Ansaid 100mg Tablets
Overview
What is this medicine?
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and read all the information provided. You can take this medication with or without food, but if it causes stomach upset, take it with food. Always take it with a full glass of water.
Storing and Disposing of Your Medication
Keep your medication at room temperature in a dry place, avoiding storage in a bathroom. Ensure all medications are stored safely and out of reach of children and pets. When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so. Instead, consult your pharmacist for guidance on proper disposal. You may also have access to local drug take-back programs.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
Lifestyle & Tips
- Take with food, milk, or an antacid to reduce stomach upset.
- Avoid alcohol while taking this medication, as it can increase the risk of stomach bleeding.
- Do not take other NSAIDs (like ibuprofen, naproxen, or aspirin for pain) without consulting your doctor.
- Stay well-hydrated, especially if you have kidney problems or are taking diuretics.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Condition-Specific Dosing:
Pediatric Dosing
Dose Adjustments
Renal Impairment:
Hepatic Impairment:
Pharmacology
Mechanism of Action
Pharmacokinetics
Absorption:
Distribution:
Elimination:
Pharmacodynamics
Safety & Warnings
BLACK BOX WARNING
GASTROINTESTINAL RISK: NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.
Side Effects
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical attention right away:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin with or without fever, wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of bleeding: vomiting or coughing up blood, vomit that looks like coffee grounds, blood in the urine, black, red, or tarry stools, bleeding from the gums, abnormal vaginal bleeding, unexplained bruises or bruises that get bigger, or uncontrolled bleeding.
Signs of kidney problems: inability to urinate, changes in urine output, blood in the urine, or sudden weight gain.
Signs of high potassium levels: abnormal heartbeat, confusion, weakness, lightheadedness, dizziness, feeling like passing out, numbness or tingling, or shortness of breath.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Signs of a urinary tract infection (UTI): blood in the urine, burning or pain while urinating, frequent or urgent need to urinate, fever, lower abdominal pain, or pelvic pain.
Shortness of breath, sudden weight gain, or swelling in the arms or legs.
Chest pain or pressure.
Weakness on one side of the body, trouble speaking or thinking, balance problems, drooping on one side of the face, or blurred vision.
Ringing in the ears.
Depression or mood changes.
Shakiness.
Changes in vision.
Memory problems or loss.
Flu-like symptoms.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have mild ones. If you are bothered by any of the following side effects or if they do not go away, contact your doctor or seek medical attention:
Headache.
Constipation, diarrhea, stomach pain, upset stomach, or vomiting.
Heartburn.
Gas.
Dizziness, drowsiness, tiredness, or weakness.
Weight gain or loss.
Trouble sleeping.
This is not a complete list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe stomach pain, black or tarry stools, vomiting blood (signs of GI bleeding)
- Chest pain, shortness of breath, sudden weakness or numbness on one side of the body, slurred speech (signs of heart attack or stroke)
- Swelling in your hands or feet, unexplained weight gain (signs of fluid retention or kidney problems)
- Yellowing of skin or eyes, dark urine, unusual tiredness (signs of liver problems)
- Severe skin rash, blistering, or peeling
- Unusual bruising or bleeding
Before Using This Medicine
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
If you are allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
If you have ever experienced asthma triggered by a salicylate medication, such as aspirin, or an NSAID.
If you have a history of gastrointestinal (GI) bleeding or kidney problems.
If you have heart failure (a weak heart) or have recently had a heart attack.
If you are currently taking another NSAID, a salicylate drug like aspirin, or pemetrexed.
If you are having difficulty getting pregnant or are undergoing fertility testing.
If you are pregnant, plan to become pregnant, or become pregnant while taking this medication. It is crucial to note that this medication may harm an unborn baby if taken after 20 weeks of pregnancy. If you are between 20 and 30 weeks pregnant, only take this medication if your doctor has instructed you to do so. Do not take this medication if you are more than 30 weeks pregnant.
To ensure your safety, it is vital to inform your doctor and pharmacist about all the medications you are taking, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you have. This will help you verify that it is safe to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
If you are taking this drug for an extended period, your doctor may recommend regular blood tests to monitor your condition. Be sure to discuss any concerns or questions with your doctor.
Drugs like this one can cause high blood pressure. Follow your doctor's instructions for checking your blood pressure regularly.
Before consuming alcohol, consult with your doctor to discuss any potential risks or interactions.
If you smoke, talk to your doctor about the potential risks and how to manage them.
Dosage and Administration
Do not exceed the dosage prescribed by your doctor, as taking more than recommended may increase your risk of severe side effects. Additionally, do not take this medication for longer than your doctor has instructed.
Special Precautions
If you have asthma, consult with your doctor, as you may be more sensitive to this medication.
Be cautious when taking this medication, as it may increase your risk of bleeding. To minimize this risk, use a soft toothbrush and an electric razor, and avoid injuries.
Cardiovascular Risks
The use of drugs like this one may increase the risk of heart failure. If you already have heart failure, your risk of heart attack, hospitalization for heart failure, and death may be higher. Discuss these risks with your doctor.
In people who have had a recent heart attack, the use of drugs like this one may increase the risk of heart attack and heart-related death. Additionally, people taking this medication after a first heart attack may be more likely to die within the year following the heart attack compared to those not taking this medication. Talk to your doctor about these risks.
If you are taking aspirin to prevent a heart attack, consult with your doctor to discuss any potential interactions.
Liver Problems
Drugs like this one can cause liver problems, which can be life-threatening. If you experience any symptoms of liver problems, such as dark urine, fatigue, decreased appetite, stomach pain, light-colored stools, vomiting, or yellow skin or eyes, contact your doctor immediately.
Severe Skin Reactions
This medication can cause severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. These reactions can be life-threatening and may affect other organs. If you experience any symptoms, such as red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands, seek medical help immediately.
Age-Related Risks
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.
Reproductive and Breastfeeding Considerations
NSAIDs like this medication may affect ovulation, which can impact fertility. However, this effect is reversible when the medication is stopped. Discuss any concerns with your doctor.
If you are breastfeeding, inform your doctor, as you will need to discuss any potential risks to your baby.
Overdose Information
Overdose Symptoms:
- Drowsiness
- Nausea
- Vomiting
- Epigastric pain
- Lethargy
- Acute renal failure (rare)
- Respiratory depression (rare)
- Coma (rare)
What to Do:
Seek immediate medical attention. Call 911 or your local poison control center (e.g., 1-800-222-1222 in the US). Treatment is generally supportive; gastric lavage or activated charcoal may be considered if ingestion is recent.
Drug Interactions
Contraindicated Interactions
- Coronary Artery Bypass Graft (CABG) surgery (peri-operative pain)
Major Interactions
- Anticoagulants (e.g., Warfarin): Increased risk of bleeding.
- Antiplatelet agents (e.g., Aspirin, Clopidogrel): Increased risk of bleeding.
- Other NSAIDs (including COX-2 inhibitors): Increased risk of GI adverse events.
- Corticosteroids: Increased risk of GI ulceration and bleeding.
- Lithium: Increased lithium plasma concentrations and toxicity.
- Methotrexate: Increased methotrexate plasma concentrations and toxicity.
- Cyclosporine: Increased nephrotoxicity.
- Tacrolimus: Increased nephrotoxicity.
- Diuretics (e.g., Furosemide, Thiazides): Reduced natriuretic and diuretic effects, increased risk of renal impairment.
- ACE Inhibitors/ARBs: Reduced antihypertensive effect, increased risk of renal impairment.
- SSRIs/SNRIs: Increased risk of GI bleeding.
Moderate Interactions
- Beta-blockers: Reduced antihypertensive effect.
- Digoxin: Increased digoxin plasma concentrations.
- Phenytoin: Increased phenytoin plasma concentrations.
- Sulfonylureas: Potentiation of hypoglycemic effect.
Monitoring
Baseline Monitoring
Rationale: To establish baseline and monitor for anemia or other hematologic abnormalities.
Timing: Prior to initiation of long-term therapy
Rationale: To establish baseline and monitor for drug-induced liver injury.
Timing: Prior to initiation of long-term therapy
Rationale: To establish baseline and monitor for drug-induced renal impairment.
Timing: Prior to initiation of long-term therapy
Rationale: To establish baseline and monitor for hypertension, as NSAIDs can elevate BP.
Timing: Prior to initiation
Routine Monitoring
Frequency: Periodically (e.g., annually or more frequently with long-term use or risk factors)
Target: Within normal limits
Action Threshold: Significant decrease in hemoglobin/hematocrit, or other abnormalities requiring investigation.
Frequency: Periodically (e.g., annually or more frequently with long-term use or risk factors)
Target: Within normal limits
Action Threshold: Significant elevation of transaminases (e.g., >3x ULN) or other signs of liver injury.
Frequency: Periodically (e.g., annually or more frequently with long-term use, elderly, or risk factors for renal impairment)
Target: Within normal limits
Action Threshold: Significant increase in BUN/creatinine, or decrease in estimated GFR.
Frequency: Regularly (e.g., at each visit, or as clinically indicated)
Target: Individualized, typically <130/80 mmHg
Action Threshold: Sustained elevation requiring intervention or adjustment of antihypertensive therapy.
Symptom Monitoring
- Signs of gastrointestinal bleeding (e.g., black, tarry stools; coffee-ground vomit; severe abdominal pain)
- Signs of cardiovascular events (e.g., chest pain, shortness of breath, weakness on one side of the body, slurred speech)
- Signs of renal impairment (e.g., decreased urine output, swelling in ankles/feet)
- Signs of liver injury (e.g., fatigue, nausea, dark urine, jaundice, right upper quadrant pain)
- Skin rash or blistering
- Unexplained weight gain or edema
- Vision changes (rare, but reported with NSAIDs)
Special Patient Groups
Pregnancy
Avoid use in the third trimester due to the risk of premature closure of the fetal ductus arteriosus and persistent pulmonary hypertension. Use in the first and second trimesters only if the potential benefit justifies the potential risk to the fetus.
Trimester-Specific Risks:
Lactation
Excreted in breast milk in small amounts. Use with caution. Monitor infant for adverse effects (e.g., irritability, poor feeding). Consider alternative agents, especially for long-term use.
Pediatric Use
Safety and effectiveness have not been established for systemic use in pediatric patients. Not recommended.
Geriatric Use
Elderly patients are at increased risk for serious adverse reactions, particularly gastrointestinal bleeding and perforation, and renal impairment. Use the lowest effective dose for the shortest duration possible. Monitor closely for adverse effects.
Clinical Information
Clinical Pearls
- Flurbiprofen is a potent NSAID, often used when other NSAIDs have been ineffective or for specific inflammatory conditions.
- Always advise patients to take with food, milk, or antacids to minimize GI upset.
- Educate patients on the signs and symptoms of serious cardiovascular and gastrointestinal adverse events, and when to seek immediate medical attention.
- Due to its non-selective COX inhibition, it carries the typical NSAID risks for GI, renal, and cardiovascular systems.
- Ansaid (brand name) has been discontinued in many markets, but generic flurbiprofen is available.
Alternative Therapies
- Other NSAIDs (e.g., Ibuprofen, Naproxen, Diclofenac, Celecoxib)
- Acetaminophen (for pain and fever, no anti-inflammatory effect)
- Corticosteroids (for severe inflammation, different mechanism and side effect profile)
- Disease-modifying antirheumatic drugs (DMARDs) for chronic inflammatory conditions like rheumatoid arthritis (e.g., Methotrexate, Hydroxychloroquine)