Flurbiprofen

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Also indexed as:

Ansaid

Flurbiprofen is used to treat pain caused by rheumatoid arthritis and osteoarthritis, and is in a family of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).

Herbs

Summary of Interactions for Flurbiprofen

Depletion or interference	Calcium* Vitamin D*
Adverse interaction	Lithium* White willow*
Side effect reduction/prevention	N-acetyl cysteine
Supportive interaction	None known
Reduced drug absorption/bioavailability	Food

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements

Calcium and Vitamin D

Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but did not alter the concentration of vitamin D.¹ One controlled study showed that flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones.² Further research is needed to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy people.

Lithium

Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion of lithium from the body, resulting in higher blood levels of the mineral, though sulindac may have an opposite effect.³ Since major changes in lithium blood levels can produce unwanted side effects or interfere with its efficacy, NSAIDs should be used with caution, and only under medical supervision, in people taking lithium supplements.

N-acetyl cysteine (NAC)

Nonsteroidal anti-inflammatory drugs commonly cause damage to stomach and intestinal tissue. Though the mechanism by which NSAIDs cause this side effect is unknown, some researchers believe that free-radical damage is involved. A test tube study showed that flurbiprofen increases free-radical activity in stomach cells, which is blocked by the antioxidant N-acetyl cysteine.⁴ Additional research is needed to determine whether people taking flurbiprofen together with N-acetyl cysteine might experience fewer gastrointestinal side effects.

Interactions with Herbs

White willow bark (Salix alba)

White willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs.⁵ Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.

Other Interactions

Food

Taking NSAIDs with food may reduce stomach and intestinal side effects.⁶ Although taking flurbiprofen with food reduces the rate at which the drug is absorbed, it does not reduce the total amount that is absorbed.⁷ Therefore, to avoid possible side effects, people on long-term flurbiprofen therapy should take the drug with meals.

References

1. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
2. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
3. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172-90.
4. Kusuhara H, Komatsu H, Sumichika H, Sugahara K. Reactive oxygen species are involved in the apoptosis induced by nonsteroidal anti-inflammatory drugs in cultured gastric cells. Eur J Pharmacol 1999;383:331-7.
5. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172-90.
6. Olin BR, et. Central Nervous System Drugs, Analgesics and Anti-inflammatory Agents, Nonsteroidal Anti-inflammatory Agents. In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172-90.
7. Dressman JB, Berardi RR, Elta GH, et al. Absorption of flurbiprofen in the fed and fasted states. Pharm Res 1992;9:901-7.

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Last Review: 01-21-2009

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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires February 2010.

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