Nimesulide - instructions for use, reviews, analogs and formulations (100 mg tablets, granules or powder for the preparation of a suspension) drugs for the treatment of arthrosis and arthritis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Nimesulide. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Nimesulide 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 Nimesulid in the presence of existing structural analogues. Use for the treatment of arthrosis and arthritis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

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

Composition

Nimesulide + excipients.

Pharmacokinetics

Absorption when ingested - high (eating intake reduces the rate of absorption, without affecting its degree). 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. It is excreted by the kidneys (65%) and with bile (35%), is subjected to enterohepatic recirculation.

Indications

• rheumatoid arthritis;
• osteoarthritis;
• arthritis of various etiologies;
• arthralgia;
• myalgia;
• postoperative and post-traumatic pain;
• bursitis;
• tendonitis;
• algodismenorea;
• toothache and headache.

The drug 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 of 100 mg.

Granules or powder for the preparation of a suspension for oral administration.

Other forms, whether it be ointment or gel, syrup, injections in ampoules for injections or suppositories, do not exist.

Instructions for use and reception scheme

Granules for the preparation of suspension

Inside.

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.

No dose reduction is required for elderly patients.

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

The minimum effective dose should be given for as short a period of time as possible in order to minimize the risk of adverse reactions. The maximum duration of the drug should not exceed 15 days.

Pills

Inside adults, 100-200 mg 2 times a day, children - 1.5 mg / kg 2-3 times a day.

The maximum dose for children is 5 mg / kg per day in 2-3 divided doses.

Side effect

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

Contraindications

• complete or incomplete combination of bronchial asthma, recurrent nasal polyposis or paranasal sinuses and intolerance to acetylsalicylic acid (ASA) and other non-steroidal anti-inflammatory drugs (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 (CHF);
• hepatic insufficiency or any active liver disease;
• hepatotoxic reactions with nimesulide in history;
• alcoholism;
• addiction;
• severe chronic renal failure (CRF) (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;
• lactation period;
• hypersensitivity.

Application in pregnancy and lactation

Contraindicated in pregnancy and lactation.

Application in elderly patients

Use with caution in elderly patients.

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

Use in children

Contraindicated in children under 12 years.

special instructions

To reduce the risk of side effects, it is necessary to apply the drug at the lowest effective dose with the 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.

If the symptoms of liver damage (eg, anorexia, nausea, vomiting, abdominal pain, increased fatigue, dark urine) or elevations in liver transaminases appear in patients taking Nimesulide, the drug should be discontinued. It is not recommended for such patients to appoint Nimesulide in the future.

Gastrointestinal bleeding or an ulcer / perforation of the stomach or duodenum may develop at any time with the use of the drug, which may not be accompanied by clinically expressed 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.

In the case of using the drug for more than 2 weeks, monitoring of liver function parameters is necessary.

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 when taking the drug, including gastrointestinal bleeding, perforation, impaired heart, kidney and liver function. Therefore, regular clinical monitoring of the patient's condition is recommended.

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

Impact on the ability to drive vehicles and manage mechanisms

In case when using the drug there are undesirable phenomena from the side of the central nervous system and sensory organs, it is necessary to refrain from driving by car and taking classes that require an increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

There is evidence that nimesulide may reduce the bioavailability of furosemide, compete with plasma fusion with fenofibrate, salicylic acid, tolbutamide.

Nimesulide can replace salicylic acid and Furosemide (but not warfarin) in plasma proteins.

It has no effect on drugs affecting the concentration of glucose and glucose tolerance in diabetic patients treated with various drugs containing sulfonylureas.

It is not recommended to take nimesulide concomitantly with diuretics, which have a damaging effect on renal hemodynamics.

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.

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

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

The concentration of lithium in plasma increases with simultaneous intake of lithium and nimesulide preparations. Nimesulide can enhance the action of cyclosporin on the kidneys.

Use with glucocorticosteroids (GCS), serotonin reuptake inhibitors increases the risk of developing gastrointestinal bleeding.

Analogues of the drug Nimesulide

Structural analogs for the active substance:

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

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