Also indexed as: Ansaid®, Froben SR®, Froben®
(Flurbiprofen)
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May be Beneficial: Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them. |
Calcium*
Vitamin D*
|
| May be Beneficial: Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication. |
N-acetyl cysteine
|
Avoid: Reduced drug absorption/bioavailability—Avoid these supplements
when taking this medication since the supplement may decrease the absorption and/or activity
of the medication in the body. |
Food
|
|
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results. |
Lithium*
White willow*
|
| Supportive interaction |
None known
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Calcium and Vitamin D
Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In
one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but
did not alter the concentration of vitamin D.1 One controlled study showed that
flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones.2 Further research is needed
to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy
people.
Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts
to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion
of lithium from the body, resulting in higher blood levels of the mineral, though sulindac may have an opposite effect.3
Since major changes in lithium blood levels can produce unwanted side effects or interfere
with its efficacy, NSAIDs should be used with caution, and only under medical supervision, in
people taking lithium supplements.
N-acetyl cysteine
(NAC)
Nonsteroidal anti-inflammatory drugs commonly cause damage to stomach and intestinal tissue.
Though the mechanism by which NSAIDs cause this side effect is unknown, some researchers
believe that free-radical damage is involved. A test tube study showed that flurbiprofen
increases free-radical activity in stomach cells, which is blocked by the antioxidant N-acetyl
cysteine.4 Additional research is needed to determine whether people taking
flurbiprofen together with N-acetyl cysteine might experience fewer gastrointestinal side
effects.
Interactions with Herbs
White willow bark
(Salix alba)
White willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce
anti-inflammatory effects after they have been converted to salicylic acid in the body. The
administration of salicylates like aspirin to individuals taking oral NSAIDs may result in
reduced blood levels of NSAIDs.5 Though no studies have investigated interactions
between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more
information is available.
Interactions with Foods and Other Compounds
Food
Taking NSAIDs with food may reduce stomach and intestinal side effects.6 Although
taking flurbiprofen with food reduces the rate at which the drug is absorbed, it does not
reduce the total amount that is absorbed.7 Therefore, to avoid possible side
effects, people on long-term flurbiprofen therapy should take the drug with meals.
References
(To view, roll mouse over heading; to hide, click on heading)
1. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase
inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
2. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase
inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
3. Olin BR, ed. Central Nervous System Drugs, Analgesics and
Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and
Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
4. Kusuhara H, Komatsu H, Sumichika H, Sugahara K. Reactive oxygen
species are involved in the apoptosis induced by nonsteroidal anti-inflammatory drugs in
cultured gastric cells. Eur J Pharmacol 1999;383:331–7.
5. Olin BR, ed. Central Nervous System Drugs, Analgesics and
Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and
Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
6. Olin BR, et. Central Nervous System Drugs, Analgesics and
Anti-inflammatory Agents, Nonsteroidal Anti-inflammatory Agents. In Drug Facts and
Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
7. Dressman JB, Berardi RR, Elta GH, et al. Absorption of flurbiprofen in
the fed and fasted states. Pharm Res 1992;9:901–7.
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with Vitamins and Herbs
The information presented in Healthnotes is for informational purposes
only. It is based on scientific studies (human, animal, or in vitro), clinical
experience, or traditional usage as cited in each article. The results reported may not
necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over the counter medication is also available. Consult your doctor,
practitioner, and/or chemist for any health problem and before using any supplements or before
making any changes in prescribed medications. Information expires March 2007.
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