Nabumetone Aspirin

Nabumetone may cause serious GI bleeding with or without pain avoid aspirin during nabumetone therapy because it increases the risk of GI bleeding... 

Tolmetin and nabumetone Tolmetin [TOLL me tin] and nabume-tone [na BYOO me tone] are as potent as aspirin in treating adult or juvenile rheumatoid arthritis or osteoarthritis, but may have fewer adverse effects. 

Clinically important, potentially hazardous interactions with acitretin, aldesleukin, aminoglycosides, amiodarone, amoxicillin, ampicillin, aspirin, bacampicillin, bismuth, carbenicillin, chloroquine, cisplatin, cloxacillin, co-trimoxazole, dapsone, demeclocycline, dexamethasone, diclofenac, dicloxacillin, etodolac, etoricoxib, etretinate, fenoprofen, flurbiprofen, folic acid antagonists, haloperidol, hydrocortisone, ibuprofen, indomethacin, influenza vaccines, ketoprofen, ketorolac, lithium, magnesium trisalicylate, meclofenamate, mefenamic acid, methicillin, mezlocillin, minocycline, nabumetone, nafcillin, naproxen, NSAIDs, omeprazole, oxacillin, oxaprozin, oxytetracycline, paromomycin, penicillin G, penicillin V, penicillins, phenylbutazone, piperacillin, piroxicam, polypeptide antibiotics, prednisolone, prednisone, probenecid, procarbazine, rofecoxib, salicylates, salsalate, sapropterin, sulfadiazine, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfisoxazole, sulindac, tazobactum, tenoxicam, tetracycline, ticarcillin, tolmetin, trimethoprim, vaccines... 

Using a developed method, laser irradiation of colloidal mixtures of the three metals, these authors dispersed Au/Ag/Pd nanoparticles with average diameters 4.4 1.5 nm. These tri-metallic nanoparticles were assessed for activity in the synthesis of nabumetone [4-(6-methoxy-2-naphthalenyl)-2-butanone], a non-steroidal anti-inflammatory drug that has greater activity than aspirin and is comparable to naproxen and indomethacin. The 0.45-mol% Au/Ag/Pd was sufficient to catalyse the coupling of the 3-buten-2-ol... 

There is little evidence to support clinically important differences with regard to the frequency of ulcers and upper GI complications among most available nonaspirin, nonselective NSAIDs (see Table 33-3) when used in equipotent anti-inflammatory dosages. However, the nonacetylated salicylates (e.g., salsalate) and newer NSAIDs (e.g., etodolac, nabumetone, and meloxicam) may be associated with a decreased incidence of GI toxicity. NSAIDs that selectively inhibit cyclooxygenase-2 (COX-2) decrease the incidence of gastroduodenal ulcers and related GI complications when compared to the nonselective NSAIDs. The use of buffered or enteric-coated aspirin confers no added protection from ulcer or GI complications. ... 

In the carrageenan-induced rat paw assay, nabumetone is approximately 13 times more potent than aspirin, one-third as active as indomethacin, and half as active as diclofenac. It is only half as active as aspirin as an analgetic, as measured by the phenylquinone-induced writhing assay in mice. Despite its lower potency, the advantages of nabumetone may reside in its favorable gastric irritancy profile. The ratio of gastric irritancy dose in rats to anti-inflammatory activity in rats (ED50) for nabumetone is 21.25, whereas this ratio is 0.41 for aspirin, 0.55 for indomethacin, 0.72 for diclofenac, 3.00 for tolmetin, and 7.85 for zomepirac. 

Aspirin 600 mg four times daily caused a 15% reduction in the plasma levels of diflunisal 250 mg twice daily for 3 days. Single-dose studies have shown that the absorption of nabumetone 1 g is not significantly altered by aspirin 1.5 g. The plasma levels of tolmetin 1.2 g daily were slightly reduced by aspirin 3.9 g daily. ... 

Paracetamol levels are increased by diflunisal. Aspirin, diclofenac, nabumetone and sulindac pharmacokinetics do not appear to be affected by paracetamol. There is no pharmacokinetic interaction between ibuprofen and paracetamol. Propacetamol, and possibly paracetamol, increase the antiplatelet effects of diclofenac, although the evidence is limited and the clinical relevance of this is uncertain. 

Pseudoallergic reactions resemble allergic reactions clinically but are not immunologically mediated. Examples include asthma and rashes caused by aspirin and maculopapular erythematous rashes due to ampicillin or amoxicillin in the absence of penicillin hypersensitivity. Few other entities that can initiate this reaction are sulfonamides, anticonvulsants (phenytoin, carbamazepine and phenobarbital), NSAIDs (aspirin, naproxen, nabumetone and keto-profen), antiretroviral agents and cephalosporins [1 ]. 

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