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Difend Dosage |
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Generic name: Difend 18mg
Dosage form: capsule
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Carefully consider the potential benefits and risks of Difend and other treatment options before deciding to use Difend. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
The effectiveness of Difend when taken with food has not been studied in clinical studies. Taking Difend with food may cause a reduction in effectiveness compared to taking Difend on an empty stomach.
Acute Pain
For management of mild to moderate acute pain, the dosage is 18 mg or 35 mg orally three times daily.
Osteoarthritis Pain
For management of osteoarthritis pain, the dosage is 35 mg orally three times daily.
Patients with hepatic disease may require reduced doses of Difend compared to patients with normal hepatic function. As with other Difend products, start treatment at the lowest dose. If efficacy is not achieved with the lowest dose, discontinue use.
Difend capsules are not interchangeable with other formulations of oral Difend even if the milligram strength is the same. Difend capsules contain Difend free acid whereas other Difend products contain a salt of Difend, i.e., Difend potassium or sodium. A 35 mg dose of Difend is approximately equal to 37.6 mg of sodium Difend or 39.5 mg of potassium Difend. Therefore, do not substitute similar dosing strengths of other Difend products without taking this into consideration.
Ask your doctor before using Difend if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.
Tell your doctor about all your current medicines and any you start or stop using, especially:
cyclosporine;
lithium;
methotrexate;
rifampin;
antifungal medicine;
a blood thinner (warfarin, Coumadin, Jantoven);
heart or blood pressure medication, including a diuretic or "water pill";
other forms of Difend (Flector, Pennsaid, Solaraze, Difend Gel);
other NSAIDs - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), indomethacin, meloxicam, and others; or
steroid medicine (prednisone and others).
This list is not complete. Other drugs may interact with Difend, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Aspirin: Concomitant administration of Difend and aspirin is not recommended because Difend is displaced from its binding sites during the concomitant administration of aspirin, resulting in lower plasma concentrations, peak plasma levels and AUC values.
Anticoagulants: While studies have not shown Difend to interact with anticoagulants of the warfarin type, caution should be exercised, nonetheless, since interactions have been seen with other NSAIDs. Because prostaglandins play an important role in hemostasis and NSAIDs affect platelet function as well, concurrent therapy with all NSAIDs, including Difend and warfarin, requires close monitoring of patients to be certain that no change in their anticoagulant dosage is required.
Digoxin, Methotrexate, Cyclosporine: Difend, like other NSAIDs, may affect renal prostaglandins and increase the toxicity of certain drugs. Ingestion of Difend may increase serum concentrations of digoxin and methotrexate and increase cyclosporine's nephrotoxicity. Patients who begin taking Difend or who increase their Difend dose or any other NSAID while taking digoxin, methotrexate or cyclosporine may develop toxicity characteristics for these drugs. They should be observed closely, particularly if renal function is impaired. In the case of digoxin, serum levels should be monitored.
Lithium: Difend decreases lithium renal clearance and increases lithium plasma levels. In patients taking Difend and lithium concomitantly, lithium toxicity may develop.
Diuretics: Difend and other NSAIDs can inhibit the activity of diuretics. Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels.
Other Drugs: In small groups of patients (7-10/interaction study), the concomitant administration of azathioprine, gold, chloroquine, D-penicillamine, prednisolone, doxycycline or digitoxin did not significantly affect the peak levels and AUC values of Difend. Phenobarbital toxicity has been reported to have occurred in a patient on chronic phenobarbital treatment following the initiation of Difend therapy.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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