Flurbiprofen

Indications & Dose:

Intraoperative miosis, ocular inflammation, ankylosing spondylitis, prevention of cognitive decline, prevention of colon cancer, dysmenorrhea,  acute gout,  migraine headache,mild-moderate pain  (bursitis, dental, cancer, episiotomy, osteoarthritis, postoperative sickle cell disease), periodontal disease, rheumatoid arthritis, tendonitis, soft tissue injury,  sunburn

• BY MOUTH

Adult: 150-200 mg daily in divided doses max. 300 mg daily.

Dysmenorrhoea:

• BY MOUTH

initially 100mg, then 50-100mg every 4-6 hours, max. 300mg daily. SR: cap once daily.

Adhesive Patch Adults: One patch applied 12 hourly.

Children:

Not recommended.

Contraindications:

Bronchospasm, nasal polyps, edema precipitated by aspirin or other NSAIDs, dendritic key (ophth) 

Side Effects:

Cautions:

Precautions:

History of ulceration, bleeding, or perforation; renal dysfunction, hypertension or cardiac conditions aggravated by fluid retention and edema, history of liver dysfunction, history of coagulation deficits

Interaction:

Drugs
Aminoglycosides: Reduced clearance with elevated aminoglycoside

levels and potential for toxicity (especially indomethacin in premature infants; other NSAIDs probably)

Antihypertensives (a-bl ockers, angiotensin-cmic effects

Corticosteroids: Increased risk of GI ulceration

Anticoagulants: Excessive hypoprothrombinemia, decreased platelet aggregation with increased risk of GI bleeding

Cyclosporine: Increased nephrotoxicity risk

Lithium: Decreased clearance of lithium (mediated via prostaglandins) resulting in elevated serum lithium levels and risk of toxicity

Methotrexate: Decreased renal secretion of methotrexate resulting in elevated methotrexate levels and risk of toxicity

Phenylpropanolamine: Possible acute hypertensive reaction

Potassium-sparing diuretics: Additive hyperkalemia potential

Triamterene: Acute renal failure reported with addition of indomethacin; caution with other NSAIDs 

Warnings:

Adverse Effects:

Lactations:

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

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Dizziness, headache, light-headedness
CV: Chest pain, CHF, dysrhythmias, edema, hypertension, 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: Acute renal failure
HEME: Agranulocytosis, eosinophilia, leukopenia, neutropenia, pancytopenia, thrombocytopenia
METAB: Hyperglycemia, hyperkalemia, hypoglycemia, hyponatremia
RESP: Bronchospasm, dyspnea
SKIN: Photosensitivity, rash, urticaria

Patient And Carer Advice: