Nabumetone

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Nabumetone Brand Names- Relafen | Relafen DS

What is Nabumetone

Nabumetone is an oral nonsteroidal anti-inflammatory drug (NSAID) of the acetic acid chemical class.

Nabumetone is a nonacidic prodrug that requires conversion to an active metabolite (6-MNA) for its anti-inflammatory, analgesic, and antipyretic activity.

Nabumetone is the only NSAID of the acetic acid class with a half-life long enough to support once daily administration.

Other NSAIDs that can be given as a single daily dose include piroxicam (enolic acid derivative) and oxaprozin (propionic acid derivative). Because the metabolites of 6-MNA are weak inhibitors of the COX enzyme and are renally excreted, nephrotoxicity of nabumetone relative to other NSAIDs is hypothesized to be less.

However, current data do not conclusively support or refute this hypothesis; more data are needed.

Nabumetone appears to inhibit cyclooxygenase-2 preferentially at low doses, but the preferential inhibition of cyclooxygenase-2 is diminished at higher doses.

All NSAIDs including nabumetone cause an increased risk of serious gastrointestinal adverse effects including bleeding, ulceration, and perforation of the stomach or intestines and may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.

The lowest effective nabumetone dose for the shortest possible duration is recommended, as the risk for adverse effects may increase with duration of use.

Nabumetone was approved by the FDA in December 1991.

Indications

  1. ankylosing spondylitis
  2. osteoarthritis
  3. rheumatoid arthritis

For the acute and chronic treatment of rheumatoid arthritis or osteoarthritis

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. agitation
  4. agranulocytosis
  5. alopecia
  6. anaphylactoid reactions
  7. anemia
  8. angina
  9. angioedema
  10. anorexia
  11. anxiety
  12. aplastic anemia
  13. appetite stimulation
  14. arrhythmia exacerbation
  15. aseptic meningitis
  16. asthenia
  17. azotemia
  18. blurred vision
  19. bullous rash
  20. chills
  21. confusion
  22. constipation
  23. cough
  24. cystitis
  25. depression
  26. diaphoresis
  27. diarrhea
  28. dizziness
  29. dysgeusia
  30. dyspepsia
  31. dysphagia
  32. dyspnea
  33. dysuria
  34. edema
  35. elevated hepatic enzymes
  36. eosinophilic pneumonia
  37. eructation
  38. erythema multiforme
  39. esophageal stricture
  40. esophageal ulceration
  41. esophagitis
  42. fatigue
  43. fever
  44. flatulence
  45. gastritis
  46. GI bleeding
  47. GI perforation
  48. gingivitis
  49. glossitis
  50. headache
  51. heart failure
  52. hematuria
  53. hemolytic anemia
  54. hepatic failure
  55. hepatic necrosis
  56. hepatitis
  57. hyperglycemia
  58. hyperkalemia
  59. hypertension
  60. hyperuricemia
  61. hypokalemia
  62. hyponatremia
  63. impotence (erectile dysfunction)
  64. infertility
  65. insomnia
  66. interstitial nephritis
  67. jaundice
  68. leukopenia
  69. malaise
  70. melena
  71. myocardial infarction
  72. nausea
  73. nephrolithiasis
  74. nephrotic syndrome
  75. neutropenia
  76. nightmares
  77. odynophagia
  78. oliguria
  79. palpitations
  80. pancreatitis
  81. paresthesias
  82. peptic ulcer
  83. photosensitivity
  84. platelet dysfunction
  85. pneumonitis
  86. polyuria
  87. proteinuria
  88. pruritus
  89. pseudoporphyria
  90. purpura
  91. pyrosis (heartburn)
  92. rash
  93. renal failure (unspecified)
  94. renal papillary necrosis
  95. Stevens-Johnson syndrome
  96. stomatitis
  97. stroke
  98. syncope
  99. thrombocytopenia
  100. thromboembolism
  101. tinnitus
  102. toxic epidermal necrolysis
  103. tremor
  104. urticaria
  105. vaginal bleeding
  106. vasculitis
  107. vertigo
  108. visual impairment
  109. vomiting
  110. weight gain
  111. weight loss
  112. xerostomia

Monitoring Parameters

  • blood pressure
  • serum creatinine/BUN

Contraindications

  • acute bronchospasm
  • acute myocardial infarction
  • alcoholism
  • anemia
  • angina
  • anticoagulant therapy
  • asthma
  • bone marrow suppression
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • cerebrovascular disease
  • chemotherapy
  • children
  • coagulopathy
  • coronary artery bypass graft surgery (CABG)
  • coronary artery disease
  • corticosteroid therapy
  • dehydration
  • dental disease
  • dental work
  • diabetes mellitus
  • geriatric
  • GI bleeding
  • GI disease
  • GI perforation
  • heart failure
  • hematological disease
  • hemophilia
  • hepatic disease
  • hypertension
  • hypovolemia
  • immunosuppression
  • infertility
  • intramuscular injections
  • jaundice
  • labor
  • myocardial infarction
  • nasal polyps
  • neutropenia
  • NSAID hypersensitivity
  • obstetric delivery
  • peptic ulcer disease
  • peripheral edema
  • peripheral vascular disease
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • reproductive risk
  • rheumatoid arthritis
  • salicylate hypersensitivity
  • stroke
  • surgery
  • systemic lupus erythematosus (SLE)
  • tachycardia
  • thrombocytopenia
  • thromboembolism
  • tobacco smoking
  • ulcerative colitis
  • urticaria

Interactions

  • Abciximab
  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetohexamide
  • Acyclovir
  • Adefovir
  • Aldesleukin, IL-2
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Alpha-blockers
  • Alteplase
  • Altretamine
  • Ambenonium Chloride
  • Amikacin
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminolevulinic Acid
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Anagrelide
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  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
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  • Docetaxel
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  • Doxazosin
  • Drospirenone
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  • Drospirenone; Ethinyl Estradiol
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  • Drotrecogin Alfa
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  • Efavirenz; Emtricitabine; Tenofovir
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  • Eltrombopag
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enalapril, Enalaprilat
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  • food
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  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Ibuprofen
  • Hydrocortisone
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibritumomab Tiuxetan
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  • Iloprost
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