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Diflunisal, Oral dy-FLOO-ni-sal

What are other names for this medicine?

Type of medicine: nonsteroidal anti-inflammatory drug (NSAID)

Generic and brand names: diflunisal, oral

What is this medicine used for?

This medicine is a nonsteroidal anti-inflammatory drug (NSAID). It is used to provide relief from:

  • the symptoms of arthritis
  • pain associated with conditions such as bursitis, menstrual cramps, gout, headache, and muscle strains

This medicine may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before you take this medicine, be sure to tell your healthcare provider if you have ever had:

  • an allergic reaction to any medicine
  • a heart attack, stroke, or recent heart surgery
  • asthma
  • bleeding problems or blood disorders such as anemia
  • heart failure or problems with swelling in ankles, feet, or hands
  • high blood pressure
  • kidney or liver disease
  • phenylketonuria (PKU). Some forms of this medicine may contain phenylalanine.
  • problems urinating
  • stomach or intestinal problems such as ulcerative colitis, Crohn's disease, heartburn, ulcers or bleeding

Tell your provider if you take steroids such as prednisone or medicine that reduces the chance of blood clots forming such as warfarin (Coumadin). Also, tell your healthcare provider if you regularly drink alcohol.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. This medicine is not usually given to pregnant women because it can harm the baby, especially in late pregnancy If you become pregnant, contact your healthcare provider right away. Do not breast-feed while taking this medicine without your health care provider's approval.

How do I use it?

Take this medicine exactly as your healthcare provider prescribes. If your healthcare provider has not given you specific instructions, follow the directions that come with the medicine package. Read the Medication Guide or directions that come in the medicine package when you start taking this medicine and each time you get a refill. Do not take more or take it longer than prescribed. Ask your healthcare provider or pharmacist about anything you do not understand.

Check the label on the medicine for directions about your specific dose. Take this medicine with a full glass (8Â ounces) of water. You may take this medicine with or without food. Taking it with food or milk may lessen the chance the drug will upset your stomach.

If you are taking this medicine for arthritis, take it regularly as prescribed by your healthcare provider.

If you are taking aspirin to prevent a heart attack or stroke, talk with your healthcare provider before you take this NSAID medicine. NSAIDs may make aspirin less effective. Your healthcare provider can tell you how much time you should allow between taking aspirin and taking this NSAID medicine.

This medicine may come in different forms. If you take delayed- or extended-release tablets or capsules, swallow them whole. Do not break, crush, or chew them. Ask your pharmacist if you have delayed- or extended-release tablets or capsules.

If you have the liquid form of this medicine, shake it well before using. Use a special measuring spoon or the dosing device in the medicine package rather than a common kitchen spoon to make sure you get the right dose.

What if I miss a dose?

If you take this medicine on a regular schedule and you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: stomach pain, nausea, vomiting, vomiting or coughing up blood, dizziness, drowsiness, confusion, black or bloody stools, trouble walking, tremors, decreased urination, fever, fast heartbeat, shallow or trouble breathing, headache, ringing in the ears, numbness, tingling, seizures, fainting, coma.

What should I watch out for?

Warning: Occasionally, this medicine may cause bleeding, ulcers, or perforation of the stomach or intestines. These problems may occur without warning symptoms. You may be at higher risk if you smoke, are over the age of 65 or in poor health, drink alcohol, or take this medicine for a long time. If you have abdominal pain, a black tarry stool, or a bloody stool, stop taking this medicine and contact your healthcare provider right away.

This medicine has been linked with increased risk for high blood pressure. Also, taking this medicine for a long time may make it more likely that you will have a heart attack or stroke. Talk with your healthcare provider about this.

You may have swelling of the ankles, feet, or hands while taking this medicine. If this becomes bothersome, contact your healthcare provider.

This medicine should not be used right before or after a heart surgery called coronary artery bypass graft (CABG). Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. This medicine may affect the results of certain lab tests.

This medicine may cause an allergic reaction in people who have asthma or who have had allergic reactions to aspirin or other painkillers. If you develop hives, itching, a rash, tightness in your chest, or trouble breathing, stop taking this medicine and contact your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.

Do not take other pain relievers or drink alcohol while you are taking this medicine unless your healthcare provider approves. They may increase the risk of stomach upset.

Check the labels of all nonprescription and prescription medicines you take. Taking other medicines that contain NSAIDs while you take this medicine may lead to an overdose. Ask your health care provider or pharmacist if you have any questions.

This medicine may cause blurred vision, dizziness, or drowsiness. Do not drive or operate machinery unless you are fully alert. Contact your healthcare provider if these problems continue or get worse.

You may need eye exams if you have vision changes while taking this medicine or if you take this medicine for a long time.

If you take this medicine for a long time, you may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors.

This medicine may cause Reye's syndrome in people with viral infections such as the flu or chickenpox, especially children and teens. Ask your healthcare provider before taking this medicine if you have flu symptoms or other viral illness.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, rash, tightness in your chest or trouble breathing), extreme headache with stiff neck.

Serious (report these to your healthcare provider right away): Confusion; feeling faint; mouth or lip sores; hearing problems or ringing in your ears; vision changes; dark urine; yellowing of your skin or eyes; loss of appetite; bloody or black tarry stools; severe vomiting, stomach pain, or diarrhea; swelling in ankles, feet, or hands or any unexplained swelling; decreased urination or trouble urinating; severe or unusual weakness or tiredness; unusual bleeding or bruising; chest pain; shortness of breath; slurring of speech; sudden weakness in one part or side of your body; sudden, severe, or continued headache, or one that is different from a usual headache; skin rash or blisters with fever; severe itching.

Other: Mild fever, chills, muscle pain, stomach pain, diarrhea, nausea, tiredness, gas, headache, dizziness, constipation, increased sweating.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

  • acetaminophen (Tylenol)
  • ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
  • antidepressants such as amitriptyline, doxepin, duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox CR), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), venlafaxine (Effexor), and vilazodone (Viibryd)
  • angiotensin II blockers such as candesartan (Atacand), losartan (Cozaar), and valsartan (Diovan)
  • antibiotics such as ciprofloxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin)
  • aspirin or other salicylates
  • antiseizure medicines such as carbamazepine (Tegretol), fosphenytoin (Cerebyx), phenobarbital, phenytoin (Dilantin) and primidone (Mysoline)
  • beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), and sotalol (Betapace)
  • bile acid sequestrants such as cholestyramine (Questran), colesevelam (WelChol), and colestipol (Colestid)
  • celecoxib (Celebrex)
  • corticosteroids such as cortisone, dexamethasone, fludrocortisone (Florinef), hydrocortisone (Cortef), prednisolone (Orapred), prednisone and methylprednisolone (Medrol, Solu-Medrol)
  • diabetes medicines such as chlorpropamide, glimepiride (Amaryl), glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase), and tolbutamide
  • digoxin (Lanoxin)
  • diuretics such as amiloride, bumetanide, chlorothiazide (Diuril), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), and triamterene (Dyrenium, Dyazide, Maxzide)
  • immunosuppressants such as cyclosporine (Sandimmune, Neoral, Gengraf) and tacrolimus (Prograf)
  • lithium (Lithobid)
  • medicines that contain NSAIDs such as cough and cold medicines or other pain or fever medicines
  • medicines to treat Alzheimer's such as galantamine (Razadyne ER, Razadyne)
  • medicines to treat bone loss such as alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel), and tiludronate (Skelid)
  • medicines to treat or prevent blood clots such as abciximab (ReoPro), argatroban, bivalirudin (Angiomax), clopidogrel (Plavix), dipyridamole (Persantine), lepirudin (Refludan), tirofiban (Aggrastat), and warfarin (Coumadin)
  • methotrexate (Rheumatrex, Trexall)
  • medicines to treat cancer or arthritis such as pemetrexed (Alimta), and pralatrexate (Folotyn)
  • natural remedies such as alfalfa, anise, bilberry, cat’s claw, celery, chamomile, chaparral, comfrey, dong quai, evening primrose, fenugreek, feverfew, fish oil, flaxseed, garlic, ginseng, ginkgo, glucosamine, grape seed, green tea, horse chestnut, kava, ma huang, pennyroyal, red clover, SAMe, turmeric, white willow, and valerian
  • pentosan polysulfate sodium (Elmiron)
  • probenecid
  • rifampin (Rifadin, Rimactane)
  • sulfa medicines such as sulfamethoxazole/trimethoprim (Bactrim, Septra) and sulfisoxazole

Do not drink alcohol while taking this medicine. Also, do not take other painkillers while you are taking this medicine without your healthcare provider's approval.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.


This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.


Developed by RelayHealth.
Medication Advisor 2012.1 published by RelayHealth.
Last modified: 2011-05-05
Last reviewed: 2011-03-01
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.
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