Drug Interaction:
NSAIDs include-
Propionic acid- Fenoprofen, Flurbiprofen, Ibiprofen, Ketoprofen, Naproxen, Naproxen Sodium, Oxaprozin Acetic acids- Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin Fenamates (anthralic acids) - Meclofenamate, Mefenamic acxid Oxicams- Piroxicam
Refer- Ibuprofen
Reduces diuretic effect of frusemide with fluid retension (important in patients with cardiac failure). Concomittant use of aspirin reduces serum level of flubiprofen. Delays absorption level of digoxin May interfere with anticoagulants.
Indication:
New drugs approved For Marketing by Drug Controller General of India(DCGI )
during the period January 1988 to November 2014
(Ref- IDMA Annual Publication 2015)
Name of Drug Indication Date of Approval
1.Flurbiprofen plaster 20mg 11-12-2009
(7mm x 10cm)
For the relief of pain and inflammation due to rheumatoid arthiritis,
osteoarthiritis and allied disorder
2.Flurbiprofen sodium 14-11-2009
0.03% Ophthalmic solution USP
For the reduction of post-operative inflammatory condition
Acute or long treatment of rheumatoid arthritis.
NSAIDs include-
Propionic acid- Fenoprofen, Flurbiprofen, Ibuprofen, Ketoprofen, Naproxen, Naproxen Sodium, Oxaprozin Acetic acids- Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin Fenamates (anthralic acids) - Meclofenamate, Mefenamic acxid Oxicams- Piroxicam
Refer- Ibuprofen
Adverse Reaction:
Peptic ulceration,haemorrhage and perforation Fluid retension, oedema, protein urea, rarely renal toxicity (papilary/glomerular necrosis, allergic nephritis), allergic reactions, G.I.upsets, dizziness, tinnitus, deafness, blurring of vision.
Contra-Indications:
Peptic ulcer, G.I.haemorrhage, ulcerative colitis, asthma, bronchospasm, anaphylactic reactions, angioedema, hypersens to Aspirin or other NSAIDs, pregnancy, lactation, neonates.
Special precautions:
Patients with history of cardiac decompensation, hypertension.
Dosages/ Overdosage Etc:
Indications:
Acute or long treatment of rheumatoid arthritis.
Dosage:
Initial recommended daily dose - 200 to 300 mg, in divided doses 2,3 or 4 times daily. Largest recommended single dose in a multiple dose regimen is 100 mg.
Other Information:
For Availability/supplies
Contact -
1.Indian Drug Manufacturers Association (IDMA)
Phone- 022- 24944624/ 24974308
Fax- 022- 24950723
Email- idma@vsnl.com
Website: www.idma-assn.org
2.Bulk Drug Manufacturers Association (India)(BDMA)
Phone - 040-23703910/ 23706718
Fax- 040-23704804
Email- info@bdmai.org
Website: www.info@bdmai.org
List of entries
1. Rheumatoid Arthritis
2. Juvenile Rheumatoid Arthritis
3. Ankylosing spondylosis
4. Reiters Syndrome
5. Osteomyelitis
6. Cervical spondylosis
7. Gout
1. Rheumatoid arthritis Rheumatoid arthritis (RA) is a chronic sytemic disease of unknown etiology, manifested primarily by inflammatory arthritis of the peripheral joints,usally in a symetrical distribution. Systemic manifestations include hematologic, pulmonary, neurological and cardiovascular abnormalities.
2. Juvenile Rheumatoid arthritis Juvenile arthritis (JRA) consists of several distinct syndromes. Three main subgroups have been identified: systemic-onset disease, polyarticular disease, and pauciarticular disease. In addition, ankylosing spondylosis and rheumatoid arthritis indistinguishable from adult onset disease may begin from childhood.
3. Ankylosing spondylosis Ankylosing spondylosis, a disease that has been called by many names, including rheumatoid spondylosis and Marie-Strumpell disease, is a chronic and usually progressive inflammatory disease invloving the articulations of the spine and adjacent soft tissues. The sacroiliac joints are always affected. Involvement of the hip and shoulder joints commonly occurs: peripheral joints are affected less frequently The disease predominantly affects young men and begin most often in the third decade. A high association has been found between this disorder and the histocompatibility antigen HLA-B27. The clinical features of this disease are distinctly different from those of rheumatoid arthritis. The etiology is unknown.
4. Reiters Syndrome Reiters syndrome is characterized by arthritis, urethritis, conjunctivitis, and mucocutaneous lesions. The complete syndrome may not be present at any given time. The diagnosis should be entertained when arthritis is associated with any of the other manifestations. The HLA-B27 is present in majority of the patients.
5. Osteomyelitis Osteomyelitis denotes infection of bone. While many types of microorganisms, including viruses and fungi may cause ostyeomyelitis, it is usually bacterial in origin
6. Cervical spondylosis The cervical intervertebral disks degenerate to some degree in the majority of individuals by the sixth and seventh decades of life. This results in narrowing of the disks especially in the most mobile parts of the cervical spine (fourth to fifth cervical, fifth to sixth cervical, sixth to seventh cervical and seventh cervical to first thoracic segments) and spur formation on the margins of the adjacent vertebrae. There are anterior beaking and posterior osteophytes which protude centrally with narrowing of the spinal canal or laterally so as to impinge on spinal roots in the intervertebral canal. This condition is incorrectly called hypertrophic arthritis, but there is no consistent association with arthritis of this type of joints. The more appropiate term cervical spondylosis refers to a wear and tear (traumatic) phenomenon.
7. Gout Gout is the term representing hetrogenous group of diseases found exclusively in humans which in their full d evelopment are manifested by a. an increase in serum urate cocentrations b. recurrent attacks of characterstic type of acute arthritis in which crystals of monosodium urate are demonstrable in leukocytes of synovial fluid c. aggregated deposits of monosodium urate monohydrate( tophi) chiefly in around the joints of the extremities and sometimes leading to severe crippling or deformity d. renal disease involving intestinal tissues and blood vessels and e. uric acid nephrolithiasis These may occur singly or in combination
Name:
Flurbiprofen Classification: Analgesics/Anti-inflammatory
Patent position: Major Brands ARFLUR FDC FROBEN KNOLL FLUROFEN HOECHST
Raw materials:
1.Ortho fluroaniline **
2.Methyldiethyl malonate
3.Tetrabutyl ammonium bromide
4.Methyl ethyl ketone
5.Difluronitrobenzene ** concessional duty Manufacturers: 1.Knoll Pharma - 6T 2.FDC Chemicals
Patient Information:
NSAIDs include-
Propionic acid-
Fenoprofen, Flurbiprofen, Ibuprofen, Ketoprofen, Naproxen, Naproxen Sodium, Oxaprozin Acetic acids- Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin Fenamates (anthralic acids) - Meclofenamate, Mefenamic acxid Oxicams- Piroxicam
Refer- Ibuprofen
1. NSAIDs can cause discomfort and rarely more serious side effects such as GI bleeding which may result in hospitalisation and even fatalities.
2.Avoid aspirin and alcoholic beverages while taking medication.
3. If GI upset occurs, take with food, milk or antacids. For GI upset with tolmetin, use antacids other than sodium bicarbonate.
4. Notify physician, if skin rash, itching, visual disturbances, weight gain, edema occurs
5. Mefanamic acid and metclofenate: if rash, diarrhoea, or digestive problem occr discontinue use and consult physician
6. Ibuprofen- Do not take for more than 3 days for fever or 10 days for pain. If these symptoms persists,consult a physican.
Pharmacology/ Pharmacokinetics:
Refer NSAIDs- Ibuprofen
Interaction with Food:
Not significant
Pregnancy and lactation:
Refer NSAIDs- Ibuprofen