Nabumetone precautions

List of precautions
Renal Effects Hepatic Function Fluid Retention and Edema Photosensitivity

Renal Effects
As a class, NSAIDs have been associated with renal papillary necrosis and other abnormal renal pathology during long-term administration to animals. A second form of renal toxicity often associated with NSAIDs is seen in patients with conditions leading to a reduction in renal blood flow or blood volume, where renal prostaglandins have a supportive role in the maintenance of renal perfusion. In these patients, administration of an NSAID results in a dose-dependent decrease in prostaglandin synthesis and, secondarily, in a reduction of renal blood flow, which may precipitate overt renal decompensation. Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics, and the elderly. Discontinuation of NSAID therapy is typically followed by recovery to the pretreatment state.

Hepatic Function
As with other NSAIDs, borderline elevations of 1 or more liver function tests may occur in up to 15% of patients. These abnormalities may progress, may remain essentially unchanged, or may return to normal with continued therapy. The ALT (SGPT) test is probably the most sensitive indicator of liver dysfunction. Meaningful (3 times the upper limit of normal) elevations of ALT (SGPT) or AST (SGOT) have occurred in controlled clinical trials of RELAFEN in less than 1% of patients. A patient with symptoms and/or signs suggesting liver dysfunction, or in whom an abnormal liver test has occurred, should be evaluated for evidence of the development of a more severe hepatic reaction while on therapy with RELAFEN. Severe hepatic reactions, including jaundice and fatal hepatitis, have been reported with RELAFEN and other NSAIDs. Although such reactions are rare, if abnormal liver tests persist or worsen, if clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g., eosinophilia, rash, etc.), RELAFEN should be discontinued.

Fluid Retention and Edema
Fluid retention and edema have been observed in some patients taking RELAFEN; therefore, as with other NSAIDs, RELAFEN should be used cautiously in patients with a history of congestive heart failure, hypertension, or other conditions predisposing to fluid retention

Photosensitivity
Based on ultraviolet (U.V.) light photosensitivity testing, RELAFEN may be associated with more reactions to sun exposure than might be expected based on skin tanning types.