diflunisal, Dolobid (cont.)

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Medical and Pharmacy Editor:

PRESCRIBED FOR: Diflunisal is used for the treatment of mild to moderate pain, osteoarthritis and rheumatoid arthritis.

DOSING: For mild to moderate pain, an initial dose of 500 to 1000 mg followed by 250 to 500 mg every 12 hours is recommended for most patients. For osteoarthritis and rheumatoid arthritis, the suggested dosage range is 250 mg to 500 mg twice daily. The maximum dose is 1.5 g/day. Tablets should be swallowed whole, not chewed. Dosing under the age of 12 has not been determined.

DRUG INTERACTIONS: Concomitant use of NSAIDs with angiotensin-converting enzyme (ACE) inhibitors such as enalapril (Vasotec) or angiotensin II receptor antagonists (ARBs) such as irbesartan (Avapro) may reduce the blood pressure response to the antihypertensive agent since prostaglandins are important in controlling blood pressure.

Diflunisal may increase the blood levels of lithium (Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.

When diflunisal is used in combination with methotrexate (Rheumatrex, Trexall), the blood levels of methotrexate may increase, presumably because the elimination from the body is reduced. This may lead to more methotrexate related side effects.

Individuals taking oral blood thinners or anticoagulants, for example, warfarin, (Coumadin) should avoid diflunisal because diflunisal also thins the blood, and excessive blood thinning may lead to bleeding.

Persons who have more than three alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking dilfunisal or other NSAIDs.

PREGNANCY: There are no adequate studies of diflunisal in pregnant women. Diflunisal should be used only if the potential benefit justifies the potential risk.

Medically Reviewed by a Doctor on 8/26/2014

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