Drug reference
Pain and inflammation in osteoarthritis and rheumatoid arthritis ▶BY MOUTH ▶Adult: 1 g once daily, dose to be taken at night ▶Elderly: 0.5–1 g daily Pain and inflammation in osteoarthritis and rheumatoid arthritis (severe and persistent symptoms) ▶BY MOUTH ▶Adult: 0.5–1 g, dose to be taken in the morning and 1 g, dose to be taken at night ▶Elderly: 0.5–1 g daily
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Active gastro-intestinal bleeding. active gastro-intestinal ulceration. history of gastro- intestinal bleeding related to previous NSAID therapy. history of gastro-intestinal perforation related to previous NSAID therapy. history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes). history of recurrent gastro-intestinal ulceration (two or more distinct episodes). severe heart failure
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Allergic disorders. cardiac impairment (NSAIDs may impair renal function). cerebrovascular disease. coagulation defects. connective-tissue disorders. dehydration (risk of renal impairment). elderly (risk of serious side-effects and fatalities). heart failure. history of gastro-intestinal disorders (e.g. ulcerative colitis, Crohn’s disease). ischaemic heart disease. peripheral arterial disease. risk factors for cardiovascular events. uncontrolled hypertension
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Contraindicated in patients with a history of hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other NSAID.
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→Appendix 1: NSAIDs
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▶Common or very common Constipation. diarrhoea. ear disorder. gastrointestinal discomfort. gastrointestinal disorders. nausea. oedema. skin reactions. tinnitus ▶Uncommon Anxiety. asthenia. confusion. dizziness. drowsiness. dry mouth. dyspnoea. eye disorder. haemorrhage. headache. hyperhidrosis. insomnia. myopathy. oral disorders. paraesthesia. photosensitivity reaction. respiratory disorders. urinary tract disorder. visual impairment. vomiting ▶Rare or very rare Alopecia. angioedema. hepatic disorders . hypersensitivity. menorrhagia. nephrotic syndrome. pancreatitis. renal failure (more common in patients with pre-existing renal impairment). severe cutaneous adverse reactions (SCARs). thrombocytopenia ▶Frequency not known Agranulocytosis. aplastic anaemia. asthma. Crohn’s disease aggravated. depression. fertility decreased female. haemolytic anaemia. hallucination. heart failure. hypertension. increased risk of arterial thromboembolism. leucopenia. malaise. meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible). nephritis tubulointerstitial. neutropenia. optic neuritis. vertigo SIDE-EFFECTS, FURTHER INFORMATION For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non- steroidal anti-inflammatory drugs p. 1193
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Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment.
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Avoid unless the potential benefit outweighs the risk. Avoid during the third trimester (risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn); onset of labour may be delayed and duration may be increased.
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Use with caution during breast-feeding. Manufacturer advises avoid.
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Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
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Avoided if possible or use with caution. Avoid in severe impairment. Dose adjustments The lowest effective dose should be used for the shortest possible duration. Monitoring In renal impairment monitor renal function; sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Nabumetone (Non-proprietary) Nabumetone 500 mg Nabumetone 500mg tablets | 56 tablet P £20.00 DT = £6.90 ▶Relifex (Mylan) Nabumetone 500 mg Relifex 500mg tablets | 60 tablet P £6.18
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0.5–1 g daily
First-line fragment. Read the complete Indications and Dose section above.
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0.5–1 g daily
First-line fragment. Read the complete Indications and Dose section above.
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