Nimulide - instructions for use, analogs, reviews and release forms (suspension or syrup, tablets 100 mg, including for resorption, gel or ointment 1%) drugs for the treatment of arthritis and arthrosis in adults, children and pregnancy

In this article, you can read the instructions for using the drug Nimoolid. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Nimulida 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 Nimulid in the presence of existing structural analogs. Use to treat arthritis and arthrosis in adults, children, as well as during pregnancy and lactation.

Nimoolid - is a non-steroidal anti-inflammatory drug (NSAID) from the class of sulfonylalides. Has anti-inflammatory, analgesic and antipyretic effect.

Nimesulide (the active substance of the drug Nimulide) refers to NSAIDs whose mechanism of action is associated with selective inhibition of cyclooxygenase-2 (COX-2) and effects on a number of other factors: suppression of the platelet activation factor, tumor necrosis factor alpha, inhibition of proteinases and histamine. Selectively inhibiting COX-2, decreases the biosynthesis of prostaglandins in the inflammatory focus, has a less pronounced inhibitory effect on COX-1 (less often causes side effects associated with the inhibition of prostaglandin synthesis in healthy tissues).

Composition

Nimesulide + excipients.

Pharmacokinetics

Absorption when ingested - high (eating intake reduces the rate of absorption, without affecting its degree). Binding to plasma proteins - 95%, with erythrocytes - 2%, with lipoproteins - 1%, with acid alpha 1-glycoproteids - 1%. The dose change does not affect the degree of binding. Penetrates into the tissue of the female genital organs, where after a single intake its concentration is about 40% of the concentration in the plasma. 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%), it is a water-soluble compound, for the removal of which glutathione and conjugation reactions of the 2-phase metabolism (sulfation, glucuronidation and others) are not required. 4-hydroxynimidesulide is excreted by the kidneys (65%) and bile (35%), is subjected to enterohepatic recirculation.

Indications

• rheumatoid arthritis;
• articular syndrome with exacerbation of gout;
• psoriatic arthritis;
• ankylosing spondylitis, osteochondrosis with radicular syndrome;
• osteoarthritis;
• myalgia of rheumatic and non-rheumatic origin;
• inflammation of ligaments, tendons, bursitis, including post-traumatic inflammation of soft tissues;
• pain syndrome of different genesis (including in the postoperative period, with trauma, algodismenorea, toothache, headache, arthralgia, lumboschialgia);
• fever or fever (as an antipyretic);
• symptomatic therapy of pain and inflammation reduction at the time of use, the progression of the disease is not affected.

Forms of release

Gel for external use 1% (sometimes mistakenly called ointment).

Suspension for oral administration (sometimes mistakenly referred to as syrup).

Tablets of 100 mg.

Tablets for resorption 100 mg.

Instructions for use and dosing regimen

Adults and children over 12 years of age (body weight more than 40 kg) inside appoint 1 tablet 2 times a day.

Tablets are taken after meals with enough water. The maximum daily dose is 5 mg / kg.

Course of treatment: as directed by a doctor.

Side effect

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

Contraindications

• erosive and ulcerative changes in gastric mucosa and duodenum, incl. inflammatory bowel disease in the phase of exacerbation;
• active gastrointestinal bleeding;
• expressed violations of the liver and / or kidney function, severe renal failure (creatinine clearance less than 30 ml / min), progressive kidney disease;
• severe heart failure;
• severe blood clotting disorders;
• confirmed hyperkalemia;
• period after aortocoronary shunting;
• anamnestic data on an attack of bronchial obstruction, rhinitis, urticaria after taking acetylsalicylic acid or other NSAIDs (complete or incomplete acetylsalicylic acid intolerance syndrome - rhinosinusitis, urticaria, polyps of the nasal mucosa, asthma);
• severe hepatic impairment or active liver disease;
• pregnancy;
• lactation period;
• children's age till 12 years;
• increased sensitivity to nimesulide and drug components.

Application in pregnancy and lactation

The drug is contraindicated in pregnancy and lactation.

Use in children

Contraindicated in children under 12 years.

special instructions

Nimulide should be used with caution in patients who have a tendency to bleeding, patients with upper gastrointestinal disorders or patients receiving anticoagulants.

Since Nimulide is partially excreted by the kidneys, its dosage should be reduced for patients with impaired renal function, depending on the creatinine clearance.

Given reports of visual impairment in patients taking other NSAIDs, treatment should be stopped immediately if any visual impairment occurs and the oculist should examine the patient.

The drug can cause fluid retention in the tissues, so patients with high blood pressure and with cardiac abnormalities Nimulide should be used with extreme caution.

To reduce the risk of developing adverse events on the part of the gastrointestinal tract, a minimum effective dose should be used with the minimum possible short course.

Nemulide with caution: coronary heart disease, cerebrovascular disease, congestive heart failure, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, creatinine clearance less than 60 ml / min, anamnestic data on the development of gastrointestinal ulcer, the presence of Helicobacter pylori infection, advanced age, prolonged use of NSAIDs, frequent alcohol use, severe physical illness, concomitant therapy with the following drug s:

• anticoagulants (eg, warfarin);
• antiaggregants (eg, acetylsalicylic acid, clopidogrel);
• oral glucocorticosteroids (GCS) (eg, prednisolone);
• selective serotonin reuptake inhibitors (eg, citalopram, fluoxetine, paroxetine, sertraline).

Impact on the ability to drive vehicles and manage mechanisms

Patients who have side effects: dizziness, drowsiness, blurred vision, caution should be exercised when driving vehicles and engaging in other potentially dangerous activities that require increased attention and speed of psychomotor reactions.

Drug Interactions

The effect of medications that reduce blood coagulability, increases with their simultaneous use with nimesulide.

Nimulide can reduce the action of furosemide. Reduces the therapeutic effect of antihypertensive drugs. Nimesulide increases the onset of side effects while taking methotrexate.

The level of lithium in the plasma increases with simultaneous reception of lithium and nimesulide preparations.

Nimesulide can enhance the nephrotoxic effect of cyclosporin on the kidneys. Use with glucocorticosteroids, serotonin reuptake inhibitors increases the risk of developing gastrointestinal bleeding.

Analogues of the drug Nimulide

Structural analogs for the active substance:

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

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