Adult Dosing
Rheumatoid arthritis and osteoarthritis
- 200-300 mg PO in divided doses, two, three, or four times a day
- MAX: 300 mg/day or 100 mg/dose
Note:
- Use the lowest effective dose for the shortest duration of therapy
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Risk of serious and potentially fatal cardiovascular thrombotic events, MI, and stroke may occur with flurbiprofen, which may increase with duration of use. Patients with cardiovascular disease or presence of cardiovascular disease risk factors may be associated with increasing fatal events [US Black Box Warning]
- Use the lowest effective dose for the shortest duration of treatment
- Patients and physicians should remain alert for the signs/symptoms of severe CV events and should be informed about the steps to take if such events occur
- Flurbiprofen is contraindicated for treatment of peri-operative pain in the setting of CABG [US Black Box Warning]
- It can lead to onset of new hypertension or worsening of preexisting hypertension, which may contribute to the increased incidence of CV events. Monitor BP prior to initiation of therapy and during the course of therapy
- Increased risk of serious GI adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal may occur during flurbiprofen therapy and these events may occur at any time during use and without any warning symptoms [US Black Box Warning]
- Risk increases in patients with a prior history of PUD and/or GI bleeding compared to patients treated with neither of these risk factors
- Risk of GI bleeding increases in patients with concomitant use of oral corticosteroids or anticoagulants, longer duration of NSAID therapy, smoking, use of alcohol, older age, and poor general health status
- Severe hepatotoxicity may occur at any time during treatment; closely monitor (ALT and AST) levels periodically in patients receiving continued therapy. Use the lowest effective dose for the shortest duration possible to minimize the potential risk of hepatotoxicity
- Avoid concomitant use of drugs known to be potentially hepatotoxic
- Patients and physicians should remain alert for signs/symptoms of GI ulceration and bleeding during therapy; initiate alternate therapy if such events occur
- Prolonged therapy may cause renal papillary necrosis and other renal injury
- Avoid use in patients with advanced renal disease; if needed, monitor patients closely and adjust dosage accordingly
- Anaphylactoid reactions may occur in patients without known prior exposure to the drug. Do not administer to patients with aspirin triad, which typically occurs in asthmatic patients who experience rhinitis with or without nasal polyps, or who exhibit severe, potentially fatal bronchospasm after taking aspirin or other NSAIDs
- Therapy may cause severe, sometimes fatal, skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Discontinue therapy at the first appearance of skin rash or any other sign of hypersensitivity
- Avoid flurbiprofen use in late pregnancy because it may cause premature closure of the ductus arteriosus
- Flurbiprofen cannot be substituted for corticosteroids or used to treat corticosteroid insufficiency. Patients on prolonged corticosteroid therapy should gradually taper the dose because abrupt discontinuation may exacerbate the disease
- Check hematology profile including hemoglobin or hematocrit at regular intervals in patients on long-term treatment with NSAIDs as it may cause anemia due to fluid retention, GI blood loss
- Cautiously administer in patients with pre-existing asthma/aspirin-sensitive asthma as it may exacerbate the symptoms
- Blurred and/or diminished vision may occur with the use of flurbiprofen
- The mechanism of flurbiprofen in reducing fever and inflammation may reduce the utility of these diagnostic signs in detecting complications of presumed noninfectious, painful conditions
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- CHF
- Fluid retention
- Dehydration
- Coagulation disorder
- Chronic use of alcohol
- Prolonged use
- Anticoagulant use
- Concurrent diuretics
- Heart failure
- ACEI or ARB use
Pregnancy Category:C (contraindicated in pregnancy 3rd trimester)
Breastfeeding: Owing to the low levels of the drug in breast milk and its shorter half-life, it is unlikely to adversely affect the infants, older than 2 months. This information is based upon Lactmed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 10 May 2011). As per manufacturer's data, a decision should be made whether to discontinue nursing or to discontinue the drug, analyzing the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Flurbiprofen 50 MG TABS [Bottle] (MYLAN)
60 mg = $18.99
180 mg = $51.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
