title: Potentiation of oral anticoagulation and hemarthrosis associated with nabumetone.
abstract: Concomitant therapy with warfarin and nonsteroidal antiinflammatory drugs (NSAIDs) is of concern due to the potential for increased bleeding. Nonsteroidal antiinflammatory drugs may alter patient response to warfarin by pharmacodynamic or pharmacokinetic interactions. A man receiving long-term, stable warfarin therapy experienced a significant increase in international normalized ratio 1 week after nabumetone was added to his regimen. Despite prompt reduction of the warfarin dosage, he experienced hemarthrosis of his right knee. Previous reports suggested lack of interaction between nabumetone and warfarin. Caution and close monitoring are advisable when the two agents are administered concomitantly.
authors.affiliation: Department of Pharmacy Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
authors.forename: V C
authors.initials: VC
authors.lastname: Dennis
authors.forename: B K
authors.initials: BK
authors.lastname: Thomas
authors.forename: J E
authors.initials: JE
authors.lastname: Hanlon
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications; D002074:Butanones / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D006395:Hemarthrosis / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008297:Male; D000077430:Nabumetone; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D002074:Butanones; D014859:Warfarin; D000077430:Nabumetone