<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="http://www.RRDnetfiler.com/XSL/SEC_Form_3.xsl"?>
<ownershipDocument>
    <schemaVersion>X0101</schemaVersion>

<documentType>3</documentType>
<periodOfReport>2003-05-05</periodOfReport>
    <noSecuritiesOwned>1</noSecuritiesOwned>
<issuer><issuerCik>0001040416</issuerCik>
        <issuerName>INSPIRE PHARMACEUTICALS INC</issuerName>
<issuerTradingSymbol>ISPH</issuerTradingSymbol></issuer>
<reportingOwner>
<reportingOwnerId>
<rptOwnerCik>0001230708</rptOwnerCik>
            <rptOwnerName>STAAB THOMAS R II</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>  </rptOwnerStreet1>
            <rptOwnerStreet2>  </rptOwnerStreet2>
            <rptOwnerCity>  </rptOwnerCity>
            <rptOwnerState>  </rptOwnerState>
            <rptOwnerZipCode>  </rptOwnerZipCode>
        </reportingOwnerAddress>
<reportingOwnerRelationship>
<isDirector>0</isDirector>
<isOfficer>1</isOfficer>
<isTenPercentOwner>0</isTenPercentOwner>
<isOther>0</isOther>
<officerTitle>Chief Financial Officer</officerTitle>
<otherText></otherText></reportingOwnerRelationship></reportingOwner>
<ownerSignature>
<signatureName>Thomas R. Staab, II</signatureName>
<signatureDate>2003-05-07</signatureDate></ownerSignature></ownershipDocument>


