Flurbiprofen is a non‑steroidal anti‑inflammatory drug (NSAID) of the arylpropionic acid class, chemically known as (2‑fluoro‑4‑biphenyl)propanoic acid. It is used therapeutically for its analgesic, antipyretic, and anti‑inflammatory properties.
Chemical properties
- IUPAC name: (2‑fluoro‑4‑biphenyl)propanoic acid
- Molecular formula: C₁₅H₁₃FO₂
- Molecular weight: 244.26 g·mol⁻¹
- Physical state: White to off‑white crystalline powder; slightly soluble in water, freely soluble in organic solvents such as ethanol and chloroform.
Pharmacodynamics and mechanism of action
Flurbiprofen inhibits cyclo‑oxygenase (COX) enzymes, primarily COX‑1 and COX‑2, thereby reducing the synthesis of prostaglandins that mediate inflammation, pain, and fever. Its inhibition of COX enzymes is reversible and dose‑dependent.
Therapeutic indications
Flurbiprofen is prescribed for the short‑term management of mild to moderate pain associated with:
- Musculoskeletal disorders (e.g., osteoarthritis, rheumatoid arthritis)
- Dental procedures and postoperative dental pain
- Dysmenorrhea (menstrual pain)
- Acute musculoskeletal injuries (sprains, strains)
In some jurisdictions, topical formulations (gel or cream) are marketed for localized musculoskeletal pain.
Dosage forms and administration
Flurbiprofen is available in several dosage forms, including:
- Oral tablets (typically 50 mg, 100 mg, and 200 mg strengths)
- Oral suspension
- Rectal suppositories (in certain regions)
- Topical gels (usually 1% or 2% w/w)
The recommended oral dose for adults is commonly 200 mg per day, divided into two or three doses, not exceeding 300 mg per day for most indications. Dosing adjustments may be required in patients with hepatic or renal impairment.
Adverse effects
Common adverse reactions include gastrointestinal disturbances (e.g., dyspepsia, nausea, abdominal pain), headache, dizziness, and rash. Serious but less frequent events involve gastrointestinal ulceration or bleeding, renal impairment, hypertension, and hypersensitivity reactions. As with other NSAIDs, flurbiprofen may increase cardiovascular risk, particularly with prolonged use at high doses.
Contraindications and precautions
Flurbiprofen is contraindicated in individuals with:
- Known hypersensitivity to flurbiprofen, other NSAIDs, or aspirin.
- Active peptic ulcer disease or gastrointestinal bleeding.
- Severe renal or hepatic dysfunction.
- Uncontrolled hypertension or significant cardiovascular disease (e.g., recent myocardial infarction, stroke).
Caution is advised when prescribing to patients with asthma, coagulation disorders, or those taking anticoagulants, as additive bleeding risk may occur.
Drug interactions
Flurbiprofen may interact with:
- Anticoagulants (e.g., warfarin) – increased bleeding risk.
- Other NSAIDs or aspirin – additive gastrointestinal toxicity.
- Selective serotonin reuptake inhibitors (SSRIs) – heightened bleeding tendency.
- Angiotensin‑converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and diuretics – potential reduction in antihypertensive efficacy and renal function.
Pharmacokinetics
- Absorption: Rapid oral absorption with peak plasma concentrations occurring within 1–2 hours.
- Distribution: Approximately 99% bound to plasma proteins, primarily albumin.
- Metabolism: Hepatic metabolism mainly via oxidation and conjugation pathways, producing inactive metabolites.
- Elimination: Primarily renal excretion (≈70% of dose) with a terminal elimination half‑life of 3–5 hours in healthy adults.
Regulatory status
Flurbiprofen is approved for medical use in many countries, including the United States (prescription‑only), European Union member states, Japan, and others. Over‑the‑counter (OTC) formulations of lower‑dose flurbiprofen (e.g., 50 mg tablets) are available in some markets for short‑term pain relief.
History
Flurbiprofen was first synthesized in the 1970s by the German pharmaceutical company Boehringer Ingelheim. It was introduced into clinical practice in the early 1980s as an oral NSAID and later expanded to topical preparations.
Research and development
Investigations have explored flurbiprofen’s utility in conditions such as Alzheimer’s disease (due to its anti‑inflammatory properties) and as a component of combination therapy with other analgesics. To date, no definitive clinical benefit beyond its established NSAID indications has been confirmed.
References
- Brunton, L. L., Hilal-Dandan, R., & Knollmann, B. C. (Eds.). (2018). Goodman & Gilman's: The Pharmacological Basis of Therapeutics (13th ed.). McGraw‑Hill.
- Micromedex (2023). Flurbiprofen: Drug Monograph.
- European Medicines Agency. (2022). Flurbiprofen Summary of Product Characteristics.
This entry presents a concise, fact‑based overview of flurbiprofen based on widely accepted pharmacological and medical references.