• Flurbiprofen Ophthalmic

    (flur" bi proe' fen)

    WHY is this medicine prescribed?

    Flurbiprofen ophthalmic is used to prevent or reduce changes in the eye that may occur during eye surgery. Flurbiprofen ophthalmic is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the release of certain natural substances that cause pain and swelling.

    HOW should this medicine be used?

    Flurbiprofen ophthalmic comes as a solution (liquid) to instill in the eyes. It is usually instilled in the eye(s) undergoing surgery every 30 minutes beginning 2 hours before surgery for a total of four doses. Use flurbiprofen ophthalmic exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
    To instill the eye drops, follow these steps:
    1. Wash your hands thoroughly with soap and water.
    2. Check the dropper tip to make sure that it is not chipped or cracked.
    3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
    4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
    5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
    6. Brace the remaining fingers of that hand against your face.
    7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
    8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
    9. Place a finger on the tear duct and apply gentle pressure.
    10. Wipe any excess liquid from your face with a tissue.
    11. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
    12. Wash your hands to remove any medication.

    Are there OTHER USES for this medicine?

    This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before taking flurbiprofen eye drops,
    • tell your doctor and pharmacist if you are allergic to flurbiprofen, aspirin, or any of the ingredients in flurbiprofen eye drops. Ask your pharmacist for a list of the ingredients.
    • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; nonsteroidal anti-inflammatory agents, such as celecoxib (Celebrex), diclofenac (Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin, Midol), indomethacin (Indocin), ketoprofen (Orudis, Oruvail), ketorolac (Toradol), meclofenamate, mefenamic (Ponstel), nabumetone (Relafen), naproxen (Aleve, Naprosyn), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin); and eye drops such as acetylcholine chloride (Miochol E) and carbachol (Miostat, Isopto Carbachol).
    • tell your doctor if you have or have ever any condition that causes you to bleed easily.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.
    • you should know that flurbiprofen eye drops may slow healing of the eye after surgery. Call your doctor right away if your pain and swelling do not improve.

    What SPECIAL DIETARY instructions should I follow?

    Unless your doctor tells you otherwise, continue your normal diet.

    What should I do IF I FORGET to take a dose?

    Instill the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill a double dose to make up for a missed one.

    What SIDE EFFECTS can this medicine cause?

    Flurbiprofen eye drops may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
    • stinging or burning of the eyes
    • an increase or decrease in size of the pupil (dark area in the center of the eye)
    Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
    • bleeding within the eye
    • sensitivity to light
    • eye pain
    • blurry, cloudy, or blocked areas of vision
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    If someone swallows flurbiprofen eye drops, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor.
    It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

    Brand Names

    • Ocufen®

    Flurbiprofen

    (flure bi' proe fen)

    IMPORTANT WARNING:

    People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as flurbiprofen may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke, if you smoke, and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.
    If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take flurbiprofen right before or right after the surgery.
    NSAIDs such as flurbiprofen may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or drink large amounts of alcohol while you are taking flurbiprofen. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Also tell your doctor if you have or have ever had ulcers or bleeding in your stomach or intestines or other bleeding disorders. If you experience any of the following symptoms, stop taking flurbiprofen and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.
    Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to flurbiprofen. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.
    Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with flurbiprofen and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( http://www.fda.gov/Drugs) or the manufacturer's website to obtain the Medication Guide.

    WHY is this medicine prescribed?

    Flurbiprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Flurbiprofen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

    HOW should this medicine be used?

    Flurbiprofen comes as a tablet to take by mouth. It usually is taken two to four times a day. Take flurbiprofen at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take flurbiprofen exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

    Are there OTHER USES for this medicine?

    Flurbiprofen is also used to treat ankylosing spondylitis (arthritis that mainly affects the spine).
    This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before taking flurbiprofen,
    • tell your doctor and pharmacist if you are allergic to flurbiprofen, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), or any other medications.
    • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); diuretics ('water pills'); lithium (Eskalith, Lithobid); and methotrexate (Rheumatrex) .
    • tell your doctor if you have or have ever had asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs; or liver or kidney disease.
    • tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking flurbiprofen, call your doctor.
    • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking flurbiprofen.

    What SPECIAL DIETARY instructions should I follow?

    Unless your doctor tells you otherwise, continue your normal diet.

    What should I do IF I FORGET to take a dose?

    Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

    What SIDE EFFECTS can this medicine cause?

    Flurbiprofen may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
    • headache
    • nervousness or anxiety
    • depression
    • memory problems
    • shaking of a part of the body that you cannot control
    • difficulty falling asleep or staying asleep
    • vomiting
    • gas
    • constipation
    • diarrhea
    • runny nose
    • ringing in the ears
    Some side effects can be serious. If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more flurbiprofen until you speak to your doctor.
    • changes in vision (blurriness, difficulty seeing)
    • unexplained weight gain
    • fever
    • blisters
    • rash
    • itching
    • hives
    • swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
    • difficulty breathing or swallowing
    • pale skin
    • fast heartbeat
    • excessive tiredness
    • unusual bleeding or bruising
    • lack of energy
    • nausea
    • loss of appetite
    • pain in the upper right part of the stomach
    • flu-like symptoms
    • yellowing of the skin or eyes
    • cloudy, discolored, or bloody urine
    • back pain
    • difficult or painful urination
    Flurbiprofen may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
    Symptoms of overdose may include:
    • lack of energy
    • drowsiness
    • nausea
    • vomiting
    • stomach pain
    • bloody, black, or tarry stools
    • vomit that is bloody or looks like coffee grounds
    • difficulty breathing
    • coma (loss of consciousness for a period of time)

    What OTHER INFORMATION should I know?

    Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
    It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

    Brand Names

    • Ansaid®
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