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What is diflunisal? What is diflunisal used for?
Diflunisal is a nonsteroidal anti-inflammatory drug (NSAID) that is effective in treating fever, pain, and inflammation in the body. Other members of this class include ibuprofen (Motrin), indomethacin (Indocin), nabumetone (Relafen), naproxen (Anaprox, Naprosyn, Aleve) and several others.
These drugs are used for the management of mild to moderate pain, fever, and inflammation. They work by reducing the levels of prostaglandins, chemicals that are responsible for pain, fever, and inflammation. Diflunisal blocks the enzymes that make prostaglandins (cyclooxygenases), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced. Diflunisal was approved by the FDA in April 1982.
What brand names are available for diflunisal?
Dolobid (This brand is no longer available in the U.S.)
Is diflunisal available as a generic drug?
Do I need a prescription for diflunisal?
What are the side effects of diflunisal?
Most patients benefit from diflunisal and other NSAIDs with few side effects. However, serious side effects can occur and generally tend to be seen at higher doses. Therefore, it is often desirable to use the lowest effective dose to minimize side effects. The most common side effects of diflunisal involve the gastrointestinal system. It can cause ulcerations, abdominal burning, pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. Sometimes, stomach ulceration and bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding. Rash, kidney impairment, ringing in the ears, and lightheadedness also may occur.
What is the dosage for diflunisal?
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.
Which drugs or supplements interact with diflunisal?
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.
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.
Is diflunisal safe to take if I'm pregnant or breastfeeding?
Diflunisal is excreted in human milk and has a potential for adverse events to infants.
What else should I know about diflunisal?
What preparations of diflunisal are available?
Tablets: 500 mg.
How should I keep diflunisal stored?
Diflunisal tablets should be stored in well-sealed containers at a temperature less than 40 C (104 F), preferably at 15 C to 30 C (59 F 86 F).
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Diflunisal (Dolobid) is a NSAID drug used to treat mild to moderate the fever, pain, and inflammation, osteoarthritis and rheumatoid arthritis. Side effects, drug interactions, warnings and precautions, and patient information should be reviewed prior to taking any medication.
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Related Disease Conditions
Low Back Pain (Lumbar Spine Pain)
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Acute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease. The 16 characteristic early RA signs and symptoms include the following. Anemia Both sides of the body affected (symmetric) Depression Fatigue Fever Joint deformity Joint pain Joint redness Joint stiffness Joint swelling Joint tenderness Joint warmth Limping Loss of joint function Loss of joint range of motion Many joints affected (polyarthritis)
Ankle Pain (Tendinitis)
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Arthritis (Joint Inflammation)
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited. Treatment incorporates medications, physical therapy, and exercise.
Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms and signs include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and anti-inflammatory and pain medications.
Shoulder bursitis is inflammation of the shoulder bursa. Bursitis may be caused by injury, infection, or a rheumatic condition. Symptoms include pain, swelling, tenderness, and pain with movement of the shoulder joint. Treatment may involve ice compresses, rest, and anti-inflammatory medications and depends on whether there is an infection.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Also known as degenerative arthritis, osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms and signs include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves anti-inflammatory medications and exercise.
Nonsteroidal Anti-inflammatory Drugs and Ulcers
Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Calcific bursitis is the calcification of the bursa caused by chronic inflammation of the bursa. Calcific bursitis most commonly occurs in the shoulder. Calcific bursitis treatment includes medication for inflammation, ice, immobilization, cortisone injections, and occasionally surgical removal of the inflamed bursa.
Juvenile Rheumatoid Arthritis (JRA)
Juvenile rheumatoid arthritis (JRA) annually affects one child in every thousand. There are six types of JRA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
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Medications & Supplements
- Nonsteroidal Antiinflammatory Drugs (NSAIDs)
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- ibuprofen (Advil, Motrin, Nuprin)
- celecoxib (Celebrex)
- naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.