drugs

flurbiprofen

Generality

Flurbiprofen is a non-steroidal anti-inflammatory drug (NSAID) with remarkable analgesic, anti-inflammatory and antipyretic properties.

Flurbiprofen - Chemical Structure

It is available in different pharmaceutical formulations suitable for oral, dermal, rectal and ocular administration. Moreover, it is also available in pharmaceutical formulations which allow its use on the oral mucosa (oral mucosa spray, mouthwash and tablets).

From the chemical point of view, flurbiprofen is a derivative of phenylpropionic acid.

Examples of medicinal specialties containing Flurbiprofen

  • Benactiv Gola ®
  • Froben ®
  • Ocufen ®
  • Tantum Activ Gola ®
  • Transact LAT ®

Indications

For what it uses

The use of flurbiprofen is indicated for the treatment of:

  • Pain, inflammation and irritation of the oral cavity and throat (when used in the form of oral mucosa spray, pads or mouthwash);
  • Inflammatory and painful states of gynecological, pneumological, rheumatological, traumatological, orthopedic etc. (oral and rectal administration);
  • Pain and inflammation of the musculoskeletal system (cutaneous administration);
  • Inflammatory and painful states (on a non-infectious basis) of the anterior segment of the eye (ocular administration).

Warnings

Since flurbiprofen can cause ulceration, perforation and gastrointestinal bleeding, the drug should be administered with caution in patients who suffer - or who have suffered - from gastrointestinal disorders.

Therefore, should any gastrointestinal symptom appear during treatment with the drug, it is necessary to immediately inform the doctor.

In patients who have a greater risk of incurring the above gastrointestinal side effects, it is possible to consider undertaking a concomitant therapy based on gastroprotective drugs.

Flurbiprofen should be administered with caution in patients suffering from cardiovascular diseases.

A great deal of caution should also be used when administering flurbiprofen in dehydrated patients and in patients with severely reduced cardiac, hepatic and / or renal function.

Also, before starting flurbiprofen therapy, you must tell your doctor if:

  • You suffer from asthma and / or allergies;
  • You suffer from systemic lupus erythematosus;
  • You suffer from hypertension;
  • You suffer from ulcerative colitis or Crohn's disease;
  • He suffered a stroke.

Interactions

Because of the dangerous side effects that can occur, before starting flurbiprofen treatment you need to tell your doctor if you are already taking any of the following medications:

  • Other NSAIDs ;
  • Selective COX-2 inhibitors ;
  • Cardioactive glycosides ;
  • Antihypertensive drugs;
  • Anticoagulants, such as, for example, warfarin;
  • Antiplatelet agents ;
  • SSRIs (selective serotonin reuptake inhibitors, antidepressant drugs);
  • Lithium salts (used in the treatment of bipolar disorder);
  • Methotrexate (an anticancer);
  • Cyclosporine, tacrolimus and other immunosuppressive drugs;
  • Zidovudine (used to treat HIV);
  • Corticosteroids ;
  • Quinolones (antibiotic drugs).

In any case, it is always a good idea to inform your doctor if you are taking - or have recently been taken - drugs of any kind, including medicines without a prescription and herbal and homeopathic products.

Side effects

Flurbiprofen can cause various types of side effects, although not all patients experience them. This depends on the sensitivity that each individual has towards the drug.

The following are the main side effects that may occur during treatment with flurbiprofen.

Blood and lymphatic system disorders

Flurbiprofen therapy may promote the onset of:

  • Aplastic anemia;
  • Piastrinopenia, ie the decrease in the number of platelets in the blood;
  • Agranulocytosis, ie the decrease in the number of granulocytes in the bloodstream.

Gastrointestinal disorders

Treatment with flurbiprofen may favor the onset of:

  • Nausea;
  • He retched;
  • Diarrhea or constipation;
  • Flatulence;
  • Dyspepsia;
  • Abdominal pain;
  • Melena;
  • Hematemesis;
  • Ulceration, perforation and / or gastrointestinal hemorrhage;
  • Worsening of colitis and Crohn's disease in patients suffering from it;
  • Pancreatitis (rarely).

Cardiovascular disorders

Flurbiprofen therapy may cause:

  • Hypertension;
  • Heart failure;
  • Arterial thrombotic events.

Kidney and urinary tract disorders

Flurbiprofen treatment can cause interstitial nephritis and nephrotic syndrome.

Skin and subcutaneous tissue disorders

Flurbiprofen therapy may promote the onset of:

  • Skin rash;
  • Urticaria;
  • Itch;
  • Purple;
  • Stevens-Johnson syndrome;
  • Toxic epidermal necrolysis.

Nervous system disorders

Flurbiprofen treatment can cause:

  • Headache;
  • dizziness;
  • Dizziness;
  • paresthesia;
  • Confusion;
  • Fatigue;
  • Drowsiness.

Other side effects

Other side effects that may occur during flurbiprofen therapy are:

  • Allergic reactions, even serious, in sensitive subjects;
  • Angioedema;
  • Edema;
  • Depression;
  • Hallucinations;
  • Tinnitus;
  • Asthma;
  • bronchospasm;
  • Dyspnoea.

Side effects associated with taking flurbiprofen by the eye

Following administration of flurbiprofen by the ocular route, adverse effects on the eye may occur, such as:

  • Bleeding of the frontal part of the eye;
  • Irritation;
  • Increased tearing;
  • Increased sensitivity to light;
  • Eye pain;
  • Redness.

Overdose

If overdoses of flurbiprofen are taken, symptoms such as nausea, vomiting and gastrointestinal irritation may occur.

There is no specific antidote against flurbiprofen overdose, therefore treatment is only symptomatic and supportive.

In any case, if flurbiprofen overdose is suspected, contact your doctor immediately or contact the nearest hospital.

Action mechanism

Flurbiprofen is an NSAID that performs its anti-inflammatory and analgesic activity by inhibiting the action of COX.

Cyclooxygenase is an enzyme of which three different isoforms are known: COX-1, COX-2 and COX-3.

COX-1 is a constitutive isoform, normally present in cells and involved in the mechanisms of cellular homeostasis.

COX-2, on the other hand, is an inducible isoform that is produced by inflammatory cells (inflammatory cytokines) activated. The task of these enzymes is to convert arachidonic acid into prostaglandins, prostacyclines and thromboxanes.

Prostaglandins - and especially PGG2 and PGH2 - are involved in inflammatory processes and mediate pain responses. While prostaglandins E (PGE) induce an increase in body temperature.

Therefore - with the inhibition of COX-2 - flurbiprofen is able to prevent the synthesis of prostaglandins responsible for inflammation and pain.

However, it should be remembered that flurbiprofen is not selective for COX-2, therefore, it is also able to inhibit COX-1. This latter inhibition is at the origin of some of the side effects typical of all non-selective NSAIDs (such as gastrointestinal side effects).

Mode of Use - Posology

As mentioned, flurbiprofen is available for:

  • Oral administration in the form of tablets, hard capsules, effervescent granules and syrup;
  • Rectal administration in the form of suppositories;
  • Dermal administration in the form of a medicated plaster;
  • Ocular administration in the form of eye drops.

Furthermore, flurbiprofen is also available in the form of oral mucosa spray, mouthwash and tablets to be dissolved in the mouth for the treatment of diseases of the cord and oral mucosa.

During treatment with the drug - to avoid the occurrence of dangerous adverse effects - it is very important to always follow the indications provided by the doctor, both as regards the amount of drug to be taken, and as regards the duration of the same treatment.

Below are some indications on the doses of flurbiprofen usually used in therapy.

Oral administration

When administered orally, the dose of flurbiprofen usually used in adults is 150-300 mg a day, to be taken in 2-4 divided doses. In any case, the maximum daily dose of 300 mg of drug should not be exceeded.

In children aged 6 to 12 years, syrup is generally used. The recommended flurbiprofen dose is 3-4 mg / kg of body weight per day, to be taken in divided doses.

Rectal administration

When administered in the form of suppositories, the dose of flurbiprofen recommended in adults is 100-300 mg per day. Even in this case, the maximum daily dose of 300 mg of drug should never be exceeded.

The use of suppositories in children under 12 years of age is not recommended.

Cutaneous administration

Flurbiprofen in the form of a medicated plaster is used for the local treatment of pain and inflammation of the musculoskeletal system. Generally, it is recommended to apply only one patch at a time directly on the affected area. The patch should be replaced after twelve hours.

Ocular administration

Flurbiprofen based eye drops are used for the treatment of painful and inflammatory states of the anterior segment of the eye and - in particular - following cataract surgery. The dosage of the drug must be established by the doctor.

Treatment of diseases of the cord and oral mucosa

As mentioned, flurbiprofen is available in the form of oral mucosa sprays, tablets to be dissolved in the mouth and mouthwash for the treatment of cable and oral mucosa diseases.

Oral mucosa spray and tablets are used to treat sore throats.

When using the spray, it is advisable to spray three times directly on the throat at 3-6 hour intervals. It is important to never exceed the five doses of medication within 24 hours.

When, on the other hand, the tablets are used, it is advisable to take one every 3-6 hours, taking care never to exceed the dose of 8 tablets in 24 hours.

The mouthwash can be used both to treat sore throats, and to treat other oral cavity ailments (such as gingivitis and stomatitis), and to relieve pain following dental surgery. Generally, it is recommended to carry out 2-3 rinses or gargles per day.

Pregnancy and breastfeeding

Flurbiprofen can be used during the first and second trimester of pregnancy only if the doctor considers it absolutely necessary.

In the third trimester of pregnancy, however, the drug is contraindicated due to the damage it can cause to the fetus (cardiopulmonary toxicity, renal dysfunction and prolonged bleeding time at birth) and to the mother (inhibition of uterine contractions with consequent delay or prolongation of the labor and increased bleeding time).

Flurbiprofen is excreted in breast milk, therefore its use is also contraindicated in breastfeeding mothers.

Contraindications

The use of flurbiprofen is contraindicated in the following cases:

  • In patients with known hypersensitivity to flurbiprofen itself;
  • In patients with known hypersensitivity to acetylsalicylic acid and / or other NSAIDs;
  • In patients who have suffered - or who suffer - from gastric ulcer, duodenal ulcer and / or gastric bleeding;
  • In patients with blood clotting disorders;
  • In patients suffering from severe cardiac, hepatic and / or renal insufficiency;
  • In the last trimester of pregnancy;
  • During breastfeeding.