Naburel
Generic Name
Nabumetone
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| naburel 750 mg tablet | ৳ 22.00 | ৳ 220.00 |
Description
Overview of the medicine
Nabumetone is a non-steroidal anti-inflammatory drug (NSAID) used for the relief of signs and symptoms of osteoarthritis and rheumatoid arthritis. It is a non-acidic prodrug that is converted to an active metabolite in the body.
Uses & Indications
Dosage
Adults
The recommended initial dose is 1000 mg once daily. Some patients may achieve satisfactory results with 750 mg daily. The maximum recommended daily dose is 2000 mg.
Elderly
Start with lower doses (e.g., 750 mg daily) and monitor carefully due to increased risk of adverse effects, especially gastrointestinal bleeding and renal impairment.
Renal_impairment
Use with caution. Dosage adjustments may be necessary based on creatinine clearance. Avoid in severe renal impairment.
How to Take
Nabumetone tablets can be taken orally, with or without food. Taking with food may help reduce gastrointestinal upset.
Mechanism of Action
Nabumetone is a prodrug that is converted to its active metabolite, 6-methoxy-2-naphthylacetic acid (6-MNA). 6-MNA inhibits prostaglandin synthesis by reversibly inhibiting cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. This leads to reduced inflammation, pain, and fever.
Pharmacokinetics
Onset
Analgesic effect begins within 1-2 hours, anti-inflammatory effects may take several days to weeks.
Excretion
Primarily excreted in the urine as 6-MNA and its glucuronide conjugates; a small amount is excreted in the feces.
Half life
The elimination half-life of the active metabolite (6-MNA) is approximately 24 hours.
Absorption
Well absorbed from the gastrointestinal tract, undergoes extensive first-pass metabolism to its active metabolite 6-MNA. Absorption is not affected by food.
Metabolism
Extensively metabolized in the liver to its active metabolite 6-MNA, followed by further metabolism to inactive conjugates.
Side Effects
Contraindications
- Known hypersensitivity to nabumetone or any component of the formulation
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Severe uncontrolled heart failure
- Severe renal impairment
- Active gastrointestinal bleeding or peptic ulceration
- Third trimester of pregnancy
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Methotrexate
Increased methotrexate levels, leading to toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Diuretics (e.g., Furosemide, Thiazides)
Reduced diuretic and antihypertensive effects, increased risk of renal impairment.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of gastrointestinal bleeding.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding.
ACE inhibitors and Angiotensin II Receptor Blockers (ARBs)
Reduced antihypertensive effect, increased risk of renal impairment, especially in elderly or dehydrated patients.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Rarely, hypertension, acute renal failure, respiratory depression, and coma may occur. Management is primarily supportive. Gastric lavage and/or activated charcoal may be considered within 1 hour of ingestion. Monitor vital signs and provide symptomatic treatment.
Pregnancy & Lactation
Pregnancy Category C/D in 3rd trimester. Avoid during the third trimester of pregnancy due to risk of premature closure of the fetal ductus arteriosus. Use with caution in early pregnancy if benefits outweigh risks. It is unknown whether nabumetone is excreted in human milk; use with caution in breastfeeding mothers.
Side Effects
Contraindications
- Known hypersensitivity to nabumetone or any component of the formulation
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
- Severe uncontrolled heart failure
- Severe renal impairment
- Active gastrointestinal bleeding or peptic ulceration
- Third trimester of pregnancy
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Methotrexate
Increased methotrexate levels, leading to toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Diuretics (e.g., Furosemide, Thiazides)
Reduced diuretic and antihypertensive effects, increased risk of renal impairment.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of gastrointestinal bleeding.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding.
ACE inhibitors and Angiotensin II Receptor Blockers (ARBs)
Reduced antihypertensive effect, increased risk of renal impairment, especially in elderly or dehydrated patients.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Rarely, hypertension, acute renal failure, respiratory depression, and coma may occur. Management is primarily supportive. Gastric lavage and/or activated charcoal may be considered within 1 hour of ingestion. Monitor vital signs and provide symptomatic treatment.
Pregnancy & Lactation
Pregnancy Category C/D in 3rd trimester. Avoid during the third trimester of pregnancy due to risk of premature closure of the fetal ductus arteriosus. Use with caution in early pregnancy if benefits outweigh risks. It is unknown whether nabumetone is excreted in human milk; use with caution in breastfeeding mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date.
Availability
Pharmacies
Approval Status
Approved (DGDA, FDA and other regulatory bodies)
Patent Status
Generic available
Clinical Trials
Nabumetone has undergone extensive clinical trials demonstrating its efficacy and safety for osteoarthritis and rheumatoid arthritis. Ongoing post-marketing surveillance continues to monitor its effects.
Lab Monitoring
- Complete blood count (CBC)
- Liver function tests (LFTs)
- Renal function tests (RFTs)
- Blood pressure monitoring
Doctor Notes
- Nabumetone is a prodrug NSAID with a relatively long half-life, allowing for once-daily dosing.
- Monitor for GI, CV, and renal adverse effects, especially in elderly or high-risk patients.
- Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not exceed the recommended dose.
- Report any signs of unusual bleeding, severe stomach pain, or black/tarry stools.
- Avoid concomitant use with other NSAIDs or aspirin without consulting your doctor.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once.
Driving Precautions
May cause dizziness, drowsiness, or visual disturbances. Exercise caution when driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Limit alcohol intake while on this medication, as it may increase the risk of stomach bleeding.
- Maintain a healthy lifestyle with regular exercise and a balanced diet.
- Consult your doctor before taking any over-the-counter pain relievers or cold medications.
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