Diflunisal

Introduction

Diflunisal is a salicylic acid product that is utilized in the therapy of chronic arthritis and mild to moderate acute aches. Diflunisal has been linked to rare instances of idiosyncratic drug-induced liver disease and mild, brief elevations in serum aminotransferase levels during treatment.

Diflunisal is an NSAID used to treat mild to moderate aches, inflammation, osteoarthritis, and rheumatoid arthritis. Diflunisal is a salicylic acid by-product with analgesic and anti-inflammatory activity. It was completed by Merck Sharp & Dohme in 1971, as MK647, after demonstrating promise in an analysis assignment examining more potent chemical analogs of aspirin

• CASE ID: 22494-42-4
• Molar mass: 250.198 g/mol
• Metabolism: Hepatic
• AHFS/Drugs.com: Monograph
• ATC code: N02BA11 (WHO)
• Bioavailability: 80 to 90%
• Elimination half-life: 8 to 12 hours
• Generic Name – Diflunisal
• Type – Small Molecule
• Groups – Approved, Investigational
• Chemical Formula – C13H8F2O3

Synonyms

• Diflunisal
• Diflunisalum

Background

Diflunisal, a salicylate result, is a nonsteroidal calming drug (NSAID) with pharmacologic results practically equivalent to those of other notable NSAIDs. Diflunisal possesses anti-inflammatory, analgesic, and antipyretic activity. Though its mechanism of action has not been established, most of its actions appear to be associated with the inhibition of prostaglandin synthesis via the arachidonic acid pathway. Diflunisal is used to relieve discomfort attended by inflammation and in the symptomatic therapy of rheumatoid arthritis and osteoarthritis. Diflunisal (dye floor ni sal) is a difluoro phenol by-product of salicylic acid that has anti-inflammatory, analgesic, and antipyretic actions comparable to aspirin. The liver is metabolized by diflunisal but not by salicylate. Diflunisal is deemed a nonsteroidal anti-inflammatory agent (NSAID) and is believed to function by inhibition of tissue cyclo-oxygenases (Cox-1 and Cox-2), which directs to a reduction in the synthesis of proinflammatory prostaglandins, important intermediates in inflammatory and ache pathways.

Diflunisal was approved for usage in the United States in 1982 and its current manifestation is chronic arthritis due to osteoarthritis or rheumatoid arthritis and mild-to-moderate ache. Diflunisal has been shown to stabilize transthyretin variants which are interested in the pathogenesis of amyloidosis, which has led to the off-label usage of diflunisal in familial amyloidosis. Diflunisal is currently available in generic form as 500 mg lozenges under the brand name Dolobid. Diflunisal is obtainable by prescription only. The recommended regimen in grown-ups is an initial dose of 1000 mg, followed by 500 to 1500 mg daily in two to three separate doses based on reaction and tolerance. Diflunisal, like most NSAIDs, is commonly well accepted, but side effects can contain intestinal upset, nausea, heartburn, and also headache, somnolence, dizziness, peripheral edema, and also hypersensitivity reactions.

Hepatotoxicity

Diflunisal therapy is reported to be associated with a lower rate of asymptomatic and transient serum aminotransferase heights, which may resolve even with drug continuation. Marked aminotransferase elevations (> 3-fold elevated) happen infrequently. Clinically enunciated liver injury with jaundice from diflunisal is unusual; only case pieces have been published. The clinical and histologic features of diflunisal hepatotoxicity, however, are distinct and resemble immunoallergic hepatitis, which is quite different from the liver injury that occurs with aspirin or other salicylates (Case 1). The latency to commencement ranges from 1 to 4 weeks and the pattern of enzyme elevations is typically cholestatic, but could also be mixed. Most patients have immunoallergic embodiments such as rash, fever, and arthralgias; eosinophilia or atypical lymphocytosis are also common. A record of aspirin allergy has not been reported among patients with allergic reactions to diflunisal. Diflunisal is not a typically used drug and is not mentioned in large patient series on drug-induced liver injury or acute liver failure.

Mechanism of action of Diflunisal

The meticulous mechanism of the analgesic and anti-inflammatory activities of diflunisal is not known. Diflunisal is a prostaglandin synthetase inhibitor. Prostaglandins make afferent nerves more sensitive and make bradykinin’s ability to cause pain stronger in animals. Since prostaglandins are known to be among the negotiators of pain and rash, the mode of action of diflunisal may be due to a reduction of prostaglandins in peripheral tissues.

Pharmacodynamics

Diflunisal is a nonsteroidal pill with analgesic, anti-inflammatory, and antipyretic belongings drug. It is a peripherally-acting non-narcotic analgesic drug. Habituation, tolerance, and dependence have not been reported. Diflunisal is a difluoro phenyl derivative of salicylic acid. Chemically, diflunisal varies from aspirin (acetylsalicylic acid) in two considerations. The first of these two is the presence of a difluoro phenyl substituent at carbon 1. The removal of the 0-acetyl group from the carbon 4 position is the second difference. The fluorine particles are not removed from their difluoro phenyl ring configuration, and diflunisal is not converted into salicylic acid.

Absorption

Rapidly and completely gripped following oral administration, with a bioavailability of 80 to 90%. Peak plasma engagement is achieved 2 – 3 hours following oral administration.

The volume of distribution – Not Available

Protein binding – A slight 98 to 99% of diflunisal in plasma is attached to proteins.

Metabolism – Hepatic, primarily via glucuronide conjugation (90% of the administered dose).

Route of elimination

The cure is eliminated in the urine as two soluble glucuronide conjugates account for about 90% of the allocated dose. The diflunisal drug is excreted in the feces in small amounts or none at all. 

Half-life – 8 to 12 hours

Clearance – Not Available

Toxicity

Oral LD50 in rats, mice, and rabbits is 392 mg/kg, 439 mg/kg, and 603 mg/kg, respectively. Sweating, nausea, vomiting, Drowsiness, diarrhea, tachycardia, hyperventilation, tinnitus, disorientation, coma, and stupor are all signs of an overdose. As a monotherapy, the smallest dosage qualified of causing death was reported as 15 grams.

Selective COX-2 inhibitors have been associated with an improved chance of serious cardiovascular occasions (e.g. myocardial infarction, stroke) in some patients. Living data are inadequate to assess the cardiovascular risk of diflunisal. Short-term usage does not appear to be associated with improved cardiovascular risk (except when used immediately following coronary artery bypass graft (CABG) surgery). Chance of GI toxicity including bleeding, ulceration, and perforation. The threat of straightforward renal injury, including renal papillary necrosis. Intense hepatic reactions, including cholestasis and/or jaundice, have been reported. May induce a rash and/or hypersensitivity syndrome.

Why is Diflunisal medication prescribed?

Diflunisal is used to treat osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), which both cause pain, tenderness, swelling, and stiffness. Diflunisal is also utilized to relieve mild to moderate pain for other reasons. Diflunisal is in a category of medicines called NSAIDs. It works by stopping the body’s production of a substance that induces aches, fever, and inflammation.

Duration of effect of this drug

Though diflunisal has a beginning duration of 1 hour, and the highest analgesia at 2 to 3 hours, the plasma levels of diflunisal will not be collected until replicated doses are taken. The extended plasma half-life is an unmistakable element of diflunisal in contrast with comparative medications. Typically, a loading dose is used to speed up the steadying of diflunisal plasma levels. It is primarily utilized to feast symptoms of arthritis and for acute aches following oral surgery, especially the reduction of wisdom teeth.

The effectiveness of diflunisal is equivalent to other NSAIDs, but the course of action is twelve hours or more. This means more occasional doses per day are required for chronic management. In acute usage, it is popular in dentistry when a single dose after oral surgery can preserve analgesia until the patient is asleep that evening.

How should Diflunisal medicine be used?

Diflunisal arrives as a tablet to take by mouth. It usually is taken with water, milk, or meals every 8 to 12 hours. Take diflunisal at almost the same times every day. Observe the directions on your prescription label, and ask your medic or pharmacist to explain any part you do not comprehend. Take diflunisal exactly as directed. Do not take more or more undersized of it or take it more often than prescribed by your doctor.

Destroy the tablets whole; do not split, chew, or crush them. It may take several days or extended for you to feel the full benefit of diflunisal. Resume taking diflunisal until your doctor tells you that you should discontinue taking the medicine. If you include any queries regarding the details, confer with your medic or pharmacist. Unless your doctor tells you otherwise, take this medication by mouth with 8 ounces (240 milliliters) of water. Do not lie down for at undersized 10 minutes after taking this drug. Take this medication with food or milk or right after meals to contain stomach upset. Swallow this drug whole. Do not destroy or chew the tablets. Doing so may improve side effects.

Dosage is based on your medical circumstances and response to therapy. Do not take better than 1,500 milligrams per day. To underestimate side effect risks (such as stomach bleeding), utilize this medication at the lowest effective dose for the shortest possible length of time. Do not raise your dose or take it more often than prescribed. For ongoing diseases such as arthritis, continue taking it as directed by your doctor. Explore the dangers and benefits with your doctor or pharmacist.

In certain circumstances (such as arthritis), it may take up to 2 weeks of regular usage before the full benefits of this drug take effect. If you are taking this medication on an “as needed” basis (not on a regular schedule), recognize that pain medications work best if they are used as the first signs of pain occur. If you wait until the ache has significantly worsened, the drug may not work as well. Inform your doctor if your situation worsens.

Medical uses

• Pain, mild to moderate
• Osteoarthritis
• Rheumatoid arthritis
• Injury to tendons
• Inflammation
• ATTR amyloidosis

Amyloidosis

Both diflunisal and several of its analogs are inhibitors of transthyretin-related hereditary amyloidosis, a disease that presently has few treatment options. Grade I trials have shown the medicine to be well tolerated, with a small Phase II trial (double-blind, placebo-controlled, 130 patients for 2 years) in 2013 showing a decreased rate of disease progression and maintained quality of life. However, a significantly larger Phase III trial would be needed to prove the effectiveness of the drug for treating this condition.

Other uses are – This medicine is also uses for other usages; request your doctor or pharmacist for more details.

What special precautions should I follow?

Before taking diflunisal,

• tell your physician and apothecary if you are allergic to diflunisal, aspirin, or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), or any other drugs. Request your doctor or druggist for a list of the ingredients.
• tell your physician and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal outcomes you are taking or plan to take. Be sure to note the medications listed in the IMPORTANT WARNING section and any of the ensuing: acetaminophen (Tylenol); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), and also moexipril (Univasc), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and/or trandolapril (Mavik, in Tarka); Candesartan (Atacand, Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), and olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor) are angiotensin II receptor antagonists. and telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (in Exforge HCT); antacids; cyclosporine (Gengraf, Neoral, Sandimmune); diuretics (‘water pills’); indomethacin (Indocin, Tivorbex); lithium (Lithobid); methotrexate (Otrexup, Rasuvo, Trexall); and sulindac. Your doctor may also require you to change the dose of your medications or monitor you carefully for side effects.
• Inform your doctor if you suffer from asthma or any of the conditions listed in the Important Warning section, particularly if you also frequently suffer from a stuffy or runny nose or nasal polyps (swelling of the lining of the nose); heart failure; swelling of the lower legs, feet, and ankles; or illness of the kidneys or liver.
• tell your medic if you are pregnant, plan to become pregnant, or are breastfeeding. If used about 20 weeks into the pregnancy or later, diflunisal may also damage the fetus and interfere with delivery. Except as directed by your doctor, avoid using diflunisal at or after 20 weeks of pregnancy. If you become expectant while taking diflunisal, contact your physician.
• talk to your physician about the risks and benefits of taking diflunisal if you are 75 years of age or older. Do not take this medication for a longer period or at a higher dose than suggested by your doctor.
• if you are having surgery, including dental surgery, announce to the doctor and/or dentist that you are accepting diflunisal.
• call your physician if you think you may have a virus, such as chicken pox or the flu. If you have a virus, don’t take diflunisal, and never give diflunisal to a child who has a virus. 

Indication of diflunisal

For the symptomatic treatment of mild to moderate pain and inflammation induced by conditions like osteoarthritis, rheumatoid arthritis, musculoskeletal trauma, dental extraction, and/or episiotomy.

Associated Conditions

• Mild pain
• Osteoarthritis (OA)
• Rheumatoid Arthritis
• Moderate Pain

Contraindications of diflunisal

• Hypersensitivity to aspirin/NSAID-induced asthma (AERD) or urticaria
• 3rd-trimester pregnancy
• Coronary artery bypass surgery (peri-op pain)

What special dietary instructions should I follow?

Except if your doctor tells you in any case, to proceed with your typical eating regimen.

If I bypass a dose, what should I do?

Accept the missed portion when you remember it. However, if it is getting close to the time for the next dose, skip the missed one and stick to your usual schedule. If you miss a dose, don’t take twice as much.

What side effects can Diflunisal medication cause?

Diflunisal may cause side effects. Tell your physician if any of these symptoms are extreme or do not go away: In October 2020, the U.S. Food and Drug Administration (FDA) required the drug label to be corrected for all nonsteroidal anti-inflammatory medications to describe the risk of kidney problems in unborn babies that result in low amniotic fluid. They advise avoiding NSAIDs in expectant women at 20 weeks or later in pregnancy.

Gastrointestinal

The inhibition of prostaglandins has the effect of reducing the protection given to the stomach from its acid. Like all NSAIDs, this leads to an improved risk of stomach ulcers, and their complications, with long-term use. Senior users of diflunisal are at a more incredible chance for serious GI events.

• Raised risk of GI events including bleeding, ulceration, and stomach or intestine perforation.
• Abdominal pain or cramps
• Constipation
• Gas
• Diarrhea
• Nausea and vomiting
• Dyspepsia

Cardiovascular

• Irregular heartbeat
• An expanded opportunity of serious and possibly deadly cardiovascular thrombotic occasions, myocardial localized necrosis, and stroke are possible.
• Risks may also improve with the period of use and for cardiovascular disease history.

Ear, nose, throat, and eye

• Ringing in the ears
• Yellowing of eyes

Central nervous system

• Drowsiness
• Dizziness
• Headache
• Insomnia
• Fatigue
• Somnolence
• Nervousness

Skin

• Swelling of the feet, ankles, lower legs, and also in hands
• Yellowing of skin
• Rash
• Ecchymosis

Awareness

• Cardiovascular diseases
• Cardiac risk factors
• Hypertension
• Congestive heart failure
• Elderly or debilitated
• Impaired liver function
• Impaired kidney function
• Dehydration
• Fluid retention
• History of gastrointestinal bleeds/PUD
• Asthma
• Coagulopathy
• Smoker (tobacco use)
• Corticosteroid use
• Anticoagulant use
• Alcohol use
• Diuretic use

Diflunisal may cause other side effects. Contact your doctor if you have any unusual situations while taking this medication. If you experience a serious side effect, you or your physician may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting timetable online or by phone. 

What should I know regarding the storage and disposal of this medication?

Keep this medication in the receptacle it came in, tightly closed, and out of distance of children. Keep it at room temperature and away from extra heat and moisture (not in the bathroom). Medicine should always be kept out of children’s sight and reach because many containers, like weekly pill minders and those for eye drops, creams, patches, and inhalers, are not safe for children to open and are also easily opened by young children. To rescue young children from poisoning, always lock safety caps and instantly place the medication in a safe establishment – one that is up and away and out of their sight and reach. 

Unnecessary medications should be disposed of in special ways to ensure that pets, youngsters, and other people cannot consume them. Nevertheless, you should not discard this medication. Instead, enrolling in a medication take-back program is the most effective method for disposing of your medication. Talk to your apothecary or contact your local garbage or recycling department to understand about take-back programs in your community. See the FDA’s Safe Disposal of Medicines for more details if you do not have access to a take-back schedule.

What other information should I know?

Before starting any laboratory test, inform your doctor and the laboratory personnel that you are using diflunisal. Do not give your medication to anyone else. Ask your pharmacist any inquiries you have about supplying your prescription. You require to keep a written list of all of the prescription and nonprescription (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should obtain this list with you each time you visit a medic or if you are admitted to a hospital. It is also essential knowledge to bring with you in case of emergencies.

Interactions

Drug interactions may also change how your medications work or increase your chance of serious side effects. This composition does not contain all probable drug interactions. Maintain a list of all the consequences you utilize (including prescription or nonprescription drugs and herbal outcomes) and share it with your medic and apothecary. Do not start, stop, or alter the dosage of any medicines without your doctor’s approval.

A couple of items that could likewise interface with this medication have aliskiren, Pro inhibitors (like captopril, and lisinopril), angiotensin II receptor blockers, (for example, losartan, and valsartan), stomach settling agents (standard use), cidofovir, and furthermore corticosteroids (like prednisone), digoxin, live flu immunization, lithium, methotrexate, pemetrexed, probenecid, “water pills” (diuretics like furosemide, hydrochlorothiazide, triamterene).

This medication may also improve the chance of bleeding when taken with other medicines that also may cause bleeding. Examples possess anti-platelet medications such as clopidogrel, and “blood thinners” such as dabigatran or enoxaparin, or warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many contain pain relievers or 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 81 to 162 milligrams a day), should be continued. Confer your doctor or pharmacist for more details. This medicine can impact the aftereffects of specific lab tests. Check with your doctor and the lab to make sure they know you take this medication.

Important warning:

Individuals who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as diflunisal may have a more increased risk of having a heart attack or a stroke than people who do not take these medications. These possibilities may happen without warning and may induce death. This risk may be more elevated for individuals who take NSAIDs for a long time. Do not take an NSAID such as diflunisal if you have newly had a heart attack unless directed to do so by your doctor. If you smoke, tell your doctor if you or anyone in your family has had heart disease, a heart attack, or stroke, and if you have diabetes, high cholesterol, or high blood pressure. Get trouble medical help right away if you encounter any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.

If you are going to have a coronary artery bypass graft (CABG); a sort of heart medical procedure), you shouldn’t accept diflunisal just previously or just after the medical procedure.

NSAIDs, for instance, diflunisal may likewise incite ulcers, death, or openings in the stomach or digestive system. These situations may develop at any time during treatment, may occur without warning symptoms, and may cause death. The chance might be increased for individuals who take NSAIDs for a lengthy time, are more senior, have poor health, or drink large amounts of alcohol while you are taking diflunisal. Convey your medic if you take any of the subsequent drugs: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) and also naproxen (Aleve, Naprosyn); oral steroids like prednisone (Rayos), methylprednisolone (Medrol), or dexamethasone citalopram (Celexa), fluoxetine (Prozac, Sarafem, or Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, and Pexeva), and selective serotonin reuptake inhibitors (SSRIs) and also sertraline (Zoloft); and/or serotonin-norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). Also, tell your doctor if you have or have ever had ulcers, stomach or intestine bleeding, or any other condition that causes bleeding. Diflunisal should not be taken if you experience any of the following symptoms; instead, consult your doctor: stomach pain, heartburn, vomiting something that looks like coffee grounds or is bloody, blood in the stool, or stools that are black and tarry

Maintain all assignments with your physician and the laboratory. Your physician will monitor your manifestation carefully and will probably order certain tests to check your body’s reaction to diflunisal. Make sure to tell your doctor how you’re feeling so they can give you the right amount of medicine to treat your condition with the least amount of risk of serious side effects.

Your doctor or apothecary will give you the manufacturer’s patient information sheet (Medication Guide) when you begin remedy with diflunisal each time you refill your prescription. Read the details carefully and ask your physician or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website or the manufacturer’s website to receive the Medication Guide.

In case of an emergency or overdose

In the problem of overdose, reach the poison management helpline at 1-800-222-1222. Information is also known online. If the victim has collapsed, had a seizure, has disrupted breathing, or can not be revived, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• drowsiness
• vomiting
• upset stomach
• diarrhea
• decreased urination
• fast breathing
• fast heartbeat
• sweating
• ringing in the ears
• confusion
• coma (loss of consciousness for some time)

Overdose

If someone has overdosed and has serious symptoms such as handing out or trouble breathing, contact 911. Otherwise, call a poison command center right away. US residents can also contact their local poison control center at 1-800-222-1222. Canada residents may also call a provincial poison control command. Extreme drowsiness, rapid breathing, confusion, and/or loss of consciousness are all signs of an overdose, as are severe stomach pain and vomiting that looks like coffee grounds.

Notes

Do not share this medication with others. Medical and/or laboratory tests, such as a complete blood count and liver and kidney function tests, may be carried out regularly to check for side effects or monitor your progress. Confer your physician for more details. Non-drug therapy for arthritis that is supported by your physician (such as weight loss if required, strengthening and conditioning exercises) may help improve your flexibility, range of motion, and joint function. Consult your doctor for specific instructions.

Missed Dose

If you are prescribed this medication on a regular schedule (rather than just “as needed”) and miss a dose, take the missed dose as soon as you notice it. If it is close to the time of the following portion, avoid the missed portion. Take your next dose at the standard time. Do not duplicate the dose to catch up.

Storage

Keep the supply at room temperature, away from moisture and light. Keep it out of the bathroom. Keep pills away from pets and kids. Unless directed otherwise, never pour drugs down a drain or flush them down the toilet. When this product has run its course or is no longer required, dispose of it appropriately. Inform your pharmacist or the waste removal company in your area.

Precautions

If you are allergic to diflunisal, tell your doctor or pharmacist before taking it; or to aspirin, other salicylates (like choline salicylate), or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or celecoxib; or then again assuming that you have some other sensitivities. There may be inactive ingredients in this product that can cause allergic reactions or other issues. For further information, consult your pharmacist.

Inform your doctor or pharmacist of your medical history before taking this medication, particularly regarding: asthma (counting a past filled with deteriorating breathing in the wake of taking headache medicine or different NSAIDs), liver sickness, inadequately controlled diabetes, stomach or digestive system or throat issues (like dying, ulcers), coronary illness, (for example, the historical backdrop of cardiovascular failure), stroke, hypertension, enlarging (edema, liquid maintenance), blood problems (like sickliness), draining or potentially thickening issues, developments in the nose (nasal polyps).

Kidney situations can sometimes occur with the use of NSAID medicines, including diflunisal. Problems are more likely to happen if you are dehydrated, have heart failure or kidney disorder, are an older adult, or if you take certain drugs (see also Drug Interactions section). Drink plenty of fluids as required by your medic to prevent dehydration and tell your doctor right away if you have a difference in the amount of urine. Before having surgery, notify your physician or dentist that you are using this medication.

This drug may make you dizzy or drowsy. Liquor or pot (weed) can make you more woozy or sluggish. Until you are safe to do so, do not drive, work machinery, or engage in any activity requiring alertness. If you are employing marijuana (cannabis), talk to your doctor. This medicine may cause stomach bleeding. Daily use of alcohol and tobacco may increase your risk of stomach bleeding, especially when combined with this medicine. Limit alcohol and stop smoking. Confer your doctor or apothecary for more information. This medication’s side effects, particularly stomach/intestinal bleeding and kidney problems, may be more pronounced in the elderly.

Juveniles under the age of 12 should not take this medicine. Furthermore, since diflunisal is connected with headache medicine, kids and teens more youthful than 18 years shouldn’t accept diflunisal if they have chickenpox, flu, or any undiscovered disease without first counseling a specialist about Reye’s condition, an uncommon yet difficult sickness.

Women of childbearing age should discuss the benefits and risks of this medication with their doctor(s). Let your PCP know if you are expectant or then again believe that you intend to become pregnant. This drug might hurt an unborn kid and create some problems with typical work or conveyance. It is not recommended for use in pregnancy from 20 weeks until conveyance. Use the lowest effective dose for as little time as possible if your doctor decides that you need to take this medication between 20 and 30 weeks of pregnancy. You should not utilize this medication following 30 weeks of pregnancy.

This medication enters breast milk. It is not recommended to employ this drug while breastfeeding. Before starting to breastfeed, talk to your doctor.

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