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Drug interactions

Nabumetone + Tacrolimus

Severity: Major

Nabumetone and Tacrolimus: major interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Nabumetone and tacrolimus can each impair kidney function, and using them together raises the chance of acute kidney injury and a rise in serum creatinine. Hyperkalemia may also occur. The risk is greatest with dehydration, existing renal impairment or high tacrolimus levels.

What this interaction means in plain words

Nabumetone and Tacrolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Nabumetone belongs to Musculoskeletal; Tacrolimus belongs to Miscellaneous.

Evidence level: Moderate

Why it happens

NSAID inhibition of renal prostaglandins reduces afferent arteriolar flow, adding to tacrolimus-induced renal vasoconstriction.

What to do

Avoid the NSAID where possible and use a non-NSAID analgesic such as paracetamol. If it is unavoidable, use the lowest dose for the shortest time and monitor serum creatinine, potassium and tacrolimus trough levels.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Nabumetone with Tacrolimus?

MediHelp rates the interaction as major. Nabumetone and Tacrolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nabumetone and tacrolimus can each impair kidney function, and using them together raises the chance of acute kidney injury and a rise in serum creatinine. Hyperkalemia may also occur. The risk is greatest with dehydration, existing renal impairment or high tacrolimus levels.

How serious is the interaction between Nabumetone and Tacrolimus?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the NSAID where possible and use a non-NSAID analgesic such as paracetamol. If it is unavoidable, use the lowest dose for the shortest time and monitor serum creatinine, potassium and tacrolimus trough levels.

What other medicines interact with Nabumetone?

MediHelp also lists interactions of Nabumetone with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Nabumetone page.

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