Classifications: analgesic, nonsteroidal antiinflammatory drug (nsaid); cox-1 and cox-2 inhibitor; antipyretic; Therapeutic: nsaid, analgesic; antipyretic
Pregnancy Category: B first or second trimester; D third trimester
50 mg, 100 mg tablets; 0.03% ophthalmic solution
Inhibits prostaglandin synthesis including in the conjunctiva and uvea by inhibiting the COX-1 or COX-2 enzymes; structurally
and pharmacologically related to ibuprofen. When administered prophylactically, ocular flurbiprofen reduces miosis, permitting
maintenance of drug-induced mydriasis during surgical procedures.
An antiinflammatory, nonsteroidal analgesic. Also inhibits migration of leukocytes into inflamed tissues, depresses monocyte
function, and may inhibit platelet aggregation.
Inhibition of intraoperative miosis; arthritis and other inflammatory diseases; mild to moderate pain.
Management of postoperative ocular inflammation, prevention of postcystoid macular edema.
Epithelial herpes simplex; keratitis; perioperative pain from CABG; pregnancy (category B in first and second trimester, and
D in third trimester), lactation. Safety in children is not established. For additional contraindications to oral use, see
Concomitant use with other NSAIDs; patient who may be adversely affected by prolonged bleeding time; patient in whom asthma, rhinitis, or urticaria is precipitated
by aspirin or other NSAIDs.
Route & Dosage
Adult: PO 200300 mg/d in 24 divided doses (max: 300 mg/d)
Mild to Moderate Pain
Adult: PO 50100 mg q68h
Inhibition of Intraoperative Miosis
Adult: Topical 1 drop in eye approximately q30min beginning 2 h before surgery for a total of 4 drops per affected eye
- Instill ophthalmic preparation with great care to avoid contamination of solution. Do not touch eye surface with dropper.
- Use the 300 mg dose for initiation of therapy or for acute exacerbations of disease.
- Store at 15°30° C (59°86° F) in tight, light-resistant container.
Adverse Effects (≥1%)Special Senses: Mild ocular stinging,
burning, itching, or foreign body sensation (transient). Other:
Slowed corneal healing; increased bleeding time. For adverse effects to oral preparations, see ibuprofen.
InteractionsDrug: oral anticoagulants
may prolong bleeding time; actions and side effects
of both flurbiprofen and phenytoin, sulfonylureas
, or sulfonamides
may be potentiated. Herbal: Feverfew, garlic, ginger, gingko
may increase bleeding potential.
80% absorbed from GI tract. Onset:
2 h. Peak:
2 h. Duration:
68 h. Distribution:
Small amounts distributed into breast milk. Metabolism:
In liver. Elimination:
Primarily in urine; some biliary excretion. Half-Life:
Assessment & Drug Effects
- Observe patients with history of cardiac decompensation closely for evidence of fluid retention and edema.
- Lab tests: Baseline and periodic evaluations of Hgb, renal and hepatic function, and auditory and ophthalmologic examinations
are recommended in patients receiving prolonged or high-dose therapy.
- Monitor for GI distress and S&S of GI bleeding.
- Note: Symptoms of acute toxicity in children include apnea, cyanosis, response only to painful stimuli, dizziness, and nystagmus.
Patient & Family Education
- Report ocular irritation that persists after flurbiprofen use during surgery (tearing, dry eye sensation, dull eye pain, photophobia)
- Be alert for bleeding tendency and report unexplained bleeding, prolongation of bleeding time, or bruises. Minor systemic
absorption may temporarily increase bleeding time.
- Notify physician immediately of passage of dark tarry stools, "coffee ground" emesis, frankly bloody emesis, or other
GI distress, as well as blood or protein in urine, and onset of skin rash, pruritus, jaundice.
- Do not drive or engage in potentially hazardous activities until response to the drug is known.
- Do not self-medicate with OTC drugs without consulting physician.
- Avoid alcohol and NSAIDs unless otherwise advised by physician. Concurrent use may increase risk of GI ulceration and bleeding tendencies.