Flurbiprofen is a prescription nonsteroidal anti-inflammatory (NSAID) that comes in a tablet form, as an ophthalmic solution (eye drop), in an intravenous (IV, in a vein) formulation, and as an ingredient in over-the-counter (OTC) throat lozenges.

The tablet is used to treat signs and symptoms of rheumatoid arthritis (RA) and osteoarthritis, and it is used off-label for other types of pain, including dysmenorrhea (menstrual pain). The eye drops are used during certain types of eye surgery. The IV form is used to manage immediate postoperative surgical pain. The lozenges are used for throat pain.

Like most NSAIDs, flurbiprofen is usually well tolerated. The side effects of flurbiprofen are similar to those of other NSAIDs, and include upset stomach, risk of cardiovascular events, and the potential for a severe allergic reaction. 

  • The oral form of this NSAID is available as a generic and as the brand Ansaid.The eye drops are available as the brand Ocufen.Strepfen is an OTC lozenge containing flurbiprofen.

Uses 

Oral flurbiprofen is prescribed for pain control and to reduce and prevent inflammation. The eye drops are placed directly on the surface of the eye before eye surgery, such as cataract surgery.

The mechanism of action of flurbiprofen involves inhibition of cyclooxygenase and inhibition of prostaglandin synthesis. These effects reduce inflammation, inhibit platelet aggregation (prevent blood clots), and reduce pain and fever.

The oral form of this medication begins to have its effect within a few hours, and the effects wear off within 12 to 24 hours. The other forms work faster than the oral formulation, and their effects can be expected to last for as long as the effects of the oral form.

Indications for flurbiprofen include:

  • Osteoarthritis: Osteoarthritis is a common condition that causes pain and limited joint motion. Associated risk factors include joint trauma or repetitive injuries that precipitate joint inflammation.
  • RA: An inflammatory condition, RA can affect joints throughout the body, causing swelling, pain, stiffness, and limitations in movement.
  • Eye surgery: When used to facilitate eye surgery, flurbiprofen drops are placed on the eye to prevent pupil constriction (narrowing). It is also sometimes used to reduce post-operative inflammation of the eye.

IV flurbiprofen has been used for managing postoperative pain associated with a variety of procedures, including:

  • Oral surgeryBreast cancer surgeryGynecologic laparotomy

Off-Label Uses

Oral flurbiprofen has been prescribed for several off-label uses, such as dysmenorrhea, joint pain, dental pain, and inflammation.

Before Taking

Flurbiprofen is not recommended if you have had an adverse reaction or any allergic reaction to flurbiprofen or other NSAIDs.

This medication should be used with caution if you have had coronary artery bypass graft (CABG) surgery.

This medication should be used with caution during pregnancy. The use of NSAIDs during the third trimester of pregnancy increases the risk of premature closure of the fetal ductus arteriosus.

NSAIDs are associated with reversible infertility. If you have trouble conceiving, it is recommended that you stop taking this medication.

This medication can cause bleeding and may increase the risk of kidney disease, so your healthcare provider may periodically monitor these effects with complete blood count (CBC) and blood chemistry tests.

Precautions and Contraindications

This medication may be contraindicated or should be used with caution for people who have bleeding disorders, hypertension (high blood pressure), kidney disease, or heart failure.

Other NSAIDs

Zorvolex and Voltaren (diclofenac) and Mobic (meloxicam) are prescription NSAIDs used to treat inflammatory conditions.

Over-the-counter (OTC) NSAIDs such as ibuprofen and naproxen generally have similar but less intense therapeutic effects and less severe side effects in comparison to prescription-strength NSAIDs.

Dosage 

The manufacturer of Ansaid recommends using the lowest effective dose to reduce the risk of adverse effects.

While they are less powerful than prescription-strength NSAIDs, OTC NSAIDs are not safe for everyone—you should check with your healthcare provider before using them, especially if you have a contraindication to using any prescription NSAID.

Ansaid comes in 50-milligram (mg) and 100-mg tablets. The recommended starting dose is 200 to 300 mg per day, divided into two, three, or four doses per day. The maximum recommended single dose to be taken at once is 100 mg.  

  • Ocufen solution is 0.03% (0.3 mg/milliliter) strength. One or more drops are placed into each eye approximately 30 minutes before surgery, and it is sometimes used after surgery as well.Strepfen is available at a strength of 8.75 mg and should be used as directed for sore throat treatment.For postoperative pain control, an IV dose of 50 mg flurbiprofen is a typically administered dose, and your healthcare provider determines dosing.

Modifications

The dosing for older adults may be started at a lower dose than the standard recommended dose to avoid side effects and toxicity.

How to Take and Store 

When using oral flurbiprofen, you should take it with food or a full glass of water (8 ounces) to avoid stomach upset. Do not lie down for at least 10 minutes after taking this drug.

If you miss your dose, you can take it when you can do so. But if it is almost time for your next dose, you should not double up on the dose, as this can increase the risk of adverse events.

Oral flurbiprofen tablets should be stored at a room temperature of 20°C to 25°C (68°C to 77°F) with excursions permitted between 15°C to 30°C (59°F to 86°F).

Side Effects

Flurbiprofen can lead to side effects, similar to those of most NSAIDs. Tell your healthcare provider about the side effects that you are having. Be sure to get medical attention if you experience severe side effects.

Common 

Common side effects may improve over time, or they can persist and can become intolerable, necessitating a dosing change or switch to another medication.

  • Abdominal painIndigestion and heartburnNauseaDiarrheaConstipationDizzinessDrowsinessHeadache

Severe

Severe side effects can cause serious adverse health consequences. Be sure to get medical attention if you experience any of the severe side effects of flurbiprofen.

Adverse effects can include:

  • Cardiovascular thrombotic events: Chest pain, heart attack, stroke
  • GI bleeding, ulceration, and perforation: Severe abdominal pain, blood in the stool, coughing up blood
  • Hepatotoxicity: Liver failure, yellow skin and eyes, feeling tired
  • Hypertension
  • Heart failure and edema: Shortness of breath, leg swelling
  • Renal toxicity and hyperkalemia: Kidney damage
  • Serious skin reactions, exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN)
  • Hematologic toxicity: Bleeding problems, anemia
  • Anaphylactic reactions (severe allergic reaction)

Ocufen ophthalmic solution may increase the risk of bleeding in the eye with eye surgery.

Strepfen can cause a distortion of taste, burning, pricking, or tingling of the tongue, or mouth ulcers.

Warnings and Interactions 

Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your healthcare provider or pharmacist. Flurbiprofen can interact with several other medications, including.

  • Aspirin: Taking aspirin with flurbiprofen decreases flurbiprofen concentration and increases the risk of bleeding.
  • NSAIDs: Flurbiprofen can increase the risk of gastrointestinal side effects when used with NSAIDs.
  • Steroids: Taking flurbiprofen and steroids together increases the risk of bleeding.
  • Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta blockers: Flurbiprofen reduces the antihypertensive effects of these medications.
  • Diuretics: Flurbiprofen reduces the antihypertensive effects of these drugs.
  • Digoxin: Flurbiprofen increases the concentration of this drug.
  • Lithium: Flurbiprofen can lead to an increase in lithium concentration, increasing the risk of lithium toxicity.
  • Methotrexate or cyclosporin: Flurbiprofen can lead to an increase in methotrexate or cyclosporin concentration, increasing the risk of toxicity.
  • Pemetrexed: Taking these medications together can increase the risk of bone marrow suppression and kidney or gastrointestinal damage.