The cardiovascular and gastrointestinal adverse effects of cyclooxygenase inhibitors seems to be a major concern that restricts their use in the treatment of urinary bladder dysfunction

Flurbiprofen is a non-selective cyclooxygenase (COX) inhibitor, which inhibits the activity of both isoforms of COX (1 and 2). Also, flurbiprofen is one of the most potent non-steroidal anti-inflammatory agent (NSAIDs) in terms of prostaglandin inhibitory activity via reversible inhibition of COX, the enzyme responsible for the conversion of arachidonic acid to prostaglandin G2 (PGG2) and PGG2 to prostaglandin H2 (PGH2). COX exists as two isoforms, constitutive COX-1 and inducible COX-2. Prostaglandins (PGs) formed by COX-1 are primarily involved in the regulation of homeostatic functions in physiological processes, whereas PGs formed by COX-2 primarily mediate pain, inflammation, and cancer pathophysiology (e.g. prostate cancer) [1]. Aktas et al. [2] investigated the effectiveness and safety of flurbiprofen alone or in combination with alfuzosin, in the treatment of lower urinary tract symptoms suggestive of benign prostate obstruction (LUTS/BPO). The results showed that flurbiprofen increases the therapeutic effectiveness of alfuzosin by further improving symptoms in patients with LUTS/BPO. Combination therapy also improves urine flow compared to baseline. However, no superiority of monotherapy with flurbiprofen to alfuzosin is observed. Additionally, gastrointestinal adverse events are predominant in patients using flurbiprofen. PGs contribute to urinary bladder physiology. It is known that PGs are released from the urinary bladder into the general circulation in response to disThe cardiovascular and gastrointestinal adverse effects of cyclooxygenase inhibitors seems to be a major concern that restricts their use in the treatment of urinary bladder dysfunction