Nabumetone (Relafen) versus ...

Based on "Essential Pain Pharmacology"
written by Howard S. Smith, MD; Marco Pappagallo, MD

Nabumetone vs Naproxen (Naprosyn, Naprelan)

Nabumetone produces significantly less deterioration of gastric mucosa and has a significantly lower ulcerogenic potential than naproxen2. Also, nabumetone is better tolerated.

Rheumatoid arthritis

Nabumetone has less effect on platelet aggregation than naproxen in patients with rheumatoid arthritis5.

Efficacy of nabumetone is equal to that of naproxen in the treatment of active rheumatoid arthritis1.

A 3-month, randomized, double-blind, multicenter, parallel-group study6 compared the tolerability and efficacy of nabumetone and naproxen in the treatment of rheumatoid arthritis (RA). Nabumetone 2000 mg per day was as effective as naproxen 1000 mg per day in relieving the signs and symptoms of RA. In this study nabumetone was associated with a higher incidence of diarrhea.


Naproxen may be superior to nabumetone in the treatment of active osteoarthritis (OA) of the knee.

The efficacy and safety of Naprelan (naproxen sodium) and nabumetone were compared in a multicenter, randomized, placebo-controlled, double-masked, 4-week study of adults with active OA of the knee11. The overall distribution of scores in all three primary efficacy assessments (investigator's global assessment of OA, patient's global assessment of OA, and walking pain) at week 2 and at the last visit was significantly better for the Naprelan group compared with both the nabumetone and placebo groups. The mean improvement from baseline was also significant for Naprelan compared with the nabumetone and placebo groups for all three assessments at week 2 and for investigator's global assessment of OA and walking pain at the last visit. At week 2, significant differences favoring Naprelan versus nabumetone and placebo were measured in overall distribution of scores for joint tenderness and nighttime pain. At the last visit, nighttime pain scores were still significantly better for patients receiving Naprelan versus nabumetone and placebo.

Nabumetone vs Diclofenac

Nabumetone has significantly fewer gastrointestinal tract side effects than diclofenac9.

Rheumatoid arthritis

Nabumetone is as effective as diclofenac sodium in the management of rheumatoid arthritis (RA) symptoms.

Results randomized, open-label, controlled, multicenter, study3 comparing nabumetone and diclofenac sodium in the treatment of RA Nabumetone Diclofenac
Regimen 1 000 mg per day 75 mg per day
Efficacy rate 92.31% 88.52%
Incidence of ulcer disease 0% 2.7%
Gastrointestinal lesions under the endoscope less severe in the nabumetone group



Nabumetone is similar in efficacy and superior in tolerability to diclofenac SR in patients with osteoarthritis4.

Nabumetone vs Etodolac (Lodine)


Etodolac is at least as effective as nabumetone and is equally well tolerated in the treatment of active osteoarthritis of the knee7. Etodolac may have an earlier onset of action and greater efficacy in the improvement of osteoarthritis symptoms than nabumetone.

Nabumetone vs Meloxicam (Mobic)

Both nabumetone and meloxicam are cyclo-oxygenase-2 (COX-2) preferential nonsteroidal anti-inflammatory drugs (NSAIDs).

Nabumetone inhibits thromboxane production much more than meloxicam, indicating less COX-2 selectivity of nabumetone. However, both nabumetone and meloxicam cause only minor impairment in platelet function and the difference between them is not significant8.

Nabumetone vs S-adenosylmethionine (SAMe)

An 8-week, multicenter, randomized, double-blind, double-dummy study10 compared the efficacy and tolerability of SAMe and nabumetone in Korean patients with knee osteoarthritis (OA). This study found no significant differences in pain relief or tolerability between treatment with SAMe or nabumetone.


Further reading

  • 1. Hazleman BL, Thomas PP. Single-blind comparative study of nabumetone (Relafen) versus naproxen in the treatment of rheumatoid arthritis. Am J Med. 1987 Oct 30;83(4B):60-4. PubMed
  • 2. Roth SH, Bennett R, Caldron P, Mitchell C, Swenson C, Koepp R. A longterm endoscopic evaluation of patients with arthritis treated with nabumetone vs naproxen. J Rheumatol. 1994 Jun;21(6):1118-23.
  • 3. Zhonghua Yi Xue Za Zhi. Comparison of the efficacy and safety of nabumetone and diclofenac sodium in the treatment of patients with rheumatoid arthritis. 2001 May 10;81(9):557-60.
  • 4. Bellamy N, Bensen WG, Beaulieu A, Siminovitch KA, Kraag GR, Lussier A, Ahmad S, Khanna VN, Davis P, Bell MJ, et al. A multicenter study of nabumetone and diclofenac SR in patients with osteoarthritis. J Rheumatol. 1995 May;22(5):915-20. PubMed
  • 5. Knijff-Dutmer EA, Martens A, vd Laar MA. Effects of nabumetone compared with naproxen on platelet aggregation in patients with rheumatoid arthritis. Ann Rheum Dis. 1999 Apr;58(4):257-9.
  • 6. Krug H, Broadwell LK, Berry M, DeLapp R, Palmer RH, Mahowald M. Tolerability and efficacy of nabumetone and naproxen in the treatment of rheumatoid arthritis. Clin Ther. 2000 Jan;22(1):40-52.
  • 7. Schnitzer TJ, Ballard IM, Constantine G, McDonald P. Double-blind, placebo-controlled comparison of the safety and efficacy of orally administered etodolac and nabumetone in patients with active osteoarthritis of the knee. Clin Ther. 1995 Jul-Aug;17(4):602-12. PubMed
  • 8. van Kraaij DJ, Hovestad-Witterland AH, de Metz M, Vollaard EJ. A comparison of the effects of nabumetone vs meloxicam on serum thromboxane B2 and platelet function in healthy volunteers. Br J Clin Pharmacol. 2002 Jun;53(6):644-7.
  • 9. Becvár R, Urbanová Z, Vlasáková V, et al. Nabumetone induces less gastrointestinal mucosal changes than diclofenac retard. Clin Rheumatol. 1999;18(4):273-8.
  • 10. Kim J, Lee EY, Koh EM, Cha HS, Yoo B, Lee CK, Lee YJ, Ryu H, Lee KH, Song YW. Comparative clinical trial of S-adenosylmethionine versus nabumetone for the treatment of knee osteoarthritis: an 8-week, multicenter, randomized, double-blind, double-dummy, Phase IV study in Korean patients. Clin Ther. 2009 Dec;31(12):2860-72.
  • 11. Fleischmann RM, Flint K, Constantine G, Kolecki B. A double-masked comparison of Naprelan and nabumetone in osteoarthritis of the knee. Naprelan Study Group. Clin Ther. 1997 Jul-Aug;19(4)

Published: November 01, 2013
Last updated: June 07, 2017


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