Drug Detail:Nabumetone (Nabumetone [ na-bue-me-tone ])
Drug Class: Nonsteroidal anti-inflammatory drugs
1. How it works
- Nabumetone may be used to help relieve helps pain and inflammation.
- Nabumetone works by blocking the effects of COX enzymes. This prevents prostaglandin synthesis (prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission).
- Nabumetone belongs to a group of medicines known as NSAIDs (nonsteroidal anti-inflammatory drugs).
2. Upsides
- Nabumetone relieves inflammation and pain associated with osteoarthritis and rheumatoid arthritis in adults.
- NSAIDs (such as nabumetone) are considered first-line options for mild-to-moderate arthritis-type pain because at correct dosages they are effective, do not cause dependence and are readily available at a low cost.
- May be less likely than some other NSAIDs (such as naproxen) to adversely affect the stomach or increase bleeding time.
- Can be given as a single or twice daily dose.
- Generic nabumetone is available.
3. Downsides
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Diarrhea, dyspepsia, abdominal pain, constipation, flatulence, or nausea.
- Tinnitus, edema, itchiness and a rash have also been reported.
- Stomach-related adverse effects such as bleeding, ulceration, or perforation. Older patients or those taking other medicines that affect the stomach may be more at risk.
- Most NSAIDs have been associated with an increased risk of stroke or heart attack. The risk may be higher for patients with pre-existing conditions, in those who drink more than three glasses of alcohol per day, and with higher dosages.
- May not be suitable for some people including those with kidney disease, a history of stomach ulcers or other gastrointestinal disorders, with pre-existing cardiovascular disease, or following coronary artery bypass graft surgery.
- May interact with some other medicines such as warfarin, SSRIs, ACE inhibitors, and diuretics.
- NSAIDs, such as nabumetone, should not be used during the last three months of pregnancy because they can cause premature closure of the fetal ductus arteriosus. In addition, the use of NSAIDs at around 20 weeks gestation or later in pregnancy may cause fetal kidney problems leading to oligohydramnios (low amniotic fluid volume) and in some cases kidney impairment. If NSAID treatment is deemed necessary between 20 and 30 weeks of pregnancy, use the lowest effective dose for the shortest possible time. Avoid NSAIDs after 30 weeks gestation.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Tips
- Take with food to reduce the risk of stomach-related adverse effects. See a doctor if you experience any persistent stomach-related adverse effects.
- Always use the lowest effective dose for the shortest duration possible, or as advised by your doctor.
- Response to different NSAIDs can vary so switching types (ie, from nabumetone to ibuprofen) may improve response.
- See a doctor immediately if you experience any difficulty with breathing, unexplained sickness or fatigue, loss of appetite, vision changes, fluid retention or abnormal bleeding.
- NSAIDs should not be used in the last 3 months of pregnancy; ask your doctor before using any medication in pregnancy.
- Avoid if you experience a worsening of asthma or develop hives with nabumetone or any other NSAID use, including aspirin.
- Do not use this medicine in the setting of heart bypass surgery (coronary artery bypass graft, or CABG).
- NSAIDs, such as nabumetone, should not be used in the last 3 months of pregnancy; always ask your doctor before using any medication during pregnancy. Do not use NSAIDs such as nabumetone between 20 and 30 weeks gestation without your doctor's advice because this may cause kidney problems and low amniotic fluid volumes in the newborn. Acetaminophen may be considered to treat pain and inflammation during pregnancy.
5. Response and effectiveness
- Peak levels of nabumetone are reached 1-2 hours after administration. The effects of one nabumetone tablet generally last for 24 hours.
6. Interactions
Medicines that interact with nabumetone may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with nabumetone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with nabumetone include:
- ACE inhibitors or ARBs, such as captopril, enalapril, or losartan
- aminoglycosides, such as gentamicin
- antibiotics, such as ciprofloxacin, norfloxacin, or vancomycin
- anticoagulants (blood thinners) such as apixaban, dabigatran, fondaparinux, heparin, or warfarin
- antidepressants, such as citalopram, escitalopram, fluoxetine, or paroxetine
- antifungals, such as voriconazole
- antiplatelets, such as clopidogrel or ticagrelor
- beta-blockers, such as acebutolol, atenolol, bisoprolol, or carvedilol
- bisphosphonates, such as alendronate
- corticosteroids, such as dexamethasone or prednisone
- cyclosporine
- digoxin
- diuretics (water pills), such as chlorthalidone, chlorothiazide, hydrochlorothiazide (HCTZ), or furosemide
- glucagon
- haloperidol
- HIV medications (eg, Stribild, tenofovir)
- metformin
- other nonsteroidal anti-inflammatories (NSAIDs), such as celecoxib, diclofenac, etodolac, ibuprofen, ketorolac, meloxicam, or naproxen
- probenecid
- sulfonylureas (a type of diabetes medication), such as glimepiride, glyburide, or glipizide
- supplements, such as glucosamine, omega-3 fatty acids, vitamin E
- others, such as cyclosporine, lithium, methotrexate, pemetrexed, pirfenidone, or tacrolimus.
Drinking alcohol while taking nabumetone may increase the risk of gastrointestinal-related side effects or kidney damage.
Note that this list is not all-inclusive and includes only common medications that may interact with nabumetone. You should refer to the prescribing information for nabumetone for a complete list of interactions.