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Flurbiprofen (Ophthalmic)

Pronunciation

(flure BI proe fen)

Index Terms

  • Flurbiprofen Sodium

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Ophthalmic, as sodium:

Ocufen: 0.03% (2.5 mL [DSC]) [contains edetate disodium, thimerosal]

Generic: 0.03% (2.5 mL)

Brand Names: U.S.

  • Ocufen [DSC]

Pharmacologic Category

  • Nonsteroidal Anti-inflammatory Drug (NSAID), Ophthalmic

Pharmacology

Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors; has antipyretic, analgesic, and anti-inflammatory properties

Other proposed mechanisms not fully elucidated (and possibly contributing to the anti-inflammatory effect to varying degrees), include inhibiting chemotaxis, altering lymphocyte activity, inhibiting neutrophil aggregation/activation, and decreasing proinflammatory cytokine levels.

Use: Labeled Indications

Intraoperative miosis: Inhibition of intraoperative miosis

Contraindications

Hypersensitivity to flurbiprofen or any component of the formulation

Dosing: Adult

Intraoperative miosis: Ophthalmic: Instill 1 drop every 30 minutes, beginning 2 hours prior to surgery for a total of 4 drops in each affected eye.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

No dosage adjustment provided in manufacturer's labeling.

Dosing: Hepatic Impairment

No dosage adjustment provided in manufacturer's labeling.

Administration

For ophthalmic use only; avoid contact of bottle tip with skin or eye. Separate bottles should be used for each eye if both eyes require treatment.

Storage

Store at 15°C to 25°C (59°F to 79°F).

Drug Interactions

Corticosteroids (Ophthalmic): Nonsteroidal Anti-Inflammatory Agents (Ophthalmic) may enhance the adverse/toxic effect of Corticosteroids (Ophthalmic). Healing of ophthalmic tissue during concomitant administration of ophthalmic products may be delayed. Exceptions: Loteprednol. Monitor therapy

Adverse Reactions

Frequency not defined.

Cardiovascular: Hyperemia (ocular)

Hematologic & oncologic: Hemorrhagic diathesis (ocular tissue; in conjunction with ocular surgery)

Ophthalmic: Anterior chamber eye hemorrhage, burning sensation of eyes (transient), eye irritation, miosis, mydriasis, stinging of eyes (transient)

Miscellaneous: Fibrosis (ocular)

Warnings/Precautions

Concerns related to adverse effects:

• Aspirin/NSAID sensitivity: Use with caution in patients with previous sensitivity to aspirin or other NSAIDs, including patients who experience bronchospasm, asthma, rhinitis, or urticaria following NSAID or aspirin.

• Bleeding/hemostasis: May increase bleeding time associated with ocular surgery. Use with caution in patients with known bleeding tendencies or those receiving anticoagulants.

• Delayed healing: Healing time may be slowed or delayed.

Special populations:

• Post-surgical patients: To minimize the risk of infection following surgery of both eyes, two separate bottles of eye drops (one for each eye) should be used; instruct patients not to use the same bottle for both eyes.

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events were observed following systemic administration of flurbiprofen in animal reproduction studies. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctual occlusion to decrease potential exposure to the fetus (Samples 1988).

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 burning or stinging. Have patient report immediately to prescriber vision changes, eye pain, severe eye irritation, or bleeding in the eye (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.

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