nabumetone: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
nabumetone: clinical details
Prescribing considerations
- Assess gastrointestinal, renal and cardiovascular risk before prescribing, especially in older people.
- Avoid concurrent NSAIDs, including COX-2 inhibitors.
- Use particular caution with hypertension, heart failure, vascular disease, inflammatory bowel disease, asthma, SLE, dehydration or impaired renal or hepatic function.
- Nabumetone may mask signs of infection and may impair female fertility.
- Review promptly if a rash, mucosal lesion, visual disturbance or unexplained liver-test abnormality develops.
Contraindications and cautions
- Hypersensitivity to nabumetone or any excipient
- Previous aspirin- or NSAID-associated asthma, rhinitis, angioedema or urticaria
- Active or recurrent peptic ulceration, gastrointestinal haemorrhage or perforation
- Previous gastrointestinal bleeding or perforation associated with NSAID treatment
- Severe heart, liver or kidney failure
- Current cerebrovascular or other haemorrhage
- Third trimester of pregnancy
- Breastfeeding
Monitoring
- Renal function, particularly in older, dehydrated or renally impaired patients and with interacting antihypertensives or diuretics
- Liver function where clinically indicated and after abnormal results or hepatic symptoms
- Blood pressure, oedema and signs of worsening heart failure
- Symptoms or signs of gastrointestinal ulceration or bleeding
- Early severe skin reactions and hypersensitivity
- Visual symptoms requiring ophthalmological assessment
Clinical pharmacology
Nabumetone is a non-acidic NSAID that undergoes extensive first-pass hepatic conversion to 6-MNA, a potent prostaglandin-synthesis inhibitor. The active metabolite is highly protein-bound, is eliminated mainly after metabolism through the urine and has a plasma half-life of about one day.
Formulation and product differences
- The selected product is an oral film-coated tablet intended to be swallowed whole.
- It is described as essentially sodium-free.
- No clinical data support use of the selected product in children.
nabumetone preparations and strengths
Tablet
Route: Oral
Strengths: 500 mg
nabumetone interactions
Check prescribed, pharmacy and herbal products before starting nabumetone. Important interactions include:
Other NSAIDs, including ibuprofen, naproxen and COX-2 inhibitors
Combining NSAIDs increases gastrointestinal, kidney and other adverse effects and should be avoided.
Anticoagulants such as warfarin
Nabumetone may strengthen anticoagulant effects and increase bleeding risk.
Antiplatelets, corticosteroids and SSRIs
These combinations can increase gastrointestinal ulceration or bleeding.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.