The mystery of ketoprofen

I don’t often use medications, but there is one — now hard to get — that is like a miracle for me. It’s ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) which I assume, given the -profen suffix, is a relative of medications such as ibuprofen.

Back in the 1990s, ketoprofen was available without a prescription. It was sold over the counter as Orudis KT. In my working days, I often had tension headaches. Aspirin, acetominophen, and ibuprofen would barely touch my headaches. One day I saw a TV commercial for Orudis KT, advertising it as a miracle headache remedy. I went out and bought some.

One Orudis KT tablet was a tiny 12.5 milligrams. For comparison, one aspirin is 325mg, one acetominophen tablet is 500mg, and one ibuprofen tablet, such as Aleve, is 220mg. I could take one Orudis KT tablet for a worst-case headache, and 30 minutes later I’d forget I ever had a headache. There were never any side effects. I called them my “little green pills,” and people I worked with would often come to me to beg for one if they had a headache. How could a tiny 12.5 milligrams of something be so effective?

Then in 2005 Orudis KT was taken off the over-the-counter market and was available only by prescription. Clearly I was not the only person who found it remarkably effective. Some of the last remaining bottles of it sold for very high prices on eBay — $30, $40, $50 and more. After that I couldn’t get Orudis KT anymore.

A few years ago a friend in California gave me some ketoprofen that his doctor had prescribed after surgery. Each capsule was a ridiculous 200mg, more ketoprofen than I would ever dare — or need — to take. A few capsules lasted me several years. I’d open the capsule and take out just enough of the powder to come to 12.5 milligrams. Then that ran out.

A couple of weeks ago, I asked my doctor if he’d prescribe some ketoprofen, just so I’d have it for minor aches and pains. I told him how effective it was in small doses and said, “Surely I’d be better off with 12.5 milligrams of ketroprofen rather than 220 milligrams of ibuprofen?” He agreed. He also said that he didn’t know why the drug company took it off the over-the-counter market, but his guess was that it was a way of making more money from it. “Most people don’t know about ketoprofen,” my doctor said. I believe ketoprofen is much better known in Europe and Canada than in the U.S.

When I took the prescription to the drug store, they didn’t have ketoprofen. The pharmacist said they had not stocked it for years and that it was available only in bulk in far larger quantities than the pharmacy would ever be able to sell. The pharmacist referred me to a “compounding pharmacy,” a specialized sort of pharmacy that mixes drugs and doses to order, particularly drugs that are not common. I got my ketoprofen!

From Googling I’ve learned that ketoprofen is very much used as a veterinary drug, particularly in cattle. It is very effective for fever and respiratory diseases in cattle, as well as for mastitis. This has been a problem in a few countries in Asia, including India and Bangladesh. There are about ten NSAID drugs which, when given to cattle, and if one of the cattle dies out in the open from whatever it’s being treated for, and if a vulture then eats it, the vulture’s kidneys may be fatally damaged. Apparently it’s only Asian vultures that are susceptible. Ketoprofen is actually used as a veterinary drug with chickens, ducks, and quail, as well as pet birds such as parakeets. As far as I know, no species of animal in the U.S. or Europe is harmed by ketoprofen.