Does Nalfon (fenoprofen) cause side effects?
Nalfon (fenoprofen) is a nonsteroidal anti-inflammatory drug (NSAID) used for management of mild to moderate pain, fever, and inflammation.
Nonsteroidal anti-inflammatory drugs work by reducing the levels of prostaglandins, chemicals that are responsible for the pain, fever, and swelling of inflammation. Nalfon blocks the enzymes that make prostaglandins (cyclooxygenases), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, swelling, pain and fever are reduced.
Common side effects of Nalfon include
- ringing in the ears,
- abdominal pain,
- fluid retention, and
- dry mouth.
Serious side effects of Nalfon include reduced ability of blood to clot and increased bleeding after an injury, stomach and intestinal bleeding and ulcers, impaired kidney function, heart attacks, high blood pressure (hypertension), and heart failure.
Drug interactions of Nalfon include lithium because Nalfon may increase the blood levels of lithium by reducing the excretion of lithium by the kidneys.
- Increased levels of lithium may lead to lithium toxicity.
- Nalfon may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins play a role in the regulation of blood pressure.
- When NSAIDs are used in combination with or aminoglycosides the blood levels of the methotrexate or aminoglycoside may increase, presumably because their elimination from the body is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.
- Individuals taking oral blood thinners or anticoagulants, for example, warfarin, should avoid Nalfon because Nalfon also thins the blood, and excessive blood thinning may lead to bleeding.
- Persons who have more than three alcoholic beverages per day are at increased risk of developing stomach ulcers when taking Nalfon or other NSAIDs.
In late pregnancy, the third trimester, as with other NSAIDs, Nalfon should be avoided because it may cause premature closure of the ductus arteriosus.
It is unknown if Nalfon is excreted in breast milk. Consult your doctor before breastfeeding.
What are the important side effects of Nalfon (fenoprofen)?
Common side effects include:
- ringing in the ears,
- abdominal pain,
- fluid retention, and
- dry mouth.
NSAIDs reduce the ability of blood to clot and therefore increase bleeding after an injury. Fenoprofen also may cause stomach and intestinal bleeding and ulcers. Sometimes, stomach ulceration and intestinal bleeding may occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing (orthostatic hypotension) may be the only signs of the bleeding.
People who are allergic to other NSAIDs should not use fenoprofen. NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of NSAIDs in these patients should be done cautiously.
Individuals with asthma are more likely to experience allergic reactions to fenoprofen and other NSAIDs. Fluid retention, blood clots, heart attacks, high blood pressure (hypertension), and heart failure also have been associated with the use of NSAIDs.
Nalfon (fenoprofen) side effects list for healthcare professionals
The following adverse reactions are discussed in greater detail in other sections of the labeling:
- Cardiovascular Thrombotic Events
- GI Bleeding, Ulceration and Perforation
- Heart Failure and Edema
- Renal Toxicity and Hyperkalemia
- Anaphylactic Reactions
- Serious Skin Reactions
- Hematologic Toxicity
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
- During clinical studies for rheumatoid arthritis, osteoarthritis, or mild to moderate pain and studies of pharmacokinetics, complaints were compiled from a checklist of potential adverse reactions, and the following data emerged.
- These encompass observations in 6,786 patients, including 188 observed for at least 52 weeks.
- For comparison, data are also presented from complaints received from the 266 patients who received placebo in these same trials.
- During short-term studies for analgesia, the incidence of adverse reactions was markedly lower than that seen in longer-term studies.
Adverse Drug Reactions Reported In > 1% Of Patients During Clinical Trials
- Digestive System — During clinical trials with Nalfon, the most common adverse reactions were gastrointestinal in nature and occurred in 20.8% of patients receiving Nalfon as compared to 16.9% of patients receiving placebo. In descending order of frequency, these reactions included dyspepsia (10.3% Nalfon vs. 2.3% placebo), nausea (7.7% vs. 7.1%), constipation (7% vs. 1.5%), vomiting (2.6% vs. 1.9%), abdominal pain (2% vs. 1.1%), and diarrhea (1.8% vs. 4.1%). The drug was discontinued because of adverse gastrointestinal reactions in less than 2% of patients during premarketing studies.
- Nervous System — The most frequent adverse neurologic reactions were headache (8.7% vs. 7.5%) and somnolence (8.5% vs. 6.4%). Dizziness (6.5% vs. 5.6%), tremor (2.2% vs. 0.4%), and confusion (1.4% vs. none) were noted less frequently. Nalfon was discontinued in less than 0.5% of patients because of these side effects during premarketing studies.
- Skin and Appendages— Increased sweating (4.6% vs. 0.4%), pruritus (4.2% vs. 0.8%), and rash (3.7% vs. 0.4%) were reported. Nalfon was discontinued in about 1% of patients because of an adverse effect related to the skin during premarketing studies.
- Special Senses — Tinnitus (4.5% vs. 0.4%), blurred vision (2.2% vs. none), and decreased hearing (1.6% vs. none) were reported. Nalfon was discontinued in less than 0.5% of patients because of adverse effects related to the special senses during premarketing studies.
- Cardiovascular — Palpitations (2.5% vs. 0.4%). Nalfon was discontinued in about 0.5% of patients because of adverse cardiovascular reactions during premarketing studies.
- Miscellaneous — Nervousness (5.7% vs. 1.5%), asthenia (5.4% vs. 0.4%), peripheral edema (5.0% vs. 0.4%), dyspnea (2.8% vs. none), fatigue (1.7% vs. 1.5%), upper respiratory infection (1.5% vs. 5.6%), and nasopharyngitis (1.2% vs. none).
Adverse Drug Reactions Reported In < 1% Of Patients During Clinical Trials
- Digestive System—Gastritis, peptic ulcer with/without perforation, gastrointestinal hemorrhage, anorexia, flatulence, dry mouth, and blood in the stool. Increases in alkaline phosphatase, LDH, SGOT, jaundice, and cholestatic hepatitis, aphthous ulcerations of the buccal mucosa, metallic taste, and pancreatitis.
- Cardiovascular—Atrial fibrillation, pulmonary edema, electrocardiographic changes, and supraventricular tachycardia.
- Genitourinary Tract—Renal failure, dysuria, cystitis, hematuria, oliguria, azotemia, anuria, interstitial nephritis, nephrosis, and papillary necrosis.
- Hypersensitivity—Angioedema (angioneurotic edema).
- Hematologic—Purpura, bruising, hemorrhage, thrombocytopenia, hemolytic anemia, aplastic anemia, agranulocytosis, and pancytopenia.
- Nervous System—Depression, disorientation, seizures, and trigeminal neuralgia.
- Special Senses—Burning tongue, diplopia, and optic neuritis.
- Skin and Appendages—Exfoliative dermatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, and alopecia.
- Miscellaneous—Anaphylaxis, urticaria, malaise, insomnia, tachycardia, personality change, lymphadenopathy, mastodynia, and fever.
What drugs interact with Nalfon (fenoprofen)?
See Table 1 for clinically significant drug interactions with fenoprophen.
Table 1: Clinically Significant Drug Interactions with
|Drugs That Interfere with Hemostasis|
|Intervention:||Monitor patients with concomitant use of Nalfon with anticoagulants (e.g., warfarin), antiplatelet agents (e.g., aspirin), selective serotonin reuptake inhibitors (SSRIs), and serotonin norepinephrine reuptake inhibitors (SNRIs) for signs of bleeding.|
|Clinical Impact:||Controlled clinical studies showed that the concomitant use of NSAIDs and analgesic doses of aspirin does not produce any greater therapeutic effect than the use of NSAIDs alone. In a clinical study, the concomitant use of an NSAID and aspirin was associated with a significantly increased incidence of GI adverse reactions as compared to use of the NSAID alone.|
|Intervention:||Concomitant use of Nalfon and analgesic doses of aspirin is not generally recommended because of the increased risk of bleeding. Nalfon is not a substitute for low dose aspirin for cardiovascular protection.|
|ACE Inhibitors, Angiotensin Receptor Blockers, and Beta-Blockers|
|Clinical Impact:||Clinical studies, as well as post-marketing observations, showed that NSAIDs reduced the natriuretic effect of loop diuretics (e.g., furosemide) and thiazide diuretics in some patients. This effect has been attributed to the NSAID inhibition of renal prostaglandin synthesis.|
|Intervention:||During concomitant use of Nalfon with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects.|
|Clinical Impact:||The concomitant use of fenoprofen with digoxin has been reported to increase the serum concentration and prolong the half-life of digoxin.|
|Intervention:||During concomitant use of Nalfon and digoxin, monitor serum digoxin levels.|
|Clinical Impact:||NSAIDs have produced elevations in plasma lithium levels and reductions in renal lithium clearance. The mean minimum lithium concentration increased 15%, and the renal clearance decreased by approximately 20%. This effect has been attributed to NSAID inhibition of renal prostaglandin synthesis.|
|Intervention:||During concomitant use of Nalfon and lithium, monitor patients for signs of lithium toxicity.|
|Clinical Impact:||Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity (e.g., neutropenia, thrombocytopenia, renal dysfunction).|
|Intervention:||During concomitant use of Nalfon and methotrexate, monitor patients for methotrexate toxicity.|
|Clinical Impact:||Concomitant use of Nalfon and cyclosporine may increase cyclosporine’s nephrotoxicity.|
|Intervention:||During concomitant use of Nalfon and cyclosporine, monitor patients for signs of worsening renal function.|
|NSAIDs and Salicylates|
|Clinical Impact:||Concomitant use of fenoprofen with other NSAIDs or salicylates (e.g., diflunisal, salsalate) increases the risk of GI toxicity, with little or no increase in efficacy.|
|Intervention:||The concomitant use of fenoprofen with other NSAIDs or salicylates is not recommended.|
|Clinical Impact:||Concomitant use of Nalfon and pemetrexed may increase the risk of pemetrexed-associated myelosuppression, renal, and GI toxicity (see the pemetrexed prescribing information).|
|Intervention:||During concomitant use of Nalfon and pemetrexed, in patients with renal impairment whose creatinine clearance ranges from 45 to 79 mL/min, monitor for myelosuppression, renal and GI toxicity. NSAIDs with short elimination half-lives (e.g., diclofenac, indomethacin) should be avoided for a period of two days before, the day of, and two days following administration of pemetrexed. In the absence of data regarding potential interaction between pemetrexed and NSAIDs with longer half-lives (e.g., meloxicam, nabumetone), patients taking these NSAIDs should interrupt dosing for at least five days before, the day of, and two days following pemetrexed administration.|
|Clinical Impact:||Chronic administration of phenobarbital, a known enzyme inducer, may be associated with a decrease in the plasma half-life of fenoprofen.|
|Intervention:||When phenobarbital is added to or withdrawn from treatment, dosage adjustment of Nalfon may be required.|
|Hydantoins, sulfonamides, or sulfonylureas|
|Clinical Impact:||In vitro studies have shown that fenoprofen, because of its affinity for albumin, may displace from their binding sites other drugs that are also albumin bound, and this may lead to drug interactions. Theoretically, fenoprofen could likewise be displaced.|
|Intervention:||Patients receiving hydantoins, sulfonamides, or sulfonylureas should be observed for increased activity of these drugs and, therefore, signs of toxicity from these drugs.|
Drug/Laboratory Test Interactions
- Amerlex-M kit assay values of total and free triiodothyronine in patients receiving Nalfon have been reported as falsely elevated on the basis of a chemical cross-reaction that directly interferes with the assay.
- Thyroid-stimulating hormone, total thyroxine, and thyrotropin-releasing hormone response are not affected.
- Thus, results of the Amerlex-M kit assay should be interpreted with caution in these patients.
Nalfon (fenoprofen) is a nonsteroidal anti-inflammatory drug (NSAID) used for management of mild to moderate pain, fever, and inflammation. Common side effects of Nalfon include rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation, heartburn, fluid retention, and dry mouth. In late pregnancy, the third trimester, as with other NSAIDs, Nalfon should be avoided because it may cause premature closure of the ductus arteriosus. It is unknown if Nalfon is excreted in breast milk.
Multimedia: Slideshows, Images & Quizzes
What Is Rheumatoid Arthritis (RA)? Symptoms, Treatment, Diagnosis
What is rheumatoid arthritis (RA)? Learn about treatment, diagnosis, and the symptoms of juvenile rheumatoid arthritis. Discover...
Osteoarthritis (OA): Treatment, Symptoms, Diagnosis
Osteoarthritis (OA) is a degenerative joint disease most often affecting major joints such as knees, hands, back, or hips....
Rheumatoid Arthritis Exercises: Joint-Friendly Workouts
Regular exercise boosts fitness and helps reverse joint stiffness for people with rheumatoid arthritis (RA). WebMD demonstrates...
Exercises for Knee Osteoarthritis and Joint Pain
Learn about osteoarthritis and exercises that relieve knee osteoarthritis pain, stiffness and strengthen the knee joint and...
Osteoarthritis Quiz: Test Your Medical IQ
How does osteoarthritis differ from other types of arthritis? Learn about osteoarthritis with this quiz.
Rheumatoid Arthritis Quiz: What is Rheumatoid Arthritis?
How is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid...
Picture of Osteoarthritis
Osteoarthritis is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more...
Tips for Healthy Joints: Exercise, Nutrition, & More
Dealing with joint pain and arthritis? Learn why weight matters--and why NOT to stretch before exercise. See these solutions for...
Arthritis: 16 Bad Habits That Cause Joint Pain
Being overweight, wearing uncomfortable shoes, or carrying a heavy purse can make joint pain and arthritis symptoms worse. Some...
Famous Faces With Rheumatoid Arthritis
Learn more about the famous faces of rheumatoid arthritis such as Lucille Ball, Glenn Frey, and more.
Osteoarthritis: 15 Tips to Improve Daily Living With OA
Have arthritis in the knee? Osteoarthritis joint pain can make it hard to carry out activities of daily living. Cartilage...
Arthritis: Causes and Treatment for Joint Stiffness and Pain
Arthritis and injuries can leave your joints swollen, tender, and damaged. Discover treatments for morning stiffness, sore...
Fun With Kids? Don't Let Arthritis Stop You
You can still have lots of fun with children despite arthritis. Our experts uncover ways to spend time with your kids or...
Active Living with Osteoarthritis
Check out this slideshow on Active Living From Day to Night with Osteoarthritis. Even with arthritis you can keep your active...
Related Disease Conditions
Buildup of uric acid crystals in a joint causes gouty arthritis. Symptoms and signs include joint pain, swelling, heat, and redness, typically of a single joint. Gout may be treated with diet and lifestyle changes, as well as medication.
Which Foods Make Arthritis Worse?
Foods that may worsen arthritis include processed foods, salt, red meat, and alcohol. Check out the center below for more medical references on arthritis, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Early RA signs and symptoms include anemia, both sides of the body affected (symmetric), depression, fatigue, fever, joint deformity, joint pain, joint redness, joint stiffness, joint swelling, joint tenderness, joint warmth, limping, loss of joint function, loss of joint range of motion, and polyarthritis.
Pain Management and Rheumatoid Arthritis
Second Source article from WebMD
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Also known as degenerative arthritis, osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
Arthritis (Joint Inflammation)
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
16 Early Rheumatoid Arthritis (RA) Signs & Symptoms
Early rheumatoid arthritis (RA) symptoms and signs vary differently from person to person. The most common body parts that are initially affected by RA include the small joints of the hands, wrists, and feet, and the knees and hip joints. Joint inflammation causes stiffness. Warmth, redness, and pain may vary in degree.
Osteoarthritis vs. Osteoporosis Differences and Similarities
Arthritis is defined as painful inflammation and joint stiffness. Osteoarthritis is a type of arthritis and the most common cause of chronic joint pain, affecting over 25 million Americans. Osteoarthritis is a type of arthritis that involves the entire joint. Osteoporosis is not a type of arthritis. It is a disease that mainly is caused by a loss of bone tissue that is not limited to the joint areas. It is possible for one person to have both osteoarthritis and osteoporosis. The differences in the signs and symptoms of osteoarthritis and osteoporosis include; pain, stiffness, and joint swelling, joint deformity, crackle sounds when the joint is moving, and walking with a limp. Osteoporosis is called the "silent disease" because it can progress for years without signs and symptoms before it is diagnosed, severe back pain, bone fractures, height loss, and difficulty or inability to walk. The differences in the causes of osteoarthritis and osteoporosis are that osteoarthritis usually is caused by wear and tear on the joints. Osteoporosis usually is caused by one or more underlying problems, for example, calcium and vitamin D deficiencies. Treatment for osteoarthritis and osteoporosis are not the same. There is no cure for osteoarthritis or osteoporosis.
Fungal arthritis is inflammation of a joint by a fungus that has invaded the body and is growing in the normally sterile joint. Fungal arthritis symptoms and signs include pain, redness, loss of range of motion, and swelling. Fungal arthritis treatment includes antibiotics, adequate drainage of the joint, and sometimes surgery.
Rheumatoid Arthritis vs. Lupus: Differences and Similarities
Rheumatoid arthritis (RA) and lupus are two varieties of autoimmune diseases that cause flare-ups. While RA attacks the immune system on the joints, lupus involves many other parts of the body besides the joints. Common RA symptoms involve warm, swollen, and painful joints; morning stiffness in the joints or stiffness after inactivity, joint deformity, fever, fatigue, etc. Lupus symptoms include Malar rash (butterfly-shaped rash involving the cheeks and bridge of the nose), fever, joint pain in the absence of joint deformity, etc.
Arthritis in Knee: 4 Stages of Osteoarthritis
Painful joint swelling is called arthritis. Osteoarthritis is due to wear and tear of the joints over many years. Arthritis maye develop in any joint, including the fingers, hips and knees. Usually, patients with arthritis feel pain in their joints even after moderate movements. There are four stages of osteoarthritis of the knee.
Can Rheumatoid Arthritis Be Caused by Stress?
Rheumatoid arthritis can be caused by and result in stress, as well as other conditions such as gastrointestinal problems (IBD).
Do Steroids Help With Arthritis?
Arthritis is the inflammation of one or more joints in the body. The disease is one of the most common chronic health conditions in the United States. Steroids are a class of drugs that reduce inflammation and have a suppressing effect on the immune system.
Rheumatoid Arthritis vs. Fibromyalgia
Though rheumatoid arthritis (RA) and fibromyalgia have similar symptoms, RA is an autoimmune disease and fibromyalgia is a chronic pain syndrome. RA symptoms include joint redness, swelling, and pain that lasts more than 6 weeks. Fibromyalgia symptoms include widespread pain, tingling feet or hands, depression, and bowel irritability. Home remedies for both include stress reduction, exercise, and getting enough sleep.
What Are the Four Stages of Rheumatoid Arthritis?
Rheumatoid arthritis is a chronic inflammatory disease categorized into the following four stages and classifications. Learn the causes, symptoms, and complications of RA below.
Rheumatoid Arthritis vs. Arthritis
Arthritis is a general term used to describe joint disease. Rheumatoid arthritis (RA) is a type of arthritis in which the body’s immune system mistakenly attacks the joints, causing chronic inflammation.
Juvenile Rheumatoid Arthritis (JRA)
Juvenile rheumatoid arthritis (JRA) annually affects one child in every thousand. There are six types of JRA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
How Serious Is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that typically affects the joints and other body parts. If not diagnosed early and appropriately treated, RA can lead to permanent deformities, disabilities, and serious systemic complications.
Safest Rheumatoid Arthritis Drugs During Pregnancy
None of the drugs used in the treatment of rheumatoid arthritis (RA) is completely safe during pregnancy. You must discuss with your physician regarding the decision to use, modify, or stop any medications.
Breastfeeding With Rheumatoid Arthritis
You can breastfeed your baby even if you have rheumatoid arthritis (RA). However, you must always consult your doctor before you start the process.
Osteoarthritis vs. Rheumatoid Arthritis
Osteoarthritis (OA) and rheumatoid arthritis (RA) are chronic joint disorders. RA is also an autoimmune disease. OA and RA symptoms and signs include joint pain, warmth, and tenderness. Over-the-counter pain relievers treat both diseases. There are several prescription medications that treat RA.
What Is the Main Cause of Osteoarthritis?
Osteoarthritis (OA) is a chronic degenerative disease of the joints affecting middle-aged and elderly people. It involves the breakdown of cartilage and associated inflammatory changes in the adjacent bone. It is a leading cause of chronic disability, affecting 30 million people in the United States alone.
Osteoarthritis and Treatment
Painful swelling of the joints due to wear and tear over many years is called osteoarthritis. Osteoarthritis may develop in any joint that includes the fingers, hips, and knees. There are many treatment options available to curb the complications of arthritis.
What Are 5 Common Risk Factors to Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is an autoimmune disorder (the body's immune system mistakenly attacks its own cells). Certain factors increase the risk of RA.
Treatment & Diagnosis
- Rheumatoid Arthritis FAQs
- Osteoarthritis FAQs
- Will Rheumatoid Arthritis Nodules Go Away?
- What if I get COVID-19 with Rheumatoid Arthritis?
- Rheumatoid Arthritis vs. Osteoarthritis
- Why Does Pregnancy Affect the Course of Rheumatoid Arthritis (RA)?
- Are Corticosteroids Safe for Pregnant and Nursing Women with Rheumatoid Arthritis?
- 5 Surprising Facts About Rheumatoid Arthritis
- Arava Approved For Rheumatoid Arthritis
- Arthritis - Whether Weather Affects Arthritis
- Arthritis Foot Care - It's In the Shoes
- Arthritis Medications
- What Not to Eat When You Have Arthritis
- Ultrasound Imaging of Joints in Rheumatoid Arthritis (RA)
- Can You Be Too Young for a Knee Replacement?
- Can Fifth Disease Cause Arthritis Pain?
- What Causes Early Onset of Hip Osteoarthritis?
- Does Crohn's Disease Cause Arthritis?
- What Is Cervical Osteoarthritis?
- Can You Get a Cartilage Transplant?
- Can Glucosamine Treat Arthritis?
- Are Women More Susceptible to Osteoarthritis?
- Can Milk Allergy Cause Rheumatoid Arthritis?
- Are Hidradenitis and Rheumatoid Arthritis Related?
- How Is Arthritis Diagnosed?
- Can You Prevent Osteoarthritis?
- Can My Diet Improve Arthritis?
- What's the Rheumatoid Arthritis Prognosis?
- What Are Home Remedies for Rheumatoid Arthritis?
Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.