nabumetone, Relafen (Discontinued) (cont.)

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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 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.

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