Precautions and Warnings With Nabumetone (Cont.)

• There are certain other medications that nabumetone can interact with (see Drug Interactions With Nabumetone).
   

  All NSAIDs, including nabumetone, have been reported to cause cardiovascular events such as a heart attack or stroke, both of which can result in loss of life. People with cardiovascular disease or who have risk factors for cardiovascular disease appear to be at greater risk.

    

• To decrease the chances of these problems occurring, you are recommended to take the smallest effective dose for the shortest period of time. Also, call 911 or an ambulance if you notice things such as chest pain, shortness of breath, weakness, or slurring of speech.

• All NSAIDs, including nabumetone, may worsen high blood pressure or cause high blood pressure. Nabumetone should be used with caution in people with known high blood pressure.
   
• All NSAIDs, including nabumetone, may cause congestive heart failure or swelling. Make sure to contact your healthcare provider if you notice unexplained weight gain or swelling. Also, nabumetone should be used with caution in people with heart failure.
   
• All NSAIDs, including nabumetone, have been reported to cause problems in the stomach and intestines, including bleeding (known as gastrointestinal bleeding), stomach ulcers, or holes in the stomach or intestines. These problems can lead to serious complications or even loss of life. Extreme caution should be used if nabumetone is prescribed to people with a history of ulcers or gastrointestinal bleeding.

To decrease the chances of these problems occurring, you are recommended to take the smallest effective dose for the shortest period of time. Make sure to contact your healthcare provider immediately if you experience any signs or symptoms of stomach ulcers or bleeding, including:

o Stomach pain

o Indigestion

o Black, tarry stools

o Vomiting blood.

• People taking NSAIDs, including nabumetone, can experience kidney damage. It is more common in the elderly and people with kidney disease, heart failure, or liver problems. It is also more common in those taking diuretics or ACE inhibitors.

• People taking nabumetone can experience liver damage. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain, or flu-like symptoms.
   
• NSAIDs, including nabumetone, have been reported to cause allergic reactions. Seek emergency medical attention immediately if you notice things such as difficulty breathing or swelling of the face and throat.
   
• In rare cases, people taking nabumetone can develop a very serious rash. If you notice an unexplained rash or blisters, fever, or itchy skin, stop taking the nabumetone and call your healthcare provider.
   
• If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting nabumetone. Alcohol can affect the way the liver works, indirectly affecting the nabumetone.
   
• NSAIDS have been known to cause an increase in liver enzymes. Therefore, it is recommended that you have a blood test that looks at your liver function before starting nabumetone and 12 weeks after treatment has started.
   
• Nabumetone has been known to cause anemia. If you are taking nabumetone for an extended amount of time and show signs of anemia, talk with your healthcare provider.
   
• Nabumetone may increase your sensitivity to the sun. Therefore, when going outside, try wearing long-sleeved shirts, pants, and a hat. Any exposed skin should be covered with sunscreen that is at least SPF 15.
   
• You should not take nabumetone with any other NSAID, as this may increase your risk of any of the problems discussed above. There are many NSAIDs available with or without a prescription; make sure to read labels carefully. Some examples of NSAIDs are ibuprofen (Motrin^®, Advil^®), naproxen (Aleve^®, Anaprox^®, Naprosyn^®, and Naprelan^®), celecoxib (Celebrex^®), ketoprofen (Orudis^®, Oruvail^®), etodolac (Lodine^®, Lodine XL), diclofenac (Cataflam^®, Voltaren^®), meloxicam (Mobic^®), and others. You can ask your doctor or pharmacist for a complete list of these medications.
   
• Nabumetone is a pregnancy Category C medicine, meaning that nabumetone could potentially cause harm to your unborn child. If you are pregnant, you should take nabumetone only if the benefit outweighs the possible risk to your unborn child. Nabumetone is not recommended for women in the third trimester of pregnancy because it can cause injury (and even death) to the developing fetus. If you become pregnant while taking nabumetone, contact your healthcare provider immediately (see Relafen and Pregnancy for more information).
   
• If you are nursing, you are recommended not to take nabumetone. Therefore, if you are taking nabumetone, ask your healthcare provider if you should stop nursing or stop taking nabumetone.