Locoa Special Precautions

This medication is to be used only if prescribed by a physician.
General: A thorough health interview should be performed to predict hypersensitivity reactions.
For long term use, periodic laboratory tests (urine analysis, blood test, liver function test, etc.) should be performed. If any abnormality is observed, appropriate measures such as dose interruption should be taken.
Special attention should be paid to elderly patients with high fever or patients with wasting disease after receiving Esflurbiprofen (LOCOA), since symptoms such as excessive decrease in body temperature, collapse, and cold extremities may occur.
Esflurbiprofen (LOCOA) must not be used with enoxacin hydrate, lomefloxacin, norfloxacin or prulifloxacin since convulsions have been reported in a few patients after receiving flurbiprofen axetil with these new quinolone antibiotics. The use of Esflurbiprofen (LOCOA) with other new quinolone antibiotics should be avoided wherever possible.
If cutaneous symptoms are observed with the use of Esflurbiprofen (LOCOA), appropriate measures such as drug interruption or discontinuation should be taken according to symptoms.
Temporary infertility has been reported in women after long term use of nonsteroidal anti-inflammatory analgesics.
Careful administration: Esflurbiprofen (LOCOA) should be administered with care in the following patients.
Patients with peptic ulcer induced by long term use of nonsteroidal anti-inflammatory analgesics who need long term use of Esflurbiprofen (LOCOA) and are being treated with agents such as misoprostol: Since some patients may have peptic ulcer resistant to agents such as misoprostol, adequate monitoring and careful administration is required, when the use of Esflurbiprofen (LOCOA) is continued.
Patients with a history of peptic ulcer: Gastric mucosal barrier decreased by inhibition of prostaglandin synthesis may cause a relapse of peptic ulcer.
Patients with current or previous blood abnormality: Blood abnormality may be aggravated or may recur.
Patients with bleeding tendency: Platelet function may decrease, resulting to increased bleeding tendency.
Patients with current or previous liver disorder: Liver disorder may be aggravated or may recur by hepatic function abnormality.
Patients with current or previous renal disorder, or reduced renal blood flow: Renal disorder may be aggravated or recur, or may be induced by reduced renal blood flow via inhibition of prostaglandin synthesis.
Patients with abnormal cardiac function: Water and sodium retention induced by inhibition of prostaglandin synthesis may aggravate cardiac dysfunction.
Patients with hypertension: Water and sodium retention induced by inhibition of prostaglandin synthesis may further increase blood pressure.
Patients with a history of hypersensitivity to esflurbiprofen or flurbiprofen: As for excipients other than esflurbiprofen, see Description.
Patients with bronchial asthma: Attacks of bronchial asthma may be triggered in patients with aspirin-induced asthma.
Patients with ulcerative colitis: Symptoms aggravated by other nonsteroidal anti-inflammatory analgesics have been reported.
Patients with Crohn's disease: Symptoms aggravated by other nonsteroidal anti-inflammatory analgesics have been reported.
Effects on ability to drive and use machine: It is considered that application of Esflurbiprofen (LOCOA) at recommended doses has no influence on the ability to drive and use machine.
Use in Children: Safety has not been established in low birth weight babies, neonates, babies, infants and children. [There is no experience in the use for the previously mentioned patients.]
Use in the Elderly: Elderly patients are more susceptible to adverse reactions. Care should be taken in administering Esflurbiprofen (LOCOA) to elderly patients, for example, limiting the use to a minimal level, while special attention should be paid to possible adverse reactions.