Fenoprofen

NALFON

Open Fenoprofen in the interactive console ↗

What it isNon-selective NSAID; arthritis and mild to moderate pain.

Why this oneAn ordinary NSAID option, effective and inexpensive.

What limits itInterstitial nephritis is reported more with fenoprofen than with other NSAIDs. It raises serum lithium; standard GI and cardiovascular risk.

FDA-approved for

Rheumatoid arthritis (1976)
osteoarthritis (1976)
mild-to-moderate pain (1976)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING NSAID class: increased risk of serious, potentially fatal cardiovascular thrombotic events (MI, stroke) and serious GI bleeding, ulceration, and perforation; contraindicated in CABG surgery setting; elderly and prior PUD/GI-bleed at greater GI risk

FDA dosing	Population	Start	Target	Max
Mild to moderate pain	Adults	200 mg q4–6h PRN	200 mg q4–6h PRN	3,200 mg/day
Rheumatoid arthritis	Adults	400–600 mg TID–QID	Tailor to response (RA often needs larger doses than OA)	3,200 mg/day
Osteoarthritis	Adults	400–600 mg TID–QID	Smallest dose giving acceptable control	3,200 mg/day

Renal Avoid in advanced renal disease unless benefits expected to outweigh risk of worsening renal function; monitor renal function in renal/hepatic impairment, heart failure, dehydration, hypovolemia

Hepatic Undefined

Instructions

Use lowest effective dose for shortest duration
May take with meals or milk (delays/diminishes peak levels; total absorption unchanged)
Full RA/OA benefit may take 2–3 additional weeks beyond initial improvement

Contraindications

History of asthma, urticaria, or other allergic-type reactions after aspirin or other NSAIDs
Setting of coronary artery bypass graft (CABG) surgery

Cautions

CV thrombotic events and GI bleeding/ulceration/perforation (boxed)
Hepatotoxicity: discontinue if abnormal liver tests persist/worsen or liver-disease signs develop
Hypertension: may blunt antihypertensives; monitor BP
Heart failure and edema: avoid in severe HF unless benefit outweighs risk
Renal toxicity and hyperkalemia; avoid in advanced renal disease
Anaphylactic reactions; aspirin-sensitive asthma contraindicated
Serious skin reactions and DRESS: discontinue at first rash/hypersensitivity sign
Fetal toxicity: limit use at 20–30 weeks gestation; avoid at ~30 weeks and later
Hematologic toxicity: monitor Hgb/Hct if anemia signs
Elderly at greater risk of serious adverse events

Adverse reactions

Dyspepsia
Headache
Somnolence
Nausea
Dizziness
Constipation
Nervousness
Asthenia
Peripheral edema

Pregnancy Limit dose/duration between ~20–30 weeks gestation (oligohydramnios/fetal renal dysfunction); avoid at ~30 weeks and later (premature ductus arteriosus closure)

Lactation Milk levels ~1.6% of maternal plasma (600 mg q6h study); little published experience — other agents may be preferred, especially for newborn/preterm infants

⚠ BOXED WARNINGS