1 What is Dolobid?

Brand: Dolobid

Generic: Diflunisal

Dolobid is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain and to relieve symptoms of arthritis, such as inflammation, swelling, stiffness and joint pain.

This medication does not cure arthritis and will only help as long as you continue to take it. This medication is only available with your doctor’s prescription. This medication is available in the following forms:

  • Tablet

2 What to Know Before Using

Before using Dolobid, you must know all about the risks and complications associated with it. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

Allergies: Inform your doctor if you have ever had an allergic reaction to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.

Pediatric: No appropriate studies have been performed on the relationship of age to the effects of this medication in children. Safety and efficacy have not been established.

Geriatric: Up-to-date studies have not shown any problems specific to the elderly that would limit the use of this medication in the elderly population. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in dose.

Pregnancy: This medication is listed as Pregnancy Category C. This means that animal studies have shown an adverse effect and no studies have been performed on pregnant women OR there are no adequate studies on pregnant animals and pregnant women.

Breastfeeding: There are no up-to-date studies in women for determining infant risk when using this medication while breastfeeding. Weigh the potential risks with the benefits before taking this medication while breastfeeding.

Drug Interactions: Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur. In these cases, your doctor may want to change your dose or take other precautions.

When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below. The following interactions were selected on the basis of potential significance and are not all-inclusive. Using this medication with any of the following is not recommended.

Your doctor may decide not to treat you with this medication, or change some of the other medications you take:

  • Ketorolac

Using this medication with any of the following medication is not recommended, but may be unavoidable in some cases.

Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:

  • Abciximab
  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Anagrelide
  • Apixaban
  • Ardeparin
  • Argatroban
  • Beta Glucan
  • Bivalirudin
  • Certoparin
  • Cilostazol
  • Citalopram
  • Clomipramine
  • Clopidogrel
  • Cyclosporine
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desipramine
  • Desirudin
  • Desvenlafaxine
  • Dibenzepin
  • Dipyridamole
  • Dothiepin
  • Doxepin
  • Duloxetine
  • Edoxaban
  • Enoxaparin
  • Eptifibatide
  • Erlotinib
  • Escitalopram
  • Feverfew
  • Fluoxetine
  • Fluvoxamine
  • Fondaparinux
  • Ginkgo
  • Gossypol
  • Heparin
  • Imipramine
  • Lepirudin
  • Levomilnacipran
  • Lofepramine
  • Meadowsweet
  • Melitracen
  • Methotrexate
  • Milnacipran
  • Nadroparin
  • Nefazodone
  • Nortriptyline
  • Opipramol
  • Parnaparin
  • Paroxetine
  • Pemetrexed
  • Pentosan Polysulfate Sodium
  • Pentoxifylline
  • Phenprocoumon
  • Pralatrexate
  • Prasugrel
  • Protein C
  • Protriptyline
  • Reboxetine
  • Reviparin
  • Rivaroxaban
  • Sertraline
  • Sibutramine
  • Tacrolimus
  • Tianeptine
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Trimipramine
  • Venlafaxine
  • Vilazodone
  • Vortioxetine

Using this medication with any of the following medications may increase your risk of side effects. However, using both medications may be the best treatment for you.

If both medications are prescribed together, your doctor may change the dose or how often you take one or both medications:

  • Acebutolol
  • Acenocoumarol
  • Alacepril
  • Alprenolol
  • Amiloride
  • Anisindione
  • Arotinolol
  • Atenolol
  • Azosemide
  • Befunolol
  • Bemetizide
  • Benazepril
  • Bendroflumethiazide
  • Benzthiazide
  • Betaxolol
  • Bevantolol
  • Bisoprolol
  • Bopindolol
  • Bucindolol
  • Bumetanide
  • Bupranolol
  • Buthiazide
  • Canrenoate
  • Captopril
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Chlorothiazide
  • Chlorthalidone
  • Cilazapril
  • Clopamide
  • Cyclopenthiazide
  • Delapril
  • Dicumarol
  • Dilevalol
  • Enalapril
  • Enalaprilat
  • Esmolol
  • Ethacrynic Acid
  • Fosinopril
  • Furosemide
  • Hydrochlorothiazide
  • Hydroflumethiazide
  • Imidapril
  • Indapamide
  • Labetalol
  • Landiolol
  • Levobunolol
  • Lisinopril
  • Mepindolol
  • Methyclothiazide
  • Metipranolol
  • Metolazone
  • Metoprolol
  • Moexipril
  • Nadolol
  • Nebivolol
  • Nipradilol
  • Oxprenolol
  • Penbutolol
  • Pentopril
  • Perindopril
  • Pindolol
  • Piretanide
  • Polythiazide
  • Propranolol
  • Quinapril
  • Ramipril
  • Sotalol
  • Spirapril
  • Spironolactone
  • Talinolol
  • Temocapril
  • Tertatolol
  • Timolol
  • Torsemide
  • Trandolapril
  • Triamterene
  • Trichlormethiazide
  • Warfarin
  • Xipamide
  • Zofenopril

Other Interactions: Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.

Other Medical Problems: Pre-existing medical problems may affect the use of this medication.

Be sure to tell your doctor if you have any other medical problems, especially:

  • Anemia
  • Asthma
  • Bleeding problems
  • Blood clots
  • Edema (fluid retention or body swelling)
  • Heart attack
  • Heart disease (i.e. congestive heart failure)
  • High blood pressure
  • Kidney disease
  • Liver disease (i.e. hepatitis)
  • Stomach or intestinal ulcers or bleeding
  • Stroke - Use with caution. This medicine may make these conditions worse.
  • Aspirin sensitivity - This medicine should NOT be used in patients with this condition .
  • Heart surgery (i.e. coronary artery bypass graft [CABG] surgery) - This medicine should NOT be used to relieve pain right before or after the surgery.

3 Proper Usage

Proper usage of Dolobid requires strict adherence to your doctor’s orders. Do not take more, less or for a longer or shorter period of time than your doctor tells you.

This medication comes with a patient information brochure. It is very important that your read this information. Ask your doctor if you have any questions.

If you are using this medication for severe or chronic (continuous) arthritis, this medication must be taken regularly as your doctor orders in order for it to help you. This medication normally begins working within 1 week, but may take up to 2 weeks or longer in more severe cases.

Swallow the tablet whole with a glass of water. Do not crush or chew it. If it makes you nauseous, you may take it with food.

Dosing: Different patients will be given a different dose of this medication based on the strength of the medication. The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.

The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.

For mild to moderate pain:

  • Adults - 1,000mg for the first dose, then 500mg every 8-12 hours as needed. Some people may only need 500mg for the first dose, then 250mg every 8-12 hours as needed. The total dose in 24 hours should not be more than 1500mg per day.
  • Children - Use and dose must be determined by your doctor.

For osteoarthritis and rheumatoid arthritis:

  • Adults and teenagers - Begin with 250-500mg twice a day. Your doctor may increase or decrease your dose as needed. The normal dose is not normally more than 1500mg per day.
  • Children - Use and dose must be determined by your doctor.

Missed dose: If you miss a dose of this medication, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and resume your normal dosing schedule. Do not double dose.

Storage: Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze.

Keep our of the reach of children. Do not keep expired medication or medication you no longer need. Ask your doctor how to dispose of any medication you do not use.

4 Precautions to Take

Before using Dolobid, there are some precautions you must take. It is very important that your doctor checks in with you often while you are receiving this medication to make sure that it is working properly.

Do not take other prescription or over-the-counter medications without asking your doctor. This medication may raise your risk of having a heart attack or stroke. This is more likely in people who have already suffered a heart attack or stroke, or in people who use this medication for a long time.

This medication may cause bleeding in the stomach or intestines. These problems may happen without any warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, are over 60 years old, are in poor health or are using certain other medications such as steroids or a blood thinner.

Serious skin reactions may occur with this medication. Inform your doctor immediately if you have to blister, peeling, loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin or fevers or chills while using this medication.

This medication may cause a rare, but serious, illness called Reye’s syndrome. It mostly occurs in children and teenagers, but may affect a person at any age. Do not give this medication to anyone who has chicken pox or symptoms of a virus or the flu unless your doctor tells you to. If a child has behavioural changes with nausea and vomiting while using this medication, call your doctor immediately.

Possible warning signs of serious side effects that may occur during your treatment may include black, tarry stool, decreased urination, severe stomach pain, skin rash, swelling of the face, fingers, feet or lower legs, unusual bleeding or bruising, unusual weight gain, vomiting blood or material that looks like coffee grounds or yellow skin or eyes (jaundice).

Signs of a serious heart problem may occur such as chest pain, tightness in the chest, fast or irregular heartbeat (tachycardia, arrhythmias), unusual flushing or warmth of the skin, weakness or slurring of speech. If you notice any of these signs, call your doctor immediately.

Using this medication while pregnant can harm your unborn child. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant, inform your doctor immediately.

Inform your doctor immediately if you have blurred vision, difficulty reading or any other change in vision while taking this medication. Your doctor may want you to have your eyes checked by an ophthalmologist.

Inform the doctor in charge that you are using this medication before any surgery or medical tests. It may be necessary to stop treatment for a while, or to change to a different NSAID medication before your treatment.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Dolobid. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

More common:

  • Stomach cramps or pain

Less common:

  • Back or leg pains
  • Bleeding gums
  • Blistering, peeling, loosening of skin
  • Bloody or black, tarry stools
  • Bloody or cloudy urine
  • Blurred or loss of vision
  • Burning feeling in chest or stomach
  • Burning while urinating
  • Clay-colored stools
  • Constipation
  • Cough or hoarseness
  • Cracks in the skin
  • Dark-colored urine
  • Diarrhea
  • Difficult or painful urination
  • Difficulty breathing
  • Difficulty swallowing
  • Disturbed color perception
  • Dizziness
  • Double vision
  • Facial swelling
  • Fast heartbeat (tachycardia)
  • Feeling of warmth
  • Fever with or without chills
  • Flu-like symptoms
  • General body swelling
  • General feeling of fatigue or weakness (malaise)
  • Greatly decreased frequency of urination or amount of urine
  • Halos around lights
  • Headache
  • Hives
  • Increased blood pressure
  • Increased thirst (polydipsia)
  • Indigestion
  • Itching
  • Joint or muscle pain
  • Large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
  • Light-colored stools
  • Liver function abnormalities
  • Loss of appetite
  • Loss of heat from the body
  • Lower back or side pain
  • Muscle aches, pains, or weakness
  • Nausea or vomiting
  • Night blindness
  • Noisy breathing
  • Nosebleeds
  • Overbright appearance of lights
  • Pale skin
  • Pinpoint red spots on skin
  • Puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
  • Red, irritated eyes
  • Redness of the face, neck, arms and occasionally, upper chest
  • Red skin lesions, often with a purple center
  • Red, swollen skin
  • Scaly skin
  • Severe or continuing stomach pain
  • Shortness of breath
  • Skin rash
  • Sores, ulcers, or white spots in mouth or on lips
  • Sore throat
  • Stomach upset
  • Swelling of face, fingers, feet or lower legs
  • Swollen lymph nodes
  • Tenderness in stomach area
  • Tightness in chest
  • Trouble breathing
  • Tunnel vision
  • Unpleasant breath odor
  • Unusual bleeding or bruising
  • Unusual fatigue or weakness
  • Upper right abdominal pain
  • Vomiting of blood or material that looks like coffee grounds
  • Weight gain
  • Wheezing
  • Yellow eyes or skin (jaundice)

Get immediate emergency medical help if any of the following symptoms of overdose occur:

  • Change in consciousness
  • Confusion about identity, place, and time
  • Continuing ringing or buzzing or other unexplained noise in ears (tinnitus)
  • Decreased awareness or responsiveness
  • Deep or fast breathing with dizziness
  • Fast, pounding, or irregular heartbeat or pulse (tachycardia, palpitations, arrhythmias)
  • Hearing loss
  • Loss of consciousness
  • Numbness of feet, hands, and around mouth
  • Severe sleepiness
  • Sweating

Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Talk to your doctor if any of the following side effects continue or are bothersome, or if you have questions:

More common:

Less common:

  • Bloated, full feeling
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • Discouragement
  • Dry mucous membranes
  • Excess air or gas in stomach or intestines
  • Fatigue
  • Feeling of constant movement of self or surroundings
  • Feeling sad or empty (depression)
  • Increased sensitivity of skin to sunlight (photosensitivity)
  • Irritability
  • Lack or loss of strength
  • Lightheadedness
  • Loss of interest or pleasure
  • Mood or mental changes
  • Nervousness
  • Seeing, hearing, or feeling things that are not there (hallucinations)
  • Sensation of spinning (vertigo)
  • Severe sunburn
  • Sleeplessness
  • Swelling or inflammation of the mouth
  • Trouble concentrating
  • Trouble sleeping
  • Unable to sleep
  • Weight loss

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects. Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.