Flurbiprofen

Registered South African indications:

• Symptomatic relief of localised pain and inflammation associated with soft tissue rheumatism, trauma and osteoarthritis

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Previous hypersensitivity-type reactions (such as bronchospasm, anaphylactoid reactions, angioedema) to aspirin or of the other non-steroidal anti-inflammatory agents 
• Application to broken or fragile skin, or to sites affected by dermatoses or infection
  - Systemic absorption is increased if flurbiprofen patches are applied to damaged skin

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• History of non-allergic asthma
• History of cardiac decompensation and hypertension
• Patients with a potential for abnormal bleeding
• Connective tissue disorder
• Cardiac disease
• Risk factors for venous thromboembolism

Forms avail. in SA and covered in this monograph: psd

Symptomatic relief of localised pain and inflammation associated with soft tissue rheumatism, trauma and osteoarthritis

• Topical (psd): 1 patch applied to affected area, 12hrly; Max duration: 4 weeks

For external use only. The affected area should be cleaned and only one patch should be applied at a time to a single site. A fresh patch is applied every 12 hours

The backing film is removed by rubbing a corner between the fingers and the adhesive side applied to the skin. When applying the flurbiprofen patch to more mobile joints such as the knee or elbow, bend the joint before applying and stretch the patch around the joint

Insufficient safety data are available for continuous use for more than 4 weeks, therefore the flurbiprofen patch is not indicated for use for more than 4 weeks

Not established for use in children below 12 years

Pregnancy

• FDA Pregnancy Category Not Rated (NR)

Breastfeeding

• Caution; not recommended

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• Caution; no information available

Central Nervous System Disorders

• Headache
• Dizziness

Gastrointestinal Disorders

• Epigastric pain
• Eructation
• Nausea
• Diarrhoea
• Ulceration 
• Haemorrhage

Hepatobiliary Disorders

• Jaundice
• Hepatitis 

Genitourinary Disorders

• Renal failure
• Nephritic syndrome

Skin and Subcutaneous Tissue Disorders

• Skin rash
• Itching
• Redness
• Numbness and tingling at the site of the application
• Oedema

Immune, Blood and Lymphatic Tissue Disorders

• Hypersensitivity reactions 
• Dyshaemopoiesis 
• Erythema multiforme

• Diuretics
• Cardiac glycosides
• Angiotension-converting enzyme inhibitors
• Anticoagulants
• Lithium
• Zidovudine
• Methotrexate
• Ciclosporin 
• Tacrolimus
• Corticosteroids
• Selective serotonin reuptake inhibitors
• Quinolones
• Aminoglycosides
• Mifepristone
• Anti-inflammatory agents

None routine. Specific cases may require 

• Renal function  
• Hepatic function 
• Full blood count 

Similar to other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), the anti-inflammatory effect of flurbiprofen occurs via reversible inhibition of cyclooxygenase (COX), the enzyme responsible for the conversion of arachidonic acid to prostaglandin G2 (PGG2) and PGG2 to prostaglandin H2 (PGH2) in the prostaglandin synthesis pathway. This effectively decreases the concentration of prostaglandins involved in inflammation, pain, swelling and fever. Non-selective COX inhibitor and inhibits the activity of both COX-1 and -2.

Patch 40mg

• Transact (Reckitt Benckiser) originator