Introduction

Prototypical NSAIA; propionic acid derivative.

Uses for Flurbiprofen (EENT)

Inhibition of Intraoperative Miosis

Prophylactically before ocular surgery (e.g., cataract extraction) to prevent or reduce intraoperative miosis.

Postoperative Ocular Inflammation

Has been used for prevention and management of postoperative ocular inflammation^{† [off-label]} associated with argon laser trabeculoplasty and cyclocryotherapy.

Cystoid Macular Edema

Has been used for prevention of postoperative cystoid macular edema^{† [off-label]} associated with cataract extraction.

Inhibition of Corneal Neovascularization

Has been reported to inhibit corneal neovascularization^{† [off-label]} induced by chemical or thermal burns or prolonged use of contact lenses in preliminary research in animals.

Flurbiprofen (EENT) Dosage and Administration

Administration

Ophthalmic Administration

Apply topically to the eye as an ophthalmic solution.

Avoid contamination of the solution container.

Dosage

Available as flurbiprofen sodium; dosage expressed in terms of flurbiprofen sodium.

Adults

Inhibition of Intraoperative Miosis

Ophthalmic

1 drop of 0.03% solution into the eye(s) undergoing surgery beginning 2 hours before the surgery; repeat at approximately 30-minute intervals for a total of 4 drops per affected eye.

Contraindications

Known hypersensitivity to flurbiprofen sodium or any ingredient in the formulation.

Warnings/Precautions

Warnings

Hematologic Effects

May inhibit platelet aggregation and prolong bleeding time.

May cause increased bleeding of ocular tissues (including hyphemas) when used in conjunction with ocular surgery.

Use with caution in patients with underlying bleeding tendencies or in those receiving drugs known to prolong bleeding time. (See Specific Drugs under Interactions.)

Sensitivity Reactions

Hypersensitivity Reactions

Possible cross-sensitivity with aspirin and other NSAIAs. Use with caution in patients with history of hypersensitivity to these drugs (severe, nearly fatal anaphylactic reaction to oral flurbiprofen reported) and in whom asthma, rhinitis, or urticaria is precipitated by aspirin or other NSAIAs.

General Precautions

Wound-healing Complications

May slow or delay wound healing (including corneal).

Ocular Effects

Exacerbation of active epithelial herpes simplex keratitis (dendritic keratitis), more severe conjunctivitis, corneal perforation, and/or clouding of cornea reported in animals. Use with extreme caution in patients with active epithelial herpes simplex keratitis.

Specific Populations

Pregnancy

Category C.

Lactation

Distributed into milk after systemic administration; not known whether distributed into milk after topical application to the eye. Discontinue nursing or the drug.

Pediatric Use

Safety and efficacy not established.

Geriatric Use

No substantial differences in safety and efficacy relative to younger adults.

Common Adverse Effects

Ocular stinging, burning, or discomfort and other minor symptoms of ocular irritation (e.g., tearing, dry eye sensation, dull eye pain, photophobia); itching; foreign body sensation; fibrosis; miosis; and mydriasis.

Administration

Ophthalmic Administration

Apply topically to the eye as an ophthalmic solution.

Avoid contamination of the solution container.

Dosage

Available as flurbiprofen sodium; dosage expressed in terms of flurbiprofen sodium.

Adults

Inhibition of Intraoperative Miosis

Ophthalmic

1 drop of 0.03% solution into the eye(s) undergoing surgery beginning 2 hours before the surgery; repeat at approximately 30-minute intervals for a total of 4 drops per affected eye.

Interactions with other topical ophthalmic drugs not fully evaluated.

Specific Drugs