- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: phenylbutazone
Brand Name: Butazolidine
What is phenylbutazone, and what is it used for?
Phenylbutazone has been removed from the United States market due to the availability of newer drugs with fewer adverse effects. Phenylbutazone is a nonsteroidal anti-inflammatory drug (NSAID) effective in treating fever, pain, and inflammation in the body.
As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps, arthritis and other musculoskeletal conditions. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try a variety of NSAIDs for any given condition. However, because of a unique risk of bone marrow suppression (causing dangerously low white blood counts), phenylbutazone is generally reserved only for short-term use in selected patients.
What are the side effects of phenylbutazone?
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.
Other important side effects include:
- abdominal burning,
- 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).
Which drugs interact with phenylbutazone?
- 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 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 and breastfeeding
Phenylbutazone is no longer available in the United States. It is, however, prescribed to treat inflammation and pain that results from ankylosing spondylitits, rheumatoid arthritis, gout, and osteoarthritis. The most common side effects of phenylbutazone involve the gastrointestinal system. Other important side effects include ulcerations, abdominal burning, pain, cramping, nausea, gastritis, serious gastrointestinal bleeding, and liver toxicity. Do not take if pregnant or breastfeeding.
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