The pharmacokinetics of oral ketoprofen in patients after gastric resection

Background: Total and partial gastric resection may affect the pharmacokinetics of drugs, especially orally administered a few days after surgery. Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) broadly used to treat postoperative pain, including patients after gastric resection. The aim of the research was to analyse the pharmacokinetics (PK) of orally administered ketoprofen in patients after gastrectomy. Methods: The research was carried out on two groups of patients after total (TG; Roux-Y procedure) and partial (PG; Billroth II procedure) gastrectomy. The patients in group TG (n = 15; mean [SD] age 61.86 [14.15] years; and BMI 24.20 [3.73] kg/m(2)) and group PG (n = 5; mean [SD] age 62.40 [16.80] years; and BMI 23.98 [3.45] kg/m(2)) received ketoprofen in a single oral dose of 100 mg. The measurement of ketoprofen plasma concentrations was made by means of the HPLC (high performance liquid chromatography) method. Results: The PK parameters in group TG and PG were as follows: maximum plasma concentration (C-max), 3.42 [0.99] and 4.66 [0.81] mg/l (p = 0.0220); area under the plasma concentration-time curve from zero to infinity (AUC(0-infinity)), 9.12 [2.78] and 9.17 [2.87] mg x h/ml (p = 0.9734); area under the first moment curve from zero to the time of infinity (AUMC(0-infinity)), 25.95 [8.52] and 26.53 [11.43] mg x h(2)/l (p = 0.9056); time to reach maximum concentration (t(max)), 0.47 [0.25] and 0.55 [0.27] h (p = 0.5327), respectively. Conclusions: Lower concentrations of ketoprofen in patients after gastrectomy suggest that it might be necessary to apply higher dose of the analgesic. (C) 2016 Published by Elsevier Sp. z o.o. on behalf of Institute of Pharmacology, Polish Academy of Sciences.