This post won’t be a typical review as this time I am looking at Flarin medication, a ‘new, lipid formulation of ibuprofen’. Ibuprofen is a very common drug available in pharmacies which is used for pain and inflammation.
A review of medication would not make any sense as 1 man study is no study at all. Although I work as healthcare processional in my daily job, this post does not make any health recommendations or claims.
What brought my attention to Flarin is the price of this products, which stands almost at £10 per box of 30 soft capsules. In comparison you can buy ibuprofen 200mg (active ingredient of Flarin) tablets in Tesco for £1.70 (box of 96 tablets). This is enormous price difference. Personally I wanted to know if there is justification in recommending Flarin to patients instead of ‘generic’ ibuprofen.
Flarin review: what is Flarin?
Flarin is a branded product containing ibuprofen 200 mg per soft capsule. Ibuprofen belongs to a group of drugs called Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are used in management of pain, and fever and to decrease inflammation.
Flarin (Ibuproen 200mg) medication is advertised as:
- joint pain relief as effective as prescription only ibuprofen
- product with unique lipid formulation which provides powerful relief from flaring joint and inflammation at the same time shielding the stomach from damage
The high price for Flarin soft capsules comes partly from the fact that company that makes Flarin did clinical trial (FLARE) before launching of this product. The results of this study is available to read in OARSI journal.
Flarin review of clinical trial information
This trial involved 462 patients with knee pain who randomly took different doses of ibuprofen over 5 days to compare efficacy, safety and tolerability between daily dose of lipid 1200mg ibuprofen (Flarin), soft-gel capsule with daily dose of ibuprofen at 1200mg and soft gel capsule with daily dose of 2400mg of ibuprofen (prescription strength).
Improvements in pain control were seen across all 3 groups of patients with ibuprofen 1200mg / day in lipid formulation (Flarin) as being non-inferior (better) to daily dosages of soft-gel capsules (1200mg and 2400mg) resulting in similar pain reduction at the end of the 5 day trial as scored by all patients.
This allows Infirst Healthcare to say that Flarin it ‘as effective as a prescription ibuprofen at reducing join pain’.
There was a minimal difference in terms of the effect on patient’s swelling between lipid formulation of ibuprofen 1200mg (Flarin) and sof-gel capsule 1200mg, but closer to soft-gel capsule 2400 mg group , recommending further investigation.
Second advertised advantage of unique formulation which shield stomach from damage lacks of reference for the statement, with actual reference being specified as ‘Infirst Healthcare, data on file 2018’. This is disappointing. One of the most common side effects for ibuprofen is to cause gastro-intestinal (GI) side effects. This was seen in FLARE trial with patients reporting GI side effects as follow:
- 26.4% in the lipid 1200 mg group (Flarin),
- 30.3% in the soft-gel 1200 mg group, and
- 33.3% in the soft-gel 2400 mg group
It is said that same unique formulation provides for powerful relief from pain. In the actual discussion of the publication, a hypothesis, is put forward explaining how possibly new lipid formulation has ‘more enhanced efficacy’ in reducing pain than soft-gel capsule 1200mg (again results showed non-inferiority between all formulations). The mechanism of action of new lipid formulation is not fully understood, but it is though that it targets ‘the lymphatic part of the immune system’ which is more advantageous as compared to other oral formulations. This is however hypothesis and it is suggested that further research is needed to investigate it.
Overall, FLARE trial is a small study involving just 462 patients. It showed that new lipid formulation is not better than other formulations in pain and swelling reduction. A further research is needed to investigate the mechanism of action of lipid formulation and to show any superiority of this formulation. This is however unlikely to happen and most likely this product will not be successful unless significant price reduction happens.
Is Flarin available on NHS prescription?
Theoretically Flarin could be prescribed on NHS prescription, as currently it is not listed as prescription item which is ‘not allowed/blacklisted’. However it is highly unlikely that any doctor will prescribe it due to high cost of this medication.
Join pain relief: what are the options
Alternative, cheap drugs that can be used (unless contra-indicated) in join pain management include:
- Paracetamol: paracetamol is mainly taken to manage the pain. Paracetamol does not reduce inflammation.
- Ibuprofen (paracetamol and ibuprofen can be taken together. Read more.). Ibuprofen help with pain and reduce inflammation.
- Co-codamol: combination of paracetamol and codeine. When bought overt the counter co-codamol can only be taken for 3 days only. Speak to your GP if you need to use it for longer than 3 days.
- Naproxen (prescription only medication) or combination of Naproxen with paracetamol or co-codamol