What You Should Know About Nabumetone Drug Interactions

While nabumetone has many benefits, some risks can occur if you mix the medication with other drugs. Available by prescription only, nabumetone is a long-acting nonsteroidal anti-inflammatory drug (NSAID) that works by stopping the body’s production of a substance that causes fever, pain, and inflammation.

If you live with chronic arthritis—osteoarthritis or rheumatoid arthritis—your healthcare provider may prescribe nabumetone to relieve the pain, tenderness, swelling, and stiffness that can accompany those conditions. Some medical professionals may also prescribe nabumetone off-label to treat ankylosing spondylitis.

As with all medications, nabumetone carries the possibility of interacting with other drugs or substances, leading to adverse reactions. These reactions range from an increase in the action of either drug, a decrease in drug efficacy, a delay in drug absorption rate, or an unexpected harmful side effect.

Once available in its brand name form, Relafen, nabumetone is now only available in its generic form. Nabumetone comes as a tablet to be taken orally in 500-milligram (mg) and 750-mg doses. The recommended starting dose is 1,000 mg per day. However, your healthcare provider may start you on a lower dose and gradually increase it if necessary.

Depending on your prescribed dose, you may be instructed to take nabumetone once or twice daily with or without food. For chronic use, the lowest effective dose is recommended. Be sure to follow the instructions on your prescription label. If you have any questions, ask your healthcare provider or pharmacist.

Before beginning any new drug, it is important to let your healthcare provider or pharmacist know what medicines—prescription, supplemental, or over-the-counter—you currently take.

Nabumetone has a known list of drugs it interacts with to varying degrees of severity. Mixing different drugs can cause serious side effects. Your healthcare provider and pharmacist should be aware of all your medications to prevent any interactions.

Severe Drug Interactions

Nabumetone is known to have severe reactions with the drugs and substances listed below. However, this list is not complete.

If you take medication for any of the following conditions, check with your healthcare provider or pharmacist to ensure the drugs you take do not interact with nabumetone. The drugs and their interactions include:

• Anticoagulants: Anticoagulants like warfarin taken with nabumetone may cause you to bleed more easily.
• Bipolar disorder medications: Nabumetone may increase the blood levels of lithium and cause lithium toxicity.
• Cancer medications: Combining nabumetone with certain cancer treatments can have adverse reactions. Cytarabine can increase the risk of internal bleeding.
• Diuretics: Nabumetone can reduce the effects of diuretics like furosemide and thiazides in some patients. If these are used together, you should be monitored for signs of renal failure.
• Disease-modifying antirheumatic drugs (DMARDs): These drugs can interact with nabumetone. Arava (leflunomide) can increase the risk of liver damage. Blood levels and side effects of methotrexate can increase when taken with nabumetone.
• NSAIDs: Taking nabumetone with other NSAIDs like ibuprofen, naproxen, and meloxicam may increase the risk of gastrointestinal side effects such as bleeding, inflammation, ulceration, and (rarely) perforation. Taking aspirin with nabumetone can increase the risk of ulcers and bleeding.
• Allergens: It is known that NSAIDs can increase rates of anaphylaxis. If you are receiving immunotherapy with a peanut allergen extract like Palforzia, taking nabumetone may increase the severity of allergic reactions that can occur with such treatment.

Moderate Drug Interactions

Taking nabumetone with the following medications can cause moderate interactions. If you are being treated for other conditions, make sure to talk to your healthcare provider before starting nabumetone so that together you can make informed decisions on your care. These drugs and their interactions include:

• ACE inhibitors: The blood pressure lowering effects of ACE inhibitors like benazepril may be reduced if taken with nabumetone. Taking nabumetone with an ACE inhibitor may also cause problems with the kidneys, and renal function should be monitored.
• Antidepressants: Taking nabumetone with antidepressants like Prozac (fluoxetine) and Zoloft (sertraline) can increase the risk of bleeding.
• Beta blockers: Taking beta blockers like propranolol and metoprolol with nabumetone can reduce the beta blockers' ability to lower blood pressure. Your healthcare provider may need to adjust your medication accordingly.
• Contrast agents: Having a procedure done that uses an injection of a contrast agent like iopamidol while on nabumetone can cause kidney damage.
• Oral steroids: Prednisolone and prednisone may increase the risk of gastrointestinal side effects such as bleeding, inflammation, ulceration, and (rarely) perforation.

Minor Drug Interactions 

Some drugs and substances may cause minor interactions with nabumetone. While the risks are small, it is still worth talking to your healthcare provider about any possible side effects you may experience taking these other medications and supplements with nabumetone.

• Alzheimer’s disease medication: Taking nabumetone with donepezil may increase gastric acid secretion and theoretically increase gastrointestinal bleeding risk.
• Gout medications: The risk of NSAID toxicity is higher when taking probenecid with nabumetone.
• Herbs: Taking clove with nabumetone could increase the risk of bleeding.

Alcohol Interaction

Drinking alcohol is not recommended while on nabumetone as it can cause increased risk of stomach bleeding. Ask your healthcare provider before consuming alcohol with nabumetone.

If you experience any symptoms of stomach bleeding—black, tarry, or bloody stools, blood when coughing, or vomit that appears like coffee grounds—contact your healthcare provider immediately.   

A Word From Verywell

Many questions may arise when you start a new medication like nabumetone. When it comes to your health, staying proactive is best. Talking to your healthcare provider about your treatment plan and understanding all the possible interactions can keep you informed.

If you are being treated for other conditions outside of the one your healthcare provider has prescribed nabumetone for, make sure your practitioner knows all of the medications, substances, and supplements you take to treat these other conditions. Keep yourself informed and talk to your healthcare provider about any concerns.

Nabumetone can provide relief from some of your arthritic symptoms. Understanding the possible negative interactions can help you achieve that relief without risking negative effects.