Nabumetone

Nabumetone is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve the pain, swelling, and stiffness of osteoarthritis and rheumatoid arthritis. It is a prodrug: after absorption, the liver converts it to its active form, 6-methoxy-2-naphthylacetic acid (6-MNA), which inhibits cyclooxygenase (COX-1 and COX-2) enzymes and reduces prostaglandin production, thereby lowering inflammation and pain. Nabumetone is taken by mouth, typically once daily (commonly 1,000 mg) or split into two doses, up to a maximum of 2,000 mg per day, and is generally taken with food to reduce stomach upset. Full anti-inflammatory benefit may take up to one to two weeks of regular use to become apparent. Like other NSAIDs, nabumetone carries a boxed warning for increased risk of serious cardiovascular thrombotic events (including heart attack and stroke) and serious gastrointestinal adverse events (including bleeding, ulceration, and perforation of the stomach or intestines), which can occur without warning symptoms. Common side effects include stomach pain, heartburn, nausea, diarrhea, dizziness, and headache. It should be avoided in patients with a history of aspirin- or NSAID-induced asthma or allergic reactions, active gastrointestinal bleeding or ulcers, severe kidney or liver impairment, and in the setting of coronary artery bypass graft (CABG) surgery. Patients should tell their prescriber about all other medications they take, especially blood thinners, other NSAIDs or aspirin, corticosteroids, and blood pressure medications, and should seek prompt medical attention for black or bloody stools, chest pain, sudden weakness or slurred speech, or signs of an allergic reaction.