Flurbiprofen (Ansaid, Ocufen)

Category:

  • Analgesic

Description:

  • NSAID, non-narcotic analgesic

Indications:

  • Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis

  • Inhibition of inoperative miosis (ophth), cystoid macular edema (non-FDA approved)

  • Inflammation after cataract or glaucoma laser surgery or uveitis syndromes (ophth: non-FDA approved)

  • Bursitis, primary dysmenorrhea, tendinitis, acute gout (all non-FDA approved)

Contraindications:

  • Dendritic keratitis (ophth)

Precautions:

  • Pregnancy category C; excreted in breast milk; use caution in nursing mothers

  • Bleeding tendencies, peptic ulcer

  • Hepatic/renal function impairment, elderly, CHF, hypertension

Adverse Reactions (Side Effects):

  • CNS: dizziness, headache, lightheadedness

  • CV: chest pain, CHF, dysrhythmias, edema, hyper/hypotension, palpitation, tachycardia

  • EENT: burning or stinging upon instillation, dry eyes, hearing disturbances, photophobia, tinnitus, visual disturbances

  • GI: abdominal cramps, constipation, diarrhea, dyspepsia, flatulence, gastric or duodenal ulcer with bleeding or perforation, hepatitis, nausea, occult blood in stool, pancreatitis, vomiting

  • GU: renal failure

  • HEME: agranulocytosis, eosinophilia, leukopenia, pancytopenia, thrombocytopenia

  • METAB: hyperglycemia, hyperkalemia, hypoglycemia, hyponatremia,

  • RESP: bronchospasm, dyspnea

  • SKIN: photosensitivity, rash, urticaria

Dosage:

  • Administered orally and ophthalmic instillation

  • Adult:            

    • Rheumatoid and osteoarthritis: PO 200-300mg daily divided 2-4 times daily

    • Dysmenorrhea: PO 50mg daily

    • Inhibition of intraoperative miosis: OPHTH 1 drop every 30 minutes beginning 2 hours before surgery (total 4 drops)

Drug interactions:

  • Warfarin: addition of flurbiprofen associated with excessive hypoprothrombinemia and bleeding; ibuprofen less likely to interact

  • Methotrexate: addition of flurbiprofen may interfere with the renal secretion of methotrexate, yielding increased risk of methotrexate toxicity

  • Prednisone: increase risk of GI ulceration

  • Loop diuretics: reduction in diuretic and antihypertensive effects

    

 
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