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.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Nabumetone belongs to a class of drugs called
non-steroidal 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.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: tablets: 500, and 750 mg
STORAGE: Store at 20-25 C (68-77 F), in a sealed, light- resistant container.
Avoid moisture.
PRESCRIBED FOR: Nabumetone is used for the treatment of inflammation and pain
that results from rheumatoid arthritis and osteoarthritis. Nabumetone has the
convenience of once daily dosing.
DOSING: May be taken with or without food. The recommended starting dose is
1000 mg daily as a single dose. Some patients may respond better to 1500 or 2000
mg 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) 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 play 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 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 ulcerations,
abdominal pain, cramping, nausea, gastritis, and 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. Rash, kidney impairment,
ringing in the ears, and lightheadedness also can occur. NSAIDs reduce the
ability of blood to clot and therefore increase bleeding after an injury.
Nabumetone should be avoided by patients with a history of exacerbation of
asthma, hives, or other allergic reactions to
aspirin or other NSAIDs. Rare but
severe allergic reactions have been reported in such individuals.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
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