phenylbutazone, Butazolidine (cont.)
Eni Williams, PharmD, PhD
Eni Williams, PharmD, PhD
Dr. Eni Williams graduated from Creighton University in 1988 with a B.S. degree in pharmacy and a Doctor of Pharmacy from Howard University in 1994. She also obtained a Ph.D. in Public Policy in 2009 at the University of Maryland, Baltimore County.
Medical and Pharmacy Editor:
DOSING: Should be taken with food.
DRUG INTERACTIONS: Phenylbutazone should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can aggravate both conditions. Phenylbutazone is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of an increased risk of bleeding. Patients taking lithium (Eskalith, Lithobid) can develop toxic blood lithium levels. Additionally, patients taking cyclosporine (Sandimmune) can develop kidney toxicity. Use in children has not been adequately studied. Phenylbutazone is not habit forming. NSAIDs should be discontinued prior to elective surgery because of a mild interference with clotting that is characteristic of this group of medicines. Phenylbutazone is best discontinued at least three days in advance of the procedure.
PREGNANCY: Phenylbutazone is generally avoided during pregnancy.
NURSING MOTHERS: Phenylbutazone is generally avoided in nursing mothers.
SIDE EFFECTS: Most patients benefit from NSAIDs with little side effects. However, serious side effects can occur, and generally tend to be dose related. Phenylbutazone is not a commonly used NSAID because of a unique potential for severe bone marrow toxicity, which results in dangerously low white blood cell counts. Therefore, it is often desirable to use the lowest effective dose to minimize side effects. The most common side effects of phenylbutazone involve the gastrointestinal system. It can also cause ulcerations, abdominal burning, pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. Sometimes, stomach 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 are also seen (all more frequently in seniors).
Reference: FDA Prescribing Information
Medically Reviewed by a Doctor on 3/6/2014
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