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Related to Ansaid: flurbiprofen
Pregnancy Category: C
†See for ophthalmic use
Oral: Inflammatory disorders including:
- Rheumatoid arthritis,
Inhibits prostaglandin synthesis, resulting in reduced inflammation and pain when administered orally.
Oral: Suppression of pain and inflammation.
Absorption: Well absorbed after oral administration.
Protein Binding: 99%.
Metabolism and Excretion: Mostly metabolized by the liver (primarily by CYP2C9). genetic implication Patients who are poor CYP2C9 metabolizers may have reduced metabolism of flurbiprofen which may lead to ↑ toxicity). 20–25% excreted unchanged by the kidneys.
Half-life: 3–6 hr.
|PO (anti-inflammatory)||few days–1 wk||1–2 wk||unknown|
Contraindicated in: Hypersensitivity; Cross-sensitivity may exist with other NSAIDs, including aspirin; Active GI bleeding or ulcer disease; Perioperative pain from coronary artery bypass graft (CABG) surgery.
Use Cautiously in: Cardiovascular disease or risk factors for cardiovascular disease (may ↑ risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, especially with prolonged use); Severe renal, or hepatic disease ; History of ulcer disease; Diabetes mellitus; Geriatric: ↑ risk of GI bleeding); Bleeding disorders; Obstetric: Should only be used if potential benefits outweigh risks to fetus; Obstetric / Pediatric: Safety not established.
Adverse Reactions/Side Effects
Central nervous system
- mental depression
- psychic disturbances
Ear, Eye, Nose, Throat
- blurred vision
- corneal opacities
- changes in BP
- GI bleeding (life-threatening)
- abdominal pain (most frequent)
- heartburn (most frequent)
- nausea (most frequent)
- bloated feeling
- drug-induced hepatitis
- exfoliative dermatitis (life-threatening)
- Stevens-Johnson syndrome (life-threatening)
- toxic epidermal necrolysis (life-threatening)
- ↑ sweating
- blood dyscrasias
- prolonged bleeding time
- allergic reactions including anaphylaxis (life-threatening)
Drug-Drug interactionConcurrent use withaspirin may ↓ effectiveness.↑ adverse GI effects with aspirin, other NSAIDs, potassium supplements, corticosteroids, or alcohol.Chronic use with acetaminophen may ↑ risk of adverse renal reactions.May ↓ effectiveness of diuretics or antihypertensives. May ↑ hypoglycemic response to insulins or oral hypoglycemic agents.May ↑ serum levels and risk of toxicity from lithium and methotrexate.Probenecid may ↑ risk of toxicity.↑ risk of bleeding with cefotetan, cefoperazone, antiplatelet agents, heparin, thrombolytics, valproic acid, or warfarin.↑ risk of adverse hematologic reactions with antineoplastics or radiation therapy.↑ risk of nephrotoxicity with cyclosporine.↑ bleeding risk with arnica, chamomile, clove, dong quai, feverfew, garlic, ginger, ginkgo, Panax ginseng, and others.
Oral (Adults) Anti-inflammatory—200–300 mg daily in 2–4 divided doses (not to exceed 300 mg/day or 100 mg/dose). Dysmenorrhea—50 mg q 4–6 hr as needed (unlabeled).
Availability (generic available)
Tablets: 50 mg, 100 mg
- Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Monitor for rhinitis, asthma, and urticaria.
- Assess pain and range of movement before and periodically during therapy.
- Lab Test Considerations: May cause prolonged bleeding time; effects may persist for <1 day.
- May cause ↓ hemoglobin, hematocrit, leukocyte, and platelet counts.
- Monitor liver function tests periodically during therapy. May cause ↑ serum alkaline phosphatase, LDH, AST, and ALT concentrations.
- Monitor BUN, serum creatinine, and electrolytes periodically during therapy. May cause ↑ BUN, serum creatinine, and electrolyte concentrations and ↓ urine electrolyte concentrations.
Potential Nursing DiagnosesAcute pain (Indications)
Impaired physical mobility (Indications)
- Administration in higher than recommended doses does not provide increased effectiveness but may cause increased side effects. Use lowest effective dose for shortest period of time.
- Oral: For rapid initial effect, administer 30 min before or 2 hr after meals. Administer after meals or with food or an antacid containing aluminum or magnesium to minimize gastric irritation.
- Advise patient to take flurbiprofen with a full glass of water and to remain in an upright position for 15–30 min after administration.
- Instruct patient to take medication as prescribed. Take missed doses as soon as remembered, but not if almost time for next dose. Do not double doses.
- May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to medication is known.
- Caution patient to avoid the concurrent use of alcohol, aspirin, other NSAIDs, acetaminophen, or other OTC or herbal products without consulting health care professional.
- Advise patient to inform health care professional of medication regimen before treatment or surgery.
- Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs.
- Decreased pain.
- Improved joint mobility. Patients who do not respond to one NSAID may respond to another.
A trademark for the drug flurbiprofen.