Skip to main content

Flurbiprofen Sodium (EENT) (Monograph)

Brand name: Ocufen
Drug class: Nonsteroidal Anti-inflammatory Agents

Medically reviewed by Drugs.com on Sep 10, 2024. Written by ASHP.

Introduction

Prototypical NSAIA; propionic acid derivative.1 2 3 4 16 17 18 19 20 21 23

Uses for Flurbiprofen Sodium (EENT)

Inhibition of Intraoperative Miosis

Prophylactically before ocular surgery (e.g., cataract extraction)74 102 to prevent or reduce intraoperative miosis.1 74 102

Postoperative Ocular Inflammation

Has been used for prevention and management of postoperative ocular inflammation† [off-label] associated with argon laser trabeculoplasty and cyclocryotherapy.75 76 78

Cystoid Macular Edema

Has been used for prevention of postoperative cystoid macular edema† [off-label] associated with cataract extraction.48 120

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.79 80 81 121

Flurbiprofen Sodium (EENT) Dosage and Administration

Administration

Ophthalmic Administration

Apply topically to the eye as an ophthalmic solution.1 74

Avoid contamination of the solution container.94

Dosage

Available as flurbiprofen sodium; dosage expressed in terms of flurbiprofen sodium.1 113

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.1

Detailed Flurbiprofen ophthalmic dosage information

Cautions for Flurbiprofen Sodium (EENT)

Contraindications

Known hypersensitivity to flurbiprofen sodium or any ingredient in the formulation.1

Warnings/Precautions

Warnings

Hematologic Effects

May inhibit platelet aggregation and prolong bleeding time.1 4 28 29 30 31 32 33

May cause increased bleeding of ocular tissues (including hyphemas) when used in conjunction with ocular surgery.1

Use with caution in patients with underlying bleeding tendencies or in those receiving drugs known to prolong bleeding time.1 (See Specific Drugs under Interactions.)

Sensitivity Reactions

Hypersensitivity Reactions

Possible cross-sensitivity with aspirin and other NSAIAs.1 3 Use with caution in patients with history of hypersensitivity to these drugs (severe, nearly fatal anaphylactic reaction to oral flurbiprofen reported)86 and in whom asthma, rhinitis, or urticaria is precipitated by aspirin or other NSAIAs.1 3

General Precautions

Wound-healing Complications

May slow or delay wound healing (including corneal).1 84

Ocular Effects

Exacerbation of active epithelial herpes simplex keratitis (dendritic keratitis), more severe conjunctivitis, corneal perforation, and/or clouding of cornea reported in animals.85 Use with extreme caution in patients with active epithelial herpes simplex keratitis.103

Specific Populations

Pregnancy

Category C.1

Lactation

Distributed into milk after systemic administration;117 118 not known whether distributed into milk after topical application to the eye.1 Discontinue nursing or the drug.1

Pediatric Use

Safety and efficacy not established.1

Geriatric Use

No substantial differences in safety and efficacy relative to younger adults.1

Common Adverse Effects

Ocular stinging,1 74 101 burning,1 76 78 101 or discomfort78 and other minor symptoms of ocular irritation1 (e.g., tearing, dry eye sensation, dull eye pain, photophobia);101 103 105 itching;78 101 105 foreign body sensation;78 105 fibrosis;1 miosis;1 and mydriasis.1

Drug Interactions

Interactions with other topical ophthalmic drugs not fully evaluated.1

Specific Drugs

Drug

Interaction

Comments

Acetylcholine chloride

Diminished miotic effect reported when used with flurbiprofen, although recent clinical and animal studies suggest no interaction1 115 116

Anesthetics, local (e.g., benoxinate, capsaicin)

Additive effects on miotic inhibition during ocular surgery demonstrated in animals40

Anticoagulants

Possible bleeding complications1

Use with caution1

Carbachol

Diminished miotic effect reported when used with flurbiprofen, although recent clinical and animal studies suggest no interaction1 115 116
Flurbiprofen ophthalmic drug interactions (more detail)

Flurbiprofen Sodium (EENT) Pharmacokinetics

Absorption

Bioavailability

Ophthalmic: Absorbed through the aqueous humor.119 Extent of systemic absorption not fully elucidated.1 101 104

Distribution

Extent

Distribution into human ocular tissues and fluids not fully characterized to date.101 103 104

Not known whether flurbiprofen crosses the placenta.103 Distributed into milk after systemic administration;117 118 not known whether distributed into milk after topical application to the eye.1

Plasma Protein Binding

≥99% (mainly albumin).3 67 69

May bind to erythrocytes.68

Stability

Storage

Ophthalmic

Solution

Tight, light-resistant containers105 at 15–25°C.1

Actions

Advice to Patients

Additional Information

The American Society of Health-System Pharmacists, Inc. represents that the information provided in the accompanying monograph was formulated with a reasonable standard of care, and in conformity with professional standards in the field. Readers are advised that decisions regarding use of drugs are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and that the information contained in the monograph is provided for informational purposes only. The manufacturer’s labeling should be consulted for more detailed information. 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 commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Flurbiprofen Sodium

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Ophthalmic

Solution

0.03%

Flurbiprofen Sodium Ophthalmic Solution (with thimerosal)

Bausch & Lomb

Ocufen (with thimerosal)

Allergan

AHFS DI Essentials™. © Copyright 2025, Selected Revisions September 10, 2024. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. Allergan , Inc. Ocufen (flurbiprofen sodium ophthalmic solution) 0.03% prescribing information. Irvine, CA; 2003 Feb.

2. Reynolds JEF, ed. Martindale: the extra pharmacopoeia. 28th ed. London: The Pharmaceutical Press; 1982:255.

3. Brogden RN, Heel RC, Speight TM et al. Flurbiprofen: a review of its pharmacological properties and therapeutic use in rheumatic diseases. Drugs. 1979; 18:417-38. https://pubmed.ncbi.nlm.nih.gov/391529

4. Adams SS, Buckler JW. Ibuprofen and flurbiprofen. Clin Rheum Dis. 1979; 5:359-79.

5. Mimnaugh MN, Gearien JE. Nonsteroidal anti-inflammatory agents. In: Foye WO, ed. Principles of medicinal chemistry. 2nd ed. Philadelphia: Lea & Febiger; 1981:561-90.

6. Flower RJ, Moncada S, Vane JR. Analgesic-antipyretics and anti-inflammatory agents; drugs employed in the treatment of gout. In: Gilman AG, Goodman LS, Rall TW et al, eds. Goodman and Gilman’s the pharmacological basis of therapeutics. 7th ed. New York: Macmillan Publishing Company; 1985:674-715.

7. Moncada S, Roderick JF, Vane JR. Prostaglandins, prostacyclin, thromboxane A2, and leukotrienes. In: Gilman AG, Goodman L, Rall TW et al, eds. Goodman and Gilman’s the pharmacological basis of therapeutics. 7th ed. New York: Macmillan Publishing Company; 1985:660-73.

8. Wolf RE. Nonsteroidal anti-inflammatory drugs. Arch Intern Med. 1984; 144:1658-60. https://pubmed.ncbi.nlm.nih.gov/6235791

9. Abramson S, Edelson H, Kaplan H et al. Inhibition of neutrophil activation by nonsteroidal anti-inflammatory drugs. Am J Med. 1984; 77(Suppl 4B):3-6. https://pubmed.ncbi.nlm.nih.gov/6093509

10. Robinson DR. Prostaglandins and the mechanism of action of anti-inflammatory drugs. Am J Med. 1983; 75(Suppl 4B):26-31. https://pubmed.ncbi.nlm.nih.gov/6416064

11. O’Brien WM. Pharmacology of nonsteroidal anti-inflammatory drugs: practical review for clinicians. Am J Med. 1983; 75(Suppl 4B):32-9.

12. Hart FD, Huskisson EC. Non-steroidal anti-inflammatory drugs: current status and rational therapeutic use. Drugs. 1984; 27:232-55. https://pubmed.ncbi.nlm.nih.gov/6368185

13. Simon LS, Mills JA. Nonsteroidal antiinflammatory drugs. N Engl J Med. 1980; 302:1179-85. https://pubmed.ncbi.nlm.nih.gov/6988717

14. Robert A. Cytoprotection by prostaglandins. Gastroenterology. 1979; 77:761-7. https://pubmed.ncbi.nlm.nih.gov/38173

15. Miller TA, Jacobson ED. Gastrointestinal cytoprotection by prostaglandins. Gut. 1979; 20:75-87. https://pubmed.ncbi.nlm.nih.gov/367886

16. Glenn EM, Rohloff N, Bowman BJ et al. The pharmacology of 2-(2-fluoro-4-biphenylyl)propionic acid (flurbiprofen): a potent non-steroidal anti-inflammatory drug. Agents Actions. 1973; 3:210-6. https://pubmed.ncbi.nlm.nih.gov/4776365

17. Adams SS, McCullough KF, Nicholson JS. Some biological properties of flurbiprofen, an anti-inflammatory, analgesic and antipyretic agent. Arzneimittelforschung. 1975; 25:1786-91. https://pubmed.ncbi.nlm.nih.gov/1081878

18. Nozu K. Flurbiprofen: highly potent inhibitor of prostaglandin synthesis. Biochim Biophys Acta. 1978; 529:493-6. https://pubmed.ncbi.nlm.nih.gov/96864

19. Crook D, Collins AJ, Rose AJ. A comparison of the effect of flurbiprofen on prostaglandin synthetase from human rheumatoid synovium and enzymatically active animal tissues. J Pharm Pharmacol. 1976; 28:535. https://pubmed.ncbi.nlm.nih.gov/7661

20. Ford-Hutchinson AW, Walker JR, Connor NS et al. Separate anti-inflammatory effects of indomethacin, flurbiprofen and benoxaprofen. J Pharm Pharmacol. 1977; 29:372-3. https://pubmed.ncbi.nlm.nih.gov/18578

21. Adams SS. Some aspects of the pharmacology and pharmacokinetics of flurbiprofen. Drugs Exp Clin Res. 1977; 2:27-33.

22. Ringrose PS, Parr MA, McLaren M. Effects of anti-inflammatory and other compounds on the release of lysosomal enzymes from macrophages. Biochem Pharmacol. 1975; 24:607-14. https://pubmed.ncbi.nlm.nih.gov/164870

23. Fitzpatrick FA, Wynalda MA. In vivo suppression of prostaglandin biosynthesis by non-steroidal anti-inflammatory agents. Prostaglandins. 1976; 12:1037-51. https://pubmed.ncbi.nlm.nih.gov/1005736

24. Blackham A, Owen RT. Prostaglandin synthetase inhibitors and leucocytic emigration. J Pharm Pharmacol. 1975; 27:201-3. https://pubmed.ncbi.nlm.nih.gov/238006

25. Adams SS, Burrows CA, Skeldon N et al. Inhibition of prostaglandin synthesis and leucocyte migration by flurbiprofen. Curr Med Res Opin. 1977; 5:11-6. https://pubmed.ncbi.nlm.nih.gov/410589

26. Vakil BJ, Kulkarni RD, Kulkarni VN et al. Estimation of gastro-intestinal blood loss in volunteers treated with non-steroidal anti-inflammatory agents. Curr Med Res Opin. 1977; 5:32-7. https://pubmed.ncbi.nlm.nih.gov/334471

27. Vakil BJ, Shah PN, Dalal NJ et al. Endoscopic study of gastro-intestinal injury with non-steroidal anti-inflammatory drugs. Curr Med Res Opin. 1977; 5:38-42. https://pubmed.ncbi.nlm.nih.gov/334472

28. Sim AK, McCraw AP, Sim MF. An evaluation of the effect of flurbiprofen [2-(2-fluoro-4-biphenylyl) propionic acid] on platelet behaviour. Thromb Res. 1975; 7:655-68. https://pubmed.ncbi.nlm.nih.gov/1198551

29. Davies T, Lederer DA, Spencer AA et al. The effect of flurbiprofen [2-(2-fluoro-4-biphenylyl) propionic acid] on platelet function and blood coagulation. Thromb Res. 1974; 5:667-83. https://pubmed.ncbi.nlm.nih.gov/4445988

30. Gupta KC, Manikeri S, Paul T et al. Effect of RH-8, flurbiprofen and aspirin on platelet function and coagulation. Ind J Med Res. 1979; 69:181-8.

31. Abe T, Goto H, Imaoka S et al. Influence of flurbiprofen on platelet aggregation. Part I: Metabolic and ultrastructural studies in vitro. Acta Haem Jap. 1978; 41:111-26.

32. Nishizawa EE, Wynalda DJ, Suydam DE et al. Flurbiprofen, a new potent inhibitor of platelet aggregation. Thromb Res. 1973; 3:577-88.

33. Nishizawa EE, Wynalda DJ, Suydam DE. Effect of flurbiprofen on platelet function. Thromb Diath Haemorrh. 1974; 60:415-23.

34. Cremoncini CM, Libroia A, Valente C et al. Flurbiprofen and thyroid function tests. Br J Clin Pract. 1984; 38:399-402. https://pubmed.ncbi.nlm.nih.gov/6397221

35. Havener WH. Ocular pharmacology. 5th ed. St. Louis: The CV Mosby Company; 1983:18-43,223-35.

36. Bhattacherjee P. Prostaglandins and inflammatory reactions in the eye. Methods Find Exp Clin Pharmacol. 1980; 2:17-31. https://pubmed.ncbi.nlm.nih.gov/6803089

37. Eakins KE. Prostaglandin and non-prostaglandin mediated breakdown of the blood-aqueous barrier. Exp Eye Res. 1977; 25(Suppl):483-98. https://pubmed.ncbi.nlm.nih.gov/338326

38. van Alphen GWHM, Wilhelm P. Effect of prostaglandins on the blood-aqueous barrier of the perfused cat eye. Invest Ophthalmol Vis Sci. 1978; 17:60-3. https://pubmed.ncbi.nlm.nih.gov/621127

39. Podos SM, Becker B. Comparison of ocular prostaglandin synthesis inhibitors. Invest Ophthalmol. 1976; 15:841-4. https://pubmed.ncbi.nlm.nih.gov/977253

40. Duffin RM, Camras CB, Gardner SK et al. Inhibitors of surgically induced miosis. Ophthalmology. 1982; 89:966-78. https://pubmed.ncbi.nlm.nih.gov/7133642

41. Srinivasan BD, Kulkarni PS. Polymorphonuclear leukocyte response: inhibition following corneal epithelial denudation by steroidal and nonsteroidal anti-inflammatory agents. Arch Ophthalmol. 1981; 99:1085-9. https://pubmed.ncbi.nlm.nih.gov/7236107

42. Srinivasan BD, Kulkarni PS. The effect of indomethacin (INDO), flurbiprofen (F) and prednisolone acetate on conjunctival prostaglandin (PG) biosynthesis and polymorphonuclear leukocyte (PMN) release following corneal injury. Invest Ophthalmol Vis Sci. 1980; 19(Suppl):228-9.

43. Kulkarni PS, Srinivasan BD. Comparative in vivo inhibitory effects of nonsteroidal anti-inflammatory agents on prostaglandin synthesis in rabbit ocular tissues. Arch Ophthalmol. 1985; 103:103-6. https://pubmed.ncbi.nlm.nih.gov/3919694

44. Beitch BR, Eakins KE. The effects of prostaglandins on the intraocular pressure of the rabbit. Br J Pharmacol. 1969; 37:158-67. https://pubmed.ncbi.nlm.nih.gov/4981000

45. Leopold IH, Murray D. Noncorticosteroidal anti-inflammatory agents in ophthalmology. Ophthalmology. 1979; 86:142-55. https://pubmed.ncbi.nlm.nih.gov/394060

46. Green K. Permeability properties of the ciliary epithelium in response to prostaglandins. Invest Ophthalmol. 1973; 12:752-8. https://pubmed.ncbi.nlm.nih.gov/4784282

47. Miller JD, Eakins KE, Atwal M. The release of PGE2-like activity into aqueous humor after paracentesis and its prevention by aspirin. Invest Ophthalmol. 1973; 12:939-42. https://pubmed.ncbi.nlm.nih.gov/4768600

48. Araie M, Sawa M, Takase M. Topical flurbiprofen and diclofenac suppress blood-aqueous barrier breakdown in cataract surgery: a fluorophotometric study. Jpn J Ophthalmol. 1983; 27:535-42. https://pubmed.ncbi.nlm.nih.gov/6656015

49. Gieser DK, Hodapp E, Goldberg I et al. Flurbiprofen and intraocular pressure. Ann Ophthalmol. 1981; 13:831-3. https://pubmed.ncbi.nlm.nih.gov/7027872

50. Araie M, Takase M. Effects of S-596 and carteolol, new beta-adrenergic blockers, and flurbiprofen on the human eye: a fluorophotometric study. Graefes Arch Clin Exp Ophthalmol. 1985; 222:259-62. https://pubmed.ncbi.nlm.nih.gov/2579877

51. van Alphen GWHM, Dutilh CE, de Deckere EAM. The high yield of prostacyclin biosynthesis by the iris and its effects on the intraocular muscles. Prostaglandins Med. 1978; 1:151-8. https://pubmed.ncbi.nlm.nih.gov/362455

52. Hall DWR, Bonta IL. Prostaglandins and ocular inflammation. Doc Ophthalmol. 1977; 2:421-34.

53. Waitzman MB. Possible new concepts relating prostaglandins to various ocular functions. Surv Ophthalmol. 1970; 14:301-26. https://pubmed.ncbi.nlm.nih.gov/4984791

54. Starr MS. Effects of prostaglandin on blood flow in the rabbit eye. Exp Eye Res. 1971; 11:161-9. https://pubmed.ncbi.nlm.nih.gov/5001094

55. Starr MS. Further studies on the effect of prostaglandin on intraocular pressure in the rabbit. Exp Eye Res. 1971; 11:170-7. https://pubmed.ncbi.nlm.nih.gov/5001095

56. Eakins KE. Increased intraocular pressure produced by prostaglandins E1 and E2 in the cat eye. Exp Eye Res. 1970; 10:87-92. https://pubmed.ncbi.nlm.nih.gov/5456783

57. Srinivasan BD, Kulkarni PS. The role of arachidonic acid metabolites in the mediation of the polymorphonuclear leukocyte response following corneal injury. Invest Ophthalmol Vis Sci. 1980; 19:1087-93. https://pubmed.ncbi.nlm.nih.gov/7409999

58. Eakins KE, Whitelocke RAF, Bennett A et al. Prostaglandin-like activity in ocular inflammation. Br Med J. 1972; 3:452-3. https://pubmed.ncbi.nlm.nih.gov/5069222

59. Kass MA, Holmberg NJ. Prostaglandin and thromboxane synthesis by microsomes of rabbit ocular tissues. Invest Ophthalmol Vis Sci. 1979; 18:166-71. https://pubmed.ncbi.nlm.nih.gov/761971

60. Camras CB, Bito LZ, Eakins KE. Reduction of intraocular pressure by prostaglandins applied topically to the eyes of conscious rabbits. Invest Ophthalmol Vis Sci. 1977; 16:1125-34. https://pubmed.ncbi.nlm.nih.gov/924742

61. Butler JM, Unger WG, Hammond BR. Sensory mediation of the ocular response to neutral formaldehyde. Exp Eye Res. 1979; 28:577-89. https://pubmed.ncbi.nlm.nih.gov/571810

62. Unger WG, Cole DF, Bass MS. Prostaglandin and neurogenically mediated ocular response to laser irradiation of the rabbit iris. Exp Eye Res. 1977; 25:209-20. https://pubmed.ncbi.nlm.nih.gov/590365

63. Jampol LM, Neufeld AH, Sears ML. Pathways for the response of the eye to injury. Invest Ophthalmol Vis Sci. 1975; 14:184-9.

64. Sawa M, Masuda K. Topical indomethacin in soft cataract aspiration. Jpn J Ophthalmol. 1976; 20:514-9.

65. Tang-Liu DDS, Liu SS, Weinkam RJ. Ocular and systemic bioavailability of ophthalmic flurbiprofen. J Pharmacokinet Biopharm. 1984; 12:611-26. https://pubmed.ncbi.nlm.nih.gov/6533296

66. Anderson JA, Chen CC, Vita JB et al. Disposition of topical flurbiprofen in normal and aphakic rabbit eyes. Arch Ophthalmol. 1982; 100:642-5. https://pubmed.ncbi.nlm.nih.gov/7073585

67. Risdall PC, Adams SS, Crampton EL et al. The disposition and metabolism of flurbiprofen in several species including man. Xenobiotica. 1978; 8:691-704. https://pubmed.ncbi.nlm.nih.gov/103331

68. Kaiser DG, Brooks CD, Lomen PL. Pharmacokinetics of flurbiprofen. Am J Med. 1986; 80(Suppl 3A):10-5. https://pubmed.ncbi.nlm.nih.gov/3963013

69. Aarons L, Khan AZ, Grennan DM et al. The binding of flurbiprofen to plasma proteins. J Pharm Pharmacol. 1985; 37:644-6. https://pubmed.ncbi.nlm.nih.gov/2867185

70. Cardoe N, de-Silva M, Glass RC et al. Serum concentrations of flurbiprofen in rheumatoid patients receiving flurbiprofen over long periods of time. Curr Med Res Opin. 1977; 5:21-5. https://pubmed.ncbi.nlm.nih.gov/913119

71. Miyake K. Prevention of cystoid macular edema after lens extraction by topical indomethacin. II: a control study in bilateral extractions. Jpn J Ophthalmol. 1978; 22:80-94.

72. BenEzra D. Neovasculogenic ability of prostaglandins, growth factors, and synthetic chemoattractants. Am J Ophthalmol. 1978; 86:455-61. https://pubmed.ncbi.nlm.nih.gov/707590

73. Sudlow G, Birkett DJ, Wade DN. Further characterization of specific drug binding sites on human serum albumin. Mol Pharmacol. 1976; 12:1052-61. https://pubmed.ncbi.nlm.nih.gov/1004490

74. Keates RH, McGowan KA. Clinical trial of flurbiprofen to maintain pupillary dilation during cataract surgery. Ann Ophthalmol. 1984; 16:919-21. https://pubmed.ncbi.nlm.nih.gov/6391333

75. Hurvitz LM, Spaeth GL, Zakhour I et al. A comparison of the effect of flurbiprofen, dexamethasone, and placebo on cyclocryotherapy-induced inflammation. Ophthalmic Surg. 1984; 15:394-9. https://pubmed.ncbi.nlm.nih.gov/6374562

76. Weinreb RN, Robin AL, Baerveldt G et al. Flurbiprofen pretreatment in argon laser trabeculoplasty of primary open-angle glaucoma. Arch Ophthalmol. 1984; 102:1629-32. https://pubmed.ncbi.nlm.nih.gov/6497745

77. Hillman JS, Frank GJ, Kheskani MB. Flurbiprofen and human intraocular inflammation. Adv Prostaglandin Thromboxane Res. 1980; 8:1723-5. https://pubmed.ncbi.nlm.nih.gov/6990732

78. Hotchkiss ML, Robin AL, Pollack IP et al. Nonsteroidal anti-inflammatory agents after argon laser trabeculoplasty: a trial with flurbiprofen and indomethacin. Ophthalmology. 1984; 91:969-76. https://pubmed.ncbi.nlm.nih.gov/6387568

79. Duffin M, Weissman BA, Glasser DB et al. Flurbiprofen in the treatment of corneal neovascularization induced by contact lenses. Am J Ophthalmol. 1982; 93:607-14. https://pubmed.ncbi.nlm.nih.gov/6177247

80. Cooper CA, Bergamini VW, Leopold IH. Use of flurbiprofen to inhibit corneal neovascularization. Arch Ophthalmol. 1980; 98:1102-5. https://pubmed.ncbi.nlm.nih.gov/6155898

81. Robin JB, Regis-Pacheco LF, Kash RL et al. The histopathology of corneal neovascularization: inhibitor effects. Arch Ophthalmol. 1985; 103:284-7. https://pubmed.ncbi.nlm.nih.gov/2579632

82. Weinberger M. Analgesic sensitivity in children with asthma. Pediatrics. 1978; 62(Suppl):910-5. https://pubmed.ncbi.nlm.nih.gov/103067

83. Pleskow WW, Stevenson DD, Mathison DA et al. Aspirin desensitization in aspirin-sensitive asthmatic patients: clinical manifestations and characterization of the refractory period. J Allergy Clin Immunol. 1982; 69(1 Part 1):11-9. https://pubmed.ncbi.nlm.nih.gov/7054250

84. Miller D, Gruenberg P, Miller R et al. Topical flurbiprofen or prednisolone: effect on corneal wound healing in rabbits. Arch Ophthalmol. 1981; 99:681-2. https://pubmed.ncbi.nlm.nih.gov/7224940

85. Trousdale MD, Dunkel EC, Nesburn AB. Effect of flurbiprofen on herpes simplex keratitis in rabbits. Invest Ophthalmol. 1980; 19:267-70.

86. Cohen RD, Bateman ED, Potgieter PD. Near-fatal bronchospasm in an asthmatic patient following ingestion of flurbiprofen: a case report. S Afr Med J. 1982; 61:803. https://pubmed.ncbi.nlm.nih.gov/7079897

87. Moebius UM. Adverse drug reactions. Lancet. 1986; 1:384.

88. Srinivasan BD, Kulkarni PS. The effect of steroidal and nonsteroidal anti-inflammatory agents on corneal re-epithelialization. Invest Ophthalmol Vis Sci. 1981; 20:688-91. https://pubmed.ncbi.nlm.nih.gov/7216684

89. VanArsdel PP Jr. Aspirin idiosyncrasy and tolerance. J Allergy Clin Immunol. 1984; 73:431-3. https://pubmed.ncbi.nlm.nih.gov/6423718

90. Stevenson DD. Diagnosis, prevention, and treatment of adverse reactions to aspirin and nonsteroidal anti-inflammatory drugs. J Allergy Clin Immunol. 1984; 74(4 Part 2):617-22. https://pubmed.ncbi.nlm.nih.gov/6436354

91. Stevenson DD, Mathison DA. Aspirin sensitivity in asthmatics: when may this drug be safe? Postgrad Med. 1985; 78:111-3,116-9. (IDIS 205854)

92. Settipane GA. Aspirin and allergic diseases: a review. Am J Med. 1983; 74(Suppl):102-9. https://pubmed.ncbi.nlm.nih.gov/6344621

93. Van Haeringen NJ, Oosterhuis JA, Van Delft JL et al. A comparison of the effects of nonsteroidal compounds on the disruption of the blood-aqueous barrier. Exp Eye Res. 1982; 35:271-7. https://pubmed.ncbi.nlm.nih.gov/7117419

94. American Society of Health-System Pharmacists, Inc.. Medication teaching manual: a guide for patient counseling. 2nd ed. Bethesda, MD: American Society of Hospital Pharmacists; 1980:300.

95. Rome LH, Lands WEM. Structural requirements for time-dependent inhibition of prostaglandin biosynthesis by anti-inflammatory drugs. Proc Natl Acad Sci USA. 1975; 72:4863-5. https://pubmed.ncbi.nlm.nih.gov/1061075

96. Bito LZ, Draga A, Blanco J et al. Long-term maintenance of reduced intraocular pressure by daily or twice daily topical application of prostaglandins to cat or rhesus monkey eyes. Invest Ophthalmol Vis Sci. 1983; 24:312-9. https://pubmed.ncbi.nlm.nih.gov/6572617

97. Miyake K. Prophylaxis of aphakic cystoid macular edema using topical indomethacin. J Am Intraocul Implant Soc. 1978; 4:174-9. https://pubmed.ncbi.nlm.nih.gov/748308

98. Adams SS, Bresloff P, Risdall PC. The contribution of metabolites to the anti-inflammatory activity of flurbiprofen. Curr Med Res Opin. 1975; 3(Suppl 4):27-30.

99. Ishii Y, Sakai Y, Masumoto S et al. Absorption, distribution, excretion and anti-inflammatory effects of flurbiprofen in animals after rectal administration. Curr Med Res Opin. 1975; 3:31-8.

100. Anderson BD, Conradi RA. Predictive relationships in the water solubility of salts of a nonsteroidal anti-inflammatory drug. J Pharm Sci. 1985; 74:815-20. https://pubmed.ncbi.nlm.nih.gov/4032262

101. Allergan Pharmaceuticals, Inc. Ocufen (flurbiprofen topical ophthalmic solution). Irvine, CA; 1987 Jan.

102. Allergan Pharmaceuticals, Inc. Ocufen (flurbiprofen sodium 0.03% ophthalmic solution): inhibition of miosis during cataract surgery. Irvine, CA; 1987 Jan.

103. Reviewers’ comments (personal observations); 1987.

104. Cheetham JK, Chen CC, Sabiston DW. The concentration of flurbiprofen in the aqueous humor of humans after multiple topical or oral dosing. Invest Ophthalmol Vis Sci. 1987; 28(Suppl):395.

105. Petrauskas J (Allergan Pharmaceuticals, Inc, Irvine, CA): Personal communication; 1987.

106. Bhattacherjee P, Williams RN, Eakins KE. A comparison of the ocular anti-inflammatory activity of steroidal and nonsteroidal compounds in the rat. Invest Ophthalmol Vis Sci. 1983; 24:1143-6. https://pubmed.ncbi.nlm.nih.gov/6874278

107. Hawkey CJ. COX-2 inhibitors. Lancet. 1999; 353:307-14. https://pubmed.ncbi.nlm.nih.gov/9929039

108. Kurumbail RG, Stevens AM, Gierse JK et al. Structural basis for selective inhibition of cyclooxygenase-2 by anti-inflammatory agents. Nature. 1996; 384:644-8. https://pubmed.ncbi.nlm.nih.gov/8967954

109. Riendeau D, Charleson S, Cromlish W et al. Comparison of the cyclooxygenase-1 inhibitory properties of nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors, using sensitive microsomal and platelet assays. Can J Physiol Pharmacol. 1997; 75:1088-95. https://pubmed.ncbi.nlm.nih.gov/9365818

110. DeWitt DL, Bhattacharyya D, Lecomte M et al. The differential susceptibility of prostaglandin endoperoxide H synthases-1 and -2 to nonsteroidal anti-inflammatory drugs: aspirin derivatives as selective inhibitors. Med Chem Res. 1995; 5:325-43.

111. Cryer B, Dubois A. The advent of highly selective inhibitors of cyclooxygenase—a review. Prostaglandins Other Lipid Mediators. 1998; 56:341-61. https://pubmed.ncbi.nlm.nih.gov/9990677

112. Simon LS. Role and regulation of cyclooxygenase-2 during inflammation. Am J Med. 1999; 106(Suppl 5B):37-42S.

113. Allergan, Inc., Irvine, CA: Personal communication; 2007 Mar 28.

114. Trousdale MD, Barlow WE, McGuigan LJB. Assessment of diclofenac on herpes keratitis in rabbit eyes. Arch Ophthalmol. 1989; 107: 1664-6.

115. Holmes JM, Jay WM. The effect of preoperative flurbiprofen on miosis produced by acetylcholine during cataract surgery. Am J Ophthalmol. 1991; 111:735-8. https://pubmed.ncbi.nlm.nih.gov/2039045

116. Jackson H, Patel CK, Westcott M et al. Does topical flurbiprofen affect the pupillary response to acetylcholine?. Eye. 1994; 8 (Part 3):329-31.

117. Cox SR, Forbes KK. Excretion of flurbiprofen into breast milk. Pharmacotherapy. 1987; 7:211-5. https://pubmed.ncbi.nlm.nih.gov/3444752

118. Smith IJ, Hinson JL, Johnson VA et al. Flurbiprofen in post-partum women: plasma and breast milk disposition. J Clin Pharmacol. 1989; 29:174-84. https://pubmed.ncbi.nlm.nih.gov/2715375

119. Gimbel H, Van Westenbrugge J, Cheetham JK et al. Intraocular availability and pupillary effect of flurbiprofen and indomethacin during cataract surgery. J Cataract Refract Surg. 1996; 22:474-9. https://pubmed.ncbi.nlm.nih.gov/8733853

120. Solomon LD. Efficacy of topical flurbiprofen and indomethacin in preventing pseudophakic cystoid macular edema. Flurbiprofen-CME Study Group 1. J Cataract Refract Surg. 1995; 21:73-81. https://pubmed.ncbi.nlm.nih.gov/7722910

121. Peyman GA, Kazi AA, Riazi-Esfahani M et al. The effect of combinations of flurbiprofen, low molecular weight heparin, and doxycycline on the inhibition of corneal neovascularization. Cornea. 2006; 25:582-5. https://pubmed.ncbi.nlm.nih.gov/16783147

Medical Disclaimer