Froben

Indications

Flurbiprofen is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling and stiffness in:

• Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis
• Muscle, joint and soft tissue injuries such as sprains, strains and back pain
• Painful periods, dental pain and pain after minor surgery

Lozenge and spray forms are used for short-term relief of sore throat, and eye drops are used during eye surgery as directed by the eye surgeon.

How It Works

Flurbiprofen blocks the cyclo-oxygenase (COX) enzymes that make prostaglandins, chemicals that cause pain, inflammation and fever. Lower prostaglandin levels mean less pain and swelling.

Dosage and Administration

For tablets, the usual adult dose is 150 to 200 mg a day divided into 2 to 4 doses, increased to a maximum of 300 mg a day for short periods if a doctor advises. For painful periods, 100 mg at the start then 50 to 100 mg every 4 to 6 hours, up to 300 mg a day. Take with or after food and a full glass of water. Use the lowest effective dose for the shortest time. Throat lozenges (8.75 mg) are dissolved slowly in the mouth every 3 to 6 hours, up to 5 in 24 hours, for no more than 3 days. Children: only as directed by a doctor.

Interactions

Avoid taking with other NSAIDs, including Aspirin at pain-relief doses. Taking it with Warfarin, Clopidogrel, SSRIs or steroids raises the risk of bleeding. It can reduce the effect of blood pressure medicines and diuretics, and with ACE inhibitors, angiotensin receptor blockers or diuretics it can harm the kidneys. It may raise blood levels of Lithium and Methotrexate. Use with Ciclosporin or Tacrolimus increases kidney risk.

Contraindications

Do not take flurbiprofen if you:

• Are allergic to it, or have had asthma, hives or nasal swelling after Aspirin or another NSAID
• Have an active stomach or duodenal ulcer, or a history of ulcers or bleeding from the gut
• Have severe heart failure, severe kidney or liver disease
• Are in the last three months of pregnancy
• Have had heart bypass surgery recently

Side Effects

Common side effects include:

• Indigestion, heartburn, nausea, stomach pain and diarrhoea
• Headache, dizziness and drowsiness
• Fluid retention and swelling of the ankles
• Skin rash; mouth irritation with lozenges

Serious but less common effects include stomach bleeding or ulcers, raised blood pressure, heart attack or stroke (especially with long-term high doses), kidney problems and liver problems.

Stop taking it and get urgent medical help if you vomit blood or material like coffee grounds, pass black or bloody stools, have chest pain, sudden weakness on one side, wheezing or difficulty breathing, swelling of the face or throat, severe skin blistering, or very little urine.

Pregnancy and Lactation

Avoid in the first six months of pregnancy unless a doctor says it is needed, and do not use in the last three months, as it can harm the baby's heart and kidneys and delay labour. Small amounts pass into breast milk; occasional short-term use may be acceptable, but ask your doctor first.

Precautions and Warnings

Use with care in older people, people with high blood pressure, heart disease, kidney or liver problems, asthma, bleeding disorders, or a history of stomach problems. Your doctor may add a stomach-protecting medicine. Avoid alcohol. NSAIDs may make it harder to become pregnant; tell your doctor if you are trying to conceive. Do not drive if you feel dizzy or drowsy.

Overdose

Overdose can cause nausea, vomiting, stomach pain, drowsiness, headache, ringing in the ears, and in severe cases bleeding from the gut, kidney failure, seizures or breathing problems. Seek emergency medical care straight away.

Therapeutic Class

Non-steroidal anti-inflammatory drug (NSAID); propionic acid derivative.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.