Formulary
Flurbiprofen: Indications, Dosing, Side Effects and Interactions
Flurbiprofen clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 5 min read
Flurbiprofen: Indications, Dosing, Side Effects and Interactions
Flurbiprofen clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Pain and inflammation in rheumatic disease and other musculoskeletal disorders,Migraine,Postoperative analgesia,Mild to moderate pain**
- **Child** (By Mouth): 12-17 years 150-200 mg daily in 2-4 divided doses, then increased to 300 mg daily, dose to be increased only in acute conditions.
- **Adult** (By Mouth): 150-200 mg daily in 2-4 divided doses, then increased to 300 mg daily, dose to be increased only in acute conditions.
**Dysmenorrhoea**
- **Child** (By Mouth): 12-17 years Initially 100 mg, then 50-100 mg every 4-6 hours; maximum 300 mg per day.
- **Adult** (By Mouth): Initially 100 mg, then 50-100 mg every 4-6 hours; maximum 300 mg per day.
**Relief of sore throat**
- **Child** (By Mouth Using Lozenges): 12-17 years 1 lozenge every 3-6 hours for maximum 3 days, allow lozenge to dissolve slowly in the mouth; maximum 5 lozenges per day.
- **Adult** (By Mouth Using Lozenges): 1 lozenge every 3-6 hours for maximum 3 days, allow lozenge to dissolve slowly in the mouth; maximum 5 lozenges per day.
**Inhibition of intra-operative miosis (but does not possess intrinsic mydriatic properties),Control of anterior segment inflammation following postoperative and post-laser trabeculoplasty when corticosteroids contra-indicated**
- **Adult** (To The Eye): (consult product literature).
**Pain and inflammation in rheumatic disease and other musculoskeletal disorders, Migraine, Postoperative analgesia, Mild to moderate pain for flurbiprofen**
- **Child 12-17 years** (By mouth): 150-200 mg daily in 2-4 divided doses, then increased to 300 mg daily, dose to be increased only in acute conditions.
**Dysmenorrhoea for flurbiprofen**
- **Child 12-17 years** (By mouth): Initially 100 mg, then 50-100 mg every 4-6 hours; maximum 300 mg per day.
**Relief of sore throat for flurbiprofen**
- **Child 12-17 years** (By mouth using lozenges): 1 lozenge every 3-6 hours for maximum 3 days, allow lozenge to dissolve slowly in the mouth; maximum 5 lozenges per day.
Cautions
General cautions: May mask symptoms of infection (in adults) Specific cautions: When used by eye Bleeding tendency (increased risk of ocular tissue bleeding, including hyphaema) (in adults); concomitant use of ocular corticosteroids (in adults); corneal epithelial breakdown (if evidence of, then discontinue immediately) (in adults); may slow or delay wound healing (in adults); patients at increased risk of corneal side-effects (in adults) With systemic use Allergic disorders; cardiac impairment (NSAIDs may impair renal function); cerebrovascular disease; coagulation defects; connective-tissue disorders; dehydration (risk of renal impairment); elderly (risk of serious side-effects and fatalities) (in adults); heart failure; history of gastro-intestinal disorders; ischaemic heart disease; may mask symptoms of infection (in children); peripheral arterial disease; risk factors for cardiovascular events; uncontrolled hypertension Cautions, further information Concomitant use of ocular corticosteroids When used by eye in adults: Concomitant use of ocular formulations containing NSAIDs with ocular formulations containing corticosteroids may increase the risk of corneal healing problems, leading to corneal melt or scarring and loss of vision. M Patients at increased risk of corneal side-effects When used by eye in adults: Patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases, rheumatoid arthritis, or repeat ocular surgeries within a short period of time may be at increased risk of corneal side-effects which may become sight threatening. M
Contraindications
With systemic use Active gastro-intestinal bleeding; active gastro-intestinal ulceration; Crohn's disease (may be exacerbated); history of gastro-intestinal bleeding related to previous NSAID therapy; history of gastro-intestinal perforation related to previous NSAID therapy; history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes); history of recurrent gastro-intestinal ulceration (two or more distinct episodes); severe heart failure; ulcerative colitis (may be exacerbated)
Side effects
Common or very common When used by eye (topical) Eye discomfort (in adults); haemorrhage (in adults) Frequency not known With buccal use Oral ulceration (move lozenge around mouth); taste altered When used by eye (topical) Eye disorders (in adults) With oral use Agranulocytosis; angioedema; aplastic anaemia; asthma; bronchospasm; confusion; constipation; Crohn's disease; depression; diarrhoea; dizziness; drowsiness; dyspnoea; fatigue; fertility decreased female; gastrointestinal discomfort; gastrointestinal disorders; haemolytic anaemia; haemorrhage; hallucination; headache; heart failure; hepatic disorders; hypersensitivity; hypertension; malaise; meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible); nausea; nephritis tubulointerstitial; nephropathy; neutropenia; oedema; optic neuritis; oral ulceration; pancreatitis; paraesthesia; photosensitivity reaction; platelet aggregation inhibition; renal failure (more common in patients with pre-existing renal impairment); respiratory tract reaction; severe cutaneous adverse reactions (SCARs); skin reactions; stroke; thrombocytopenia; tinnitus; vertigo; visual impairment; vomiting Side-effects, further information Cardiovascular and gastrointestinal side-effects For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non-steroidal anti-inflammatory drugs When used by eye (topical) Prolonged use can cause epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration and corneal perforation which might be sight-threatening. Discontinue if corneal epithelial breakdown occurs and monitor closely.
Interactions
**Other interactions (16):**
- Diuretics, ACE inhibitors and Angiotensin II Antagonists: NSAIDs may reduce the effect of diuretics and other antihypertensive drugs.
- Diuretics can also increase the risk of nephrotoxicity of NSAIDs.
- These interactions should be considered in patients taking flurbiprofen concomitantly with ACE inhibitors or angiotensin II antagonists.
- Lithium salts : Decreased elimination of lithium.
- Methotrexate : Caution is advised in the concomitant administration of flurbiprofen and methotrexate since NSAIDs may increase methotrexate levels.
- Anticoagulants : NSAIDs may enhance the effects of anticoagulants such as warfarin (see section 4.4).
Pregnancy
Important safety information For flurbiprofen MHRA/CHM advice: NSAIDs: potential risks following prolonged use after 20 weeks of pregnancy (June 2023) With systemic use: See Non-steroidal anti-inflammatory drugs .
Breast feeding
With systemic use: Use with caution during breast-feeding. Small amount present in milk-manufacturer advises avoid.
Hepatic impairment
With systemic use: Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
Renal impairment
With systemic use: In general, for NSAIDs the MHRA advises to avoid where possible; if necessary, use with caution (risk of fluid retention and further renal impairment, including renal failure). For flurbiprofen , avoid in severe impairment. M
Medicinal forms
Tablet
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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