May affect ability to drive or operate machinery. Childn & adolescents. Dexketoprofen: History of allergic conditions. Avoid concomitant use w/ other NSAIDs including COX-2 selective inhibitors. W/draw treatment if GI bleeding or ulceration occurs; risk of GI bleeding, ulceration or perforation; history of ulcer, oesophagitis, gastritis &/or peptic ulcer; history of GI disease (ulcerative colitis, Crohn's disease); increase risk of ulceration or bleeding w/ concomitant intake of oral corticosteroids, anticoagulants eg, warfarin, SSRIs or anti-platelet agents eg, ASA. Renal impairment; patients receiving diuretic therapy or those who could develop hypovolemia; ensure adequate fluid intake; glomerular nephritis, interstitial nephritis, renal papillary necrosis, nephrotic syndrome & acute renal failure. Patients w/ impaired hepatic functions; may be associated w/ small increase in the risk of arterial thrombotic event (eg, MI or stroke); patients w/ risk factors for CV disease (eg, HTN, hyperlipidemia, DM, smoking); patients receiving other therapy that interferes w/ haemostasis eg, warfarin, other coumarins or heparins. Exfoliative dermatitis, SJS & TEN. Elderly. Patients w/ congenital disorder of porphyrin metabolism (eg, acute intermittent porphyria), dehydration, directly after major surgery; asthma combined w/ chronic rhinitis, sinusitis &/or nasal polyposis; haematopoietic disorders, SLE or mixed connective tissue disease. Tramadol: Addicted patients, patients w/ head injury, shock, reduced level of consciousness of uncertain origin, disorders of the resp centre/function or increased intracranial pressure; patients sensitive to opiates; possibility of resp depression; convulsions; may increase risk of seizure.
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