Flurbiprofen (EENT) (monograph)

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Veröffentlicht am 19.10.2025

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introduction

Prototypical NSAIA; Propionic acid derivative.

Uses for flurbiprofen (EENT)

Inhibition of intraoperative miosis

Postoperative eye inflammation

Used to prevent and treat postoperative ocular inflammation† [off-label] associated with argon laser trabeculoplasty and cyclocryotherapy.

Cystoid macular edema

Used to prevent postoperative cystoid macular edema† [off-label] associated with cataract extraction.

Inhibition of corneal neovascularization

It has been reported to inhibit corneal neovascularization† [off-label] caused by chemical or thermal burns or prolonged contact lens use in preliminary animal studies.

Dosage and administration of flurbiprofen (EENT).

Administration

Ophthalmological administration

Apply topically to the eye as an ophthalmic solution.

Avoid contamination of the solution container.

dosage

Available as flurbiprofen sodium; Dosage expressed in flurbiprofen sodium.

Adult

Inhibition of intraoperative miosis

Ophthalmology

1 drop of 0.03% solution into the eye(s) to be operated on, starting 2 hours before surgery; Repeat at approximately 30 minute intervals for a total of 4 drops per affected eye.

Flurbiprofen (EENT) Precautions

Contraindications

Known hypersensitivity to flurbiprofen sodium or any of the components of the formulation.

Warnings/Precautions

Warnings

Hematological effects

May inhibit platelet aggregation and prolong bleeding time.

May cause increased bleeding of ocular tissue (including hyphema) when used in conjunction with eye surgery.

Caution should be exercised in patients with an underlying bleeding tendency or in patients taking medications known to prolong bleeding time. (See “Specific Medications” under “Interactions.”)

Sensitivity reactions

Hypersensitivity reactions

Possible cross-sensitivity with aspirin and other NSAIAs. Caution should be exercised in patients with a history of hypersensitivity to these drugs (severe, almost fatal, anaphylactic reaction to oral flurbiprofen has been reported) and in whom asthma, rhinitis, or urticaria are triggered by aspirin or other NSAIAs.

General precautions

Complications in wound healing

May slow or delay wound healing (including calluses).

Eye effects

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

Specific populations

pregnancy

Category C

lactation

Excreted in milk after systemic administration; It is not known whether it passes into milk after topical application to the eye. Stop breast-feeding or taking the medicine.

Pediatric use

Safety and effectiveness not proven.

Geriatric use

No significant differences in safety and effectiveness compared to younger adults.

Common side effects

Stinging, burning or discomfort in the eye and other minor symptoms of eye irritation (e.g. tearing, dry eyes, dull eye pain, photophobia); Itching; Foreign body sensation; fibrosis; miosis; and mydriasis.

Interactions with other medications

Interactions with other topical eye medications have not been fully studied.

Specific medications

drug	interaction	Comments
Acetylcholine chloride	Decreased miotic effects have been reported when used with flurbiprofen, although recent clinical and animal studies do not suggest interactions
Anesthetics, local (e.g. benoxinate, capsaicin)	Additive effects on miotic inhibition during eye surgery have been demonstrated in animals
Anticoagulants	Possible bleeding complications	Use with caution
Carbachol	Decreased miotic effects have been reported when used with flurbiprofen, although recent clinical and animal studies do not suggest interactions

Flurbiprofen (EENT) pharmacokinetics

absorption

Bioavailability

Ophthalmic: Absorbed through the aqueous humor. Extent of systemic absorption not fully understood.

distribution

extent

The distribution in human ocular tissues and fluids has not yet been fully characterized.

It is not known whether flurbiprofen crosses the placenta. Excreted in milk after systemic administration; It is not known whether it passes into milk after topical application to the eye.

Plasma protein binding

≥99% (mainly albumin).

Can bind to erythrocytes.

stability

storage

Ophthalmology

Solution

Tight, light-resistant containers at 15-25°C.

Actions

Systemic pharmacological effects similar to other prototypical NSAIAs; has anti-inflammatory, analgesic and antipyretic effects. However, the risk of systemic effects following topical ophthalmic use appears to be minimal.
The exact mechanism of ocular action is not clearly understood, but it inhibits prostaglandin synthesis in the eye by inhibiting COX-1 and COX-2.
Prostaglandins are mediators of intraocular and extraocular inflammation. Prostaglandins also appear to produce a miotic response during eye surgery by constricting the iris sphincter independently of cholinergic mechanisms.
When applied topically to the eye, flurbiprofen inhibits or reduces miosis and ocular inflammation caused by ocular trauma (e.g., eye surgery).

Advice for patients

Risk of eye bleeding. Risk of anaphylactoid and other hypersensitivity reactions.
It is important to learn and follow proper administration techniques to avoid product contamination.
It is important for women to tell doctors if they are pregnant, plan to become pregnant, or want to breastfeed.
It is important to inform physicians about any existing or planned concomitant therapies, including prescription and over-the-counter medications, as well as any comorbidities.
It is important to inform patients of other important precautionary information. (See Precautions.)

More information

The American Society of Health-System Pharmacists, Inc. certifies that the information provided in the accompanying monograph has been formulated with reasonable care and in accordance with professional standards in the field. Readers are cautioned that drug use decisions are complex medical decisions that require the independent, informed decision of an appropriate health care professional and that the information contained in the monograph is provided for informational purposes only. For more detailed information, the manufacturer's label should be consulted. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information contained in the monograph is not a substitute for medical care.

Preparations

Excipients in commercial drug preparations may have clinically significant effects in some individuals; Details can be found on the respective product labeling.

For information about shortages of one or more of these drugs, visit the ASHP Drug Shortages Resource Center.

Flurbiprofen sodium

Routes	Dosage forms	Strengthen	Brand names	Manufacturer
Ophthalmology	Solution	0.03%	Flurbiprofen sodium ophthalmic solution (with thimerosal)	Bausch & Lomb
			Ocufen (with thimerosal)	Allergan

† Off-Label: Use is not currently included in U.S. Food and Drug Administration-approved labeling.

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