Nabumetone

Indications & Dose:

Osteoarthritis/Rheumatoid arthritis:

• BY MOUTH

ADULT:1g as a single dose with or without food, in severe case; 1-2 tablets in the  morning 

Soft-tissue injuries:

• BY MOUTH

2g per day taken in divided doses for a maximum of 7 days. Maximum dose 2g once a day.

Children:

Not recommended

Contraindications:

Bronchospasm, nasal polyps, angioedema precipitated by aspirin or other NSAIDs 

Side Effects:

Cautions:

Precautions:

History of GI ulceration, bleeding, or perforation; renal dysfunction, hypertension or cardiac conditions aggravated by fluid retention and edema, history of liver dysfunction, history of coagulation 

Interaction:

Drugs

Aminoglycosides: Reduced clearance with elevated aminoglycoside levels and potential for toxicity (especially indomethacin in premature infants:other NSAIDs-pzobably)

Antihypertensives: (alpha blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics) inhibition of antihypertensive and other favorable hemodynamic effects

Corticosteroids: Increased risk ofGI ulceration

Anticoagulants: Excessive hypoprothrombinemia, decreased platelet aggregation with increased risk of GI bleeding

Cyclosporine: Increased nephrotoxicity risk

Lithium: Decreased clearance of lithium (mediated via prostaglandins) resulting in elevated serum lithium levels and risk of toxicity

Methotrexate: Decreased renal secretion of methotrexate resulting in elevated methotrexate levels and risk of toxicity

Phenylpropanolamine: Possible acute hypertensive reaction

Potassium-Sparing Diuretics: Additive hyperkalemia potential

Triamterene: Acute, renal failure reported with addition. of indomethacin; caution with other NSAIDs

Warnings:

Adverse Effects:

Lactations:

Pregnancy

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Anxiety, confusion, depression. dizziness, drowsiness, fatigue, headache, insomnia, nervousness, tremors
CV: CHF, dysrhythmias, edema, palpitations, peripheral, tachycardia
EENT: Blurred vision, hearing loss, tinnitus
GI: Anorexia, cholestatic hepatitis, constipation, cramps, diarrhea, dry mouth. flatulence, gastritis, jaundice, nausea, peptic ulcer, perforation, ulceration, vomiting
GU: Azotemia, cystitis, dysuria, hematuria, nephrotoxicity,. oliguria
HEME: Blood dyscrasias
RESP: Bronchospasm, dyspnea, pharyngitis
SKIN: Photosensitivity, pruritus, purpura, rash, sweating 

Patient And Carer Advice: