Introduction
Flurbiprofen (brand name Ansaid tablet in Pakistan) is a nonsteroidal anti-inflammatory drug (NSAID)webmd.com. It belongs to the propionic acid class (related to ibuprofen) and was developed to reduce pain, fever and inflammation. Clinically, flurbiprofen is used for disorders like osteoarthritis and rheumatoid arthritiswebmd.com. As an NSAID, flurbiprofen blocks the body’s pain and inflammation signalswebmd.com.
Mechanism
Flurbiprofen works by inhibiting cyclooxygenase (COX) enzymes (both COX‑1 and COX‑2). COX enzymes normally convert arachidonic acid into prostaglandins, which are mediators of pain, fever and inflammationncbi.nlm.nih.gov. By blocking COX, flurbiprofen dramatically reduces prostaglandin formation. In simple terms, it “blocks” the chemical messengers that cause pain and swellingwebmd.com. Because it inhibits both COX‑1 and COX‑2 (a non-selective NSAID), flurbiprofen relieves inflammation and pain but can also affect protective functions (for example, stomach lining and kidney blood flow), which underlies its potential side effectsncbi.nlm.nih.gov.
Uses
Flurbiprofen is approved for a range of inflammatory and pain conditions. In Pakistan (per official labeling), it is indicated for rheumatoid disease (arthritis), osteoarthritis, ankylosing spondylitis and other musculoskeletal disorders (such as periarthritis or frozen shoulder, bursitis, tendinitis, low back pain, sprains and strains)labeling.pfizer.com. It also has an approved analgesic indication: relief of mild-to-moderate pain in situations like dental pain, post-operative pain, primary dysmenorrhea (menstrual cramps), and migraine headacheslabeling.pfizer.com.
Globally, the U.S. FDA label for flurbiprofen (Ansaid) specifically lists only rheumatoid arthritis and osteoarthritis for symptom reliefaccessdata.fda.gov, but many clinicians also use it for similar conditions. In practice, flurbiprofen is widely used for any acute or chronic inflammatory pain where an NSAID is appropriate. For example:
Rheumatoid arthritis and osteoarthritis – to reduce joint pain and stiffnesswebmd.comaccessdata.fda.gov.
Ankylosing spondylitis – to relieve spinal and joint inflammationlabeling.pfizer.com.
Soft-tissue/trauma pain – tendonitis, bursitis, muscle sprains, frozen shoulder, etc.labeling.pfizer.com.
Acute pain conditions – toothache or dental surgery pain, surgical/post-operative pain, menstrual cramps, migrainelabeling.pfizer.com.
How to Use It
Flurbiprofen tablets are swallowed whole with water. Take with or after food (or a glass of milk) to reduce stomach upsetlabeling.pfizer.com. The tablets should not be chewed or crushedmayoclinic.org. Typical adult dosing for arthritis is 100 mg two or three times a day, not exceeding 300 mg in 24 hoursaccessdata.fda.govlabeling.pfizer.com. Some patients may use 50 mg tablets (or half of a 100 mg tablet) if smaller doses are needed. For dysmenorrhea, one approach is 100 mg at onset of cramps, then 50–100 mg every 4–6 hours as needed (max 300 mg/day)labeling.pfizer.com. Always use the lowest effective dose for the shortest duration consistent with treatment goalslabeling.pfizer.com. After starting flurbiprofen for arthritis, relief may take a few days; it can take up to 1–2 weeks for full effectmayoclinic.org.
Who Should Use It?
Flurbiprofen is most useful for patients with inflammatory pain. In particular:
Patients with arthritis (OA or RA) – to ease joint inflammation and painaccessdata.fda.gov.
Patients with ankylosing spondylitis – to reduce spinal joint inflammationlabeling.pfizer.com.
People with soft-tissue or musculoskeletal pain – such as tendonitis, bursitis, low back strains, frozen shoulder, and sprainslabeling.pfizer.com.
Individuals needing relief of moderate acute pain – e.g., after dental procedures or minor surgery, or women with menstrual cramps or migraine headacheslabeling.pfizer.com.
This medication is prescribed when a nonsteroidal anti-inflammatory is needed; patient factors (age, medical history) and other treatments are also considered. Flurbiprofen is a prescription-only drug, so a doctor will determine if it’s appropriate.
Dosage (Overdose and Missed Dose)
Adults: For arthritis, 200–300 mg per day in divided doses is commonaccessdata.fda.gov. A practical regimen is 100 mg taken two to three times daily (every 8–12 hours) with mealslabeling.pfizer.comaccessdata.fda.gov. The maximum total per day is 300 mg. For dental or menstrual pain, starting with 100 mg then 50–100 mg every 4–6 hours can be used (again not exceeding 300 mg/day)labeling.pfizer.com.
Children: Flurbiprofen tablets are not recommended for children under 12 yearslabeling.pfizer.com. For older children (12+), a doctor would calculate a dose (often by weight) if needed, but use in minors is uncommon and should be supervised by a physician.
Overdose: Take flurbiprofen only as prescribed. In case of accidental overdose (taking too much), seek emergency medical help immediately. Treatment of NSAID overdose is supportive: doctors secure airway/breathing, may administer activated charcoal if recent ingestion, and monitor vital signs and kidney functionemedicine.medscape.com. There is no specific antidote for flurbiprofen; care focuses on symptom management (e.g. fluids, gastric protection, monitoring for bleeding or kidney issues)emedicine.medscape.com.
Missed dose: If you forget a dose, take it as soon as you remember. However, if it is almost time for the next scheduled dose, skip the missed dose and resume your regular schedule – do not take a double dose to catch upmayoclinic.org.
Off‑label Uses
Off-label uses are those not specifically approved by regulators. Flurbiprofen has a few such reported uses: for example, it has been used off-label to treat primary dysmenorrhea and migraine headaches, though these are actually labeled indications in some countrieslabeling.pfizer.com. It has also been studied in inflammatory eye diseases: one clinical report used oral flurbiprofen to treat non-infectious anterior scleritispmc.ncbi.nlm.nih.gov. (Note: an ophthalmic flurbiprofen solution exists for eye inflammation, but that is a separate formulation.) Clinicians should not rely on off-label use without evidence and should do so under guidance of current research or specialist advice.
Side Effects
Common (frequent) side effects: These are usually mild-to-moderate and affect the gastrointestinal tract, nervous system or fluid balance. They may include abdominal pain or dyspepsia, nausea, diarrhea or constipationdrugs.com. Headache or dizziness can occurdrugs.com. Some patients experience fluid retention or swelling (edema)drugs.com. Other side effects seen in clinical studies (>3% incidence) include heartburn, indigestion, rash, fatigue and urinary symptomsdrugs.com. If bothersome, talk to a doctor (sometimes adjusting the dose or taking with food helps).
Rare (serious) side effects: Though uncommon, flurbiprofen (like all NSAIDs) can cause severe reactions. These include:
Gastrointestinal bleeding or ulceration: NSAIDs increase the risk of stomach/intestinal bleeding, ulcer, or perforationdrugs.com. This can be life-threatening and may occur without warning, especially in long-term use. Warning signs are black stools or severe abdominal pain – stop the drug and seek help if these occurlabeling.pfizer.comdrugs.com.
Cardiovascular events: Prolonged use may slightly increase the risk of heart attack or strokedrugs.com. Patients with existing heart disease or risk factors should use NSAIDs only under close supervision (lower risk for short-term use)drugs.comlabeling.pfizer.com.
Allergic reactions: Some people may develop hypersensitivity (hives, facial swelling, asthma attack) to flurbiprofen or other NSAIDslabeling.pfizer.com. This can rarely progress to anaphylaxis. Discontinue immediately if breathing difficulty or facial swelling occurs.
Serious skin reactions: Very rarely, NSAIDs can cause life-threatening skin disorders such as Stevens–Johnson syndrome or toxic epidermal necrolysislabeling.pfizer.com. Patients should stop flurbiprofen at the first sign of rash or mucosal lesions.
Liver damage: NSAIDs can cause liver enzyme elevations. In rare cases, flurbiprofen has caused severe hepatotoxicity (fulminant hepatitis, liver failure)drugs.com. Patients should report signs of liver injury (jaundice, dark urine, severe fatigue) immediately.
Kidney injury: Flurbiprofen may reduce kidney function (especially in dehydration or pre-existing renal disease)drugs.com. Long-term use can cause renal papillary necrosis or acute renal failure. Watch for reduced urine output or unexplained swelling.
If any severe or unusual symptoms occur (e.g. chest pain, difficulty breathing, black/tarry stools, yellow skin, decreased urination), stop the drug and seek medical help immediately. Regular lab monitoring may be needed during prolonged therapy.
Drug Interactions
Flurbiprofen can interact with many common medications. Important interactions include:
Anticoagulants and antiplatelets: Drugs like warfarin, heparin, clopidogrel or high-dose aspirin increase bleeding risk when combined with flurbiprofendrugs.com. The combination should be used cautiously, with close monitoring for signs of bleedingdrugs.com. SSRIs or SNRIs (e.g. fluoxetine, sertraline) also increase GI bleeding risk with NSAIDs.
Blood pressure medications: Flurbiprofen may diminish the effect of ACE inhibitors, ARBs or beta-blockersdrugs.com. It can also cause fluid retention that counteracts these drugs. Conversely, these antihypertensives (especially ACE inhibitors or diuretics) can exacerbate NSAID-induced kidney injury. Monitoring of blood pressure and kidney function is adviseddrugs.comdrugs.com.
Diuretics (water pills): NSAIDs can blunt the natriuretic effect of diuretics (furosemide, thiazides)drugs.com. This may reduce diuretic efficacy and promote salt/water retention.
Lithium: Flurbiprofen can raise lithium levels (by reducing renal clearance)webmd.com, risking lithium toxicity. If combined, monitor lithium serum levels closely.
Methotrexate: Flurbiprofen may increase methotrexate blood levels, enhancing its toxicitywebmd.com. Caution is needed, especially in high-dose methotrexate therapy.
Other NSAIDs or salicylates: Using more than one NSAID (e.g., naproxen, ibuprofen) or adding a salicylate (diflunisal, salsalate) provides no extra benefit but greatly increases side-effect riskwebmd.com. Concomitant NSAIDs is generally avoided.
Corticosteroids: Concomitant use with steroids (e.g. prednisone) greatly increases gastrointestinal riskwebmd.com.
Digoxin: Some reports suggest NSAIDs may increase digoxin levels or reduce its clearance, so monitor digoxin when starting flurbiprofen.
Cyclophosphamide/Cyclosporine: NSAIDs may add to nephrotoxicity of these drugs.
Alcohol: Although not a drug-drug interaction per se, alcohol combined with flurbiprofen further increases GI bleeding risk and should be avoided or limited.
Always tell your healthcare provider all medications and supplements you take, so they can adjust doses or monitor for interactions.
Warnings and Precautions
Certain patients should avoid flurbiprofen or use it with extra caution:
Allergy/Asthma: Contraindicated in anyone with known allergy to flurbiprofen or other NSAIDs, including aspirin-sensitive asthma (taking flurbiprofen could trigger asthma attacks, hives or shock)labeling.pfizer.com.
Gastrointestinal disease: Avoid if there is active peptic ulcer, gastrointestinal bleeding or a history of recurrent ulcers or GI hemorrhagelabeling.pfizer.com. NSAIDs should be used with extreme care (if at all) in patients with ulcerative colitis or Crohn’s diseaselabeling.pfizer.com.
Cardiovascular disease: Patients with uncontrolled hypertension, heart failure, ischemic heart disease or history of stroke should use flurbiprofen only if absolutely necessaryaccessdata.fda.govlabeling.pfizer.com. NSAIDs can cause fluid retention, worsen hypertension and increase risk of myocardial infarction or strokeaccessdata.fda.govdrugs.com.
Renal impairment: Not for use in severe kidney disease. Caution if there is mild to moderate renal impairment, dehydration, or if taking diuretics/ACE inhibitors (may lead to renal failure)labeling.pfizer.comdrugs.com. Monitor renal function.
Hepatic impairment: Avoid in severe liver diseaselabeling.pfizer.com; NSAIDs can worsen hepatic function.
Heart failure: Flurbiprofen is contraindicated in severe heart failurelabeling.pfizer.com. Even mild heart failure may worsen due to fluid retentionlabeling.pfizer.com.
Pregnancy: NSAIDs can cause fetal harm (premature closure of ductus arteriosus, renal dysfunction). Avoid use in the third trimester. Many sources advise against use after about 20–30 weeks’ gestationdrugs.com. In early pregnancy, NSAIDs are generally Category C (use only if benefit justifies risk). Women who are or may become pregnant should consult their doctor.
Breastfeeding: Flurbiprofen is excreted in breast milk. Caution or avoid in nursing motherswebmd.com. Consult a doctor about breastfeeding.
Elderly patients: The elderly are more susceptible to adverse effects (especially GI bleeding and kidney injury)(labeling.pfizer.com). Use the lowest effective dose and monitor closely.
Infertility: NSAIDs can impair fertility (they may inhibit ovulation). Consider discontinuing flurbiprofen in women who have difficulty conceiving(drugs.com).
Other precautions: Avoid simultaneous use of other NSAIDs or high-dose aspirin(labeling.pfizer.com). Do not exceed recommended dose. Avoid alcohol and smoking (both increase ulcer risk) during NSAID therapy(labeling.pfizer.com). Flurbiprofen tablets contain lactose; patients with rare hereditary problems of galactose intolerance should not use them(labeling.pfizer.com).
Patients should be counseled to watch for warning signs (e.g., GI bleeding, chest pain, shortness of breath, edema) and to have regular check-ups (blood pressure, blood counts, kidney function) if treatment is prolonged. Always use flurbiprofen under medical supervision and report any unusual symptoms.
Storage
Store flurbiprofen tablets at room temperature. The ideal range is around 20–25 °C (68–77 °F)(webmd.com). Keep the medicine in its original container, tightly closed, and protect it from moisture and heat(mayoclinic.org). Do not freeze. Store in a dry place away from direct sunlight. Keep out of reach of children and pets(mayoclinic.org). Do not use after the expiration date.
Sources: Authoritative prescribing information (U.S. FDA and Pakistani SmPC) and pharmacology referenceslabeling.pfizer.comaccessdata.fda.govdrugs.comlabeling.pfizer.comncbi.nlm.nih.gov. (For more details, consult the drug’s patient leaflet or a pharmacist.)
Disclaimer
This article is for information purposes only. Please don’t take it as medical advice.