Interactions : אינטראקציות

4.5    Interaction with other medicinal products and other forms of interaction



Flurbiprofen should be avoided in combination with:
Other NSAIDS including       Avoid concomitant use of two or more NSAIDs as this may increase cyclooxygenase-2             the risk of adverse effects (esp. gastrointestinal adverse events such selective inhibitors:        as ulcers and bleeding), (see section 4.4).
Acetylsalicylic acid (low    Unless low-dose aspirin (not above 75mg daily) has been advised by dose)                        a doctor, as this may increase the risk of adverse reactions (see section 4.4).
Flurbiprofen should be used with caution in combination with:
Anticoagulants:              NSAIDs may enhance the effects of anti-coagulants, such as warfarin (see section 4.4).
Anti-platelet Agents         Increased risk of gastrointestinal ulceration or bleeding (see section 4.4).
Antihypertensive drugs       NSAIDs may reduce the effect of diuretics and other (Diuretics, ACE              antihypertensive drugs may enhance nephrotoxicity caused by inhibitors, angiotensin-     inhibition of cyclooxygenase, especially in patients with II-antagonists):             compromised renal function (Patients should be adequately hydrated)
Alcohol                      May increase the risk of adverse reactions, especially of bleeding in the gastrointestinal tract
Cardiac glycosides:          NSAIDs may exacerbate cardiac failure, reduce GFR and increase plasma glycoside levels - adequate control and, if necessary, dose adjustment is recommended
Ciclosporin:                 Increased risk of nephrotoxicity.
Corticosteroids:             May increase the risk of adverse reactions, especially of the gastrointestinal tract (see section 4.3)
Lithium:                     May increase serum levels of lithium – adequate control and, if necessary, dose adjustment is recommended


Methotrexate:                   The administration of NSAIDs within 24 hours before or after administration of methotrexate may lead to elevated concentrations of methotrexate and an increase in its toxic effect.
Mifepristone:                   NSAIDs should not be used for 8 – 12 days after mifepristone administration as NSAIDs can reduce the effect of mifepristone.
Oral antidiabetics              Alteration of blood glucose levels reported (increased check rate recommended)
Phenytoin                       May increase serum levels of phenytoin – adequate control and, if necessary, dose adjustment is recommended
Potassium sparing               Concomitant use may cause hyperkalaemia diuretics
Probenecid                      Medicinal products that contain probenecid or sulfinpyrazone may Sulfinpyrazone                  delay the excretion of flurbiprofen.
Quinolone antibiotics           Animal data indicate that NSAIDs can increase the risk of convulsions associated with quinolone antibiotics. Patients taking
NSAIDs and quinolones may have an increased risk of developing convulsions.
Selective serotonin             Increased risk of gastrointestinal ulceration or bleeding (see section reuptake inhibitors             4.4).
(SSRI's)
Tacrolimus:                     Possible increased risk of nephrotoxicity when NSAIDs are given with tacrolimus.
Zidovudine:                     Increased risk of haematological toxicity when NSAIDs are given with zidovudine.


No studies so far have revealed any interactions between flurbiprofen and tolbutamide or antacids.