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Related to Relafen: Norflex
Pregnancy Category: C
Symptomatic management of rheumatoid arthritis and osteoarthritis.
Inhibits prostaglandin synthesis.
Suppression of pain and inflammation.
Absorption: Nabumetone (a prodrug) is 80% absorbed after oral administration; 35% is rapidly converted to 6-methoxy-2-naphthylacetic acid (6-MNA), which is the active drug.
Protein Binding: >99%.
Metabolism and Excretion: 6-MNA is metabolized by the liver to inactive compounds.
Half-life: 24 hr (increased in severe renal impairment).
Time/action profile (analgesia/anti-inflammatory effects)
|PO||1–2 days||few days–2 wk||12–24 hr|
Contraindicated in: Hypersensitivity;Use with other NSAIDs, including aspirin; cross-sensitivity may occur;Active GI bleeding or ulcer disease;Peri-operative pain from coronary artery bypass graft (CABG) surgery; Lactation: Lactation.
Use Cautiously in: Severe renal, or hepatic disease;History of ulcer disease; Obstetric: Avoid using during 2nd half of pregnancy due to potential of NSAIDs to cause premature closure of ductus arteriosus; Pediatric: Safety not established.
Adverse Reactions/Side Effects
Central nervous system
Ear, Eye, Nose, Throat
- abnormal vision
- hypersensitivity pneumonitis
- fluid retention
- gi bleeding (life-threatening)
- abdominal pain (most frequent)
- diarrhea (most frequent)
- ↑ liver function tests
- dry mouth
- ↑ appetite
- interstitial nephritis
- exfoliative dermatitis (life-threatening)
- stevens-johnson syndrome (life-threatening)
- toxic epidermal necrolysis (life-threatening)
- increased sweating
- prolonged bleeding time
- weight gain
- allergic reactions including anaphylaxis (life-threatening)
- angioneurotic edema (life-threatening)
Drug-Drug interaction↑ adverse GI effects with aspirin, other NSAIDs, potassium supplements, corticosteroids, or alcohol.Chronic use with acetaminophen may ↑ risk of adverse renal reactions.May ↓ effectiveness of diuretics or antihypertensives.May ↑ hypoglycemic effects of insulins or oral hypoglycemic agents.↑ risk of toxicity from methotrexate.↑ risk of bleeding with cefotetan, cefoperazone, valproic acid, anticoagulants, ticlopidine, clopidogrel, eptifibatide, tirofiban, or thrombolytic agents.↑ risk of adverse hematologic reactions with antineoplastics or radiation therapy.Concurrent use with cyclosporine may ↑ risk of renal toxicity.
Oral (Adults) 1000 mg/day as a single dose or divided dose twice daily; may be ↑ up to 2000 mg/day; use lowest effective dose during chronic therapy.
Availability (generic available)
Tablets: 500 mg, 750 mg
- Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Monitor for rhinitis, asthma, and urticaria.
- Assess pain and range of motion before and periodically throughout therapy.
- Lab Test Considerations: Evaluate BUN, serum creatinine, CBC, and liver function periodically in patients receiving prolonged therapy.
- Serum potassium, BUN, serum creatinine, alkaline phosphatase, LDH, AST, and ALT tests may show ↑ levels. Blood glucose, hemoglobin, and hematocrit concentrations, leukocyte and platelet counts, and CCr may be ↓.
- May cause prolonged bleeding time.
Potential Nursing DiagnosesAcute pain (Indications)
Impaired physical mobility (Indications)
- Administration in higher than recommended doses does not provide increased effectiveness but may cause increased side effects. Use lowest effective dose for the shortest duration possible to minimize cardiac risks.
- Oral: Administer with meals or antacids to decrease GI irritation and increase absorption.
- Advise patient to take this medication with a full glass of water and to remain in an upright position for 15–30 min after administration.
- Instruct patient to take medication as directed. Take missed doses as soon as remembered but not if almost time for the next dose. Do not double dose.
- May cause drowsiness, dizziness, or visual disturbances. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known.
- Advise patient to use sunscreen and protective clothing to prevent photosensitivity reactions.
- Caution patient to avoid the concurrent use of alcohol, aspirin, acetaminophen, or other OTC medications without consulting health care professional.
- Advise patient to inform health care professional of medication regimen before treatment or surgery.
- Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs.
- Decreased pain and improved joint mobility. Partial arthritic relief is usually seen within 1 wk, but maximum effectiveness may require 2 wk or more of continuous therapy. Patients who do not respond to one NSAID may respond to another.
A trademark for the drug nabumetone.