Drug General Information (ID: DDIAE0MSQI)
Drug Name			Nabumetone		Drug Info		Tofacitinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Nsaids/Analgesics				Antirheumatics
Structure

Mechanism of Nabumetone-Tofacitinib Interaction (Severity Level: Moderate)
Increased risk of GI mucosal injury/bleeding risk Click to Show/Hide Mechanism Graph
Drug Name		Nabumetone				Tofacitinib
Mechanism		GI mucosal injury/bleeding risk				GI mucosal injury/bleeding risk
Key Mechanism Factor 1
		Factor Name		Gastrointestinal toxicity
		Factor Description		The risk and severity of gastrointestinal toxicity, including inflammation, bleeding, ulceration, and perforation, increases when drugs with gastrointestinal mucosal irritant effects are combined.
Mechanism Description		Increased risk of GI mucosal injury/bleeding risk by the combination of Nabumetone and Tofacitinib

Recommended Action
Management		Caution is recommended when using baricitinib or tofacitinib in patients with a history of diverticular disease and in patients receiving long-term concomitant treatment with drugs associated with an increased risk of DV and/or GI perforation, such as aspirin, NSAIDs, corticosteroids, and opioids. Patients should be advised to contact their healthcare provider if they experience signs of DV or GI perforation, such as severe abdominal pain, fever, nausea, or vomiting.

References
1	Strate LL, Liu YL, Huang ES, Giovannucci EL, Chan AT "Use of Aspirin or Nonsteroidal Anti-inflammatory Drugs Increases Risk for Diverticulitis and Diverticular Bleeding." Gastroenterology 140 (2011): 1427-33.[PMID: 21320500]
2	Harigai M, Honda S. Selectivity of Janus Kinase Inhibitors in Rheumatoid Arthritis and Other Immune-Mediated Inflammatory Diseases: Is Expectation the Root of All Headache? Drugs. 2020 Aug;80(12):1183-1201.