Esflurbiprofen Patch Indications
Primary Indication
Esflurbiprofen patches are indicated for the topical treatment of osteoarthritis (OA), particularly for knee OA and other musculoskeletal pain conditions. 1, 2
Specific Approved Uses
Osteoarthritis Treatment
- Knee osteoarthritis is the primary and most extensively studied indication, with phase III trials demonstrating superior efficacy compared to flurbiprofen patches 2
- Other joint sites including lumbar spine, cervical spine, and additional musculoskeletal locations have shown clinical benefit in long-term safety studies 3
- The patch provides localized pain relief through high synovial tissue and fluid penetration—achieving 14.8-fold higher synovial tissue and 32.7-fold higher synovial fluid concentrations compared to standard flurbiprofen patches 4
Postoperative Pain Management
- Multimodal analgesia after total knee arthroplasty (TKA) represents an effective use, with esflurbiprofen patches reducing pain scores on postoperative days 1 and 3 and improving knee flexion angles 5
- When combined with oral analgesics and local periarticular injections, the patch enhances pain control without increasing systemic adverse events 5
Clinical Context and Positioning
Role in Treatment Algorithm
- Esflurbiprofen patches serve as an alternative to oral NSAIDs for patients requiring localized anti-inflammatory therapy 6
- Topical NSAIDs, including esflurbiprofen patches, are strongly recommended for older adults (>75 years) with symptomatic joints, offering superior safety profiles compared to oral NSAIDs 6
- The patch provides an option for patients with gastrointestinal, cardiovascular, or renal contraindications to systemic NSAIDs 6
Dosing Parameters
- Standard dosing: 40 mg/day (one patch) for single-site application 3
- Maximum dosing: 80 mg/day (two patches) for multiple sites or more severe symptoms 3
- Treatment duration can extend to 52 weeks with acceptable safety profiles, though most dermatologic adverse events occur at application sites (46.8% incidence, predominantly mild) 3
Important Safety Considerations
Advantages Over Oral NSAIDs
- Dramatically lower systemic exposure compared to oral formulations, with sustained plasma concentrations and high percutaneous absorption (51.4-72.2%) 4
- Minimal gastrointestinal and renal adverse events in long-term studies 3
- No photosensitive dermatitis observed in 52-week safety trials 3
Common Pitfalls
- Application site dermatitis is the most frequent adverse event (46.8% of sites), though only 4.3% of patients discontinue treatment due to skin reactions 1, 3
- Systemic adverse events remain possible but occur in only 9.0% of patients during long-term use 3
Note: The FDA label reference 7 describes flurbiprofen sodium ophthalmic solution for intraoperative miosis inhibition, which is unrelated to esflurbiprofen patches for musculoskeletal conditions.