Flarin

PATIENT INFORMATION SHEET 

Inflammation has long been associated with the development of cancer symptoms such as pain and swelling (Grivennikov, Sergei I. et al, 2010).  In certain tumours, mediators produced as part of the inflammatory response, facilitate blood supply and promote the growth and spread of tumour cells. Research suggests that using anti-inflammatories we can make an intervention against cancer development, in those cancers associated with  inflammation.  

Targeting drugs to cancer cells using lipid formulations is thought to increase anti-cancer efficacy substantially (Kumar and Divya, 2015). The use of targeted anti-inflammatories is likely to deal with inflammation associated symptoms such as pain and swelling and may be an intervention against cancer development.  

Version 1.1 (July 2017) 

FLARIN 

This information is about a novel lipid formulation of an anti-inflammatory medication (ibuprofen) belonging to a group called non-steroidal anti inflammatory drugs (NSAID).  NSAIDs are particularly helpful for relieving muscular and bone pain whilst additionally easing swelling and fevers.   

This information should be read with the information leaflet contained in the box. You will see your doctor regularly during your treatment so they can monitor your progress and manage any side effects experienced. 

Flarin has been developed to enhance the efficacy of ibuprofen and a clinical trial has been conducted which confirms this in an inflammatory condition (flaring osteoarthritis), not related to cancer. The results of this study have been published by Bierma-Zeinstra et al, 2017 (see References).  

ANTI-INFLAMMATORY ACTION 

Ibuprofen works by blocking the actions of substances in the body which are involved in the production of chemicals that respond during injury and disease. Following injury or disease, Cyclooxygenase (COX) is the substance which produces prostaglandins which causes the pain, swelling and inflammation we experience. NSAIDs block the production of prostaglandins and reduce these effects. If considered suitable following your consultation, Ibuprofen can be given as part of your treatment. By means of administering a regular dose of oral Ibuprofen we can relieve the effects experienced due to the inflammatory response associated with cancer, such as fluid accumulation and ongoing pain. 

When ibuprofen is exposed to cells at higher concentrations than normal it can interact with additional anti-inflammatory targets such as PPAR alpha and gamma (Lehmann et al., 1997).  Flarin may permit interaction with these additional targets and assist with the ability to treat cancer related symptoms (pain and swelling), and potentially treat the development of cancer.  

WHEN DO I TAKE IT? 

Ibuprofen is an oral medication taken 3 times a day with a 6 hourly gap between doses (can be taken four times a day in 24hrs). You will need to take ibuprofen on a long term basis and Ibuprofen is best taken with food or milk. Your doctors will discuss dosages and length of treatment appropriate for you. Ibuprofen can safely be taken as a long term treatment or as long as it is controlling your cancer symptoms. 

SIDE EFFECTS 

Each person reacts differently to medications, and a large proportion of patients have no side effects whatsoever. Here is an outline of the most common side effects comprehensive list, including the more rare side effects will be supplied with your medications every time the drug is supplied. Your doctor may prescribe concurrent medications to counteract any side effects if required. 

Nausea (feeling sick)            

Vomiting (being sick)        

Diarrhoea       

Abdominal pain      

Indigestion  

THINGS TO REMEMBER 

 Ibuprofen may interact with other medications; ensure you inform your doctor of all the medications you are taking including complimentary therapies, vitamins and herbal drugs.

  Store at room temperature and keep out of the reach of children. 

 Do not exceed the stated dose within a 24hr period. 

 If you accidently take too many tablets contact your doctor for advice or attend your nearest accident and emergency department. 

 If you stop taking your medications do not throw them away, return unused medications to the clinic or your pharmacy. 

REFERENCES 

Bierma-Zeinstra et al. (2017) A new lipid formulation of low dose (1200 mg) ibuprofen is non-inferior to high dose (2400 mg) standard ibuprofen capsules in managing episodic knee pain flares.  Osteoarthritis and Cartilage, Volume 25 , S439 - S440 

British Medical Association and the Royal Pharmaceutical Society of Great Britain (2013) British National Formulary, BMJ Publishing Group, 66th Edition, pp 681. 

Harris et al. (2005) Aspirin, ibuprofen, and other non-steroidal antiinflammatory drugs in cancer prevention: A critical review of non-selective COX-2 blockade. (Review) Oncology Reports, 13(4), pp 559 – 583. 

 Kumar and Divya, (2015) Nanoemulsion Based Targeting in Cancer Therapeutics. Med Chem 2015, 5:6 

Lehmann et al., (1997) Peroxisome proliferator-activated receptors alpha and gamma are activated by indomethacin and other non-steroidal antiinflammatory drugs. J Biol Chem. 1997 Feb 7; 272(6):3406-10 

Grivennikov, Sergei I. et al. (2010) Immunity, Inflammation, and Cancer Cell. 2010, March 19 140 , (6) , 883 - 899