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Severe immediate reaction to nabumetone.
M A Gonzalo-Garijo1, C Cordobés-Duran, A M Lamilla-Yerga
1Department of Allergology, Infanta Cristina University Hospital, Badajoz, Spain. magonzalog@telefonica.net
Journal of Investigational Allergology & Clinical Immunology
|August 19, 2007
Summary
Two patients experienced severe, immediate systemic reactions to nabumetone, a nonsteroidal anti-inflammatory drug (NSAID), despite prior tolerance. These rare reactions highlight potential hypersensitivity risks even with NSAID-naive individuals.
Area of Science:
- Pharmacology
- Clinical Immunology
Background:
- Nabumetone, a nonsteroidal anti-inflammatory drug (NSAID) prodrug, selectively inhibits cyclooxygenase-2 (COX-2).
- It is often considered a safer NSAID alternative for patients with hypersensitivity to other NSAIDs.
- Systemic adverse reactions to nabumetone are infrequently reported.
Observation:
- Two cases of immediate systemic reactions to nabumetone are presented.
- Case 1: A 68-year-old woman developed generalized pruritus, erythema, morbilliform eruption, tongue swelling, diarrhea, and hypotension after a single dose.
- Case 2: A 77-year-old woman experienced generalized pruritus, palm erythema, abdominal pain, diarrhea, dizziness, chest tightness, dyspnea, and hypotension post-ingestion.
Findings:
- Both patients had previously tolerated nabumetone without issue.
- Subsequent skin prick tests with nabumetone were negative.
- Oral challenge tests with other NSAIDs, including those in the same class, were also negative in both patients.
Implications:
- These cases suggest that immediate systemic hypersensitivity reactions to nabumetone can occur, even in patients with a history of tolerance.
- The underlying mechanisms for these rare nabumetone-induced reactions remain undetermined.
- Further investigation is warranted to understand the immunological basis of these adverse events.
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