Flurbiprofen

A to Z Drug Facts

Flurbiprofen

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(FLURE-bih-PRO-fen)

Ansaid, Alti-Flurbiprofen, Apo-Flurbiprofen, Froben, Froben SR, Novo-Flurbiprofen, Nu-Flurbiprofen

Flurbiprofen Sodium

Ocufen

Class: Analgesic/NSAID

Action Decreases inflammation, pain and fever, probably through inhibition of cyclooxygenase activity and prostaglandin synthesis.

Indications Systemic: Treatment of rheumatoid arthritis and osteoarthritis. Ophthalmic: Inhibition of intraoperative miosis. unlabeled use(s): Treatment of juvenile rheumatoid arthritis; migraine; dysmenorrhea; sunburn; mild to moderate pain; acute gout; ankylosing spondylitis; tendonitis; bursitis; inflammation after cataract surgery; uveitis.

Contraindications Systemic/ophthalmic: Patients in whom aspirin, iodides, or any NSAID has caused allergic-type reactions; dendritic keratitis. Ophthalmic: Epithelial herpes simplex keratitis.

Route/Dosage

Rheumatoid Arthritis or Osteoarthritis

ADULTS: PO 200 to 300 mg in divided doses bid to qid; do not exceed 300 mg/day.

Dysmenorrhea

ADULTS: PO 50 mg qid.

Inhibition of Intraoperative Miosis

ADULTS: Topical 1 drop of 0.03% solution q 30 min beginning 2 hr before surgery.

Interactions

Beta-blockers: Decreased antihypertensive effect of beta-blocker. Cyclosporine: Increased risk of nephrotoxicity. Lithium: Increased levels and effects of lithium. Loop diuretics: Decreased diuretic effect. Methotrexate: Increased methotrexate levels. Salicylates: Increased risk of GI toxicity. Warfarin: Increased risk of gastric erosion and bleeding.

Lab Test Interferences May prolong bleeding time.

Adverse Reactions

CV: CHF; hypotension; hypertension; peripheral edema; fluid retention; vasodilation. CNS: Dizziness; drowsiness; vertigo; headaches; nervousness; migraine; anxiety; confusion. DERM: Pruritus; erythema; photosensitivity; urticaria. EENT: Systemic use: Blurred vision; changes in color vision; hearing disturbances; taste changes. Ophthalmic use: Ocular irritation; transient stinging and burning of eyes. GI: Heartburn; dyspepsia; nausea; vomiting; anorexia; diarrhea; constipation; increased or decreased appetite; indigestion; GI bleeding; ulceration. GU: Hematuria; proteinuria; renal insufficiency; glomerular and interstitial nephritis; acute renal failure with pre-existing renal dysfunction. HEMA: Anemia; bone marrow depression; neutropenia; leukopenia; hypocoagulability. RESP: Bronchospasm; laryngeal edema; dyspnea; hemoptysis; shortness of breath. OTHER: Hyperglycemia; hypoglycemia; hyponatremia.

Precautions

Pregnancy: Category B (flurbiprofen); Category C (flurbiprofen sodium). Lactation: Excreted in breast milk. Children: Safety and efficacy not established. Elderly: Increased risk of adverse reactions. GI effects: Serious GI toxicity (eg, bleeding, ulceration, perforation) can occur at any time, with or without warning symptoms. Hypersensitivity: May occur; use caution in aspirin-sensitive individuals because of possible cross-sensitivity. Renal effects: Acute renal insufficiency, interstitial nephritis, hyperkalemia, hyponatremia, and renal papillary necrosis may occur. Renal impairment: Assess function before and during therapy, because NSAID metabolites are eliminated renally.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Give with food, milk or antacids.
Have patient remain in an upright position for 15 to 30 min after administration, if possible.
Store at room temperature in tightly closed, light-resistant container.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies. Note hypersensitivity to aspirin products, renal impairment, ulcer disease or bleeding disorders.
Monitor effectiveness of drug therapy by evaluating joint symptoms and pain regularly.
For patients undergoing prolonged or high-dose therapy, monitor hemoglobin and renal and hepatic function.
Be aware that effects of this drug may mask signs and symptoms of infection.

OVERDOSAGE: SIGNS & SYMPTOMS
	Drowsiness, dizziness, mental confusion, disorientation, lethargy, numbness, vomiting, nausea, gastric upset, abdominal pain, headache, convulsions, renal failure, coma

Patient/Family Education

Instruct patient to take medication as prescribed, not to skip a dose, and not to double up doses if close to next dose.
Advise diabetic patient to monitor blood glucose levels carefully during treatment.
Warn patients about the potential for bleeding and the need to notify other health care professionals that drug is being taken.
Instruct patient using ophthalmic preparation to use great care to prevent contamination of solution.
Instruct patient to report the following symptoms to physician: Bleeding, bruising, dyspnea, edema (oral drug); burning or stinging, tearing, photophobia (ophthalmic drug).
Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
Tell patient to avoid intake of alcoholic beverages, aspirin or other otc medications without consulting physician.