Generic Name: Diflunisal Brand Name(s): Diflunisal.

Uses

What is Diflunisal used for?

Diflunisal is commonly used to relieve mild to moderate pain from various conditions. It also reduces pain, swelling, and joint stiffness caused by arthritis. Reducing these symptoms helps you do more of your normal daily activities. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID).

How should I take Diflunisal?

Take this medication by mouth with a full glass of water (8 ounces or 240 milliliters) unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this drug. Take this medication with food/milk or right after meals to prevent stomach upset.

Swallow this medication whole. Do not crush or chew the tablets. Doing so may increase side effects.

Dosage is based on your medical condition and response to therapy. Do not take more than 1,500 milligrams per day. To minimize side effect risks (e.g., stomach bleeding), use this medication at the lowest effective dose for the shortest possible length of time. Do not increase your dose or take it more often than prescribed. For ongoing conditions such as arthritis, continue taking it as directed by your doctor. Discuss the risks and benefits with your doctor or pharmacist.

In certain conditions (e.g., arthritis), it may take up to 2 weeks of regular use before the full benefits of this drug take effect.

If you are taking this drug on an “as needed” basis (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has significantly worsened, the medicine may not work as well.

Inform your doctor if your condition worsens.

How do I store Diflunisal?

Diflunisal is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Diflunisal in the bathroom or the freezer. There may be different brands of Diflunisal that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Diflunisal down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Diflunisal?

Before taking diflunisal, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other salicylates (e.g., choline salicylate), or other NSAIDs (e.g., ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), liver disease, poorly controlled diabetes, stomach/intestine/esophagus problems (e.g., bleeding, ulcers), heart disease (e.g., history of heart attack), stroke, high blood pressure, swelling (edema, fluid retention), blood disorders (e.g., anemia), bleeding or clotting problems, growths in the nose (nasal polyps).

Kidney problems can sometimes occur with the use of NSAID medications, including diflunisal. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.

Before having surgery, tell your doctor or dentist that you are using this medication.

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana.

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco may increase your risk for stomach bleeding, especially when combined with this medicine. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.

The elderly may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding and kidney problems.

This medication is not recommended for use in children under 12 years of age. In addition, since diflunisal is related to aspirin, children and teenagers should not take diflunisal if they have chickenpox, influenza, or any undiagnosed illness without first consulting a doctor about Reye’s syndrome, a rare but serious illness.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.

This drug passes into breast milk. Therefore, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Diflunisal during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Diflunisal. This Diflunisal is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Diflunisal?

Upset stomach, heartburn, headache, tiredness, drowsiness, or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: stomach pain, swelling of the hands/feet, sudden/unexplained weight gain, vision changes, hearing changes (e.g., ringing in the ears), mental/mood changes (e.g., confusion, hallucinations), fast/pounding heartbeat, persistent/severe headache, fainting, difficult/painful swallowing.

Tell your doctor right away if any of these rare but very serious side effects occur: signs of kidney problems (such as change in the amount of urine), easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), unexplained stiff neck.

This drug may rarely cause serious (possibly fatal) liver disease. If you notice any of the following rare but very seriousside effects, stop taking diflunisal and tell your doctor right away: yellowing eyes/skin, dark urine, unusual/extreme tiredness, severe stomach/abdominal pain, persistent nausea/vomiting.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Diflunisal?

Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), antacids (regular use), cidofovir, corticosteroids (e.g., prednisone), digoxin, live influenza vaccine, lithium, methotrexate, pemetrexed, probenecid, “water pills” (diuretics such as furosemide, hydrochlorothiazide, triamterene).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, indomethacin, ketorolac or naproxen) which if taken together with diflunisal may increase your risk for side effects. Low-dose aspirin, as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day), should be continued. Consult your doctor or pharmacist for more details.

This medication can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug.

Diflunisal may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Diflunisal?

Diflunisal may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Diflunisal?

Diflunisal may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Diflunisal.

What is the dose of Diflunisal for an adult?

Usual Adult Dose for Pain

Initial dose: 1000 mg orally once

Maintenance dose: 500 mg every 12 hours; some patients may require 500 mg every 8 hours

Maximum dose: 1500 mg/day

Comments: A lower dose may be appropriate depending on such factors as pain severity, patient response, weight, or advanced age; for example, 500 mg initially, followed by 250 mg every 8 to 12 hours.

Use: For the treatment of mild to moderate pain

Usual Adult Dose for Osteoarthritis

500 to 1000 mg orally per day in 2 divided doses

Comments:

-Dosage may be increased or decreased based on patient response.

-Not to exceed 1500 mg/day.

Uses: For the treatment of osteoarthritis and rheumatoid arthritis

Usual Adult Dose for Rheumatoid Arthritis

500 to 1000 mg orally per day in 2 divided doses

Comments:

-Dosage may be increased or decreased based on patient response.

-Not to exceed 1500 mg/day.

Uses: For the treatment of osteoarthritis and rheumatoid arthritis

Renal Dose Adjustments

Advanced renal dysfunction: Not recommended; if therapy is necessary, closely monitor renal function.

Liver Dose Adjustments

-Patients who have an abnormal liver test or who develop signs or symptoms of liver dysfunction should be evaluated for a more severe hepatic reaction.

-If liver disease develops or if systemic manifestations such as eosinophilia or rash occur, this drug should be discontinued.

Dose Adjustments

Elderly patients may require lower doses due to increased risk for adverse effects and increased likelihood of concomitant renal impairment.

Other Comments

Administration advice:

-Swallow tablets whole; do not crush or chew.

General:

-Concentration-dependent pharmacokinetics prevail with this drug; a doubling of dosage produces a greater than doubling of drug accumulation and effects become more apparent with repetitive doses.

-Following initial response to therapy, dose and frequency should be adjusted to suit individual patient needs.

-Prior to initiating treatment, the potential benefits and risks of this drug should be weighed against other treatment options.

-The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.

-There is an increased risk of heart attack, heart failure, and stroke when taking nonsteroidal anti-inflammatory drugs (NSAIDs); these events may occur at any time during treatment and risk increases with long term use, a history of cardiovascular (CV) disease or risk factors for CV disease, and higher doses.

Monitoring:

-Cardiovascular: Monitor blood pressure closely during initiation and throughout the course of therapy.

-Gastrointestinal: Monitor for signs/symptoms of gastrointestinal bleeding.

-Renal function: Monitor renal status, especially in patients with conditions where renal prostaglandins have a supportive role in the maintenance of renal perfusion.

-Monitor blood counts, renal, and hepatic function periodically for patients receiving long-term therapy.

Patient advice:

-Patients should seek medical advice for signs and symptoms of gastrointestinal events, adverse skin reactions, allergic reactions, hepatotoxicity, or unexplained weight gain or edema.

-Patients should seek medical attention immediately if signs/symptoms of cardiovascular events occur including, shortness of breath, slurred speech, chest pain, or weakness on one side of the body.

-Patients should talk to their health care provider if they are pregnant, planning to become pregnant, or breastfeeding; this drug is not recommended for use while breastfeeding or during pregnancy.

What is the dose of Diflunisal for a child?

Usual Pediatric Dose for Pain

12 years or older:

-Initial dose: 1000 mg orally once

-Maintenance dose: 500 mg every 12 hours; some patients may require 500 mg every 8 hours

-Maximum dose: 1500 mg/day

Comments: A lower dose may be appropriate depending on such factors as pain severity, patient response, weight, or advanced age; for example, 500 mg initially, followed by 250 mg every 8 to 12 hours.

Use: For the treatment of mild to moderate pain

Usual Pediatric Dose for Osteoarthritis

12 years or older: 500 to 1000 mg orally per day in 2 divided doses

Comments:

-Dosage may be increased or decreased based on patient response.

-Not to exceed 1500 mg/day.

Uses: For the treatment of osteoarthritis and rheumatoid arthritis

Usual Pediatric Dose for Rheumatoid Arthritis

12 years or older: 500 to 1000 mg orally per day in 2 divided doses

Comments:

-Dosage may be increased or decreased based on patient response.

-Not to exceed 1500 mg/day.

Uses: For the treatment of osteoarthritis and rheumatoid arthritis

How is Diflunisal available?

Diflunisal is available in the following dosage forms and strengths:

  • Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Diflunisal, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 22, 2018 | Last Modified: January 22, 2018

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