Mebutan (Nabumetone)

Mebutan (nabumetone) is indicated for inflammatory joint diseases and related pain conditions.

• Rheumatoid arthritis: reduces joint inflammation and pain, improving functional ability.
• Osteoarthritis: alleviates chronic joint discomfort and stiffness, supporting mobility.
• Ankylosing spondylitis: diminishes spinal inflammation and associated pain.
• Pain: provides symptomatic relief for moderate musculoskeletal pain not controlled by non‑opioid analgesics.

• Nabumetone is a pro‑drug that is metabolised to an active hydroxynaphthoic acid, which selectively inhibits cyclooxygenase (COX) enzymes, particularly COX‑2. This inhibition decreases prostaglandin synthesis, leading to reduced inflammation, pain, and fever without markedly affecting platelet aggregation.

Adverse reactions may occur with nabumetone therapy.

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia, or abdominal discomfort.
• Headache: mild to moderate intensity.
• Dizziness: transient sensation of light‑headedness.
• Rash: mild skin erythema or itching.

Serious or Rare Side Effects

• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Gastrointestinal bleeding: ulceration or hemorrhage requiring medical attention.

Before initiating nabumetone, consider the following precautions.

• Renal function assessment: evaluate baseline kidney status, especially in elderly patients.
• Hepatic monitoring: check liver enzymes periodically during therapy.
• Lowest effective dose: prescribe the minimum dose needed to achieve therapeutic effect.
• Peptic ulcer disease: avoid in patients with active ulceration or a history of gastrointestinal bleeding.
• Concomitant anticoagulants: use with caution due to increased bleeding risk.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Nabumetone may interact with several medicines; clinical judgement is required.

Major Interactions (Avoid)

• Warfarin: increased anticoagulant effect and bleeding risk.
• Lithium: elevated lithium concentrations leading to toxicity.
• ACE inhibitors: potential reduction in renal function.
• Diuretics: heightened risk of renal impairment.

Moderate Interactions (Monitor Closely)

• Other NSAIDs: additive gastrointestinal toxicity.
• Selective serotonin reuptake inhibitors (SSRIs): increased bleeding tendency.
• Methotrexate: possible elevation of methotrexate levels and toxicity.