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Diflunisal, a nonsteroidal anti-inflammatory drug, requires careful consideration before use due to potential risks and side effects. Below is a detailed overview of the safety warnings and precautions to consider:

• Heart Attack and Stroke Risk: Diflunisal may elevate the risk of blood clots, leading to heart attacks or strokes, which can occur even within the first weeks of use. Those with heart conditions, taking higher doses, or using the medication long-term are at greater risk. Avoid usage if you have undergone or will undergo heart bypass surgery. Seek immediate medical attention if experiencing chest pain, breathing difficulties, or muscle weakness.

• Stomach Bleeding and Ulcers: The drug may cause severe stomach bleeding or ulcers, sometimes without warning. This risk increases for individuals with a history of gastrointestinal issues, older adults, or those taking other NSAIDs, corticosteroids, or blood thinners. Look out for symptoms like persistent stomach pain or black stools and consult your healthcare provider promptly.

• High Blood Pressure and Heart Failure: Diflunisal can affect kidney function, leading to increased blood pressure and potential heart failure. Monitor your blood pressure regularly, especially if you have a history of heart conditions. Contact your provider if you notice changes in blood pressure or experience symptoms like swelling or sudden weight gain.

• Kidney Damage: Long-term use of diflunisal can impair kidney function, particularly if combined with certain blood pressure medications or in individuals with pre-existing kidney or liver issues. Report any changes in urination frequency to your healthcare provider.

• Liver Damage: Although rare, diflunisal can cause severe liver damage, especially when taken with acetaminophen. Watch for signs like jaundice or dark urine and seek medical advice if these occur.

• Low Red Blood Cell Levels: Diflunisal may cause anemia, often linked to gastrointestinal bleeding or kidney damage. Regular blood tests may be necessary for long-term users to monitor red blood cell levels.

• Severe Asthma Attacks: This medication might trigger asthma attacks, particularly in individuals with a history of reactions to aspirin or other NSAIDs. Avoid use if you have a history of asthma attacks induced by these medications.

• Serious Allergic Reactions: Diflunisal can cause severe skin reactions or allergic responses. Discontinue use and seek medical help if symptoms such as blistering or swelling occur.

• Pregnancy Risks: Using diflunisal during the second or third trimester can harm the unborn baby, affecting amniotic fluid levels and fetal kidney or heart function. Discuss potential risks with your provider if pregnant or planning pregnancy.

• Reye's Syndrome: Rarely, diflunisal may cause Reye’s syndrome, particularly in children or teenagers recovering from viral infections. Be vigilant for symptoms like confusion or seizures and consult a healthcare provider immediately.

• Contraindications: Do not use diflunisal if you have had allergic reactions to aspirin or other NSAIDs, or if you have recently had heart bypass surgery.

Always discuss the benefits and risks of diflunisal with your healthcare provider to ensure it is appropriate for your condition.

When taking this medication, some individuals may experience mild side effects such as nausea, heartburn, stomach pain, diarrhea, rash, headache, upset stomach, tiredness, drowsiness, dizziness, constipation, or passing gas. These are typically not serious and often subside on their own. However, if they persist or become bothersome, it's advisable to consult a healthcare provider for guidance.

In some cases, other side effects such as sleepiness, difficulty falling asleep, ringing in the ears, or vomiting may occur. While these are less common, they should still be monitored, and medical advice should be sought if they are severe or persistent.

There are rare, but serious side effects that require immediate medical attention. These include signs of a heart attack (such as chest pain, trouble breathing, or cold sweat), stroke (including blurred vision or difficulty speaking), stomach bleeds (such as blood in vomit or black, tarry stools), and symptoms of heart failure like sudden weight gain or swelling. Liver damage is another severe concern, with symptoms like yellowing of the eyes or skin, dark urine, and extreme fatigue. Additionally, a severe asthma attack or a serious allergic reaction, characterized by difficulty breathing, swelling, or severe skin reactions, necessitates urgent medical care.

Being aware of these potential side effects can help in identifying any adverse reactions early. Always consult a healthcare professional if you have any concerns about side effects you experience.

Diflunisal can interact with a variety of medications, which may affect how it or the other drugs work, or increase the risk of side effects. It is crucial to inform your doctor and pharmacist about all the medications and supplements you are taking, including prescribed, over-the-counter, vitamins, and herbal supplements. Some interactions should be avoided altogether, while others may require careful management by your healthcare provider.

Medications Not Recommended with Diflunisal:

• Ketorolac: Using diflunisal with ketorolac is not advised as it can lead to increased risks of adverse effects. Your doctor may choose to either avoid prescribing diflunisal or adjust your other medications accordingly.

Medications Usually Not Recommended: Certain medications, when used with diflunisal, typically require caution. If deemed necessary, your doctor may adjust dosages or monitor you closely. These include:

• Blood thinners and anti-platelet drugs like Clopidogrel, Dabigatran, Enoxaparin, and Warfarin.
• Other NSAIDs such as Aspirin, Ibuprofen, Indomethacin, and Naproxen.
• Diuretics like Furosemide and Hydrochlorothiazide.
• Corticosteroids such as Prednisone and Methotrexate.
• Drugs like Lithium, pemetrexed, and Probenecid.

Increased Risk of Side Effects: When diflunisal is taken with some medications, there may be a heightened risk of side effects, but the combination might still be necessary. Your doctor may adjust your treatment plan to mitigate these risks. These medications include:

• Blood pressure medications like ACE inhibitors (Captopril, Lisinopril) and angiotensin II receptor blockers (Losartan, Valsartan).

Additional Considerations:

• Regular use of antacids can affect how diflunisal works.
• Diflunisal can increase the risk of bleeding, especially when combined with other drugs that have similar effects.
• Make sure all your healthcare providers and lab personnel know you are taking diflunisal, as it may interfere with certain lab tests.

Always follow your healthcare provider's instructions and discuss any concerns you have about potential interactions.