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Information about Diflunisal

Diflunisal is a salicylic acid derivative that is used in the therapy of chronic arthritis and mild to moderate acute pain. 

Liver safety of Diflunisal

Diflunisal has been linked mild, transient elevations in serum aminotransferase levels during therapy as well as to rare instances of idiosyncratic drug induced liver disease.  

Mechanism of action of Diflunisal

Diflunisal (dye floo' ni sal) is a difluorophenol derivative of salicylic acid that has antiinflammatory, analgesic and antipyretic actions similar to aspirin.  Diflunisal is metabolized by the liver, but not to salicylate.  Diflunisal is considered a nonsteroidal antiinflammatory agent (NSAID) and is believed to act by inhibition of tissue cyclo-oxygenases (Cox-1 and Cox-2), which leads to a decrease in synthesis of proinflammatory prostaglandins, important mediators in inflammatory and pain pathways. 

FDA approval information for Diflunisal

Diflunisal was approved for use in the United States in 1982 and current indications are for chronic arthritis due to osteoarthritis or rheumatoid arthritis and for mild-to-moderate pain.  Diflunisal has been shown to stabilize transthyretin variants which are involved in the pathogenesis of amyloidosis, which has led to the off-label use of diflunisal in familial amyloidosis.  Diflunisal is available as tablets of 500 mg in generic forms and formerly under the brand name of Dolobid.  Diflunisal is available by prescription only. 

Dosage and administration for Diflunisal

The recommended regimen in adults is an initial dose of 1000 mg, followed by 500 to 1500 mg daily in two to three divided doses based upon response and tolerance.  Diflunisal, like most NSAIDs, is generally well tolerated, but side effects can include intestinal upset, nausea, heartburn, headache, somnolence, dizziness, peripheral edema and hypersensitivity reactions.

Nonsteroidal Antiinflammatory Drugs (NSAIDs)

Acetaminophen, Celecoxib, Diclofenac, Diflunisal, Etodolac, Fenoprofen, Flurbiprofen, Ibuprofen, Indomethacin, Ketoprofen, Ketorolac, Mefenamic Acid, Meloxicam, Nabumetone, Naproxen, Nimesulide, Oxaprozin, Phenylbutazone, Piroxicam, Rofecoxib, Sulindac, Tolmetin
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