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Diflunisal

Diflunisal

Diflunisal belongs to the class of medications known as non-steroidal anti-inflammatories (NSAIDs). It is used to treat mild to moderate pain with inflammation.

Available form

Tablet

Dosage

250mg, 500mg

Manufacturers

Aa Pharma, Teva

Branded drugs

Dolobid

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Diflunisal information

Dosage

Side Effects

Available Form

Contraindications

Precautions

Warnings

Directions of use

The recommended adult dose of diflunisal for the treatment of rheumatoid arthritis and osteoarthritis ranges from 500mg to 1,000mg daily, in two divided doses with food or milk.

For the relief of pain associated with other types of inflammation, the usual dose is an initial dose of 1000 mg, followed by 500mg every 12 hours. In some cases, such as for seniors or people with a low body weight, a smaller dose of 250mg every 12 hours may be used.

Diflunisal produces significant pain relief within one hour and maximum relief after 2 to 4 hours. Pain relief lasts for 8 to 12 hours. Do not crush or chew the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Diflunisal exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Diflunisal at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes Diflunisal. If you are concerned about side effects, discuss the risks and benefits of Diflunisal with your doctor.

The following side effects have been reported by at least 1% of people taking Diflunisal. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

abdominal or stomach cramps, pain, or discomfort (mild to moderate)
Diarrhea
dizziness, drowsiness, or lightheadedness
headache (mild to moderate)
heartburn, indigestion, nausea, or vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

bladder pain
bleeding from cuts or scratches that lasts longer than usual
bleeding or crusting sores on lips
bloody or cloudy urine or any problem with urination, such as difficult, burning, or painful urination
burning feeling in throat, chest, or stomach
change in urine colour or odour
confusion, forgetfulness, mental Depression, or other mood or mental changes
cough or hoarseness
decreased hearing, any other change in hearing, or ringing or buzzing in ears
difficulty swallowing
eye pain, irritation, dryness, redness, or swelling
frequent urge to urinate
hallucinations
headache (severe), throbbing, or with stiff neck or back
increased blood pressure
light-coloured stools
muscle cramps, pain, or weakness
numbness, tingling, pain, or weakness in hands or feet
pain in lower back or side (severe)
sudden, large increase or decrease in the amount of urine or loss of bladder control
skin rash
swelling of face, feet, or lower legs
swelling of lips or tongue
swollen or painful glands (especially in the neck or throat area)
swelling or tenderness in upper abdominal or stomach area
thirst (continuing)
unexplained runny nose or sneezing
unexplained, unexpected, or unusually heavy vaginal bleeding
unusual tiredness or weakness
weight gain (rapid)
yellow eyes or skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

abdominal or stomach pain, cramping, or burning (severe)
bloody or black, tarry stools
blurred vision or any change in vision
chest pain
convulsions (seizures)
fainting
fast or irregular breathing
fast, irregular heartbeat or pulse
Fever with or without chills
hive-like swellings (large) on face, eyelids, mouth, lips, or tongue
Hives, itching of skin, or any other skin problem (such as blisters, redness or other colour change, tenderness, burning, peeling, loosening or splitting of fingernails)
nausea, heartburn, or indigestion (severe and continuing)
pinpoint-sized red spots on skin
puffiness or swelling of the eyelids or around the eyes
shortness of breath, troubled breathing, wheezing, or tightness in chest
sores, ulcers, or white spots on lips or in mouth
spitting up of blood
trouble speaking
unexplained nosebleeds
unusual bleeding or bruising
vomiting of blood or material that looks like coffee grounds

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Diflunisal.

There may be an interaction between diflunisal and any of the following:

Acetaminophen
alcohol
angiotensin II receptor blockers (ARBs; e.g., Candesartan, Irbesartan)
angiotensin converting enzyme (ACE) inhibitors (e.g., Ramipril)
beta-blockers (e.g., Metoprolol, Atenolol)
bisphosphonates (e.g., Alendronate, etidronate, Pamidronate, Risedronate, Zoledronic Acid)
Celecoxib
Cholestyramine
Colestipol
corticosteroids (e.g., Prednisone)
Cyclosporine
Desmopressin
Desvenlafaxine
diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, Spironolactone)
Digoxin
fluoroquinolone antibiotics (e.g., Ofloxacin, ciprofloxacin)
Haloperidol
herbal medications that affect blood clotting (e.g., ginkgo biloba, garlic, ginger, ginseng, glucosamine)
lithium
medications used to treat stomach or intestinal ulcers, reflux, or excessive acidity (e.g., Ranitidine, Omeprazole, Esomeprazole, Pantoprazole)
medications that affect blood clotting, such as acetylsalicylic acid (ASA, Aspirin), Apixaban, Clopidogrel, Enoxaparin, Dalteparin, Heparin, lepirudin, Tinzaparin, or Warfarin
Methotrexate
other NSAIDs (e.g.,Naproxen, Indomethacin)
Pentoxifylline
potassium supplements
probenecid
Pemetrexed
SSRIs (e.g., Paroxetine, Fluoxetine, Citalopram, Sertraline)
Sulfinpyrazone
Tacrolimus
tenofovir
tricyclic antidepressants (e.g., Amitriptyline, Doxepin, Imipramine)
warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Diflunisal. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Diflunisal.

HEALTH CANADA ADVISORY

June 8, 2021

Health Canada has issued new information concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

A previous advisory on non-steroidal anti-inflammatory drugs (NSAIDs) was issued on October 30, 2020.

Drowsiness/reduced awareness: Headache, dizziness, lightheadedness, and confusion have been reported by some people using Diflunisal. Avoid operating machinery or motor vehicles or doing other potentially hazardous tasks until you determine how Diflunisal affects you.

Fluid and electrolyte balance: Fluid retention and edema have been reported with use of Diflunisal. People who have the following conditions should be monitored by their doctor while taking Diflunisal:

certain heart conditions (e.g., Congestive Heart Failure)
high blood pressure
Kidney Disease or impaired kidney function
liver disease
recovering from surgical operations under general anesthesia
other conditions that might lead to fluid retention

There is a risk of high blood potassium with treatment with diflunisal. People most at risk are seniors, those having conditions such as Diabetes or kidney failure, and those taking beta-adrenergic blockers, angiotensin converting enzyme (ACE) inhibitors, or some diuretics (water pills).

Heart problems: NSAID medications may increase the risk of heart attacks, strokes, and Blood Clots. The risk is greater with higher doses and long-term use. People at risk of heart problems, such as those with high blood pressure, High Cholesterol, diabetes, peripheral arterial disease, heart failure, or Coronary Artery Disease, should discuss with their doctor how Diflunisal may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Diflunisal, and whether any special monitoring is needed.

Infection: Diflunisal may mask the signs of an infection, such as a fever.

Kidney function: Long-term use of diflunisal may lead to a higher risk of reduced kidney function. This is most common for people who already have kidney disease, liver disease, or heart failure; for people who take diuretics (water pills); and for seniors.

Liver function: Diflunisal may cause liver problems. If you have a liver condition, you may need more frequent checkups with your doctor. If you develop signs of a liver problem (such as yellow skin or eyes, dark urine, pale stools, abdominal pain, or itchy skin), stop taking the medication and see your doctor as soon as possible.

Stomach problems: Stomach ulcers, perforation, and bleeding from the stomach have been known to occur while taking diflunisal. These complications can occur at any time, and are sometimes severe enough to require immediate medical attention. The risk of ulcers and bleeding are increased in people taking higher doses of diflunisal for longer periods of time.

Diflunisal should be taken under close medical supervision by people prone to irritation of the stomach and intestines, particularly those who have had a stomach ulcer, bloody stools, or diverticulosis or other inflammatory disease of the stomach or intestines (such as ulcerative colitis or Crohn's Disease). In these cases, your doctor must weigh the benefits of treatment against the possible risks.

Stop taking the medication and contact your doctor immediately if you experience symptoms or signs suggestive of stomach ulcers or bleeding in the stomach (black, tarry stools). These reactions can occur at any time during treatment without warning.

Pregnancy: Diflunisal should not be used during the third trimester (last 3 months) of pregnancy. Diflunisal should not be used during the first and second trimester (first 6 months) of pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Diflunisal, contact your doctor immediately.

Breast-feeding: Diflunisal passes into breast milk. If you are a breast-feeding mother and are taking Diflunisal, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children:. Diflunisal is not recommended for children under 12 years of age. The safety, effectiveness, and dosages of Diflunisal for this age group have not been established.

Seniors: Seniors appear to have a higher risk of side effects. They should use the lowest effective dosage under close medical supervision.

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All material © 1996-2025 MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition.

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