Flurbiprofen
Indications
Flurbiprofen is used for:
Dysmenorrhoea, Sore throat, Ocular inflammation, Pain and inflammation associated w/ musculoskeletal and joint disorders, Prophylaxis of miosis during ocular surgery
Adult Dose
Oral
Pain and inflammation
Adult: 150-200 mg daily in divided doses, increased to 300 mg daily in acute or severe conditions if necessary.
Dysmenorrhoea
Adult: Initially, 100 mg followed by 50-100 mg 4-6 hrly. Max: 300 mg daily.
Rheumatoid Arthritis, Osteoarthritis
200-300 mg/day divided q6-12hr PO, not to exceed 100 mg/dose or 300 mg/day
Child Dose
<12 years: Not recommended
Renal Dose
Renal Impairment
Severe Impairment: Not recommended
Administration
Should be taken with food.
Contra Indications
Peptic ulcer, GI haemorrhage, asthma, bronchospasm, rhinitis, angioedema, hypersensitivity; aspirin intolerance; pregnancy (3rd trimester); lactation.
Precautions
Patients w/ known CV disease or risk factors for CV disease, fluid retention. Hepatic and renal impairment. Lactation.
Lactation: excreted in breast milk; not recommended
Pregnancy-Lactation
Pregnancy Category: C; avoid in late pregnancy
Lactation: excreted in breast milk; not recommended
Interactions
Reduced antihypertensive effect of ACE inhibitors, angiotensin II receptor antagonists and ?-blockers. Slight reduction in blood glucose concentration in patients w/ DM receiving certain antidiabetic agents (e.g. glyburide, metformin). Reduced diuretic effect of furosemide and thiazides. May increase toxicity of lithium and methotrexate. May increase risk of bleeding w/ antiplatelets, anticoagulants, SSRIs, corticosteroids.
Adverse Effects
Side effects of Flurbiprofen :
Oedema, abdominal pain, constipation, diarrhoea, dyspepsia/heartburn, liver enzyme elevations, flatulence, nausea, vomiting, wt change, headache, nervousness, CNS stimulation (e.g. anxiety), CNS inhibition (e.g. somnolence), rhinitis, vision changes, dizziness/vertigo, tinnitus, signs and symptoms of UTI, rash. Ocular hyperaemia, eye irritation, fibrosis, miosis, mydriasis.
Potentially Fatal: GI bleeding, ulceration and perforation, jaundice, fulminant hepatitis, liver necrosis, hepatic failure.
Mechanism of Action
Flurbiprofen inhibits prostaglandin synthesis by decreasing the activity of cyclooxygenase resulting in reduced prostaglandin levels. It is also a potent inhibitor of platelet aggregation.