Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Greece: Analeric, Di-Flu; Sweden: Donobid.

North America

Canada: Diflunisal; USA: Diflunisal.

Drug combinations


Diflunisal: C~13~H~8~F~2~O~3~. Mw: 250.20. (1) [1,1′-Biphenyl]-3-carboxylic acid, 2′,4′-difluoro-4-hydroxy-; (2) 2′,4′-Difluoro-4-hydroxy-3-biphenylcarboxylic acid. CAS-22494-42-4 (1975).

Pharmacologic Category

Analgesics and Antipyretics; Other Nonsteroidal Anti-inflammatory Agents. (ATC-Code: N02BA11).

Mechanism of action

Inhibits prostaglandin synthesis by decreasing activity of the enzyme cyclooxygenase, which results in decreased formation of prostaglandin precursors.

Therapeutic use

Used for anti-inflammatory and analgesic effects in the symptomatic treatment of acute and chronic rheumatoid arthritis and osteoarthritis. Can also be used as an analgesic for treatment of mild-to-moderate pain.

Pregnancy and lactiation implications

Diflunisal should not be used during the 3^rd^ trimester of pregnancy, since inhibitors of prostaglandin synthesis may have adverse effects on the fetus. The drug should be used during the 1^st^ or 2^nd^ trimester of pregnancy only when potential benefits justify possible risks to the fetus.

Unlabeled use


Hypersensitivity to diflunisal, aspirin, other NSAIDs, or any component of the formulation. Perioperative pain in the setting of coronary artery bypass graft surgery.

Warnings and precautions

Anaphylactoid reactions might occur (avoid use in bronchospasm, asthma, rhinitis, or urticaria with NSAID therapy). May prolong bleeding time. Anemia might occur. Increased risk of cardiovascular thrombotic events (MI, stroke, and new onset or worsening of pre-existing hypertension)(use caution with fluid retention, heart failure, or hypertension). May increase risk of GI irritation, inflammation, ulceration, bleeding, and perforation (use caution with history of GI disease (bleeding or ulcers), concurrent therapy with aspirin, anticoagulants and/or corticosteroids, smoking, use of alcohol, elderly or debilitated patients). Hypersensitivity syndrome reported. Diflunisal is possibly associated with Reye’s syndrome. May cause exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Caution in decreased hepatic function (severe hepatic reactions occurred). May compromise existing renal function (patients with impaired renal function, dehydration, heart failure, liver dysfunction, those taking diuretics, and ACE inhibitors, and the elderly are at greater risk of renal toxicity). Withhold for at least 4-6 half-lives prior to surgical or dental procedures. NSAID formulations reversibly decrease platelet aggregation via mechanisms different than those observed with aspirin, therefore caution should be exercised in the use of NSAIDs in patients already on anticoagulant therapy with drugs such as warfarin.



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