|Ansaid® Oral; Ocufen®
Froben-SR®; Novo-Flurprofen; Nu-Flurprofen|
Nonsteroidal Anti-Inflammatory Agent (NSAID)
Dental: Management of postoperative pain
Medical: Inhibition of intraoperative miosis; acute or long-term treatment of
signs and symptoms of rheumatoid arthritis and osteoarthritis; prevention and
management of postoperative ocular inflammation and postoperative cystoid
macular edema remains to be determined
C (D in 3rd trimester)
Dendritic keratitis, hypersensitivity to flurbiprofen or any
Should be used with caution in patients with a history of herpes simplex,
keratitis, and patients who might be affected by inhibition of platelet
aggregation; dehydration; slowing of corneal wound healing patients in whom
asthma, rhinitis, or urticaria is precipitated by aspirin or other
>10%: Ocular: Slowing of corneal wound healing, mild ocular stinging,
itching and burning eyes, ocular irritation
1% to 10%: Ocular: Eye redness
Central nervous system: Dizziness
Gastrointestinal: Abdominal cramps, heartburn, indigestion, nausea
1% to 10%:
Central nervous system: Headache, nervousness
Endocrine & metabolic: Fluid retention
<1%: Congestive heart failure, hypertension, arrhythmias, tachycardia,
confusion, hallucinations, aseptic meningitis, mental depression, drowsiness,
insomnia, urticaria, erythema multiforme, toxic epidermal necrolysis,
Stevens-Johnson syndrome, angioedema, polydipsia, hot flashes, gastritis, GI
ulceration, cystitis, polyuria, agranulocytosis, anemia, hemolytic anemia, bone
marrow suppression, leukopenia, thrombocytopenia, hepatitis, peripheral
neuropathy, toxic amblyopia, blurred vision, conjunctivitis, dry eyes, decreased
hearing, acute renal failure, shortness of breath, allergic rhinitis, epistaxis
Symptoms include apnea, metabolic acidosis, coma, and nystagmus;
leukocytosis, renal failure
Management of a nonsteroidal anti-inflammatory drug (NSAID) intoxication is
primarily supportive and symptomatic. Fluid therapy is commonly effective in
managing the hypotension that may occur following an acute NSAIDs overdose,
except when this is due to an acute blood loss. Seizures tend to be very
short-lived and often do not require drug treatment; although, recurrent
seizures should be treated with I.V. diazepam. Since many of the NSAID undergo
enterohepatic cycling, multiple doses of charcoal may be needed to reduce the
potential for delayed toxicities.
CYP2C9 enzyme substrate; CYP2C9 enzyme inhibitor
Inhibits prostaglandin synthesis by decreasing the activity of the enzyme,
cyclo-oxygenase, which results in decreased formation of prostaglandin
Onset of effect: Within 1-2 hours
Oral: Rheumatoid arthritis and osteoarthritis: 200-300 mg/day in 2-, 3-, or 4
Ophthalmic: Instill 1 drop every 30 minutes, 2 hours prior to surgery (total
of 4 drops to each affected eye)
Can be taken with food, milk, or antacid to decrease GI effects; food alters
rate of absorption but not amount
|Mental Health: Effects
on Mental Status|
Dizziness is common; may cause nervousness; may rarely cause drowsiness,
confusion, depression, or hallucinations
Effects on Psychiatric
May rarely cause agranulocytosis; use caution with clozapine and
carbamazepine; may decrease the clearance of lithium resulting in elevated serum
levels and potential toxicity; monitor serum lithium levels
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
<1% of patients experience dry mouth; NSAID formulations are known to
reversibly decrease platelet aggregation via mechanisms different than observed
with aspirin. The dentist should be aware of the potential of abnormal
coagulation. Caution should also be exercised in the use of NSAIDs in patients
already on anticoagulant therapy with drugs such as warfarin
Oral: Take this medication exactly as directed; do not increase dose without
consulting prescriber. Do not crush tablets or break capsules. Take with food or
milk to reduce GI distress. Maintain adequate fluid intake (2-3 L/day of fluids
unless instructed to restrict fluid intake). Do not use alcohol, aspirin, or
aspirin-containing medication, and all other anti-inflammatory medications
without consulting prescriber. You may experience drowsiness, dizziness,
nervousness, or headache (use caution when driving or engaging in tasks
requiring alertness until response to drug is known); anorexia, nausea,
vomiting, or heartburn (frequent small meals, frequent mouth care, sucking
lozenges, or chewing gum may help); fluid retention (weigh yourself weekly and
report unusual (3-5 lb/week) weight gain). GI bleeding, ulceration, or
perforation can occur with or without pain; discontinue medication and contact
prescriber if persistent abdominal pain or cramping, or blood in stool occurs.
Report breathlessness, difficulty breathing, or unusual cough; chest pain, rapid
heartbeat, palpitations; unusual bruising/bleeding; blood in urine, stool,
mouth, or vomitus; swollen extremities; skin rash or itching; acute fatigue;
changes in hearing or ringing in ears. Pregnancy/breast-feeding
precautions: Inform prescriber if you are or intend to be pregnant. Consult
prescriber if breast-feeding.
Ophthalmic: Wash hands before instilling. Sit or lie down to instill. Open
eye, look at ceiling, and instill prescribed amount of medication. Close eye and
roll eye in all directions, and apply gentle pressure to inner corner of eye. Do
not let tip of applicator touch eye or contaminate tip of applicator. Use
protective dark eyewear until healed; avoid direct sunlight. Temporary stinging
or burning may occur. Report persistent pain, burning, redness, vision
disturbances, swelling, itching, or worsening of condition.
Care should be taken to avoid contamination of the solution container
Solution, ophthalmic, as sodium (Ocufen®): 0.03% (2.5
mL, 5 mL, 10 mL)
Tablet, as sodium (Ansaid®): 50 mg, 100 mg
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