Drug General Information (ID: DDIUIG0S8A)
Drug Name			Nabumetone		Drug Info		Heparin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Nsaids/Analgesics				Anticoagulants
Structure

Mechanism of Nabumetone-Heparin Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Nabumetone				Heparin
Mechanism		Risk of bleeding Antiplatelet effects				Risk of bleeding Anticoagulant
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Nabumetone and Heparin

Recommended Action
Management		Until further data are available, products containing NSAIDs, especially if given chronically or in high dosages, should preferably be avoided in patients receiving heparin or LMWH. Close clinical and laboratory observation for bleeding complications is recommended if concurrent therapy is necessary.

References
1	Bang CJ, Riedel B, Talstad I, Berstad A "Interaction between heparin and acetylsalicylic acid on gastric mucosal and skin bleeding in humans." Scand J Gastroenterol 27 (1992): 489-94. [PMID: 1321488]
2	Heiden D, Rodvien R, Mielke CH "Heparin bleeding, platelet dysfunction, and aspirin." JAMA 246 (1981): 330-1. [PMID: 7241778]
3	Price AJ, Frcpath DO "Is there a clinical interaction between low molecular weight heparin and non-steroidal analgesics after total hip replacement?" Ann R Coll Surg Engl 77 (1995): 395. [PMID: 7486773]
4	Theroux P, Ouimet H, McCans J, et al. "Aspirin, heparin, or both to treat acute unstable angina." N Engl J Med 319 (1988): 1105-6. [PMID: 3050522]
5	Walker AM "Predictors of bleeding during heparin therapy." JAMA 244 (1980): 1209-12. [PMID: 7411781]
6	Weale AE, Warwick DJ, Durant N, Prothero D "Is there a clinical interaction between low molecular weight heparin and non-steroidal analgesics after total hip replacement?" Ann R Coll Surg Engl 77 (1995): 35-7. [PMID: 7717643]