Nabumetone with Ginkgo Interaction Details
Brand Names Associated with Nabumetone
- Nabumetone
- Relafen®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 17, 2023
Interaction Effect
An increased risk of bleeding
Interaction Summary
Avoid concomitant use of ginkgo with any medicine that can inhibit platelet aggregation or coagulation, including NSAIDs. One case report describes a fatal intracerebral hemorrhage associated with concomitant use of ginkgo and ibuprofen, though definite causality could not be proven. Cases of subarachnoid hemorrhage, subdural hematoma, intracerebral hemorrhage, and postoperative bleeding have been reported in patients taking ginkgo alone as well as with warfarin and aspirin . Ginkgolide B has been shown to inhibit PAF-induced platelet aggregation . The gastrointestinal effects of NSAIDs may increase the risk of gastrointestinal bleeding if ginkgo is taken concomitantly.
Severity
Major
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Avoid concomitant use of ginkgo and NSAIDs. If both agents are taken together, frequently monitor the patient for bleeding time and signs and symptoms of excessive bleeding to determine if platelet function has been adversely affected by ginkgo.
Mechanism Of Interaction
Ginkgolide B may inhibit platelet activating factor (PAF) induced platelet aggregation
Literature Reports
A) A 71-year-old man suffered a fatal intracerebral hemorrhage considered likely associated with concomitant use of Ginkgo biloba and ibuprofen. The patient was normotensive, nondiabetic, and did not drink alcohol. His medical history included total hip replacement and benign prostatic hyperplasia. No regular medication use was mentioned, including no long-term anticoagulation therapy post hip replacement. He had been taking Ginkgo biloba extract (Gingium(R), Biocur, Germany) 40 mg twice daily for at least 2.5 years prior to his death. He started taking ibuprofen 600 mg daily 4 weeks prior to his death for osteoarthritic hip pain. Since the patient did not have any risk factors for cerebral hemorrhage, the event was considered associated with the use of gingko and ibuprofen .
Nabumetone Overview
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Nabumetone is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Nabumetone is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.