Flurbiprofen is a medicinal agent belonging to the group of nonsteroidal anti-inflammatory drugs. Because of its analgesic, anti-inflammatory, and antipyretic properties, flurbiprofen can be used on a broad basis.
What is flurbiprofen?
Flurbiprofen can be used as a lozenge for inflammation of the throat. To the chemist, the white to cream-colored powder flurbiprofen is known by several names, the most common being 2-fluoro-alpha-methyl-4-biphosphenylacetyl acid. Like the better-known active ingredient ibuprofen, it belongs to the group of propionic acid derivatives. In 1978, the active ingredient was also approved in Germany. Currently, flurbiprofen is used in over-the-counter lozenges to treat sore throats associated with pharyngitis; they are available in pharmacies under the names Dobendan Direkt and Strepsils Direkt. Furthermore, the prescription eye drops Ocuflur O.K. contain the active ingredient flurbiprofen.
Pharmacologic Action
Flurbiprofen is an antiphlogistic, which means it has an anti-inflammatory effect. To achieve this effect, flurbiprofen inhibits certain enzymes called cyclooxygenases. These enzymes, in turn, are mainly involved in the production of the body’s own messenger substances, the prostaglandins. Prostaglandins increase inflammation and irritate the nerve endings, which send pain signals to the brain. This is where the actual perception and processing of pain takes place. If flurbiprofen inhibits prostaglandin synthesis from arachidonic acid – which is one of the unsaturated fatty acids – inflammation is also relieved and pain perception is reduced. In addition, flurbiprofen influences temperature regulation in the brain and therefore has a fever-reducing effect. Usually taken orally, flurbiprofen is almost completely absorbed in the small intestine. In the liver, the active ingredient is processed by the enzyme CYP-2C9 and then excreted renally, i.e. via the kidneys. This also results in a contraindication in cases of liver and kidney dysfunction. Other contraindications include allergies to nonsteroidal anti-inflammatory drugs, gastric ulcers, and bleeding. People with Parkinson’s disease should also avoid flurbiprofen.
Medicinal use and application
Most commonly, flurbiprofen is used as an over-the-counter lozenge for inflammation of the throat. The drug relieves pain caused by inflammation and reduces swelling. However, only the symptoms are combated; an antibacterial effect is not expected. Furthermore, the doctor can prescribe eye drops with flurbiprofen for conjunctivitis. Here, the anti-inflammatory properties are also used. These eye drops are also used in the clinical field before and after eye surgery. Before surgery, the drops are instilled into the eye to prevent pupil constriction during surgery. After surgery, prophylactic administration is common to prevent inflammation. In addition, after cataract surgery on the eye, the administration of Ocuflur eye drops prevents water accumulation at the back of the eye. The active ingredient also plays a role in the treatment of rheumatoid arthritis and juvenile arthritis, i.e. rheumatic diseases. Bursitis and tendonitis likewise respond to treatment with flurbiprofen.
Risks and side effects
Side effects result from the way flurbiprofen works. Because prostaglandins not only have a reinforcing effect on inflammation but, on the other hand, also protect the stomach lining, their reduction can lead to abdominal pain, loss of appetite, and diarrhea or constipation. Rarely, gastritis and gastric ulcers occur. Fatigue, dizziness, dry mouth, itching and headaches are among the common side effects. Visual and hearing disturbances and ringing in the ears are also commonly reported. Some people react to nonsteroidal anti-inflammatory drugs with hypersensitivity. This can cause various allergic reactions ranging from mild redness of the skin to analgesic asthma. However, this complication is rare. Rare side effects also include sleep disturbances and depression, as well as renal dysfunction, intestinal ulcers, and gastrointestinal bleeding. Very rarely, liver dysfunction occurs. Interactions with other agents are also known.If medications contain the active ingredients digoxin, lithium, methotrexate or phenytoin, their concentration in the blood is increased when flurbiprofen is taken at the same time. In contrast, medications for drainage and for lowering blood pressure are weakened. If anticoagulants such as ASA are taken, a medical check of the coagulation status is recommended, as there is an increased risk of bleeding. Flurbiprofen should not be taken during pregnancy or while breastfeeding, and there are no reliable studies on the safety of the active substance in children under the age of twelve. As with all medications, the following applies when taking flurbiprofen: if there is no significant improvement or even a worsening, a doctor should be consulted immediately.
