Flurbiprofen
Flurbiprofen is a topical ophthalmic non-steroidal anti-inflammatory drug (NSAID). It is primarily used to prevent intraoperative miosis during intraocular surgery (such as cataract surgery) and to manage ocular inflammation. **Clinical Pearl:** While highly effective at controlling anterior uveitis and preventing surgically induced miosis, topical NSAIDs like flurbiprofen can delay corneal epithelial healing and should be used with extreme caution in patients with existing corneal ulceration.
Mechanism: Inhibits **cyclooxygenase (COX)** enzymes, thereby blocking the synthesis of **prostaglandins** from arachidonic acid. → Reduces ocular inflammation and provides analgesic action. → Prevents prostaglandin-mediated miosis (constriction of the iris sphincter) during intraocular surgery, acting independently of cholinergic mechanisms.
Dosing by species
- Prevention of intraocular surgical miosis · 1 drop in the affected eye(s) · Topical · Every 30 minutes for 4 doses prior to surgery · Pre-operative · Standard pre-surgical protocol
- Ocular inflammation (uveitis) · 1 drop in the affected eye(s) · Topical · q6h to q12h · As directed by veterinarian · Monitor for corneal ulceration
- Prevention of intraocular surgical miosis · 1 drop in the affected eye(s) · Topical · Every 30 minutes for 4 doses prior to surgery · Pre-operative · Standard pre-surgical protocol
- Ocular inflammation (uveitis) · 1 drop in the affected eye(s) · Topical · q6h to q12h · As directed by veterinarian · Monitor for corneal ulceration
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Routes of administration
Contraindications
- Hypersensitivity to flurbiprofen or other NSAIDs
- Active corneal ulceration (relative contraindication)
- Bleeding disorders
- Hypersensitivity to NSAIDs
- Active intraocular bleeding
- Corneal ulceration (use with extreme caution)
- Epithelial herpes simplex keratitis
Adverse effects
- Transient ocular stinging or burning upon application
- Delayed corneal healing
- Increased risk of ocular bleeding during surgery
- Corneal melting (rare but severe)
- Transient stinging or burning upon instillation
- Ocular irritation
- Increased bleeding tendency of ocular tissues (rare)
Drug interactions
- Topical Corticosteroids · Concurrent use may increase the risk of delayed corneal healing and severe complications such as corneal melting. · moderate
- Topical Prostaglandin Analogues (e.g., Latanoprost) · NSAIDs may blunt the intraocular pressure-lowering efficacy of topical prostaglandins. · minor
- Topical prostaglandins (e.g., Latanoprost) · NSAIDs may decrease the intraocular pressure-lowering efficacy of topical prostaglandin analogues. · minor
Monitoring
- Resolution of ocular inflammation (flare and cells in the anterior chamber)
- Intraocular pressure (IOP)
- Corneal integrity (via fluorescein staining)
- Resolution of ocular inflammation
- Maintenance of pupillary dilation during surgery
- Corneal integrity (via fluorescein staining) if used long-term
Overdose
Topical overdose is unlikely to cause systemic toxicity due to the small volume administered. Ocular overdosage may lead to increased local irritation, hyperemia, and delayed corneal healing. If significant overexposure occurs, flush the eye with sterile saline.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.