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Medically reviewed on Nov 15, 2018


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Index Terms

  • Flavan

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

Limbrel: 250 mg

Limbrel: 500 mg [contains brilliant blue fcf (fd&c blue #1)]

Limbrel250: Flavocoxid 250 mg and citrated zinc bisglycinate 50 mg [contains brilliant blue fcf (fd&c blue #1)]

Limbrel500: Flavocoxid 500 mg and citrated zinc bisglycinate 50 mg [contains brilliant blue fcf (fd&c blue #1)]

Brand Names: U.S.

  • Limbrel
  • Limbrel250
  • Limbrel500

Pharmacologic Category

  • Anti-inflammatory Agent
  • Medical Food


Exerts anti-inflammatory properties through nonspecific inhibition of cyclooxygenase (COX) and lipoxygenase (5-LOX) pathways; may also possess general analgesic and antioxidant/anticytokine properties


Effect of food: May increase absorption.


Primarily via glucuronidation and sulfation

Time to Peak

Plasma: 5.8 hours (baicalin); 1.5 hours (catechin)

Half-Life Elimination

11 to 12 hours (baicalin); 3 to 4 hours (catechin)

Use: Labeled Indications

Osteoarthritis: A medical food for dietary management of the metabolic processes of osteoarthritis

Note: A medical food is formulated to be administered enterally under the supervision of a physician and is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements are established by medical evaluation. Medical foods are not drugs and, therefore, are not subject to any FDA regulatory requirements that specifically apply to drugs (eg, requirement for written/oral prescription prior to dispensing, premarket review or approval, proof of safety and efficacy).


Hypersensitivity to flavocoxid, flavonoids, or any component of the formulation; foods rich in flavonoid include colored fruits and vegetables, dark chocolate, tea (especially green tea), red wine, and Brazil nuts.

Dosing: Adult

Osteoarthritis: Oral: 250 to 500 mg (with or without zinc) every 12 hours

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied).

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied).


Oral: Administer with or without meals.


Store at 15°C to 30°C (59°F to 86°F). Protect from light and moisture.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

1% to 10%:

Cardiovascular: Edema (1% to 4%)

Central nervous system: Headache (1% to 4%), insomnia (1% to 4%)

Endocrine & metabolic: Hypercholesterolemia (1% to 4%), hyperglycemia (1% to 4%), hyperuricemia (1% to 4%)

Gastrointestinal: Diarrhea (1% to 4%), dyspepsia (1% to 4%)

Hepatic: Increased liver enzymes (<10%), increased serum ALT (<2%), increased serum AST (<2%)

Neuromuscular & skeletal: Arthralgia (1% to 4%)

Renal: Increased blood urea nitrogen (1% to 4%)

Respiratory: Dyspnea (1% to 4%)

Postmarketing and/or case reports: Eosinophilia, hepatotoxicity (idiosyncratic) (Chalasani 2014), hypersensitivity pneumonitis (FDA Safety Alert Nov. 21, 2017), jaundice, liver injury, upper gastrointestinal hemorrhage


Concerns related to adverse effects:

• Hepatic effects: Notable elevations of ALT and AST (approximately >3 to 5 times ULN) occurred in clinical trials in <2% of subjects; rare cases of severe hepatic reactions accompanied by jaundice or eosinophilia have been reported (cases resolved within 2 to 4 weeks after discontinuation). Discontinue immediately if abnormal liver function tests persist or worsen, if clinical signs/symptoms consistent with liver disease develop, or if systemic manifestations occur (eg, eosinophilia, rash, abdominal pain, diarrhea, dark urine).

Disease-related concerns:

• Gastrointestinal disease: Use with caution in patients with a history of gastrointestinal disorders.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Pregnancy Considerations

Flavocoxid has not been studied in pregnant women; use during pregnancy is not recommended.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience diarrhea, nausea, or flatulence. Have patient report immediately to prescriber signs of liver problems (dark urine, fatigue, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or jaundice), or signs of a severe pulmonary disorder (lung or breathing problems like difficulty breathing, shortness of breath, or a cough that is new or worse) (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.