Drug General Information (ID: DDIGFAWIOM)
Drug Name			Nabumetone		Drug Info		Sulindac		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Nsaids/Analgesics				Antiinflammatory Agents
Structure

Mechanism of Nabumetone-Sulindac Interaction (Severity Level: Moderate)
Increased risk of GI mucosal injury/bleeding risk Click to Show/Hide Mechanism Graph
Drug Name		Nabumetone				Sulindac
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 Sulindac

Recommended Action
Management		Concomitant use of more than one NSAID at a time should generally be avoided. Patients treated with an NSAID should be advised to take it with food and to immediately report signs and symptoms of GI ulceration and bleeding such as severe abdominal pain, dizziness, lightheadedness, and the appearance of black, tarry stools. The selective use of prophylactic anti-ulcer therapy (e.g., antacids, misoprostol, proton pump inhibitors) may be considered in high risk patients.

References
1	Product Information. Mobic (meloxicam) Boehringer-Ingelheim, Ridgefield, CT.
2	Product Information. Ponstel (mefenamic acid). Pfizer U.S. Pharmaceuticals Group, New York, NY.
3	Product Information. Duexis (famotidine-ibuprofen). Horizon Pharma USA Inc, Northbrook, IL.