diflunisal
Diflunisal works well to treat mild to moderate pain. It also helps with pain and swelling in osteoarthritis and rheumatoid arthritis. Diflunisal should be used at the lowest dose possible for the shortest duration of time to manage your symptoms because it can cause serious side effects, such as stroke, heart attack, and stomach bleeds.
What is Diflunisal?
What is Diflunisal used for?
- Mild to moderate pain
- Osteoarthritis
- Rheumatoid arthritis
How Diflunisal works
Diflunisal is a non-steroidal anti-inflammatory drug (NSAID). It works by blocking proteins in your body that cause pain and swelling.
Drug facts
Side effects of Diflunisal
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Up to 9% of people who used diflunisal experienced the following side effects:
- Nausea
- Heartburn
- Stomach pain
- Diarrhea
- Rash
- Headache
Less Common Side Effects
- Vomiting
- Constipation
- Passing gas
- Sleepiness
- Tiredness
- Difficulty falling asleep
- Dizziness
- Ringing in the ear
Diflunisal serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: dizziness, tiredness, cold sweat, trouble breathing, chest pain or tightness, anxiety
- Stroke: tiredness, lightheadedness, blurred vision, difficulty speaking, difficulty walking, weakness on one side of the body
- Stomach bleeds: blood in your vomit, stool that looks like black coffee grounds, pain in your stomach that doesn't go away
- Heart failure: trouble breathing, tiredness, swelling in your body, sudden weight gain
- Liver damage: fever, chills, fatigue, nausea, vomiting, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine
- Severe asthma attack: chest pain, cough, difficulty breathing, wheezing
- Serious allergy and skin reaction: fever, rash, body aches, cough, swelling of the face, peeling skin, painful blisters all over your body
The following Diflunisal side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Stomach cramps or pain
Less common
Back or leg pains
bleeding gums
blistering, peeling, loosening of skin
bloody or black, tarry stools
bloody or cloudy urine
blurred or loss of vision
burning feeling in chest or stomach
burning while urinating
clay-colored stools
cough or hoarseness
cracks in the skin
dark-colored urine
difficult or painful urination
difficulty breathing
difficulty swallowing
disturbed color perception
dizziness
double vision
facial swelling
fast heartbeat
feeling of warmth
fever with or without chills
flu-like symptoms
general body swelling
general feeling of tiredness or weakness
greatly decreased frequency of urination or amount of urine
halos around lights
headache
increased blood pressure
increased thirst
indigestion
joint or muscle pain
large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
light-colored stools
liver function abnormalities
loss of appetite
loss of heat from the body
lower back or side pain
muscle aches, pains, or weakness
nausea or vomiting
night blindness
noisy breathing
nosebleeds
overbright appearance of lights
pale skin
pinpoint red spots on skin
puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
red, irritated eyes
redness of the face, neck, arms and occasionally, upper chest
red skin lesions, often with a purple center
red, swollen skin
severe or continuing stomach pain
shortness of breath
skin rash
sores, ulcers, or white spots in mouth or on lips
stomach upset
swelling of face, fingers, feet or lower legs
swollen lymph nodes
tenderness in stomach area
tightness in chest
troubled breathing
tunnel vision
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal pain
vomiting of blood or material that looks like coffee grounds
yellow eyes or skin
Symptoms of overdose
Change in consciousness
confusion about identity, place, and time
continuing ringing or buzzing or other unexplained noise in ears
decreased awareness or responsiveness
deep or fast breathing with dizziness
fast, pounding, or irregular heartbeat or pulse
hearing loss
loss of consciousness
numbness of feet, hands, and around mouth
severe sleepiness
sweating
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Bloated, full feeling
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
discouragement
dry mucous membranes
excess air or gas in stomach or intestines
feeling of constant movement of self or surroundings
feeling sad or empty
increased sensitivity of skin to sunlight
irritability
lack or loss of strength
lightheadedness
loss of interest or pleasure
mood or mental changes
nervousness
passing gas
seeing, hearing, or feeling things that are not there
sensation of spinning
severe sunburn
swelling or inflammation of the mouth
tiredness
trouble concentrating
trouble sleeping
unable to sleep
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Diflunisal
Pros
- Available as a less expensive generic medication
- Works well to lower pain and swelling
- Starts working within one hour
- Lasts longer than some other NSAIDs, so you only need to take it twice daily
Cons
- Can cause stomach bleeding or stomach ulcers
- Not recommended for use starting the second trimester of pregnancy or later
- Not a good option for people with certain conditions, such as heart problems, history of stroke, or kidney problems
- Interacts with many medications, such as warfarin (Coumadin), lisinopril (Zestril), and furosemide (Lasix)
Pharmacist tips for Diflunisal
- If you're taking diflunisal for mild to moderate pain, you'll need to take a one-time higher dose before continuing at a lower dose. The purpose of this one-time higher dose is to help you feel pain relief sooner. Without it, it might take 2-3 days before you feel the maximum benefit of this medication.
- Take diflunisal with food or milk to ease stomach-related side effects, such as stomach pain and nausea.
- Diflunisal can cause stomach bleeds, a very serious side effect. Symptoms of stomach bleeds include blood in your vomit, stool that looks like black coffee grounds, and pain in your stomach that doesn't go away. If you experience these symptoms, get medical help right away.
- Diflunisal can cause Stevens-Johnson syndrome (SJS), a life-threatening skin condition. If you notice fever, body aches, cough, peeling skin, and painful blisters all over your body (especially on the skin around the eyes, mouth, throat, or genitals), stop diflunisal and talk to your healthcare provider right away.
- It's not recommended to take diflunisal with other NSAIDs, such as ibuprofen (Advil) or naproxen (Aleve). Doing so puts you at higher risk for stomach bleeds, stroke, and heart attack. NSAIDs are common over-the-counter pain medications and sometimes appear in combination with other medications. Talk with your healthcare provider or pharmacist if you're not sure whether you're already taking a NSAID.
- Diflunisal might cause your blood thinner to not work as well, which can put you at risk for blood clots. Let your provider know if you're taking blood thinners, such as warfarin (Coumadin), because your dose might need to be adjusted. Get medical help right away if you experience symptoms of blood clots, such as pain and swelling in your arms and legs, chest pain, trouble breathing, and a headache.
Common questions about Diflunisal
Arthritis is a condition where there's swelling, stiffness, and pain at the joints. Osteoarthritis and rheumatoid arthritis are two different types of arthritis. While they share some similar symptoms, they develop differently in your body. Osteoarthritis happens when your cartilage, the "cushion" between your joints, wears out over time and your bones rub against each other. Rheumatoid arthritis occurs when your body's own immune system, which works to protect you from infections, attacks your joints instead. Healthcare providers don't treat these two conditions the same. But diflunisal can lower joint pain and swelling in both.
Diflunisal won't stop your arthritis from getting worse. It can only ease joint pain and swelling. There are treatments that can prevent your condition from getting worse, but they differ depending on the type of arthritis you have. Weight loss and exercise might be recommended for some people with osteoarthritis. Interleukin antagonists or TNF-blockers might be recommended for some people with rheumatoid arthritis. Discuss with your healthcare provider to see what are the best options for you.
Diflunisal lowers pain and swelling by blocking proteins called cyclooxygenase 1 and 2 (COX-1 and COX-2) enzymes from making chemicals called prostaglandins. Prostaglandins cause pain and swelling when your body is injured. They also protect your gut from stomach acid, control blood flow through your kidneys, and balance between blood clot and blood flow in your body. When you take diflunisal, you're not only preventing prostaglandins from causing pain and swelling, you're blocking them from working in other parts of your body as well. That's why taking diflunisal puts you at risk for certain side effects, such as stomach pain, kidney damage, stroke, and heart attack.
Taking both diflunisal and ibuprofen (Advil) is typically not recommended. These medications are NSAIDs and taking them together can raise your risk of serious side effects, such as stroke, heart attack, and stomach bleeds. If your current dose of diflunisal is not enough to control your pain, talk to your provider to see what other options are good for you.
It's possible to take diflunisal and acetaminophen (Tylenol) together because they work differently to ease your pain. Please be aware that taking them together might cause your body to absorb more acetaminophen (Tylenol) compared to taking acetaminophen (Tylenol) alone. Higher levels of acetaminophen (Tylenol) might lead to liver damage over time. Talk with your healthcare provider if you're thinking about taking both medications at the same time.
Diflunisal is not FDA-approved and doesn’t work well to treat fever. There are other medications, such as ibuprofen (Advil) and acetaminophen (Tylenol), that are more commonly prescribed for fever. If you have a fever, talk to your provider to see what's the best option.
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Risks and warnings for Diflunisal
Diflunisal can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart attack and stroke
- Risk factors: History of heart problems | History of heart bypass surgery | Taking higher doses of diflunisal | Taking diflunisal for a long time
Diflunisal can raise your risk of having blood clots, heart attacks, or strokes. This can happen as early as within the first weeks of starting this medication. People with heart problems, those taking higher doses of diflunisal, and those taking diflunisal for a long time are at greater risk for these side effects. That’s why it’s important to take the lowest possible dose for the shortest possible time. If you have heart problems, talk to your healthcare provider before starting this medication. Don't take diflunisal if you've had or will be having heart bypass surgery. Call 911 or seek immediate medical help if you experience chest pain, trouble breathing, weakness on one side of your body, or trouble speaking or walking.
Stomach bleeding and ulcers
- Risk factors: History of stomach bleeding or ulcers | Older adults | Taking aspirin (Aspir-Low), other NSAIDs, corticosteroids, or blood thinners | Drinking alcohol | Smoking | Having poor health | Taking diflunisal for a long time | Taking higher doses of diflunisal
Diflunisal can cause stomach bleeding and ulcers, which can be dangerous. There are many conditions and medications that raise your risk of this problem, so speak with your provider before starting this medication. If you notice blood in your vomit, stool that looks like black coffee grounds, or if you have pain in your stomach that doesn't go away, stop this medication and talk to your healthcare provider right away. Stomach bleeding and ulcers can occur without warning or symptoms, so it's best to take the lowest possible dose for the shortest possible time to minimize your risk. If you take diflunisal for a long time, you might need to get regular lab work to check if you have any bleeding inside your body.
High blood pressure, heart failure, and swelling of your arms and legs
- Risk factors: History of high blood pressure | History of heart failure
Diflunisal can make it more difficult for your kidneys to pass urine. This can raise your blood pressure and cause your body to hold on to more water, leading to or worsening problems such as high blood pressure, heart failure, and swelling of your arms and legs. Diflunisal can also interact with certain medications used to treat these conditions, such as furosemide (Lasix), lisinopril (Zestril), and losartan (Cozaar). Monitor your blood pressure closely when you take diflunisal. It's not recommended to use diflunisal if you have heart failure, unless the benefit of this medication is greater than the risk of side effects. Let your provider know right away if you notice any changes in your blood pressure or experience symptoms such as trouble breathing, tiredness, swelling in your body, or sudden weight gain.
Kidney damage
- Risk factors: Kidney problems | Heart failure | Liver problems | Taking certain high blood pressure medications, such as water pills and ACEIs | Older adults | Loss of body fluid through conditions such as severe vomiting, bleeding, or diarrhea | Taking diflunisal for a long time
Diflunisal can damage your kidneys by slowing down blood flow to the kidneys. The risk is higher if you take this medication for a long time, are taking certain blood pressure medications (like ACEIs or water pills), or have certain conditions (like kidney or liver problems and heart failure). Let your healthcare provider know if you notice a change in how often you urinate after starting diflunisal. Kidney damage is usually reversible once you stop taking this medication.
Liver damage
- Risk factors: History of liver damage | Taking acetaminophen (Tylenol)
Very rarely, diflunisal can cause life-threatening liver damage. Your risk is higher if you take diflunisal and acetaminophen (Tylenol) together because diflunisal can raise the level of acetaminophen (Tylenol). High levels of acetaminophen (Tylenol) can damage your liver over time. Talk to your healthcare provider right away if you experience symptoms such as fever, chills, fatigue, nausea, vomiting, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine.
Low red blood cell levels
Diflunisal can cause anemia (low red blood cell levels). It typically occurs as a result of some side effect of diflunisal, such as stomach bleeds or kidney damage. If you need to take this medication for a long time, your healthcare provider might ask you to get regular lab work done to check your red blood cell levels.
Severe asthma attack
- Risk factors: Asthma and stuffy nose with or without nasal polyps | Allergic reaction to aspirin
Diflunisal can cause your airways to tighten, which might lead to severe asthma attacks. Be careful using this medication if you have asthma. People who have experienced asthma attacks triggered by aspirin (Aspir-Low) or other NSAIDs in the past should avoid diflunisal. Get medical help right away if your throat tightens and you can't breathe.
Serious allergy and skin reaction
Diflunisal might cause sudden and very serious skin reactions, such as Stevens-Johnson syndrome (SJS). Symptoms of SJS include fever, body aches, cough, peeling skin, and painful blisters all over your body (especially the skin around the eyes, mouth, throat, or genitals). This medication might also cause drug reaction with eosinophilia and systemic symptoms (DRESS). People with DRESS can experience symptoms like fever, rash, and swelling of the face, which can lead to multiple organ damage in severe cases. Stop the medication and get medical help right away if you experience these symptoms.
Harm to unborn babies
- Risk factors: Currently pregnant
If diflunisal is taken during or after the second trimester of pregnancy, it can lower the amniotic fluid (the fluid that surrounds the baby in the womb). This can occur as soon as 2 days after starting the medication and result in serious kidney problems in your unborn baby. Babies born to mothers who take diflunisal starting the third trimester of pregnancy or later can also develop heart problems. This medication is typically not used in pregnant women unless the benefit is greater than the risks of side effects and harm to the unborn baby. Talk to your provider if you're thinking of getting pregnant or become pregnant while taking diflunisal.
Reye's syndrome
- Risk factors: Children or teenagers recovering from viral infections
Diflunisal can cause Reye’s syndrome, a serious condition affecting the liver and brain. Symptoms include sleepiness, tiredness, confusion, and seizures. Reye's syndrome is more commonly seen in children or teenagers taking medications like diflunisal while recovering from a viral infection, but it can occur at any age. Talk to your healthcare provider right away if you experience symptoms of Reye's syndrome.
Diflunisal dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 500mg | 60 tablets | $41.54 | $0.69 |
Typical dosage for Diflunisal
Your dose might differ depending on how well this medication works for you, your pain level, weight, and age.
Mild to moderate pain: When you start this medication for the first time, take 1000 mg by mouth once. After that, the typical dose is 500 mg by mouth every 12 hours. The maximum daily dose is 1500 mg.
Osteoarthritis and rheumatoid arthritis: The typical dose is 250 mg to 500 mg by mouth twice daily. The maximum daily dose is 1500 mg.
Interactions between Diflunisal and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abciximab
- Aceclofenac
- Acemetacin
- Acenocoumarol
- Amiloride
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amtolmetin Guacil
- Anagrelide
- Apixaban
- Ardeparin
- Argatroban
- Aspirin
- Balsalazide
- Bemiparin
- Bendroflumethiazide
- Benzthiazide
- Betamethasone
- Betrixaban
- Bismuth Subsalicylate
- Bivalirudin
- Bromfenac
- Budesonide
- Bufexamac
- Bumetanide
- Cangrelor
- Celecoxib
- Certoparin
- Chlorothiazide
- Chlorthalidone
- Choline Magnesium Trisalicylate
- Choline Salicylate
- Cilostazol
- Citalopram
- Clomipramine
- Clonixin
- Clopamide
- Clopidogrel
- Cortisone
- Cyclopenthiazide
- Cyclosporine
- Dabigatran Etexilate
- Dalteparin
- Danaparoid
- Deflazacort
- Desipramine
- Desirudin
- Desmopressin
- Desvenlafaxine
- Dexamethasone
- Dexibuprofen
- Dexketoprofen
- Diazoxide
- Dibenzepin
- Diclofenac
- Digoxin
- Dipyridamole
- Dipyrone
- Dothiepin
- Doxepin
- Droxicam
- Duloxetine
- Edoxaban
- Enoxaparin
- Eplerenone
- Epoprostenol
- Eptifibatide
- Escitalopram
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Feverfew
- Floctafenine
- Flufenamic Acid
- Fluocortolone
- Fluoxetine
- Flurbiprofen
- Fluvoxamine
- Fondaparinux
- Furosemide
- Ginkgo
- Gossypol
- Heparin
- Hydrochlorothiazide
- Hydrocortisone
- Hydroflumethiazide
- Ibuprofen
- Iloprost
- Imipramine
- Indapamide
- Indomethacin
- Inotersen
- Ketoprofen
- Lepirudin
- Levomilnacipran
- Lithium
- Lofepramine
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Magnesium Salicylate
- Meadowsweet
- Meclofenamate
- Mefenamic Acid
- Melitracen
- Meloxicam
- Mesalamine
- Methotrexate
- Methyclothiazide
- Methylprednisolone
- Metolazone
- Milnacipran
- Morniflumate
- Nabumetone
- Nadroparin
- Naproxen
- Nefazodone
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nortriptyline
- Olsalazine
- Opipramol
- Oxaprozin
- Oxyphenbutazone
- Paramethasone
- Parecoxib
- Parnaparin
- Paroxetine
- Pemetrexed
- Pentosan Polysulfate Sodium
- Pentoxifylline
- Phenindione
- Phenprocoumon
- Phenylbutazone
- Phenyl Salicylate
- Piketoprofen
- Piroxicam
- Polythiazide
- Prasugrel
- Prednisolone
- Prednisone
- Proglumetacin
- Propyphenazone
- Proquazone
- Protein C
- Protriptyline
- Reboxetine
- Reviparin
- Rivaroxaban
- Rofecoxib
- Salicylamide
- Salicylic Acid
- Salsalate
- Sertraline
- Sibutramine
- Sodium Salicylate
- Spironolactone
- Sulfasalazine
- Sulindac
- Tacrolimus
- Tenofovir Disoproxil Fumarate
- Tenoxicam
- Tianeptine
- Tiaprofenic Acid
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tirofiban
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Trazodone
- Treprostinil
- Triamterene
- Trichlormethiazide
- Trimipramine
- Trolamine Salicylate
- Valdecoxib
- Venlafaxine
- Vilazodone
- Vorapaxar
- Vortioxetine
- Warfarin
- Xipamide
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Alacepril
- Anisindione
- Atenolol
- Azilsartan
- Azilsartan Medoxomil
- Benazepril
- Betaxolol
- Bisoprolol
- Candesartan Cilexetil
- Captopril
- Carteolol
- Carvedilol
- Celiprolol
- Dicumarol
- Enalapril
- Enalaprilat
- Eprosartan
- Esmolol
- Fosinopril
- Irbesartan
- Labetalol
- Levobunolol
- Lisinopril
- Losartan
- Metipranolol
- Metoprolol
- Moexipril
- Nadolol
- Nebivolol
- Olmesartan Medoxomil
- Oxprenolol
- Penbutolol
- Perindopril Erbumine
- Pindolol
- Practolol
- Propranolol
- Quinapril
- Ramipril
- Sotalol
- Spirapril
- Telmisartan
- Timolol
- Trandolapril
- Valsartan
How much does Diflunisal cost?
$41.54
Diflunisal contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Diflunisal will not be safe for you to take.
- Asthma, hives, or allergic reactions after taking aspirin (Aspir-Low) or other NSAIDs
- Heart bypass surgery
What are alternatives to Diflunisal?
Diflunisal images
