Side Effects of Ansaid (flurbiprofen)

Ansaid (flurbiprofen) is a nonsteroidal anti-inflammatory drug (NSAID) used to treat fever, inflammation, and pain caused by rheumatoid arthritis, osteoarthritis, and soft tissue injuries such as tendinitis and bursitis.

NSAIDs reduce pain, fever, and inflammation by blocking the enzyme that produces prostaglandins. As a result, Ansaid lowers prostaglandin levels, providing relief from these symptoms. The brand name Ansaid has been discontinued, but generic versions are available.

Common side effects of Ansaid include:

• stomach ulcerations,
• abdominal burning,
• pain,
• cramping,
• indigestion,
• constipation,
• headache,
• nervousness,
• drowsiness,
• water retention,
• sensitivity to sunlight,
• nausea, and
• gastritis.

Serious side effects of Ansaid include:

• serious gastrointestinal bleeding,
• liver toxicity,
• rash,
• ringing in the ears,
• lightheadedness,
• rare but severe allergic reactions,
• aggravation of peptic ulcer disease or poor kidney function,
• heart attack,
• stroke,
• accumulation of fluid,
• worsening heart failure, and
• causing or worsening high blood pressure (hypertension) and kidney failure.

Drug interactions of Ansaid include blood thinners such as warfarin, because of the increased risk of bleeding.

• Patients taking lithium can develop toxic blood levels because Ansaid may inhibit lithium elimination by the kidney.
• Side effects from methotrexate and cyclosporine may also be increased by Ansaid.
• Ansaid may reduce the effectiveness of medications used to treat high blood pressure.
• NSAIDs may diminish the blood pressure-lowering effects of angiotensin converting enzyme (ACE) inhibitors.
• Combining NSAIDs with angiotensin receptor blockers or ACE inhibitors in elderly patients, those on diuretic therapy, or with poor kidney function may result in reduced kidney function, including kidney failure.
• Persons who have more than three alcoholic beverages per day are at increased risk of developing stomach ulcers when taking Ansaid or other NSAIDs.

Ansaid should generally be avoided during pregnancy and is excreted in breast milk. Nursing mothers should decide whether to stop breastfeeding or stop taking Ansaid to avoid adverse effects in the infant.

What are the important side effects of Ansaid (flurbiprofen)?

Most patients benefit from flurbiprofen and other NSAIDs with few side effects. However, serious side effects can occur and tend to be dose related. Therefore, using the lowest effective dose is advisable to minimize side effects. The most common side effects of flurbiprofen involve the gastrointestinal system:

• Ulcerations
• Abdominal burning
• Pain
• Cramping
• Indigestion
• Constipation
• Headache
• Nervousness
• Drowsiness
• Water retention
• Sensitivity to sunlight
• Nausea
• Gastritis
• Serious gastrointestinal bleeding
• Liver toxicity

Sometimes, stomach ulceration and bleeding can occur without abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding.

Other important side effects include:

• Rash
• Kidney impairment
• Liver impairment
• Allergic reactions
• Ringing in the ears
• Lightheadedness

Flurbiprofen should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals.

It should also be avoided by patients with peptic ulcer disease or poor kidney function, as it can aggravate both conditions.

Like other NSAIDs, flurbiprofen may cause heart attacks, strokes, fluid accumulation, worsening heart failure, and hypertension and kidney failure.

Ansaid (flurbiprofen) side effects list for healthcare professionals

TABLE 2: Reported adverse events in patients receiving ANSAID (flurbiprofen) or other NSAIDs

What drugs interact with Ansaid (flurbiprofen)?

ACE-inhibitors

• Reports suggest that nonsteroidal anti-inflammatory drugs may diminish the antihypertensive effect of ACE-inhibitors.
• This interaction should be considered in patients taking nonsteroidal anti-inflammatory drugs along with ACE-inhibitors.

Anticoagulants

• The effects of warfarin and NSAIDs on GI bleeding are synergistic, increasing the risk of serious GI bleeding when both drugs are used together.
• Physicians should exercise caution when administering ANSAID (flurbiprofen) to patients taking warfarin or other anticoagulants.

Aspirin

• Concurrent administration of aspirin lowers serum flurbiprofen concentrations.
• The clinical significance of this interaction is not known; however, concomitant use of flurbiprofen and aspirin is generally not recommended due to the potential for increased adverse effects.

Beta-adrenergic blocking agents

• Flurbiprofen attenuated the hypotensive effect of propranolol but not atenolol.
• The mechanism underlying this interference is unknown.
• Patients taking both flurbiprofen and a beta-blocker should be monitored to ensure that a satisfactory hypotensive effect is achieved.

Diuretics

• Clinical studies and postmarketing observations have shown that ANSAID (flurbiprofen) can reduce the natriuretic effect of furosemide and thiazides in some patients.
• This response has been attributed to inhibition of renal prostaglandin synthesis.
• During concomitant therapy with NSAIDs, the patient should be closely observed for signs of renal failure and diuretic efficacy.

Lithium

• NSAIDs have been shown to increase plasma lithium levels and reduce renal lithium clearance.
• The mean minimum lithium concentration increased 15%, and renal clearance was decreased by approximately 20%.
• These effects are attributed to inhibition of renal prostaglandin synthesis by the NSAID.
• Therefore, when NSAIDs and lithium are administered concurrently, subjects should be closely monitored for signs of lithium toxicity.

Methotrexate

• NSAIDs have been reported to competitively inhibit methotrexate accumulation in rabbit kidney slices, suggesting that they could enhance the toxicity of methotrexate.
• Caution should be used when NSAIDs are administered concomitantly with methotrexate.

Summary

Ansaid (flurbiprofen) is an effective NSAID used to treat fever, inflammation, and pain caused by rheumatoid arthritis, osteoarthritis, and soft tissue injuries. Common side effects of Ansaid include stomach ulcerations, abdominal burning, pain, cramping, indigestion, constipation, headache, nervousness, drowsiness, water retention, sensitivity to sunlight, nausea, and gastritis. Ansaid should generally be avoided during pregnancy and while breastfeeding to prevent adverse effects in the infant.