Nabumetone: Uses, Side Effects, Dosages, Precautions - Verywell Health

Nabumetone is the generic version of a nonsteroidal anti-inflammatory drug (NSAID) of the now discontinued brand name Relafen. Used to treat mild to moderate pain, nabumetone works by reducing hormones in the body that cause inflammation and pain.

It is particularly effective at relieving symptoms of arthritis(e.g., inflammation, swelling, and joint pain). Nabumetone is available in pill/tablet form, and only by prescription.

Nabumetone has a "black box" warning from the U.S. Food & Drug Administration (FDA). Black box warnings alert patients and doctors to potentially dangerous side effects caused by a medication. 

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Uses

Nabumetone is used to reduce pain, joint stiffness, and swelling caused by certain types of arthritis, most commonly osteoarthritis and rheumatoid arthritis. 

Off-Label Uses

Nabumetone is typically prescribed to individuals living with arthritis. It is generally not prescribed by doctors for other uses, but may also be prescribed if other NSAIDs are not providing relief for non-arthritis related joint pain. It is sometimes prescribed for gout attacks.

Before Taking

When deciding to use nabumetone to treat pain, you will weigh the risks vs. benefits with your healthcare provider. When prescribed this medication to manage pain, it is important to take it exactly as prescribed in order for it to help relieve your symptoms.

In some cases, it may take two weeks or longer to begin to feel symptom relief. Nabumetone is often the second-line choice for treating osteoarthritis and rheumatoid arthritis and is prescribed if other NSAIDs have not been effective at offering pain relief.

Before you begin taking nabumetone, tell your healthcare provider if you are allergic to aspirin or other NSAIDs (e.g., ibuprofen, naproxen). This medication may contain inactive ingredients that can trigger an allergic reaction.

Precautions and Contraindications

Before taking this medication, talk to your doctor or pharmacist about your medical history, particularly if you have: 

• Asthma
• Experienced worsening of breathing after taking NSAIDs or aspirin in the past
• Bleeding/clotting problems
• Heart disease
• High blood pressure
• Liver disease
• Stomach/intestinal problems (e.g., ulcers, bleeding, recurring heartburn)

Nabumetone may increase your risk of: 

• Heart attack or stroke
• Stomach or intestinal bleeding (particularly if you are over 60 years old, smoke, or drink alcohol regularly)
• Skin reactions (e.g., blistering, peeling skin, sore throat, ulcers)
• Swelling in the face, fingers, legs, and/or feet
• Decreased urination

Individuals with kidney disease should not take nabumetone, as it can worsen their condition. Caution is advised when using this drug in individuals ages 60 and over, as this population may be more sensitive to its side effects, particularly kidney problems and stomach bleeding. 

Other NSAIDs

Non-prescription NSAIDs include Advil (ibuprofen), aspirin, and Naprosyn (naproxen). There are several other prescription NSAIDs that may be prescribed for arthritis pain, including:

Dosage

The dosage of nabumetone you take depends on your medical condition and will vary from patient to patient. It is important to follow your doctor's orders and directions on the medication label. Do not increase your dose or take it more often than prescribed without first discussing it with your doctor and/or pharmacist.

The recommended dose for adults varies depending on the condition it is prescribed for, but is most often prescribed at first as 1,000 milligrams (mg) orally (tablet/pill) once a day or split into two doses of 500 mg twice a day.

Your doctor may increase the dose if necessary, up to 2,000 mg a day. Doses higher than 2,000 mg have not been thoroughly studied and therefore may not be safe.

The dose and frequency you take nabumetone may be adjusted if your initial dose does not work or causes unwanted side effects. 

How to Take and Store

Take this medication directed by your doctor. This is most commonly once or twice a day. Take it with a full glass of water. To prevent stomach upset, take it with food or an antacid. Do not lie down for 10 or more minutes after taking it to prevent heartburn. 

Store the medication in a cupboard at room temperature, away from heat, moisture and direct light. Keep out of the reach of children. Do not keep the medication after its expiration date. Talk to your doctor about safe disposal of excess doses you do not need. 

Side Effects

Some side effects may occur as a result of taking nabumetone. Most of these side effects are mild and do not need medical attention; they typically go away once your body adjusts to the medication. 

Common

Common side effects may include:

• Constipation
• Diarrhea
• Dizziness
• Headache
• Itchy skin
• Nausea or vomiting 
• Upset stomach, indigestion, or gas
• Ringing in the ears

If any of these effects persist or worsen, talk to your healthcare provider.

Severe

Tell your doctor right away you experience any of these serious (but less common) side effects:

• Difficulty swallowing 
• Hearing changes or ringing in the ears
• Mood changes 
• Symptoms of heart failure (e.g., swelling ankles or feet, unusual lethargy, sudden weight gain) 

Seek medical immediately if any of these rare but very serious side effects occur:

• Signs of kidney problems (e.g., changes in urine output, swelling in the feet or ankles) 
• Signs of liver problems (e.g., nausea, stomach pain, itching, flu-like symptoms, jaundice, loss of appetite) 
• Signs of stomach bleeding (e.g., tarry stools, coughing up blood)
• Stiff neck

Nabumetone may rarely cause serious liver disease. If you notice any of the following serious side effects, talk to your doctor and/or pharmacist right away: 

• Dark urine
• Persistent nausea and/or vomiting
• Severe stomach pain
• Yellowing eyes or skin

Some people may experience a serious allergic reaction to this medication. Seek medical attention immediately if you notice signs of a serious allergic reaction, including: 

• Rash
• Itching/swelling (especially if in the face/throat)
• Severe dizziness
• Trouble breathing

In addition to speaking with your doctor, you can also report side effects to the Food and Drug Administration (FDA) at 1-800-FDA-1088.

Warnings and Interactions

Speak with your doctor about all prescription and over-the-counter medications and herbal products you are taking before being prescribed nabumetone, as it may interact with other drugs and change the way medications work or increase your risk for adverse side effects. Some medications that may interact with nabumetone include:

• ACE inhibitors
• Aspirin
• Corticosteroids (such as prednisone)
• Lithium
• Methotrexate
• Other NSAIDs
• "Water pills" (diuretics)
• Warfarin

This list is not complete. Other medications may affect nabumetone, including prescription and over-the-counter medicines, vitamins, and herbal products.

Do not take nabumetone with other NSAIDs, as it may increase your risk of stomach bleeding or other serious side effects.

Black Box Warning

Nabumetone oral tablet comes with a black box warning from the FDA due to the increased risk of heart attack or stroke when taking this medication and other NSAIDs. Seek medical attention immediately if you experience symptoms such as shortness of breath, chest pain, weakness in the body, or slurred speech.