Non-selective NSAID Pregnancy: Contraindicated during the third trimester of pregnancy. During the first and second trimesters flurbiprofen should not be given unless clearly necessary, at the lowest dose and shortest duration; epidemiological data suggest increased risk of miscarriage, cardiac malformation and gastroschisis with prostaglandin synthesis inhibitors in early pregnancy. From the 20th week of pregnancy onward it may cause oligohydramnios from foetal renal dysfunction, and ductus arteriosus constriction has been reported in the second trimester — consider antenatal monitoring and discontinue if either is found. Use may impair female fertility and is not recommended in women attempting to conceive.

Flurbiprofen

Brand names: Strefen, Froben

Flurbiprofen is a non-steroidal anti-inflammatory drug (NSAID) of the propionic acid class used for pain and inflammation in musculoskeletal and rheumatic conditions.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 150 to 200 mg daily, in two, three or four divided doses

Route: Oral — coated tablets, taken preferably with or after food

Frequency: In two, three or four divided doses daily

Max: The maximum total daily dosage should not exceed 300 mg

In patients with severe symptoms or disease of recent origin, or during acute exacerbations, the total daily dosage may be increased to 300 mg in divided doses. DYSMENORRHOEA: 100 mg may be given at the start of symptoms, followed by 50 or 100 mg at four- to six-hourly intervals; maximum total daily dosage 300 mg. General principle (§4.2/§4.4): undesirable effects may be minimised by using the lowest effective dose for the shortest duration necessary to control symptoms. PAEDIATRIC POPULATION: flurbiprofen tablets are NOT recommended for use in children under 12 years; no paediatric dose is given in the SPC. OLDER PEOPLE: the elderly are at increased risk of serious consequences of adverse reactions; some, especially those with impaired renal function, may eliminate NSAIDs more slowly than normal — use with caution, assess dosage individually, use the lowest effective dose for the shortest possible duration, and monitor regularly for GI bleeding during NSAID therapy. Avoid concomitant use with other NSAIDs, including cyclooxygenase-2 selective inhibitors, because of additive effects. NOTE: the US label in the same bundle is flurbiprofen sodium OPHTHALMIC solution (Bausch & Lomb) for pre-operative use — a different route and product, and nothing has been extracted from it for this page.

Dose adjustments

Renal

Contraindicated in renal failure. No numerical dose adjustment is given; §4.2 states that elderly patients, especially those with impaired renal function, may eliminate NSAIDs more slowly than normal, so flurbiprofen should be used with caution and dosage assessed individually.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity (asthma, urticaria or allergic-type reactions) to flurbiprofen or to any of the inactive ingredients, or previous hypersensitivity reactions (asthma, rhinitis, angioedema or urticaria) to flurbiprofen, aspirin or other NSAIDs
History of gastrointestinal bleeding or perforation related to previous NSAID therapy
Active, or history of, ulcerative colitis, Crohn's disease, recurrent peptic ulceration or gastrointestinal haemorrhage (two or more distinct episodes of proven ulceration or bleeding)
Severe heart failure, hepatic failure and renal failure
Third trimester of pregnancy

Side effects

Gastrointestinal (most common): nausea, vomiting, diarrhoea, dyspepsia, flatulence, constipation, abdominal pain, melaena, haematemesis, ulcerative stomatitis, and exacerbation of colitis and Crohn's disease; peptic ulcer, perforation or GI bleeding — sometimes fatal, particularly in the elderly
Headache and dizziness (common); paraesthesia (uncommon); somnolence and insomnia (rare)
Hypersensitivity reactions — non-specific allergic reaction and anaphylaxis; asthma, aggravated asthma, bronchospasm or dyspnoea; rashes, pruritus, urticaria, purpura, angioedema and, very rarely, erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis
Oedema, hypertension and cardiac failure; use of some NSAIDs (particularly at high doses and long term) may be associated with an increased risk of arterial thrombotic events such as myocardial infarction or stroke
Anaemia (uncommon); very rarely leukopenia, agranulocytosis, aplastic anaemia, neutropenia, thrombocytopenia and haemolytic anaemia
Visual impairment (uncommon), tinnitus and vertigo (uncommon)

Interactions

NOTE: SPC §4.5 was not retrieved in this bundle; the following are drawn from §4.4 and must be checked against the full §4.5.
Other NSAIDs, including cyclooxygenase-2 selective inhibitors — concomitant use should be avoided because of additive effects
Concomitant low-dose aspirin or other anti-platelet agents — increased gastrointestinal risk; consider gastroprotection (e.g. misoprostol or a proton pump inhibitor)
Oral corticosteroids — increased risk of gastrointestinal ulceration or bleeding
Anticoagulants such as warfarin — increased risk of gastrointestinal ulceration or bleeding
Selective serotonin-reuptake inhibitors — increased risk of gastrointestinal ulceration or bleeding
Alcohol — concomitant consumption may increase active-substance-related undesirable effects, particularly gastrointestinal and CNS effects

Clinical monograph

How it works

It inhibits cyclo-oxygenase enzymes, reducing prostaglandin synthesis and thereby producing analgesic, anti-inflammatory and antipyretic effects.

Prescribing in practice

Like other NSAIDs it carries gastrointestinal, cardiovascular and renal risks, so use the lowest effective dose for the shortest duration, particularly in older patients.
Co-prescription of gastroprotection should be considered in those at increased risk of gastrointestinal ulceration or bleeding.
Caution is needed with concurrent anticoagulants, antiplatelets and other nephrotoxic or interacting drugs.

Monitoring

Monitor blood pressure and renal function in at-risk patients and remain alert to gastrointestinal symptoms during treatment.

Counselling the patient

Take with or after food and report any black stools, vomiting blood or severe indigestion.
Tell your clinician if you have heart, kidney or stomach problems before continuing.
Avoid combining with other anti-inflammatory painkillers unless advised.

Evidence & guidelines

The gastrointestinal, cardiovascular and renal risks of NSAIDs as a class are well characterised and reflected in MHRA safety advice.

Reference: NICE NG84; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways