While this patient was taking diflunisal and indomethacin he
developed cholestatic jaundice, and when the diflunisal was stopped and
the indomethacin continued the jaundice gradually cleared. He is
still taking indomethacin and Distalgesic.
Indomethacin has been implicated in hepatitis.2 Diflunisal may
increase plasma concentrations of indomethacin by up to 35%.3 In
this case, before the introduction of diflunisal the patient was taking
150 mg of indomethacin daily and when the diflunisal was introduced
the dose of indomethacin was halved. Thus it seems highly unlikely
that the indomethacin caused the jaundice. It must be concluded that
diflunisal was the cause; the time interval from the beginning of the