0
ARTICLE |

Diflunisal: Title and subTitle BreakA New Oral Analgesic With an Unusually Long Duration of Action FREE

James A. Forbes, MS; William T. Beaver, MD; E. Hartley White, DDS; R. Wendell White, DDS; Gloria B. Neilson, RN; Robert W. Shackleford, MD
[+] Author Affiliations

Read in part before the 81st annual meeting of the American Society for Clinicial Pharmacology and Therapeutics, San Francisco, March 19, 1980.

Reprint requests to 5 S Main St, Shrewsbury, PA 17361 (Mr Forbes).


JAMA. 1982;248(17):2139-2142. doi:10.1001/jama.1982.03330170043025
Text Size: A A A
Published online

The analgesic efficacy of single 500- and 1,000-mg doses of diflunisal (Dolobid), a new nonsteroidal anti-inflammatory analgesic, was compared in a double-blind study with that of acetaminophen, 600 mg, the combination of acetaminophen, 600 mg, with codeine phosphate, 60 mg, and placebo in 159 oral surgery outpatients. Using a self-rating record, patients rated their pain and its relief hourly for 12 hours after medication. Both doses of diflunisal were significantly more effective than acetaminophen alone and produced peak analgesia comparable to that of the acetaminophen-codeine combination. Diflunisal proved to have an unusually long duration of analgesic action. Acetaminophen and the combination were significantly superior to placebo through hours 2 and 5, respectively; both doses of diflunisal were significantly superior through the end of the 12-hour observation period. None of the active treatments produced more side effects than the placebo.

(JAMA 1982;248:2139-2142)

REFERENCES

Hannah J, Ruyle WV, Jones H, et al:  Discovery of diflunisal . Br J Clin Pharmacol 1977;;4( (suppl 1) ):7-13.
DeVroey P, Steelman SL, Caudron J, et al:  A double-blind, placebo-controlled, single-dose study comparing three dose levels of diflunisal with aspirin and placebo in patients with pain due to episiotomy . Acta Ther 1977;;3:205-216.
Van Winzum C, Rodda B:  Diflunisal: Efficacy in post-operative pain . Br J Clin Pharmacol 1977;;4( (suppl 1) ):39-43.
DeSchepper PJ, Tjandramaga TB, DeRoo M, et al:  Gastrointestinal blood loss after diflunisal and after aspirin: Effect of ethanol . Clin Pharmacol Ther 1978;;23:669-676.
Smit Sibinga CT:  Effect of diflunisal on platelet function and blood coagulation . Br J Clin Pharmacol 1977;;4( (suppl 1) ):37-38.
Tempero KF, Cirillo VJ, Steelman SL:  Diflunisal: A review of pharmacokinetic and pharmacodynamic properties, drug interactions, and special tolerability studies in humans . Br J Clin Pharmacol 1977;;4( (suppl 1) ):31-36.
Winer BJ: Statistical Principles in Experimental Design . New York, McGraw-Hill Book Co Inc, 1962;, pp 105-135.
Kramer CY:  Extension of multiple range tests to group means with unequal numbers of replications . Biometrics 1956;;12:307-310.
Cooper SA, Beaver WT:  A model to evaluate mild analgesics in oral surgery outpatients . Clin Pharmacol Ther 1976;;20:241-250.
Cooper SA, Breen JF, Giuliani RL:  Replicate studies comparing the relative efficacies of aspirin and indoprofen in oral surgery outpatients . J Clin Pharmacol 1979;;19:151-159.
Cooper SA:  Efficacy of zomepirac in oral surgery pain . J Clin Pharmacol 1980;;20:230-242.
Forbes JA, White RW, White EH, et al:  An evaluation of the analgesic efficacy of proquazone and aspirin in postoperative dental pain . J Clin Pharmacol 1980;;20:465-474.
Beaver WT:  Mild analgesics: A review of their clinical pharmacology . Am J Med Sci 1965;;250:577-604
1966;251:576-599.
Beaver WT:  Aspirin and acetaminophen as constituents of analgesic combinations . Arch Intern Med 1981;;141:293-300.
Moertel CG, Ahmann DL, Taylor WF, et al:  A comparative evaluation of marketed analgesic drugs . N Engl J Med 1972;;286:813-815.
Moertel CG, Ahmann DL, Taylor WF, et al:  Relief of pain by oral medications: A controlled evaluation of analgesic combinations . JAMA 1974;;229:55-59.
Moertel CG:  Relief of pain with oral medications . Aust NZ J Med 1976;;6( (suppl 1) ):1-8.
Beaver WT:  Analgesic development: A brief history and perspective . J Clin Pharmacol 1980;;20:213-215.
Houde RW, Wallenstein SL, Beaver WT:  Clinical measurement of pain , in deStevens G (ed): Analgetics . New York, Academic Press Inc, 1965;, pp 75-122.
Wallenstein SL:  Analgesic studies of aspirin in cancer patients , in Dale TLC (ed): Proceedings of the Aspirin Symposium . London, The Aspirin Foundation, 1975;, pp 5-10.
Forbes JA, Calderazzo JP, Bowser MW, et al:  A 12-hour evaluation of the analgesic efficacy of diflunisal, aspirin, and placebo in postoperative dental pain . J Clin Pharmacol 1982;;22:89-96.
Forbes JA, Kolodny AL, Beaver WT, et al:  A 12-hour evaluation of the analgesic efficacy of diflunisal, acetaminophen, an acetaminophencodeine combination, and placebo in postoperative pain . Pharmacotherapy , in press.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Hannah J, Ruyle WV, Jones H, et al:  Discovery of diflunisal . Br J Clin Pharmacol 1977;;4( (suppl 1) ):7-13.
DeVroey P, Steelman SL, Caudron J, et al:  A double-blind, placebo-controlled, single-dose study comparing three dose levels of diflunisal with aspirin and placebo in patients with pain due to episiotomy . Acta Ther 1977;;3:205-216.
Van Winzum C, Rodda B:  Diflunisal: Efficacy in post-operative pain . Br J Clin Pharmacol 1977;;4( (suppl 1) ):39-43.
DeSchepper PJ, Tjandramaga TB, DeRoo M, et al:  Gastrointestinal blood loss after diflunisal and after aspirin: Effect of ethanol . Clin Pharmacol Ther 1978;;23:669-676.
Smit Sibinga CT:  Effect of diflunisal on platelet function and blood coagulation . Br J Clin Pharmacol 1977;;4( (suppl 1) ):37-38.
Tempero KF, Cirillo VJ, Steelman SL:  Diflunisal: A review of pharmacokinetic and pharmacodynamic properties, drug interactions, and special tolerability studies in humans . Br J Clin Pharmacol 1977;;4( (suppl 1) ):31-36.
Winer BJ: Statistical Principles in Experimental Design . New York, McGraw-Hill Book Co Inc, 1962;, pp 105-135.
Kramer CY:  Extension of multiple range tests to group means with unequal numbers of replications . Biometrics 1956;;12:307-310.
Cooper SA, Beaver WT:  A model to evaluate mild analgesics in oral surgery outpatients . Clin Pharmacol Ther 1976;;20:241-250.
Cooper SA, Breen JF, Giuliani RL:  Replicate studies comparing the relative efficacies of aspirin and indoprofen in oral surgery outpatients . J Clin Pharmacol 1979;;19:151-159.
Cooper SA:  Efficacy of zomepirac in oral surgery pain . J Clin Pharmacol 1980;;20:230-242.
Forbes JA, White RW, White EH, et al:  An evaluation of the analgesic efficacy of proquazone and aspirin in postoperative dental pain . J Clin Pharmacol 1980;;20:465-474.
Beaver WT:  Mild analgesics: A review of their clinical pharmacology . Am J Med Sci 1965;;250:577-604
1966;251:576-599.
Beaver WT:  Aspirin and acetaminophen as constituents of analgesic combinations . Arch Intern Med 1981;;141:293-300.
Moertel CG, Ahmann DL, Taylor WF, et al:  A comparative evaluation of marketed analgesic drugs . N Engl J Med 1972;;286:813-815.
Moertel CG, Ahmann DL, Taylor WF, et al:  Relief of pain by oral medications: A controlled evaluation of analgesic combinations . JAMA 1974;;229:55-59.
Moertel CG:  Relief of pain with oral medications . Aust NZ J Med 1976;;6( (suppl 1) ):1-8.
Beaver WT:  Analgesic development: A brief history and perspective . J Clin Pharmacol 1980;;20:213-215.
Houde RW, Wallenstein SL, Beaver WT:  Clinical measurement of pain , in deStevens G (ed): Analgetics . New York, Academic Press Inc, 1965;, pp 75-122.
Wallenstein SL:  Analgesic studies of aspirin in cancer patients , in Dale TLC (ed): Proceedings of the Aspirin Symposium . London, The Aspirin Foundation, 1975;, pp 5-10.
Forbes JA, Calderazzo JP, Bowser MW, et al:  A 12-hour evaluation of the analgesic efficacy of diflunisal, aspirin, and placebo in postoperative dental pain . J Clin Pharmacol 1982;;22:89-96.
Forbes JA, Kolodny AL, Beaver WT, et al:  A 12-hour evaluation of the analgesic efficacy of diflunisal, acetaminophen, an acetaminophencodeine combination, and placebo in postoperative pain . Pharmacotherapy , in press.
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.