nabumetone, Relafen (Discontinued)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: nabumetone
BRAND NAME: Relafen (Discontinued)
DRUG CLASS AND MECHANISM: Nabumetone belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Other members of this class include ibuprofen (Motrin), indomethacin (Indocin), naproxen (Aleve) and several others. These drugs are used for the management of mild to moderate pain, fever, and inflammation. They work by reducing the levels of prostaglandins, chemicals produced by the body that are responsible for pain, fever and inflammation. NSAIDs block the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try different NSAIDs for any given condition. The FDA approved nabumetone in December 1991.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 500 and 750 mg
STORAGE: Nabumetone should be stored at 20 C to 25 C (68 F to 77 F), in a sealed, light- and moisture-resistant container.
DOSING: May be taken with or without food. The recommended starting dose for osteoarthritis or rheumatoid arthritis is 1000 mg daily as a single dose. Some patients may respond better to 1500 or 2000 mg daily. Doses may also be divided and administered twice daily. The lowest effective dose should be used.
DRUG INTERACTIONS: Nabumetone, like other NSAIDs is associated with several suspected or probable interactions that affect the action of other drugs. Nabumetone may increase the blood levels of lithium (Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.
Nabumetone may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins have a role in the regulation of blood pressure.
When nabumetone is used in combination with aminoglycosides (for example, gentamicin [Garamycin]) the blood levels of the aminoglycoside may increase, presumably because the elimination of aminoglycosides from the body is reduced. This may lead to more aminoglycoside-related side effects. Individuals taking oral blood thinners or anticoagulants (for example, warfarin [Coumadin]) should avoid nabumetone because nabumetone also thins the blood, and excessive blood thinning may lead to bleeding.
Combining NSAIDs with methotrexate (Rheumatrex, Trexall) may reduce the elimination of methotrexate from the body, increase the levels of methotrexate in the body, and result in increased side effects of methotrexate.
Persons who have more than three alcoholic beverages per day are at increased risk of developing stomach ulcers when taking nabumetone or other NSAIDs.
PREGNANCY: Like other NSAIDs, nabumetone is generally avoided during pregnancy because it may affect the cardiovascular system of the fetus.
NURSING MOTHERS: It is not known whether nabumetone is excreted in breast milk.
SIDE EFFECTS: Most patients, benefit from nabumetone and other NSAIDs with few side effects. However, serious side effects can occur, and generally tend to be dose-related. Therefore, it is advisable to use the lowest effective dose to minimize side effects. The most common side effects of nabumetone involve the gastrointestinal system. Some studies have shown that nabumetone may have a lower risk of gastrointestinal side effects than the other NSAID medications. However, like the other NSAID medications, it still can cause ulceration, abdominal pain, cramping, nausea, gastritis, even serious gastrointestinal bleeding, and liver toxicity. Sometimes, ulceration and bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding.
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