Flarin, a prominent brand featuring a unique lipid formulation of ibuprofen, has established its presence in the market due to heavy advertising over the last few years. Ibuprofen, a widely recognized and readily available over-the-counter medication, is renowned for its effectiveness in alleviating acute pain and addressing conditions characterized by inflammation. Exploring a Flarin review can shed light on the distinctive features and efficacy of this lipid-formulated ibuprofen product, which has garnered attention for its premium pricing.
What truly draws attention to Flarin, however, is the premium price tag associated with this product, with a single box of 30 soft capsules costing over £10. In stark contrast, conventional ibuprofen tablets containing 200mg of the same active ingredient can be purchased at local pharmacies for approximately £3 for the same quantity. This raises a compelling question: What justifies this substantial disparity in pricing?
Table of Contents
Flarin review: what is Flarin?
Flarin is a branded version of ibuprofen. Each soft capsule of Flarin contains 200 mg of ibuprofen in the lipid formulation. Ibuprofen belongs to a group of drugs called Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are commonly used in the management of pain and fever and to decrease inflammation.
Flarin review of the licensed use
Like other NSAIDs, Flarin can be used in the management of a wide range of acute pain, including:
- headache
- backache
- migraine
- dental pain
- dysmenorrhoea (period pains)
- symptoms of cold and flu and
- pain associated with arthritic conditions
Despite a wide range of licensed uses, the producers of Flarin focused their marketing efforts on targeting only patients who experience joint pain. Flarin is advertised as:
- joint pain relief as effective as prescription-only ibuprofen
- product with a unique lipid formulation that provides powerful relief from flaring joints and inflammation at the same time shielding the stomach from damage
The high price for Flarin soft capsules comes partly from the fact that the company that makes Flarin did a clinical trial (FLARE) before launching Flarin into the market. The results of this study are available to read in the OARSI journal.
Flarin review of clinical trial information
FLARE trial involved 462 patients with knee pain who randomly took different doses of ibuprofen over 5 days to compare efficacy, safety, and tolerability between a daily dose of lipid 1200mg ibuprofen (Flarin), soft-gel capsule with a daily dose of ibuprofen at 1200mg and soft gel capsule with a daily dose of 2400mg of ibuprofen (prescription strength).
Improvements in pain control were seen across all 3 groups of patients with ibuprofen 1200 mg/day in lipid formulation (Flarin) as being non-inferior (equivalent) 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.
The above results allow Infirst Healthcare to say that Flarin is ‘as effective as prescription ibuprofen at reducing joint pain.’
There was a minimal difference in terms of the effect on the patient’s swelling between the lipid formulation of ibuprofen 1200mg (Flarin) and soft-gel capsule 1200mg, but closer to soft-gel capsule 2400 mg group (‘prescription strength’ ibuprofen), recommending further investigation.
Does Flarin really shield your stomach from damage?
The second advertised advantage of a unique formulation that shields the stomach from damage lacks reference for the statement, with the actual reference being specified as ‘Infirst Healthcare, data on file 2018’.
This is disappointing. When a significant claim like this is made, one would expect information to be available for public review. One of the most common side effects of ibuprofen is to cause gastrointestinal (GI) side effects. All three groups of patients taking part in the FLARE trial reported GI side effects with the following frequency:
- 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
The above results further question the ‘uniqueness of the formulation’ and any proposed protective benefits.
What about Flarin’s powerful relief?
It is said that the same unique formulation provides powerful relief from pain. In the actual discussion of the publication, a hypothesis is put forward explaining how possibly a new lipid formulation has ‘more enhanced efficacy’ in reducing pain than a soft-gel capsule 1200mg (again results showed non-inferiority (equally effective) between all formulations). The mechanism of action of new lipid formulation is not fully understood, but it is thought that it targets ‘the lymphatic part of the immune system’, which is more advantageous as compared to other oral formulations. This, however, is just a hypothesis, and as it is suggested, further research is needed to investigate it.
Overall, the FLARE trial is a small study involving just 462 patients and of short duration (5 days). It showed that the new lipid formulation is equivalent to other formulations used in the trial for pain and swelling reduction. Further research is needed to investigate the mechanism of action of lipid formulation and to show any superiority of this formulation. This, however, is unlikely to happen, and most likely, this product will not be successful unless a significant price reduction happens.
Although this small trial confirmed that Flarin is equivalent to a dose of ibuprofen at ‘prescription strength’, in reality, this does not mean much. Ibuprofen is not commonly prescribed above the recommended daily dose of 1200mg (one 400mg tablet taken three times a day) as other NSAIDs are available on prescription, which are more effective than ibuprofen with a relatively good safety profile, such as naproxen.
Is Flarin available on NHS prescription?
Theoretically, Flarin could be prescribed on NHS prescription, as currently it is not listed as a prescription item which is ‘not allowed/blacklisted.’ However, it is highly unlikely that any doctor will prescribe it due to the high cost of this medication and weak evidence for benefit in treatment.
Joint pain relief: what are the options
When it comes to the management of joint pain or acute pain, few over the counter drugs can be used (unless contra-indicated) including:
- Paracetamol
Paracetamol is mainly taken to manage the pain. Paracetamol does not have anti-inflammatory properties, so it may be less effective for inflammatory joint conditions. The main advantage of paracetamol treatment is its effectiveness as a pain reliever and low incidence of side effects.
- Ibuprofen
Ibuprofen helps with pain and reduces inflammation. Ibuprofen is available as 200mg and 400mg tablets or capsules. The maximum daily adult dose of ibuprofen is 1200mg (One 400mg tablet or capsule taken three times a day). Ibuprofen is also available in the form of a gel and patches. A more effective NSAIDS, such as naproxen or naproxen alternative drugs can be prescribed.
- Co-codamol
Opioid pain medicines like codeine, can be purchased over the counter or may be prescribed for severe joint pain when other treatments are ineffective. Co-codamol, a combination of paracetamol and a low dose of codeine however, come with a risk of dependence and should be used sparingly and under close medical supervision.
A combination of paracetamol and codeine (opioid) can be used on a short-term basis. When bought over the counter, co-codamol can only be taken for 3 days. Speak to your GP if you need to use it for longer than three days.
- Diclofenac
Diclofenac is another NSAID. Diclofenac is available over the counter only in the form of a gel (Voltarol 12-hour joint pain relief 2.32% and standard 1.16%).
