | Lower likelihood of severe issues, but can still cause stomach irritation. Taking with food may help. | Significantly increased potential for ulcers, bleeding, and perforation. |
| Cardiovascular Risk | Small increased potential for heart attack or stroke. | The risk tends to increase with the duration of use and the amount taken. |
| Kidney Risk | Generally low in healthy individuals. | Increased potential for acute kidney injury, particularly in vulnerable populations. |
When to See a Doctor
It is important to use Keral at the lowest amount that is effective for the shortest time necessary to alleviate symptoms. Consulting a healthcare professional is essential in the following circumstances:
- If pain persists or worsens after the recommended short-term treatment period.
- Before starting Keral if you have a history of heart, kidney, or liver problems, high blood pressure, or stomach ulcers.
- If you are an older adult, as this demographic is more susceptible to experiencing side effects.
- If you encounter severe adverse effects such as black or bloody stools, chest pain, shortness of breath, sudden weakness, or skin rash.
- If you are planning to become pregnant, are currently pregnant, or are breastfeeding.
Conclusion
Keral (dexketoprofen) is an effective option for alleviating acute pain but is strictly intended for short-term use. Adhering to the recommended duration, typically for no more than a few days for acute pain, is crucial to minimize the potential for serious gastrointestinal, cardiovascular, and renal side effects. Managing chronic pain requires a different strategy developed in consultation with a healthcare provider. Always follow the prescribed duration of treatment and read the patient information leaflet before beginning medication.
For more detailed information from a medicines regulator, you can view a patient information leaflet here: Keral 25 mg film-coated tablets - Patient Information Leaflet (PIL)
