Nabumetone (Relafen)

• Type of Drug: Nonsteroidal anti-inflammatory drug (NSAID).
• Prescribed for: Rheumatoid arthritis and osteoarthritis.

Nabumetone General Information

Nabumetone is one of 16 nonsteroidal anti-inflammatory drugs (NSAIDs) used to relieve pain and inflammation. We do not know exactly how NSAIDs work, but part of their action may be due to an ability to inhibit the body’s production of a hormone called prostaglandin and to inhibit the action of other body chemicals, including cyclo-oxygenase, lipoxygenase, leukotrienes, lysosomal enzymes, and a host of other factors. NSAIDs are generally absorbed into the blood fairly quickly. Pain relief generally comes within an hour after taking the first dose, but the NSAID’s anti-inflammatory effect generally takes a lot longer (several days to 2 weeks) to become apparent, and may take a month or more to reach its maximum effect. Nabumetone is broken down in the liver; it must be converted to its active form by the liver before it can work for your arthritis.

Nabumetone Cautions and Warnings

People who are allergic to Nabumetone (or any other NSAID) and those with a history of asthma attacks brought on by other NSAIDs, Iodides, or Aspirin should not take it.

Nabumetone can cause gastrointestinal (GI) bleeding, ulcers, and stomach perforation. This can occur at any time, with or without warning, in people who take chronic Nabumetone treatment. People with a history of active GI bleeding should be cautious about taking any NSAID. Minor stomach upset, distress, or gas is common during the first few days of treatment with Nabumetone. People who develop bleeding or ulcers and continue treatment should be aware of the possibility of developing more serious drug toxicity.

Nabumetone can affect platelets and blood clotting at high doses, and should be avoided by people with clotting problems and by those taking Warfarin.

People with heart problems who use Nabumetone may experience swelling in their arms, legs, or feet.
Nabumetone can cause severe toxic effects to the kidney. Report any unusual side effects to your doctor, who may need to periodically test your kidney function.

Nabumetone can make you unusually sensitive to the effects of the sun (photosensitivity).

Nabumetone Possible Side Effects

• Most common: diarrhea, nausea, vomiting, constipation, stomach gas, stomach upset or irritation, and loss of appetite.
• Less common: stomach ulcers, GI bleeding, hepatitis, gallbladder attacks, painful urination, poor kidney function, kidney inflammation, blood and protein in the urine, dizziness, fainting, nervousness, depression, hallucinations, confusion, disorientation, tingling in the hands or feet, light-headedness, itching, increased sweating, dry nose and mouth, heart palpitations, chest pain, difficulty breathing, and muscle cramps.
• Rare: severe allergic reactions, including closing of the throat, fever and chills, changes in liver function, jaundice (yellowing of the skin or eyes), and kidney failure. People who experience such effects must be promptly treated in a hospital emergency room or doctor’s office.

NSAIDs have caused severe skin reactions; if this happens to you, see your doctor immediately.

Nabumetone Drug Interactions

• Nabumetone can increase the effects of oral anticoagulant (blood-thinning) drugs such as Warfarin. You may take this combination, but your doctor may have to reduce your anticoagulant dose.
• Taking Nabumetone with Cyclosporine may increase the toxic kidney effects of both drugs. Methotrexate toxicity may be increased in people also taking Nabumetone.
• Nabumetone may reduce the blood-pressure-lowering effect of beta blockers and loop diuretic drugs.
• Nabumetone may increase blood levels of Phenytoin, leading to increased Phenytoin side effects. Blood-Lithium levels may be increased in people taking Nabumetone.
• Nabumetone blood levels may be affected by Cimetidine because of that drug’s effect on the liver.
• Probenecid may interfere with the elimination of Nabumetone frorp the body increasing the chances for Nabumetone toxic reactions.
• Aspirin and other salicylates may decrease the amount of Nabumetone in your blood. These medicines should never be taken at the same time.

Food Interactions

Take Nabumetone with food or a magnesium/aluminum antacid if it upsets your stomach.

Usual Dose

1000 to 2000 mg per day taken in 1 or 2 doses. Take each dose with a full glass of water and don’t lie down for 15 to 30 minutes after you take the medicine.

Nabumetone Overdosage

People have died from NSAID overdoses. The most common signs of overdosage are drowsiness, nausea, vomiting, diarrhea, abdominal pain, rapid breathing, rapid heartbeat, increased sweating, ringing or buzzing in the ears, confusion, disorientation, stupor, and coma.

Take the victim to a hospital emergency room at once. ALWAYS bring the medicine bottle.

Nabumetone Special Information

Nabumetone can make you drowsy and/or tired: Be careful when driving or operating hazardous equipment. Do not take any nonprescription products with Acetaminophen or Aspirin while taking this drug; also, avoid alcoholic beverages. Contact your doctor if you develop skin rash or itching, visual disturbances, weight gain, breathing difficulty, fluid retention, hallucinations, black or tarry stools, persistent headache, or any unusual or intolerable side effects.

If you forget to take a dose of Nabumetone, take it as soon as you remember. If you take several doses a day and it is within 4 hours of your next dose, skip the one you forgot and continue with your regular schedule. If you take Nabumetone once a day and it is within 8 hours of your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.

Nabumetone Special Populations

Pregnancy/Breast-feeding
NSAIDs may cross into the fetal blood circulation. They have not been found to cause birth defects, but may affect a developing fetal heart during the second half of pregnancy; animal studies indicate a possible effect. Women who are or might become pregnant should not take Nabumetone without their doctors7 approval; be particularly cautious about using this drug during the last 3 months of your pregnancy. When the drug is considered essential by your doctor, its potential benefits must be carefully weighed against its risks.

NSAIDs may pass into breast milk, but have caused no problems among breast-fed infants, except for seizures in a baby whose mother was taking Indomethacin. Other NSAIDs have caused problems in animal studies. There is a possibility that a nursing mother taking Nabumetone could affect her baby’s heart or cardiovascular system. If you must take Nabumetone, bottle-feed your baby.

Seniors
Older adults may be more susceptible to Nabumetone side effects, especially ulcer disease.