Nemux - instructions for use, analogs, reviews and release forms (granules or powder for the preparation of 100 mg suspension) of the drug for the treatment of colds, headaches and toothaches, lowering the temperature in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Nemux. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Nemulex 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 Nemulex in the presence of existing structural analogs.Use to treat colds, headaches and toothaches, reduce temperature in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Nemux non-steroidal anti-inflammatory drug (NSAID). Has anti-inflammatory, analgesic, antipyretic and antiplatelet effect. Unlike other NSAIDs, it selectively suppresses COX-2, inhibits the synthesis of prostaglandins in the inflammatory focus; has a less pronounced inhibitory effect on COX-1 (rarely causes side effects associated with the inhibition of prostaglandin synthesis in healthy tissues).

Composition

Nimesulide + excipients.

Pharmacokinetics

Absorption when ingested - high. The intake of food reduces the rate of absorption, without affecting its degree. Binding to plasma proteins - 95%, with erythrocytes - 2%, with lipoproteins - 1%, with acid alpha 1-glycoprotein 1%. The dose change does not affect the degree of binding. It penetrates into the acidic environment of the inflammatory focus (40%), synovial fluid (43%). Easily penetrates through the histohematological barriers. Metabolized in the liver by tissue monooxygenases. The main metabolite is 4-hydroxynimidesulide (25%),has a similar pharmacological activity, but due to the reduction in the size of the molecules it is able to diffuse quickly through the hydrophobic channel of COX-2 to the active methyl group binding site. 4-hydroxyimidesulide is a water-soluble compound, for the elimination of which glutathione and conjugation of the 2-phase metabolism (including sulfation, glucuronation) are not required. 4-hydroxyimidesulide is subjected to enterohepatic recycling. 4-hydroxynimidesulide is excreted by the kidneys (65%) and with bile (35%).

Indications

• rheumatoid arthritis;
• osteoarthritis;
• arthritis of various etiologies;
• arthralgia;
• myalgia;
• postoperative and post-traumatic pain;
• bursitis;
• tendonitis;
• decrease in temperature for colds, acute respiratory infections, ARVI;
• algodismenorea;
• toothache;
• headache.

The drug is intended for symptomatic therapy, reduces pain and inflammation at the time of use, the progression of the disease is not affected.

Forms of release

Granules for the preparation of a suspension for oral administration (sometimes mistakenly referred to as powder).

Instructions for use and dosing regimen

The drug is taken orally. The contents of 1 packet of granules are dissolved in 80-100 ml of water.

The recommended dose for adults and adolescents aged 12-18 years is 100 mg (1 sachet) 2 times a day after meals. The maximum daily dose for adults and adolescents aged 12-18 years is 200 mg.

Older patients do not need a dose reduction.

Patients with chronic renal failure require a reduction in the daily dose to 100 mg.

To minimize the risk of adverse reactions, the drug should be given at the lowest effective dose for as short a period of time as possible. The maximum duration of the drug is 15 days.

Side effect

• diarrhea, constipation;
• nausea, vomiting;
• flatulence;
• gastritis;
• stomach ache;
• stomatitis;
• tarry stools;
• gastrointestinal bleeding;
• ulcer and / or perforation of the stomach or duodenum;
• increased hepatic transaminases;
• hepatitis;
• jaundice;
• cholestasis (bile stasis);
• hypersensitivity reactions;
• anaphylactoid reactions;
• dizziness;
• a sense of fear;
• nervousness;
• nightmarish dreams;
• headache;
• drowsiness;
• encephalopathy (Reye syndrome);
• itching;
• skin rash;
• increased sweating;
• erythema (redness of the skin);
• dermatitis;
• hives;
• angioedema;
• swelling of the face;
• multi-form exudative erythema, incl. Stevens-Johnson syndrome;
• toxic epidermal necrolysis (Lyell's syndrome);
• edema;
• dysuria (violation of urination);
• hematuria (blood in the urine);
• retention of urine;
• hyperkalemia;
• kidney failure;
• oliguria;
• interstitial nephritis;
• anemia;
• eosinophilia, thrombocytopenia, pancytopenia;
• purpura;
• prolonged bleeding time;
• dyspnea;
• exacerbation of bronchial asthma;
• bronchospasm;
• blurred vision;
• arterial hypertension;
• tachycardia;
• hemorrhage;
• tides;
• general weakness;
• hypothermia.

Contraindications

• hypersensitivity to the components of the drug;
• 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 lesions of 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 chronic heart failure;
• hepatic insufficiency or any active liver disease;
• hepatotoxic reactions with nimesulide in history;
• alcoholism;
• addiction;
• severe chronic renal failure (CC less than 30 ml / min);
• progressive kidney disease;
• confirmed hyperkalemia;
• period after aortocoronary shunting;
• simultaneous reception of other hepatotoxic drugs;
• children's age till 12 years;
• pregnancy;
• the period of breastfeeding.

Application in pregnancy and lactation

Contraindicated in the use of Nemulex during pregnancy and lactation (breastfeeding).

The use of Nimesulide may adversely affect female fertility and is not recommended for women planning a pregnancy.

Use in children

Contraindicated in children under 12 years.

Application in elderly patients

Older patients do not need a dose reduction.

special instructions

To reduce the risk of side effects, it is necessary to apply the drug at the lowest effective dose withthe shortest duration. If the patient's condition does not improve, treatment should be stopped.

It is necessary to stop taking the drug in case of fever or development on the background of its intake of influenza-like symptoms.

When patients who present with Nemux have signs of liver damage (eg, anorexia, nausea, vomiting, abdominal pain, fatigue, dark urine), or an increase in hepatic transaminase activity, the drug should be withdrawn. It is not recommended for such patients to prescribe Nemuxle in the future.

Gastrointestinal bleeding or an ulcer / perforation of the stomach or duodenum can develop at any time with the use of the drug and not be accompanied by clinically pronounced symptoms (including pain syndrome). If there is a gastrointestinal bleeding or ulcers, the drug should be discarded.

If the kidney function worsens, the drug should be discarded.

If the drug is used for more than 2 weeks, it is necessary to monitor the liver function.

In patients with cirrhosis of the liver or with renal insufficiency with hypoalbuminemia or hyperbilirubinemia, the binding of nimesulide is reduced.

In elderly patients, the most common side effects are when taking the drug, incl. gastrointestinal bleeding, perforation, impaired function of the heart, kidneys and liver. Therefore, regular clinical monitoring of the patient's condition is recommended.

Impact on the ability to drive vehicles and manage mechanisms

If the application of the drug there are undesirable phenomena from the side of the central nervous system and sensory organs, then patients need to refrain from driving vehicles and classes of activities that require increased concentration and speed of psychomotor reactions.

Drug Interactions

There is evidence that nimesulide is able to reduce the bioavailability of furosemide, compete for binding to plasma proteins of fenofibrate, salicylic acid, tolbutamides. Nemux can replace salicylic acid and Furosemide (but not warfarin) in plasma proteins.

Nemux has no effect on drugs that affect the concentration of glucose in the blood and glucose tolerance in diabetic patients treated with sulfonylurea derivatives.

The physiological concentrations of unsaturated fatty acids do not affect the binding of nimesulide to serum albumin.

In therapeutic concentrations, the binding of nimesulide was not affected by warfarin, furosemide, glibenclamide, digitoxin.

It is not recommended to take the drug Nemux at the same time as diuretics, which have a damaging effect on renal hemodynamics.

Taking the drug Nemux in therapeutic doses for a short period does not change the serum Digoxin profile in patients with mild heart failure.

In the presence of nimesulide, free fractions of Methotrexate can increase significantly.

The concentration of lithium in the plasma increases with simultaneous administration of lithium preparations and the drug Nemux.

Nemulex can enhance the action of cyclosporin on the kidneys.

With the simultaneous use of the drug Nemuxle with glucocorticosteroids (GCS), serotonin reuptake inhibitors, the risk of developing gastrointestinal bleeding increases.

Analogues of the drug Nemux

Structural analogs for the active substance:

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

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

• Actasulide;
• Ambien;
• Amelotex;
• Antigrippin;
• Apizarthron;
• Arkoxy;
• Arthrosan;
• Ascofen;
• Aspirin;
• Aflubin;
• Aertal;
• Brustan;
• Brufen;
• Viprosal;
• Voltaren;
• Voltaren Emulgel;
• Diklobene;
• Diqlovit;
• Diclofenac;
• Dimexide;
• Dolgit;
• Ibuklin;
• Ibufen;
• Capsicam;
• Caffetin;
• Ketanov;
• Ketonal Duo;
• Ketoprofen;
• Ketorolac;
• Ketorol;
• Meloksikam;
• Menovazine;
• Migrenol;
• Movix;
• Naisylate;
• Nyz;
• Next;
• Nimesil;
• Niflugel;
• Novigan;
• Paracetamol;
• Pentalgin;
• Pliwalgin;
• Prohodol;
• Spasgan;
• Spazmalgon;
• Tempalgin;
• Teraflex Advance;
• Fendivia;
• Finalgon;
• Flamadex;
• Flamax;
• Flamax forte;
• Fleksen;
• Hyrumat;
• Celebrex;
• Yunispaz.

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