Usage
- Felbinac is prescribed for the relief of pain and inflammation associated with musculoskeletal conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, sprains, strains, and other soft tissue injuries.
- Pharmacological Classification: Non-steroidal anti-inflammatory drug (NSAID) for topical use.
- Mechanism of Action: Felbinac acts by inhibiting the cyclooxygenase (COX) enzymes, primarily COX-1 and COX-2. These enzymes are responsible for producing prostaglandins, which are chemical messengers that mediate pain and inflammation. By inhibiting COX enzymes, felbinac reduces the production of prostaglandins, thus alleviating pain and inflammation.
Alternate Names
- Traxam® (discontinued in some regions).
- Other brand names: Nabolin® Felbinac 70 (in Japan), Fumac Gel, Felbimax Gel.
How It Works
- Pharmacodynamics: Felbinac primarily exerts its effects locally at the site of application. It inhibits COX enzymes, reducing prostaglandin synthesis and consequently decreasing pain and inflammation. Its antioxidant properties may also contribute to its therapeutic effects.
- Pharmacokinetics:
- Absorption: When applied topically, felbinac is absorbed through the skin, achieving low systemic concentrations, minimizing the risk of systemic side effects.
- Distribution: Felbinac preferentially distributes to inflamed tissues. Peak plasma concentrations are reached 12-24 hours after topical application.
- Metabolism: Felbinac is metabolized primarily in the liver.
- Elimination: Felbinac and its metabolites are primarily eliminated through the kidneys (renal excretion). Some hepatic excretion may also occur.
Dosage
Standard Dosage
Adults:
- Apply approximately 1 inch (2.5 cm) of gel or a golf ball-sized amount of foam to the affected area 2-4 times daily.
- Maximum daily dose: 25 grams, regardless of the number of affected areas.
- Reassess treatment after 14 days.
Children:
- Not recommended for children under 15 years of age (under 18 in some regions).
Special Cases:
- Elderly Patients: Use with caution due to increased susceptibility to adverse effects. The lowest effective dose should be used. Regular monitoring is recommended.
- Patients with Renal Impairment: Use with caution. Dose adjustment might be necessary. Monitor renal function.
- Patients with Hepatic Dysfunction: Use with caution. Dose adjustment might be necessary. Monitor liver function.
- Patients with Comorbid Conditions: Use with caution in patients with a history of peptic ulcer, asthma, or other allergic disorders. Monitor for adverse events.
Clinical Use Cases
Felbinac is primarily indicated for topical use and is not generally used in clinical settings like intubation, surgical procedures, mechanical ventilation, or emergency situations. Its use is limited to the management of musculoskeletal pain and inflammation.
Dosage Adjustments
Dose adjustments may be required in elderly patients, those with renal or hepatic impairment, or those with specific comorbidities. Always follow medical advice for appropriate dosage adjustments.
Side Effects
Common Side Effects
- Local skin reactions: Redness, itching, burning sensation, rash, dryness, irritation at the application site.
Rare but Serious Side Effects
- Allergic reactions: Swelling, hives, difficulty breathing (anaphylaxis).
- Systemic effects (rare with topical use): Asthma exacerbation, renal disease.
Long-Term Effects
- Potential for skin photosensitivity with prolonged use. Avoid excessive sun exposure to treated areas.
- Risk of gastrointestinal issues with prolonged high-dose use, although this is rare with topical application.
Adverse Drug Reactions (ADR)
- Anaphylactoid reactions (rare).
- Severe skin reactions (e.g., epidermal necrolysis, erythema multiforme) are rare.
Contraindications
- Hypersensitivity to felbinac or other NSAIDs (including aspirin).
- History of asthma, urticaria, or acute rhinitis precipitated by aspirin or other NSAIDs.
- Open wounds or damaged skin.
- Pregnancy (especially the third trimester).
Drug Interactions
- Increased incidence of adverse reactions with concomitant use of aspirin or other NSAIDs (both topical and systemic).
- Potential interactions with anticoagulants (increased bleeding risk), corticosteroids (increased gastrointestinal side effects), and some antihypertensives (reduced antihypertensive effect).
Pregnancy and Breastfeeding
- Pregnancy: Felbinac is contraindicated during pregnancy, especially in the third trimester, due to potential fetal risks.
- Breastfeeding: Felbinac should be used with caution during breastfeeding, as it is unknown if it is excreted in breast milk.
Drug Profile Summary
- Mechanism of Action: Inhibits COX-1 and COX-2 enzymes, reducing prostaglandin synthesis.
- Side Effects: Primarily local skin reactions. Rarely, allergic reactions or systemic effects.
- Contraindications: Hypersensitivity to NSAIDs, pregnancy (especially the third trimester), open wounds.
- Drug Interactions: Other NSAIDs, anticoagulants, corticosteroids, some antihypertensives.
- Pregnancy & Breastfeeding: Contraindicated in pregnancy, use with caution during breastfeeding.
- Dosage: Apply topically 2-4 times daily. Maximum 25g/day.
- Monitoring Parameters: Monitor for local skin reactions, allergic reactions, and any systemic effects. Monitor renal and hepatic function in patients at risk.
Popular Combinations
- Felbinac is typically used as a single agent.
- Concomitant use with other topical therapies to the same site is generally avoided.
Precautions
- Avoid application to broken skin, eyes, mucous membranes.
- Do not use with occlusive dressings unless directed by a physician.
- Avoid excessive sun exposure to treated areas.
- Use with caution in patients with renal, cardiac, or hepatic impairment.
- Use the lowest effective dose for the shortest duration necessary.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Felbinac?
A: For adults, apply approximately 1 inch (2.5 cm) of gel or a golf ball-sized amount of foam to the affected area 2-4 times daily. The maximum daily dose is 25g. Not recommended for children under 15 (under 18 in some regions).
Q2: What are the common side effects of Felbinac?
A: Common side effects include local skin reactions like redness, itching, burning, and rash at the application site.
Q3: Is Felbinac safe to use during pregnancy or breastfeeding?
A: Felbinac is contraindicated during pregnancy, especially the third trimester. Use with caution while breastfeeding, as it is unknown if it is excreted in breast milk.
Q4: What should I do if I experience a skin reaction to Felbinac?
A: Discontinue use immediately and consult a doctor.
Q5: Can I use Felbinac with other pain relievers?
A: Consult a doctor before using Felbinac with other NSAIDs (including aspirin, ibuprofen), as this can increase the risk of side effects.
Q6: How long can I use Felbinac?
A: Reassess treatment after 14 days. Consult a doctor if symptoms persist or worsen.
Q7: Can I apply Felbinac to open wounds or broken skin?
A: No. Felbinac should only be applied to intact skin.
Q8: Can I use Felbinac if I am allergic to aspirin?
A: No. Felbinac is contraindicated in individuals with a known hypersensitivity to aspirin or other NSAIDs.
Q9: Can Felbinac be used for acute pain?
A: Yes, it is used for relief of acute pain from muscle injuries, strains, sprains, and other similar conditions.
Q10: Is Felbinac a steroid?
A: No. Felbinac is a non-steroidal anti-inflammatory drug (NSAID).
