Diflunisal

• 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.

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.