Diflunisal

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Diflunisal
Systematic (IUPAC) name
5-(2,4-difluorophenyl)-2-hydroxy-benzoic acid
Identifiers
CAS number 22494-42-4
ATC code N02BA11
PubChem 3059
DrugBank APRD00922
Chemical data
Formula C13H8F2O3 
Mol. mass 250.198 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability 80-90%
Protein binding >99%
Metabolism Hepatic
Half life 8 to 12 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat.

C(AU) C(US)
Legal status

POM(UK) ℞-only(US)
Routes Oral

Diflunisal is a generic NSAID (non-steroidal anti-inflammatory drug). It is often used under the brand name Dolobid marketed by Merck & Co. Diflunisal acts by inhibiting the production of prostaglandin, a hormone that creates inflammation and stimulates the neuro receptors for pain. Though diflunisal has an onset of 1 hour, and maximum analgesia at 2 to 3 hours, the diflunisal plasma levels will not be steady until repeated doesages are achieved. To increase the rate at which the diflunisal plasma levels become steady, a loading dose is usually used. It is primarily used to treat symptoms of arthritis.

Overdose

Deaths that have occurred from diflunisal usually involved mixed drugs and or extremely high dosages. The oral LD50 is 500 mg/kg. Symptoms of overdose include coma, tachycardia, stupor, and vomiting. The lowest dose without the presence of other medicines which caused death was 15 grams. Mixed with other medicines, a death at 7.5 grams has also occurred. Diflunisal usually comes in 250 or 500 mg, thus it is relatively hard to overdose by accident.

Abuse

This medication has no side effects like those of recreational drugs. Therefore it has no chance of misuse.

Indicated for:
  • Pain, mild-moderate
  • Osteoarthritis
  • Rheumatoid arthritis
  • Injury to tendons
  • Inflammation

Do not cut/crush/chew. Monitor blood pressure. Use lowest effective dose for shortest duration.
Side effects:

Cardiovascular:

  • Irregular heart beat (!)
  • This medication may increase risk of serious and potentially fatal cardiovascular thrombotic events, MI, and stroke (!)
  • Risk may increase with duration of use (!)
  • Increased risk for Cardiovascular disease history (!)
  • Contraindicated for Heart Bypass peri-op pain (!)

Ear, nose, and throat:

  • Ringing in the ears (!)

Eye:

  • Yellowing of eyes (!)

Gastrointestinal:

  • Increased risk of serious GI adverse events including bleeding, ulceration, and stomach or intestine perforation which can be fatal: may occur at any time during use and without warning. Elderly at greater risk for serious GI events (!)
  • Abdominal pain and cramps
  • Constipation
  • Gas & Flatulence
  • Diarrhea
  • Nausea & Vomiting
  • Dyspepsia

Central Nervous System:

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

Psychiatric:

  • Nervousness

Skin:

  • Swelling of the feet, ankles, lower legs, and hands (!)
  • Yellowing of skin (!)
  • Rash
  • Ecchymosis

Contraindications:

  • Hypersensitivity to aspirin/NSAID-induced asthma or urticaria
  • Aspirin triad
  • Pregnancy 3rd trimester
  • CABG surgery (peri-op pain)

Cautions:

  • Cardiovascular disease
  • Cardiac risk factors
  • Hypertension
  • Congestive Heart Failure
  • Elderly or debilitated
  • Impaired liver function
  • Impaired kidney function
  • Dehydration
  • Fluid retention
  • GI bleed history/PUD
  • Asthma
  • Coagulopathy
  • Smoker
  • Corticosteriod use
  • Anticoagulant use
  • Alcohol use
  • Diuretic use
  • ACE Inhibitor use
  • Prolonged use

Precautions:

  • If symptoms labeled, (!), appear, stop usage immediately and contact your doctor.
  • Overdose is possible and deaths have occurred.
  • Do not take while on other pain medications.
  • Do not take while pregnant or breast feeding.

External links

v • d • e
Anti-inflammatory products (M01A)
Pyrazolidine/Butylpyrazolidines
Acetic acid derivatives
and related substances
Oxicams
Propionic acid derivatives
Fenamates
Coxibs
Other
v • d • e
Non-steroidal anti-inflammatory drug (NSAID) products (primarily M01A and M02A, also N02BA)
Salicylates
Arylalkanoic acids
2-Arylpropionic acids
(profens)
N-Arylanthranilic acids
(fenamic acids)
Pyrazolidine derivatives
Oxicams
COX-2 inhibitors
Sulphonanilides
Topically used products
COX-inhibiting nitric oxide donators
Others
Items listed in bold indicate initially developed compounds of specific groups. †Withdrawn drugs. ‡Veterinary use medications.
v • d • e
Analgesic products (N02A, N02B)
Opioids
See also: Opioids template
Opium & alkaloids thereof
Semi-synthetic opium
derivatives
Synthetic opioids
Pyrazolones
Cannabinoids
Anilides
Non-steroidal
anti-inflammatories
See also: NSAIDs template
Propionic acid class
Oxicam class
Acetic acid class
Anthranilic acid
(fenamate) class
Atypical, adjunct
& miscellaneous

Wikipedia content modification information:

  • This page was last modified on 30 September 2008, at 23:15.

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