Nimide - instructions for use, reviews, analogs and formulations (Forte 100 mg tablets, suspension, gel or ointment, powder or granules) for headache, toothache, arthritis, arthritis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Nimid. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Nimid in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Nimid with available structural analogues.Use for the treatment of headaches and dental pain, with arthrosis, arthritis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Nimid - has the ability to selectively inhibit COX-2 and suppress the synthesis of prostaglandins in the inflammatory focus.

Nimide has analgesic, anti-inflammatory and antipyretic effects. Nimide inhibits the release of myeloperoxidase and inhibits the formation of free radicals of oxygen, without influencing the processes of chemotaxis and phagocytosis. Nimesulide (the active substance of the drug Nimid) is able to inhibit the formation of inflammatory mediators and tumor necrosis factor. By suppressing the synthesis of urokinase and interleukin-6, Nimide helps prevent the destruction of cartilaginous tissue. Nimesulide has the ability to reduce the synthesis of metalloproteases (collagenase and elastase), preventing the destruction of cartilage collagen and proteoglycans. Nimid is able to block pain impulses from the nociceptive system. Virtually without affecting COX-1, Nimide does not change the synthesis of cytoprotective prostaglandins in the stomach mucosa.

The mechanism of an analgesic effect of Nimide is also associated with the suppression of release from mast cells of histamine and the influence of nimesulide on glucocorticosteroid receptors. By suppressing the activity of myeloperoxidase, the drug reduces the formation of toxins in the inflammatory focus, thereby exerting an antioxidant effect.

Nimesulide inhibits the synthesis of endoperoxides, thromboxane A2, inhibits the activation of plasminogen, resulting in a decrease in platelet aggregation. Nimid has the ability to reduce bronchospasm, provoked by acetaldehyde and histamine.

Composition

Nimesulide + auxiliary substances.

Pharmacokinetics

After ingestion, Nimide is well absorbed from the digestive tract. Simultaneous food intake somewhat reduces the absorption rate of nimesulide, but does not affect its plasma concentrations. After 1.5-3 hours after oral administration of the drug in blood plasma, maximum concentrations of nimesulide are noted. Nimide is characterized by a high degree of ability to bind to plasma proteins. It penetrates well through the hematoplacental and blood-brain barrier.Nimesulide is defined in high concentrations in the synovial fluid and in the inflammatory focus. The drug is metabolized in the liver, excreted mostly by the kidneys, in less - with feces. The half-life of nimesulide reaches 3-5 hours. Nimesulide is excreted unchanged and in the form of active metabolites. In elderly patients, in children, in patients with impaired renal function, the pharmacokinetic parameters practically do not change. When applying the topical formulations of Nimide on the skin, the absorption of nimesulide into the total blood flow is negligible. The drug is slowly resorbed, penetrating the subcutaneous fat layer, muscles, joint capsule and synovial fluid. In the focus of inflammation for a long time, high concentrations of nimesulide are created.

Indications

Nimide in the form of tablets, granules and suspensions is used for:

• symptomatic treatment of pain syndrome in diseases of bones, joints and muscles, incl. with osteoarthritis, rheumatoid arthritis, bursitis, tendinitis, myalgia;
• as an analgesic for post-traumatic and post-operative pain, for pain caused by diseases of the ENT organs, pain in gynecological and dental practice;
• as an antipyretic agent for fever, accompanied by diseases of the upper respiratory tract and ENT organs.

Nimide in the form of a gel is applied topically at:

• degenerative and inflammatory diseases of the musculoskeletal system accompanied by edema and pain (rheumatic and rheumatoid arthritis, psoriatic and gouty arthritis, Bechterew's disease (ankylosing spondylitis), osteoarthritis, Reiter's syndrome, tendinitis, myositis, tendosynovitis, myalgia, osteochondrosis with radicular syndrome, neuralgia , lumbago, sciatica);
• inflammation of soft tissues caused by trauma (ruptures and ligament damage, bruising and stretching of the muscles).

Forms of release

Forte tablets 100 mg.

Gel (sometimes mistakenly called ointment).

A suspension of 60 ml.

Granules in sachets (sometimes mistakenly referred to as powder).

Instructions for use and dosing regimen

Tablets and suspension

The drug is taken after a meal. The dose and duration of therapy is determined by the doctor. In normal cases, Nimid is prescribed to adults twice a day for 100 mg. The maximum dose is 400 mg per day. Children from 12 years take the drug twice a day for 1.5 mg per kg of body weight.The maximum dose of Nimidum for children is 5 mg per kg of body weight per day. Children from 12 years old, weighing more than 40 kg, can take Nimide twice a day for 100 mg. The maximum dose of Nimide for such patients is 200 mg per day.

Granules

The drug is prescribed for children from 12 years and adults twice a day after meals for 100 mg (1 sachet). The contents of the sachet should be dissolved in a glass of warm water.

Gel

The drug in a small amount of a thin layer should be applied to the area of ​​the body where the pain syndrome is most pronounced, not rubbing, not more often than four times a day. It is recommended to wash hands thoroughly before and after using the gel.

Side effect

• skin rashes;
• itching;
• erythema;
• increased sweating;
• dermatitis;
• angioedema;
• erythema multiforme;
• swelling of the face;
• hives;
• epidermal necrolysis;
• gastralgia;
• nausea, vomiting;
• abdominal pain;
• constipation, diarrhea;
• flatulence;
• melena;
• stomatitis;
• peptic ulcers of the duodenum or stomach;
• gastrointestinal bleeding or perforation;
• cholestasis;
• jaundice;
• acute hepatitis;
• drowsiness;
• dizziness;
• headache;
• encephalopathy (Reye's syndrome);
• nervousness;
• anxiety;
• nightmarish dreams;
• dysuria;
• edema;
• hematuria (blood in the urine);
• retention of urination;
• oliguria;
• interstitial nephritis;
• eosinophilia, anemia, thrombocytopenic purpura, thrombocytopenia;
• bleeding;
• anaphylaxis;
• bronchospasm;
• bronchial asthma;
• arterial hypertension;
• tachycardia;
• asthenia;
• violation of visual acuity;
• hypothermia.

Contraindications

• patients with peptic ulcer of the duodenum and stomach in the stage of exacerbation;
• expressed by violations of the liver (hepatic insufficiency);
• hepatotoxic reactions to a drug in the anamnesis;
• severe impairment of kidney function (with creatinine clearance less than 30 ml per minute);
• with simultaneous administration with potentially hepatotoxic agents;
• with a tendency to bleeding;
• patients with heart failure;
• hypersensitivity to the components of the drug;
• women during breastfeeding and pregnancy;
• children under 12 years;
• patients with chronic alcoholism or drug dependence;
• with fever and influenza-like conditions;
• when suspected of acute surgical pathology.

Application in pregnancy and lactation

In the third trimester of pregnancy, Nimide is strictly contraindicated.Nimesulide may affect fertility, its use is not recommended for women who plan pregnancy. Nimid inhibits the synthesis of prostaglandins, which can cause pulmonary hypertension, premature infestation of the ductal duct, malodontia, oliguria. When using Nimid, the risk of bleeding, peripheral edema and weakness of labor is increased.

The drug Nimid is not recommended for use in the 1-2 trimester of pregnancy and is contraindicated in the period of breastfeeding.

Use in children

Contraindicated in children under 12 years.

special instructions

It is recommended to take the drug Nimid in minimally effective dosages with a minimum duration of therapy.

When Nimid appears on the background of symptoms of liver damage (vomiting, nausea, anorexia, abdominal pain, dark urine, fatigue) or with liver function indicators indicative of liver damage, Nimid should be discarded.

During the administration of Nimid, it is recommended to avoid the use of analgesics, hepatotoxic drugs, alcohol and other non-steroidal anti-inflammatory drugs (NSAIDs).

The appearance of signs of gastrointestinal bleeding while taking Nimid requires the withdrawal of the drug.

Patients with a history of gastrointestinal anemia (Crohn's disease or ulcerative colitis) should be prescribed with caution.

The appearance of signs of impaired renal function requires the drug to be discontinued.

Patients with advanced age should be monitored regularly when they are prescribed.

The appointment of Nimid to patients with hemorrhagic diathesis requires constant medical monitoring of the condition in connection with the ability of nimesulide to influence the function of platelets.

Admission of Nimid should be discontinued when flu-like symptoms appear or when the body temperature rises.

Drug Interactions

Simultaneous administration of the drug with Acetylsalicylic acid (aspirin), Warfarin and other anticoagulants may lead to an increased risk of bleeding.

The simultaneous use of Nimide and Furosemide in patients with impaired cardiac and renal function requires caution.

Preparations of the NSAID group can reduce the clearance of lithium, thereby increasing its concentration in the blood plasma and increasing its toxicity.In this regard, it is necessary to monitor the concentrations in lithium plasma with simultaneous use of lithium preparations and Nimide.

With the simultaneous administration of Nimid with theophylline, digoxin, ranitidine, glibenclamide, antacids, there was no clinically significant interaction.

With the simultaneous administration of Nimide with cyclosporins, the nephrotoxicity of the latter will be increased.

If Nimide is used less than 24 hours before Methotrexate is administered or less than 24 hours after its administration, an increase in the concentration of methotrexate in the blood and an increase in its toxicity may be noted.

Analogues of the drug Nimid

Structural analogs for the active substance:

• Actasulide;
• Amoeolin;
• Aponil;
• Aulin;
• Mesulide;
• Nyz;
• Nemux;
• Nimegesic;
• Nimesan;
• Nimesil;
• Nimesulide;
• Nimika;
• Nimulid;
• Novolide;
• Prolid;
• Sulaydine;
• Fllolid.

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