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(FLURE-bih-PRO-fen)
Ansaid, Alti-Flurbiprofen, Apo-Flurbiprofen, Froben, Froben SR, Novo-Flurbiprofen, Nu-Flurbiprofen
Flurbiprofen Sodium
Ocufen
Class: Analgesic/NSAID

 Action Decreases inflammation, pain and fever, probably through inhibition of cyclooxygenase activity and prostaglandin synthesis.

 Indications Systemic: Treatment of rheumatoid arthritis and osteoarthritis. Ophthalmic: Inhibition of intraoperative miosis. unlabeled use(s): Treatment of juvenile rheumatoid arthritis; migraine; dysmenorrhea; sunburn; mild to moderate pain; acute gout; ankylosing spondylitis; tendonitis; bursitis; inflammation after cataract surgery; uveitis.

 Contraindications Systemic/ophthalmic: Patients in whom aspirin, iodides, or any NSAID has caused allergic-type reactions; dendritic keratitis. Ophthalmic: Epithelial herpes simplex keratitis.

 Route/Dosage

Rheumatoid Arthritis or Osteoarthritis

ADULTS: PO 200 to 300 mg in divided doses bid to qid; do not exceed 300 mg/day.

Dysmenorrhea

ADULTS: PO 50 mg qid.

Inhibition of Intraoperative Miosis

ADULTS: Topical 1 drop of 0.03% solution q 30 min beginning 2 hr before surgery.

 Interactions

Beta-blockers: Decreased antihypertensive effect of beta-blocker. Cyclosporine: Increased risk of nephrotoxicity. Lithium: Increased levels and effects of lithium. Loop diuretics: Decreased diuretic effect. Methotrexate: Increased methotrexate levels. Salicylates: Increased risk of GI toxicity. Warfarin: Increased risk of gastric erosion and bleeding.

 Lab Test Interferences May prolong bleeding time.

 Adverse Reactions

CV: CHF; hypotension; hypertension; peripheral edema; fluid retention; vasodilation. CNS: Dizziness; drowsiness; vertigo; headaches; nervousness; migraine; anxiety; confusion. DERM: Pruritus; erythema; photosensitivity; urticaria. EENT: Systemic use: Blurred vision; changes in color vision; hearing disturbances; taste changes. Ophthalmic use: Ocular irritation; transient stinging and burning of eyes. GI: Heartburn; dyspepsia; nausea; vomiting; anorexia; diarrhea; constipation; increased or decreased appetite; indigestion; GI bleeding; ulceration. GU: Hematuria; proteinuria; renal insufficiency; glomerular and interstitial nephritis; acute renal failure with pre-existing renal dysfunction. HEMA: Anemia; bone marrow depression; neutropenia; leukopenia; hypocoagulability. RESP: Bronchospasm; laryngeal edema; dyspnea; hemoptysis; shortness of breath. OTHER: Hyperglycemia; hypoglycemia; hyponatremia.

 Precautions

Pregnancy: Category B (flurbiprofen); Category C (flurbiprofen sodium). Lactation: Excreted in breast milk. Children: Safety and efficacy not established. Elderly: Increased risk of adverse reactions. GI effects: Serious GI toxicity (eg, bleeding, ulceration, perforation) can occur at any time, with or without warning symptoms. Hypersensitivity: May occur; use caution in aspirin-sensitive individuals because of possible cross-sensitivity. Renal effects: Acute renal insufficiency, interstitial nephritis, hyperkalemia, hyponatremia, and renal papillary necrosis may occur. Renal impairment: Assess function before and during therapy, because NSAID metabolites are eliminated renally.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Give with food, milk or antacids.
  • Have patient remain in an upright position for 15 to 30 min after administration, if possible.
  • Store at room temperature in tightly closed, light-resistant container.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note hypersensitivity to aspirin products, renal impairment, ulcer disease or bleeding disorders.
  • Monitor effectiveness of drug therapy by evaluating joint symptoms and pain regularly.
  • For patients undergoing prolonged or high-dose therapy, monitor hemoglobin and renal and hepatic function.
  • Be aware that effects of this drug may mask signs and symptoms of infection.
OVERDOSAGE: SIGNS & SYMPTOMS
  Drowsiness, dizziness, mental confusion, disorientation, lethargy, numbness, vomiting, nausea, gastric upset, abdominal pain, headache, convulsions, renal failure, coma

 Patient/Family Education

  • Instruct patient to take medication as prescribed, not to skip a dose, and not to double up doses if close to next dose.
  • Advise diabetic patient to monitor blood glucose levels carefully during treatment.
  • Warn patients about the potential for bleeding and the need to notify other health care professionals that drug is being taken.
  • Instruct patient using ophthalmic preparation to use great care to prevent contamination of solution.
  • Instruct patient to report the following symptoms to physician: Bleeding, bruising, dyspnea, edema (oral drug); burning or stinging, tearing, photophobia (ophthalmic drug).
  • Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
  • Tell patient to avoid intake of alcoholic beverages, aspirin or other otc medications without consulting physician.

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