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Relafen (nabumetone), a nonsteroidal anti-inflammatory drug, is used to relieve the inflammation, swelling, stiffness, and joint pain associated with rheumatoid arthritis and osteoarthritis (the most common form of arthritis).

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Uses

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. Consequently, 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.

How to take

Nabumetone can be taken with or without food. Take it exactly as prescribed.

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.

Precaution

Tell your doctor your medical history especially of: any liver or kidney disease, blood disorders, ulcers, heart disease, alcohol use, high blood pressure, eye disease, asthma, nasal polyps, any allergies - especially aspirin/NSAID allergy (e.g., ibuprofen, celecoxib). Use caution when performing tasks requiring alertness. Limit alcohol intake as it may intensify the drowsiness effect of this medication. This medicine may cause stomach bleeding. Daily use of alcohol, especially when combined with this medicine, may increase your risk for stomach bleeding. Check with your doctor or pharmacist for more information. Do not take aspirin without consulting your doctor. Check the ingredients of any nonprescription medication you may be taking since many cough-and-cold formulas contain aspirin. Caution is advised when this drug is used in the elderly. This medication should be used during pregnancy only if clearly needed. Discuss the risks and benefits with your doctor. Use of this drug in the last 6 months of pregnancy is not recommended. It is unknown if nabumetone is excreted into breast milk. Consult your doctor before breast-feeding.

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.

Missed dose

If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store at 20-25 C (68-77 F), in a sealed, light- resistant container. Avoid moisture. Keep away from children and pets.