Drugs List

Therapeutic Indications

Uses

Inhibition of intraoperative miosis. Flurbiprofen does not have intrinsic mydriatic properties and does not replace mydriatic agents.

The management of post-operative and post-laser trabeculoplasty inflammation in the anterior segment of the eye in patients in whom steroid therapy is not recommended.

Administration

For ocular administration.

Other topical medication should not be co-administered with Flurbiprofen. Leave an interval of at least 5 minutes before instilling another ophthalmic medication.

To reduce systemic absorption compress the lacrimal sac during administration and for one minute afterwards.

Contraindications

Epithelial herpes simplex keratitis (dendritic keratitis)

Patients with known haemostatic defects

Children under 18 years

Precautions and Warnings

Wound healing may be delayed with the use of flurbiprofen.

The medication may cause an increased bleeding tendency of ocular tissues in conjunction with surgery.

Patients with a history of herpes simplex keratitis should be monitored closely.

Pregnancy (see Pregnancy)

Breastfeeding (see Lactation)

Other topical medication should not be co-administered with Flurbiprofen. Leave an interval of at least 5 minutes before instilling another ophthalmic medication.

To reduce systemic absorption compress the lacrimal sac during administration and for one minute afterwards.

Application may cause transient blurring of vision; patients should avoid driving or operating machinery until vision is clear.

Pregnancy and Lactation

Pregnancy

Safety of use in pregnancy has not been established.

No reports describing flurbiprofen use during pregnancy have been reported. Constriction of the ductus arteriosus in utero is a pharmacological consequence arising from the use of prostaglandin synthesis inhibitors during pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

It is not known whether this drug is excreted in breast milk.

LactMed states that because of the low levels of flurbiprofen in breast milk and its short half-life it is unlikely to adversely affect the breastfed infant, especially where the infant is older than 2 months. Maternal use of flurbiprofen eye drops would not be expected to cause any adverse effects in breastfed infants.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Burning (transient)
Stinging (on instillation)
Ocular irritation
Blurred vision (transient)

Presentation

Eye drops containing flurbiprofen sodium 0.03% w/v

Drugs List

Therapeutic Indications

Uses

Inhibition of intraoperative miosis. Flurbiprofen does not have intrinsic mydriatic properties and does not replace mydriatic agents.

The management of post-operative and post-laser trabeculoplasty inflammation in the anterior segment of the eye in patients in whom steroid therapy is not recommended.

Dosage

Other topical medication should not be co-administered with Flurbiprofen. Leave an interval of at least 5 minutes before instilling another ophthalmic medication.

Containers are for single use only, to be discarded immediately after use.

Wash hands prior to use.

Avoid contact of the container with the eye or other surfaces as contamination leading to ophthalmic infection may occur.

Adults

Elderly

Children

Administration

For ocular administration.

Other topical medication should not be co-administered with Flurbiprofen. Leave an interval of at least 5 minutes before instilling another ophthalmic medication.

To reduce systemic absorption compress the lacrimal sac during administration and for one minute afterwards.

Contraindications

Epithelial herpes simplex keratitis (dendritic keratitis)

Patients with known haemostatic defects

Children under 18 years

Precautions and Warnings

Wound healing may be delayed with the use of flurbiprofen.

The medication may cause an increased bleeding tendency of ocular tissues in conjunction with surgery.

Patients with a history of herpes simplex keratitis should be monitored closely.

Pregnancy (see Pregnancy)

Breastfeeding (see Lactation)

Other topical medication should not be co-administered with Flurbiprofen. Leave an interval of at least 5 minutes before instilling another ophthalmic medication.

To reduce systemic absorption compress the lacrimal sac during administration and for one minute afterwards.

Application may cause transient blurring of vision; patients should avoid driving or operating machinery until vision is clear.

Pregnancy and Lactation

Pregnancy

Safety of use in pregnancy has not been established.

No reports describing flurbiprofen use during pregnancy have been reported. Constriction of the ductus arteriosus in utero is a pharmacological consequence arising from the use of prostaglandin synthesis inhibitors during pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

It is not known whether this drug is excreted in breast milk.

LactMed states that because of the low levels of flurbiprofen in breast milk and its short half-life it is unlikely to adversely affect the breastfed infant, especially where the infant is older than 2 months. Maternal use of flurbiprofen eye drops would not be expected to cause any adverse effects in breastfed infants.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Counselling

Advise patient to wash their hands prior to use.

Advise patients to leave an interval of at least 5 minutes before instilling another ophthalmic medication.

Advise patients that instillation of eye drops may cause transient blurring of vision and to avoid driving or operating machinery until vision is clear.

Containers are for single use only, to be discarded immediately after use.

Side Effects

Burning (transient)
Stinging (on instillation)
Ocular irritation
Blurred vision (transient)

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Shelf Life and Storage

Store at or below 25 degrees C

Reference Sources

British National Formulary, 63rd Edition (2012) Pharmaceutical Press, London.

BNF for Children (2011-2012) Pharmaceutical Press, London.

Summary of Product Characteristics: Ocufen. Allergan Ltd. Revised November 2006.

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Flurbiprofen Last revised: July 16, 2008
Last accessed: March 28, 2012