Nayzilat - instructions for use, analogs, testimonials and release forms (tablets 600 mg) of a medicament for the treatment of pain and inflammation in arthrosis, arthritis, gout, migraine in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Nisilat. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of experts on the use of Naizilat in their practice are presented. 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 Naisilate in the presence of existing structural analogues. Use for the treatment of pain and inflammation with arthrosis, arthritis, gout, migraine in adults, children, as well as during pregnancy and lactation.Composition and interaction of the drug with alcohol.

Nisilat - is a non-steroidal anti-inflammatory drug (NSAID), a nonselective inhibitor of cyclooxygenase (COX). Amtolmethine guacyl (the active substance of the preparation Naisilat) is a precursor of tolmetine. Has anti-inflammatory, analgesic, antipyretic, desensitizing effect, has a gastroprotective effect. Suppresses inflammatory factors, reduces platelet aggregation; oppresses COX-1 and COX-2, disrupts the metabolism of arachidonic acid, reduces the formation of prostaglandins (including in the focus of inflammation), suppresses the exudative and proliferative phases of inflammation. Reduces the permeability of capillaries; stabilizes the lysosomal membranes; inhibits synthesis or inactivates mediators of inflammation (prostaglandins, histamine, bradykinins, cytokines, complement factors). It blocks the interaction of bradykinin with tissue receptors, restores disturbed microcirculation, and reduces pain sensitivity in the inflammatory focus. Affects thalamic centers of pain sensitivity; reduces the concentration of biogenic amines with algogenic properties; increases the threshold of pain sensitivity of the receptor apparatus.Eliminates or reduces the intensity of pain syndrome, reduces morning stiffness and swelling, increases the amount of motion in the affected joints after 4 days of treatment.

The protective effect of Naisilate on the gastric mucosa is realized by stimulating Capsaicin receptors (also called vanilloid receptors) present in the gastrointestinal wall. Due to the presence of the vanillin group in amtolmetin guacyl, it can stimulate capsaicin receptors, which in turn causes the release of the peptide encoded by the calcitonin gene (PCHA) and the subsequent increase in the production of nitric oxide (NO). Both of these actions create a counterbalance to the negative effect caused by a decrease in the amount of prostaglandins due to inhibition of COX. Nayzilat was well tolerated by patients with prolonged use (within 6 months).

Composition

Amtolmethine guacyl + auxiliary substances.

Pharmacokinetics

Absorption of Naisilat after oral administration is rapid and complete. Basically, the drug is concentrated in the walls of the stomach and intestines, where a very high concentration is maintained for 2 hours after ingestion. Binding to plasma proteins - 99%.After absorption of amtolmethine, guacyl is immediately subjected to hydrolysis by plasma esterases with the formation of three metabolites: MED5, tolmetine and guiacaul, which are transformed to the active metabolite of tolmetin, which penetrates into tissues, providing pharmacological action. The main way of metabolism of tolmetine is the oxidation of the methyl group in the benzene ring to the carboxyl group. Within 24 hours the drug is almost completely eliminated from the body in the form of glucuronides (with urine - 80%, with bile - 20%).

Indications

• rheumatoid arthritis;
• osteoarthritis;
• ankylosing spondylitis;
• articular syndrome with exacerbation of gout;
• bursitis, tendovaginitis;
• pain syndrome of mild and moderate intensity (arthralgia, myalgia, neuralgia, migraine, dental and headache, algodismenorea, pain with injuries, burns).

It is intended for symptomatic therapy, reducing pain and inflammation at the time of use, the progression of the disease is not affected.

Forms of release

Tablets coated with 600 mg.

Instructions for use and dosing regimen

The recommended dose of the drug is 600 mg 2 times a day. Depending on the degree of control of the symptoms of the disease, the maintenance dose can be reduced to 600 mg once a day. The maximum daily dose is 1800 mg.To maintain the gastroprotective action of the drug, Naisilate should be taken on an empty stomach.

Side effect

• nausea, vomiting;
• dyspepsia;
• discomfort in the stomach and intestines;
• bloating;
• stomach ache;
• diarrhea, constipation;
• gastritis;
• peptic ulcer;
• impaired liver function;
• increase of urea nitrogen in the blood;
• urinary tract infections;
• noise in ears;
• visual impairment;
• bronchospasm;
• dyspnea;
• rhinitis;
• laryngeal edema;
• dizziness;
• headache;
• drowsiness;
• depression;
• lifting blood pressure;
• Anemia, thrombocytopenia, agranulocytosis, leukopenia;
• skin rash (including maculopapular rash);
• purpura;
• exfoliative dermatitis (fever with chills or without, redness, densification or flaking of the skin, swelling and / or tenderness of the tonsils);
• hives;
• Stevens-Johnson syndrome;
• Lyell's syndrome;
• anaphylaxis or anaphylactoid reactions (skin discoloration of the face, skin rash, hives, skin itch, tachypnea or dyspnea, edema of the eyelids, periorbital edema, shortness of breath, shortness of breath, chest pain, wheezing);
• weakness;
• edema (face, legs, ankles, fingers, feet, weight gain);
• increased sweating;
• fever;
• lymphadenopathy;
• swelling of the tongue.

Contraindications

• complete or incomplete combination of bronchial asthma, recurrent nasal polyposis or paranasal sinuses and intolerance to acetylsalicylic acid and other NSAIDs (including in the anamnesis);
• erosive and ulcerative changes in the mucous membrane of the stomach and duodenum;
• active gastrointestinal bleeding;
• cerebrovascular or other bleeding;
• inflammatory bowel disease (Crohn's disease, ulcerative colitis) in the phase of exacerbation;
• hemophilia and other bleeding disorders;
• Decompensated heart failure;
• hepatic insufficiency or active liver disease;
• marked renal failure (CC less than 30 ml / min);
• progressive kidney disease, confirmed hyperkalemia;
• period after aortocoronary shunting;
• arterial hypertension;
• congenital lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
• deficiency of glucose-6-phosphate dehydrogenase;
• pregnancy;
• lactation period;
• children's age till 18 years;
• hypersensitivity to amtolmethine, tolmetin.

Application in pregnancy and lactation

The drug Naisilat is contraindicated in pregnancy and lactation.

Use in children

Contraindicated in children and adolescents under 18 years.

Application in elderly patients

Precautions are prescribed for elderly patients.

special instructions

During treatment, it is necessary to monitor the picture of peripheral blood and the functional state of the liver and kidneys.

Treatment should be discontinued 48 hours before the determination of 17-ketosteroids.

Be wary appoint in the following diseases and conditions: hyperbilirubinemia, chronic heart failure, IHD, cerebrovascular disease, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, chronic renal failure (QC 30-60 ml / min), ulcerative gastrointestinal lesions anamnesis, presence of Helicobacter pylori infection (Helicobacter), long-term use of NSAIDs, alcoholism, severe somatic diseases, elderly age, simultaneous intake of oral glucocorticosteroids (D COP) (including prednisolone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, Paroxetine , sertraline).

Impact on the ability to drive vehicles and manage mechanisms

During treatment, one should refrain from engaging in potentially dangerous activities that require increased attention and speed of mental and motor reactions.

Drug Interactions

Inducers of microsomal oxidation in the liver (phenytoin, ethanol (alcohol), barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites.

Reduces the effectiveness of uricosuric, hypotensive drugs and diuretics.

Strengthens the hypoglycemic effect of derivatives of sulfonylurea, the effect of anticoagulants, antiplatelet agents, fibrinolytic agents, side effects of estrogens, glucocorticosteroids (GCS) and mineralocorticoids.

Antacids and colestyramine reduce absorption.

Increases the concentration in the blood of lithium preparations, methotrexate.

In some patients with impaired renal function, joint administration of NSAIDs and ACE inhibitors may lead to further impairment of kidney function.

Myelotoxic drugs increase the manifestation of hematotoxicity of the drug.

Analogues of the medicinal product Nyzilat

Naizilat has no structural analogs for the active substance.

Analogues on the curative effect (means for relief of pain in the joints):

• Actasulide;
• Amelotex;
• Apizarthron;
• Arkoxy;
• Arthrosan;
• Aspirin;
• Aertal;
• Viprosal B;
• Voltaren;
• Diklobene;
• Diqlovit;
• Diclofenac;
• Dimexide;
• Deep Relief;
• Ibuklin;
• Ibufen;
• Capsicam;
• Caffetin;
• Ketanov;
• Ketonal Duo;
• Ketoprofen;
• Ketorolac;
• Ketorol;
• Meloksikam;
• Menovazine;
• Migrenol;
• MOMENT;
• Movix;
• Nyz;
• Nextrim;
• Next;
• Nemux;
• Nimesil;
• Nimesulide;
• Niflugel;
• Nifluryl;
• Novigan;
• Nurofen;
• Oxycamox;
• Paracetamol;
• Pentafuphene;
• Pentalgin;
• Pliwalgin;
• Prohodol;
• Rapent Rapid;
• Revalgine;
• Solpaflex;
• Spasgan;
• Spazmalgon;
• The Texman;
• Tempalgin;
• Tetralgin;
• Fendivia;
• Finalgon;
• Flamadex;
• Flamax;
• Flamax forte;
• Fleksen;
• Hyrumat;
• Excedrin;
• Yunispaz.

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