Arthritis/rheumatic disorders:

Indications for: Flurbiprofen

Rheumatoid arthritis. Osteoarthritis.

Adult Dosage:

Use lowest effective dose for shortest duration. 200–300mg/day in 2–4 divided doses; max single dose 100mg. Reduce dosage for renal impairment.

Children Dosage:

Not established.

Flurbiprofen Contraindications:

Aspirin allergy. Coronary artery bypass graft surgery.

Boxed Warning:

Risk of serious cardiovascular and gastrointestinal events.

Flurbiprofen Warnings/Precautions:

Increased risk of serious cardiovascular events (including MI, stroke). Avoid in recent MI, severe heart failure; if necessary, monitor. Increased risk of serious GI adverse events (including inflammation, bleeding, ulceration, perforation). History of ulcer disease and/or GI bleeding. Hypertension; monitor BP closely. Hepatic or renal impairment. Discontinue if signs/symptoms of liver disease develop, or if abnormal LFTs persist or worsen. Dehydration. Hypovolemia. Advanced renal disease: not recommended. Hyperkalemia. Coagulation disorders. Monitor CBCs, blood chemistry, hepatic, renal, and ocular function in long-term therapy. Pre-existing asthma. May mask signs of infection or fever. Discontinue at 1st sign of rash or any other hypersensitivity. Elderly. Debilitated. Labor & delivery. Pregnancy (≥30 weeks gestation; avoid). Nursing mothers.

Flurbiprofen Classification:

NSAID (phenylalkanoic acid deriv.).

Flurbiprofen Interactions:

Avoid concomitant aspirin, salicylates (eg, diflunisal, salsalate) or other NSAIDs. Increased risk of GI bleed with anticoagulants, antiplatelets, oral corticosteroids, SSRIs, SNRIs, smoking, alcohol, or prolonged NSAID therapy; monitor. May antagonize, or increase risk of renal failure with diuretics (eg, loop or thiazides), ACE inhibitors, ARBs, or β-blockers; monitor closely. Potentiates digoxin; monitor levels. May potentiate lithium, methotrexate, cyclosporine; monitor for toxicity. Concomitant with pemetrexed may increase risk of pemetrexed-associated myelosuppression, renal, and GI toxicity.

Adverse Reactions:

GI upset, abdominal pain, dyspepsia, constipation, headache, edema, UTI; cardiovascular thrombotic events, GI ulcer/bleed, hepatotoxicity, renal toxicity, hypersensitivity reactions, anemia.

Note:

Formerly known under the brand name Ansaid.

Metabolism:

Hepatic (CYP2C9); UGT2B7 is the predominant UGT isozyme responsible for the glucuronidation.

Drug Elimination:

Predominantly renal elimination. Half-life of R- and S-flurbiprofen are similar, about 4.7 and 5.7 hours, respectively.

How Supplied:

Contact supplier