What to Know About Orudis (Ketoprofen)

A Medication That Treats Pain and Inflammation

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Orudis is the most common brand name of ketoprofen, a medication that reduces fever and inflammation and eases pain. In the U.S., only a prescribed oral form of this drug is available; however, topical and over-the-counter forms are available abroad. It is also sold under the name Oruvail, among others.

A medication of the nonsteroidal anti-inflammatory drug (NSAID) class, it’s often indicated to take on menstrual pain as well as discomfort, tenderness, soreness, and stiffness associated with osteoarthritis and rheumatoid arthritis, two disorders of the joints. It may also be used to treat a wider set of diseases and painful conditions.

As with all pharmaceutical drugs, Orudis does cause side effects, and it may not be safe for some patients to take. If you’ve been prescribed this medication, it’s important to have a sense of what it treats and how to take it safely.  

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Uses

The U.S. Food and Drug Administration (FDA) has approved Orudis for use in taking on symptoms of:

  • Rheumatoid arthritis: This type of arthritis is caused by inflammation and swelling in the synovial membrane which lines the joints.
  • Osteoarthritis: The most common form of arthritis, osteoarthritis occurs due to wear and tear of the joint lining.
  • Severe menstrual cramps: Orudis or other NSAIDs may also be indicated to relieve severe pain related to menstrual cramps.
  • Other kinds of pain: Among others, Orudis may also be considered to take on post-surgical pain, or other sources of acute pain.

Off-Label Uses

Though not explicitly indicated, Orudis has also been shown to be effective in taking on:

Before Taking

Orudis can also come in an extended-release form, Oruvail, which is considered for more chronic forms of pain. In the U.S., these are only available with a prescription, though over-the-counter varieties are available in other countries.

Orudis doesn’t treat or cure the underlying condition so much as help manage symptoms. For osteoarthritis, rheumatoid arthritis, and other forms of chronic arthritis, pharmaceutical approaches are typically attempted before surgery.

Proper diagnosis and assessment are needed before Orudis is considered, as doctors need to ensure that this medication will be effective and safe to take. In cases of arthritis, doctors will employ imaging (usually X-ray), physical evaluation, and blood tests to assess the scope of the issue.

Testing liver, kidney, and heart function may also be needed to rule out cases where taking Orudis would be risky. In addition, your medical history, overall health status, and other current medications you are taking will be considered.   

Know What You’re Taking

Talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks with Orudis, others may be contraindicated outright or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

Precautions and Contraindications

There are several outright contraindicators for Orudis:

  • Allergy to Orudis, leading to facial swelling, breathing difficulties (asthma), among other symptoms
  • Allergy to NSAIDs including both prescribed and over-the-counter varieties
  • Coronary artery bypass graft (CABG) surgery patients, including before and after the procedure

Orudis and Oruvail may also be risky to take for several other kinds of patients due to an increased risk of adverse side-effects. Factors prompting careful consideration include:

  • A history of cardiovascular (heart) problems, including a history of heart attack, or other conditions
  • Other heart issues, such as high blood pressure, congestive heart failure, and edema (swelling in the limbs)
  • Stomach ulcers or other kinds of gastrointestinal bleeding
  • Kidney disease or a history of kidney problems
  • Pre-existing asthma, characterized by wheezing and other breathing problems
  • Coagulation disorders, in which the blood is unable to clot due to medications, hemophilia or other conditions
  • Liver dysfunction, such as hepatitis or liver disease
  • Pregnancy in the final trimester (months 7 to 10)
  • Age over 65, especially if taken for long-term, chronic pain
  • People who are breastfeeding, as well as infants under 6 months of age
  • Other lifestyle factors such as smoking tobacco, and drinking more than three alcoholic drinks a day.

 

Other NSAIDs

As NSAIDs, Orudis and other ketoprofen drugs are part of a broad class available in both over-the-counter and prescribed forms. Here are some of the most common of these are:

Dosage

Orudis is a capsule that comes in three dosage strengths: those with 25 milligrams (mg), 50 mg, and 75 mg of ketoprofen. The extended-release variant, Oruvail, is a capsule filled with little pellets that comes in 100, 150, and 200 mg forms.

How much you need to take, ultimately, depends on what your doctor and pharmacist indicate for you. As with some other drugs that manage pain and inflammation, their goal is to find the smallest effective dose for the shortest possible period of time.

Recommended dosages of Orudis and Oruvail vary based on the condition being treated:

  • Rheumatoid arthritis and osteoarthritis: The starting dosage of Orudis is either three 75 mg tablets or four 50 mg tablets a day for pain and swelling associated with arthritis. One 200 mg capsule of Oruvail is indicated in these cases.
  • Menstrual cramps and other pain: For mild to moderate pain due to menstruation or other causes, one 25 or 50 mg capsule of Orudis every 6 to 8 hours is indicated as needed. If necessary, this can be boosted to 75 mg, though daily intake of 300 mg or more should be avoided. Oruvail is not recommended for acute pain like this.

All listed dosages are according to Wyeth Pharmaceuticals, the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you. 

Modifications

As with other pharmaceutical medications, modifications to intake may need to be made for certain classes of patients. These include:

  • Mildly impaired kidney patients shouldn’t take more than 150 mg of Oruvail or Orudis per day.
  • Patients above the age of 75 are also indicated smaller initial doses and require extra monitoring of kidney function.
  • Impaired liver function cases also prompt a reduction in dose, with maximum total daily dosage of Orudis or Oruvail capped at 100 mg.

How to Take and Store

Generally speaking, you won’t need to adjust your diet when taking Orudis or other NSAIDs. However, to prevent stomach upset, you may want to take this medication with a glass of milk or food.

If you miss a dose, you can typically take your medication when you remember, though if it’s almost time for your next one, you can skip it. Importantly, you should never double-up on medications.

Overdose

As with many other medications, it’s important to be careful about how much Orudis you’re taking. Overdose of this drug is a medical emergency. Call 911 and get immediate help if you or a loved one experience:

  • Loss of consciousness
  • Seizure
  • Collapse
  • Vomiting
  • Nausea
  • Coma
  • Breathing difficulty
  • Stomach pains


As you’ll be counseled, there’s also quite a bit to keep in mind about storage:

  • Keep everything in the prescription bottle, tightly closed and out of the reach of children.
  • Store at room temperature defined as about 77 F (25 C).
  • Keep out of direct light, humidity, or excess heat.
  • Dispose of excess medications safely by taking unused portions to the pharmacy or a safe disposal site

Side Effects

Common

Given its activity on inflammatory and pain processes in the body, it’s little wonder that Orudis, like other NSAIDs, can cause a range of side-effects, from the mild and common to the more severe. Here’s a quick breakdown of the more common side effects:

  • Constipation and/or diarrhea
  • Sores in the mouth
  • Headache
  • Dizziness
  • Nervousness
  • Fatigue
  • Insomnia (trouble falling or staying asleep)
  • Tinnitus (ringing in the ears)

If these become persistent or severe, be sure to let your doctor know.

Severe

Though much rarer, severe side-effects of Orudis and other ketoprofen-based drugs can be deadly if untreated. Requiring prompt medical attention, they can be categorized based on the kind of damage that’s occurred:

  • Allergy: Allergic shock in reaction to NSAID drugs cause swelling in the face, arms, and hands, abdomen, or elsewhere, hives, itching, as well as breathing difficulties.
  • Liver damage symptoms: When Orudis impacts liver functions, patients experience jaundice (a yellowing of the skin and eyes), abdominal pain and swelling, and pale-colored stool.
  • Renal (kidney) insufficiency: Damage to the kidneys can cause difficulty urinating, and cloudy, discolored, or bloody urine.
  • Heart failure: NSAIDs can sometimes impair cardiac activity, making the heart unable to pump blood properly. This leads to swelling in the feet and lower limbs, sudden weight gain, and fatigue, among other symptoms.
  • Gastrointestinal bleeding: Bleeding can occur anywhere along the digestive tract, including the stomach and intestines. This leads to stomach pain, discolored urine and feces, and other symptoms.  
  • Other symptoms: Blurred vision, fever, hoarseness, and difficulty swallowing are all signs of a severe adverse reaction.

Keep in mind that some severe side-effects may not be listed above. Read the prescribing information carefully, and don’t hesitate to let your doctor know if you feel unwell or off.

Warnings and Interactions

Safely taking Orudis may also require making other changes to your routine. Lifestyle adjustments that need to be made include:

  • Avoiding alcohol intake: When alcohol and NSAID drugs like Orudis are combined, there’s an increased risk of gastrointestinal bleeding. Doctors advise you severely limit—if not cut out entirely—this habit during treatment.
  • Pausing cannabis use: While there’s more work to be done, some researchers have found potentially adverse interactions between cannabis and NSAIDs.

Notably, Orudis and Oruvail can also interact with many medications. Most prominent among these are:

  • ACE Inhibitors: Drugs of this class are heart medications and include Capoten (captopril), and Prinivil and Zestril (lisinopril), and Lotensin (benazepril), among others.  
  • Coumadin (warfarin): This blood-thinning drug can interact with NSAIDs to increase the chance of bleeding.
  • Lithium: This drug, which treats major depressive disorder and bipolar disorder, may also interact with Orudis, reducing its efficacy.
  • Methotrexate: This drug is used in chemotherapy; animal studies have shown that its effectiveness can be impacted by NSAIDs.  
  • Probenicid: This treatment for gouty arthritis works by modulating uric acid levels in the body. Efficacy is impacted when this is combined with Orudis.
  • Diuretics: Also known as water pills, these are used to adjust fluid and salt levels in the bloodstream to treat high blood pressure. They lose efficacy when taken alongside Orudis.
  • Aspirin: Among other NSAIDs, taking aspirin alongside Orudis increases the risk of gastrointestinal bleeding.

In addition, some supplements can also interact with Orudis, including:

  • Vitamin E
  • Garlic
  • Citrate (vitamin C) supplements
  • St. John’s wort
  • Feverfew

Keep in mind that this isn’t a list of all of the drugs, herbs, and supplements that interact with Orudis. It’s essential to double-check your medication’s labeling and talk to your doctor or pharmacist to make sure you know what’s safe to take.  

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Article Sources
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