Usage
Flurbiprofen + Phenyl Mercuric Nitrate is prescribed for the management of pain, irritation, and inflammation associated with various ocular conditions. This includes post-operative inflammation, allergic conjunctivitis, corneal injury or abrasion, and dry eye syndrome. It is also used to prevent intraoperative miosis (pupil constriction) during eye surgeries.
Its pharmacological classifications are:
- Non-steroidal anti-inflammatory drug (NSAID): Flurbiprofen
- Lubricant: Hydroxypropyl Methylcellulose (HPMC) - often included in these formulations
- Antimicrobial Preservative: Phenyl Mercuric Nitrate
The mechanism of action involves flurbiprofen inhibiting cyclooxygenase (COX) enzymes, reducing prostaglandin production, thereby decreasing inflammation and pain. HPMC lubricates the ocular surface, providing comfort and relieving dryness. Phenyl mercuric nitrate acts as a preservative, preventing microbial contamination of the eye drops.
Alternate Names
There are no widely recognized alternate names for this specific combination. However, it is crucial to differentiate between Flurbiprofen Sodium and Flurbiprofen. The combination commonly utilizes Flurbiprofen Sodium for enhanced water solubility in ophthalmic solutions.
Brand names containing this combination or similar formulations include:
- Flur Eye Drop
- Flur Ophthalmic Solution
- Flurcure Eye Drop
- Ocuflur Eye Drops
- Rayflur Eye Drop
- Proflur Eye Drops
- Flurin Eye Drops
- Lumat Eye Drop
- Ocupain
How It Works
Pharmacodynamics: Flurbiprofen, an NSAID, exerts its anti-inflammatory and analgesic effects by inhibiting COX-1 and COX-2 enzymes. This inhibition reduces the production of prostaglandins, key mediators of inflammation and pain. HPMC, a lubricating polymer, increases tear film viscosity and improves ocular surface wettability. Phenyl mercuric nitrate acts as a bactericidal and fungicidal preservative, preventing microbial growth in the ophthalmic solution.
Pharmacokinetics: Flurbiprofen, when administered as an eye drop, achieves therapeutic concentrations in ocular tissues. Systemic absorption is minimal, minimizing potential systemic side effects. HPMC is not absorbed systemically. Phenyl mercuric nitrate absorption is also minimal. Flurbiprofen is metabolized primarily in the liver and eliminated through renal excretion.
Dosage
Standard Dosage
Adults:
Instill one drop into the affected eye(s) every 6-12 hours for post-operative inflammation. For prevention of intraoperative miosis, one drop is instilled every 30 minutes starting 2 hours before surgery, with the last dose administered at least 30 minutes prior to the procedure.
Children:
Dosage should be determined by a pediatric ophthalmologist. Age restrictions apply (typically for children under 2 years old).
Special Cases:
- Elderly Patients: Use with caution due to potential age-related renal or hepatic impairment. Close monitoring is advised.
- Patients with Renal Impairment: Caution is advised, and dose adjustment based on creatinine clearance may be necessary, especially in severe impairment.
- Patients with Hepatic Dysfunction: Dosage adjustments may be required.
- Patients with Comorbid Conditions: Caution should be exercised in patients with asthma, bleeding disorders, or other NSAID hypersensitivity.
Clinical Use Cases
- Intubation/Surgical Procedures/Mechanical Ventilation/ICU Use/Emergency Situations: Dosage recommendations for these situations are not specifically defined for this combination. However, the principles of post-operative inflammation management apply.
Dosage Adjustments
Adjustments are made on a case-by-case basis depending on patient response, age, and comorbidities. Monitor renal and hepatic function in elderly patients and those with renal or hepatic impairment.
Side Effects
Common Side Effects:
Ocular burning or stinging, blurred vision, itching, eye irritation, eye redness, headache.
Rare but Serious Side Effects:
Corneal damage, allergic reactions, and systemic effects (e.g., gastrointestinal issues, renal impairment).
Contraindications
Hypersensitivity to any component of the formulation, active ocular infections, severe dry eyes or corneal abnormalities, hypersensitivity to other NSAIDs.
Drug Interactions
Other ophthalmic NSAIDs, anticoagulants, and systemic NSAIDs.
Pregnancy and Breastfeeding
Pregnancy: Use only if clearly needed, especially during the third trimester, due to potential risks to the fetus.
Breastfeeding: Limited information is available. Use with caution.
Drug Profile Summary
- Mechanism of Action: Flurbiprofen inhibits COX enzymes, reducing inflammation; phenyl mercuric nitrate acts as an antimicrobial preservative. HPMC lubricates the eye.
- Side Effects: Ocular burning/stinging, blurred vision, itching, eye irritation.
- Contraindications: Hypersensitivity, active ocular infections, severe dry eyes.
- Drug Interactions: Other ophthalmic NSAIDs, anticoagulants, systemic NSAIDs.
- Pregnancy & Breastfeeding: Use with caution; limited breastfeeding data.
- Dosage: See detailed dosage section above.
- Monitoring Parameters: Ocular health, signs of systemic side effects.
Popular Combinations
Flurbiprofen is often combined with HPMC for lubrication.
Precautions
Monitor for corneal health during prolonged use. Avoid contact of dropper tip with any surface. Caution in patients with asthma or bleeding disorders.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Flurbiprofen + Phenyl Mercuric Nitrate?
A: See detailed dosage guidelines above.
Q2: Can this medication be used during pregnancy or breastfeeding?
A: Use with caution during pregnancy, especially in the third trimester. Consult a physician before use during breastfeeding.
Q3: What are the common side effects?
A: Burning or stinging, blurred vision, itching, eye irritation.
Q4: Are there any serious side effects?
A: Rarely, corneal damage or allergic reactions can occur. Systemic effects are possible but less common.
Q5: What should I do if eye irritation persists or worsens?
A: Discontinue use and consult an ophthalmologist.
A: No, it’s generally recommended to avoid contact lenses during treatment.
Q7: Can I use other eye drops concurrently?
A: Consult your doctor before using other eye drops concurrently.
Q8: Can this medicine affect my ability to drive or operate machinery?
A: It may cause temporary blurred vision. Avoid these activities until vision clears.
Q9: What is the role of HPMC in the combination?
A: HPMC acts as a lubricant, improving comfort and reducing dryness.
