If you suffer from pain, inflammation, doctors often prescribe Nimesil powder to drink. The drug begins to act quickly, so it will be an excellent tool for emergency relief of discomfort.
Nimesil - description, therapeutic effect
Nimesil is a drug in the form of granules in sachets belonging to the group of non-steroidal anti-inflammatory drugs (NSAIDs), a subgroup of selective COX2 inhibitors. Each sachet contains 2 g of the preparation for the preparation of a suspension (the granules must be dissolved in water). The resulting product will have a light yellow tint, has a slight orange smell and taste.
The composition of the product is represented by a substance such as nimesulide, as well as a number of additional ingredients:
The price for a large package (30 bags) is 770 rubles, the manufacturer is Berlin-Chemie. The active ingredient belongs to methanesulfonanilide derivatives, which give a pronounced anti-inflammatory, analgesic effect, and normalize body temperature.
The effects are due to the impact on the formation and transformation of arachidonic acid (a precursor of inflammatory mediators). After taking, the production of prostaglandins, substances that cause a person to feel pain, decreases.
Nimesil is able to reduce the formation of free radicals that appear during the inflammatory reaction.
The drug has a selective effect. This means that inflammation subsides only where it is pathological. In the gastrointestinal tract, the production of prostaglandins, which have the ability to protect cells, does not stop. This reduces the risk of side effects from treatment with Nimesil, therefore, the drug is better tolerated than a number of analogues with non-selective action.
Indications for appointment
The drug has very extensive indications for use, it is recommended for children from 12 years old and adults. The drug helps to reduce pain and relieve inflammation in many diseases:
The drug in powder Nimesil helps against infectious diseases - influenza, SARS, but its effect is only symptomatic! We must not forget about the possible masking of signs of high fever, complications of a viral infection - against the background of treatment with Nimesil, the symptoms are greatly smoothed out! Additionally, it is important to take antibiotics, antiviral agents, depending on the etiology of the disease.
Instructions for use
The medicine is prescribed by a doctor, it should be taken only according to the indications. You can not combine the reception with alcohol - this increases the risk of complications, side effects, especially bleeding!
The procedure for Nimesil therapy is as follows:
Adolescents 12-18 years of age can use the same doses as indicated for adults, dosage reduction is not required.
To reduce the risk of "side effects", you need to drink the smallest effective dose of the drug and be treated for the shortest possible period.
In case of impaired renal function, the dosage should also not be reduced unless the disorders are severe. For the elderly, the dose is selected by the doctor individually.
Contraindications, side effects
Among the contraindications are allergic reactions to the drug of this group in history, especially in the form of the "aspirin triad", as well as in the form of urticaria, angioedema. Other restrictions on admission are:
The drug can have a variety of side effects. Occasionally, lesions of the blood system are observed - anemia, an increase in eosinophils in the blood, a drop in platelets, the development of hemorrhagic diathesis.
Of the allergic reactions, itching, a rash on the skin are most often noted, less often urticaria, Quincke's edema. From the side of the nervous system, dizziness, migraines, insomnia, nightmares may appear. It is possible to reduce the clarity of vision, pressure drop, arrhythmia, shortness of breath, dyspepsia, stomach pain, hepatitis, blood in the urine.
Analogues and other information
There is a drug cheaper than Nimesil - with the same active ingredient. Its price is about 100 rubles for 20 tablets, the difference is only in the form of release. There are other analogues that are widely sold in pharmacies containing nimesulide or other NSAIDs.
In the absence of a positive effect within 3-4 days, Nimesil therapy should be discontinued. With long-term use, it is important to monitor liver function, since severe forms of hepatitis may develop. With an increase in liver tests, therapy is urgently stopped. At any stage of treatment, the powder can provoke the development of gastritis and ulcers, bleeding and ulcerative colitis, therefore, with a tendency to damage the gastrointestinal tract, special care must be taken.
Nimesil (Nimesil)Compound
The main active ingredient of the drug is nimesulide. There are also excipients: citric acid, orange flavor, ketomacrogol 1000 and maltodextrin.pharmachologic effect
Nimesil provides a pronounced analgesic, antipyretic and anti-inflammatory effect. The principle of functioning of this drug lies in the inhibition of the synthesis of prostaglandins. Nimesil inhibits the synthesis of prostaglandins at the site of inflammation more effectively than in the gastric mucosa or in the kidneys. With long-term treatment, the drug is fairly well tolerated. Its action develops relatively quickly, which is facilitated by the properties of the dosage form. The duration of the effect is on average 6 hours.Indications for use
Nimesil is prescribed for:Pain syndromes of various origins (headache, toothache, menstrual pain, consequences of injuries, postoperative pain, pain from rheumatism, etc.);
infectious and inflammatory diseases (traumatic and postoperative inflammations)
degenerative and inflammatory diseases of the musculoskeletal system (arthritis, osteoarthrosis, osteochondrosis, bursitis, sciatica, rheumatism, etc.);
urological, gynecological and vascular diseases;
diseases accompanied by an increase in body temperature.
This remedy is appropriate both for long-term therapeutic therapy and for dulling severe pain syndromes.
Mode of application
Nimesil is prescribed exclusively for adults. The drug is taken orally, after a meal. The average daily allowance is 200 mg: two doses of 100 mg. To prepare the suspension, the contents of the sachet are poured into a glass and poured with warm water. The dose can be increased if necessary. This is necessary for especially severe symptoms. Also, the dose may be adjusted according to the patient's response. Elderly people need to adjust the dose of the medicine.Side effects
The drug is usually well tolerated with long-term use, but at the beginning of the course of administration, as well as at high doses, various side effects are not excluded.Disorders can be from the following systems:
Central nervous system. These are headache, dizziness, encephalopathy, drowsiness, nervousness, fear, nightmares. If you sharply reduce the dose of the drug and further increase it more smoothly and carefully, then these disorders will pass.
The cardiovascular system. These are hypertension, tachycardia, hemorrhage, hot flashes. These occurrences are quite rare.
Organs of the gastrointestinal tract. Nausea, vomiting and diarrhea are rare. Dispersion, ulcer, tarry stools, gastrointestinal bleeding and gastric perforation are very rare. Sometimes flatulence, constipation or gastritis may occur.
Sense organs. Very rarely there is visual impairment.
Respiratory system. Bronchospasm and shortness of breath may also occur quite rarely.
Skin covering. Sometimes hyperemic reactions are possible, such as rash, itching and redness, excessive sweating is possible. Rarely, dermatitis, erythema, and very rarely, various edema may appear.
Bile system and liver. An increase in liver enzymes is possible, jaundice, hepatitis and cholestasis are rare.
Urinary system and kidneys. Dysuria, urinary retention, and hematuria are rare, while oliguria, renal failure, and interstitial nephritis are very rare.
The hematopoietic system. Eosinophilia and anemia are rare. Events such as pancytopenia, thrombocytopenia and purpura are very rare.
Contraindications
The drug should not be used when:stomach or duodenal ulcer;
severe bleeding from the gastrointestinal tract;
pregnancy and lactation;
overt and severe renal dysfunction;
hypersensitivity to any component of this agent;
heartburn, nausea, diarrhea, vomiting, abdominal pain;
type 2 diabetes;
congestive heart failure;
arterial hypertension.
Nimesil is contraindicated for use by children.
Pregnancy
The use of this drug is incompatible with pregnancy. If you need to take Nimesil, breastfeeding should be stopped.drug interaction
The drug enhances the effect of drugs that are used to reduce blood clotting. Nimesil can also increase the effect of furosemide. With the simultaneous administration of Nimesil and methotrexate, side effects may worsen. Nimesulide quickly binds to plasma proteins, so people who are treated with sulfonamides and hydantoin should be under close medical supervision. The drug enhances the effect of cyclosporine on the kidneys. If Nimesil is used simultaneously with lithium preparations, then the plasma concentration of lithium will increase.Treatment with Nimesil requires caution if pressure drugs, diuretics, or other anti-inflammatory and analgesic drugs are used in combination with it.
Overdose
With an overdose of the drug, side effects become more pronounced. Obvious symptoms: nausea, apathy, drowsiness, vomiting, rarely gastrointestinal bleeding. There is no specific antidote for this case. To eliminate the results of an overdose, gastric lavage and activated charcoal are taken. If necessary, supportive and symptomatic therapy is carried out.Release form
Nimesil is distributed in cardboard packs containing 30 laminated aluminum foil sachets. The sachet contains granules for the preparation of a therapeutic suspension.Storage conditions
Keep the drug in a dark, dry place at room temperature.Shelf life - 2 years.
Additionally
Caution should be exercised when treating the elderly with this drug. If during the treatment cycle the vision worsens, then Nimesil should be stopped immediately and contact an ophthalmologist for help. Persons suffering from diabetes should be aware that this medicinal product contains sucrose. Also, caution in the use of Nimesil is needed for those people whose activities are associated with a quick reaction and increased attention.Producer: Laboratori GUIDOTTI S.p.A./Menarini (Italy).
The authors
Links
- Official instructions for the drug Nimesil.
- Modern drugs: a complete practical guide. Moscow, 2000. S. A. Kryzhanovsky, M. B. Vititnova.
Description of the drug Nimesil" on this page is a simplified and supplemented version of the official instructions for use. Before purchasing or using the drug, you should consult a doctor and read the annotation approved by the manufacturer.
Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide on the appointment of the drug, as well as determine the dose and methods of its use.
Nimesil is a medical drug that belongs to the group of anti-inflammatory non-hormonal drugs.
The active ingredient is nimesulide, a substance that relieves pain, reduces temperature, and fights the inflammatory process. The tablets act as an inhibitor of cyclooxygenase extracts, which is responsible for the formation of prostaglandins and inhibits mainly cyclooxygenase-2.
Nimesil is prescribed for the treatment of infectious diseases, the fight against degenerative inflammatory pathologies of the musculoskeletal system (osteochondrosis, arthritis, rheumatism, bursitis, osteoarthritis, radiculitis), the elimination of fever of various origins, the treatment of vascular, gynecological and urological diseases.
Clinical and pharmacological group
NSAIDs. Selective COX-2 inhibitor.
Terms of dispensing from pharmacies
Released without a doctor's prescription.
Prices
How much does Nimesil cost in pharmacies? The average price is at the level of 900 rubles for a pack of 30 bags. For comparison, the price for 1 sachet of Nimesil is 25-32 rubles.
Release form and composition
The drug Nimesil is available in the dosage form of a powder for the preparation of a suspension, which is intended for oral administration. It has a light green color, coarse grain and an orange smell. The main active ingredient of the drug is nimesulide, its content in 1 sachet of powder is 100 mg.
The drug also contains additional compounds, which include:
- Ketomacrogol.
- Anhydrous citric acid.
- Sucrose.
- Orange flavor.
- Maltodextrin.
Nimesil powder is packaged in aluminum foil bags of 2 g each. A carton pack contains 9, 15 or 30 bags.
Pharmacological effect
The therapeutic effect of the drug Nimesil, the instruction indicates this, is due to the fact that it affects the metabolism of arachidonic acid by inhibiting cyclooxygenase (COX), which reduces the biosynthesis of prostaglandins.
The drug has a selective (selective) effect on COX-2, due to which the formation of prostaglandins with cytoprotective properties in the gastric mucosa is not disturbed. In this case, the risk of adverse reactions is reduced. The drug reduces the production of superoxide anions by neutrophils, and also inhibits the formation of free radicals that appear during the inflammatory process.
Indications for use
What is Nimesil for? This drug is prescribed for the diagnosis of the following diseases:
- Gynecological and urological diseases;
- Pain syndrome - menstrual, traumatic, rheumatic, postoperative origin;
- Inflammatory and infectious diseases, including postoperative and traumatic inflammations;
- Inflammatory and degenerative diseases affecting the musculoskeletal system - bursitis;
- Diseases that are accompanied by high fever.
The drug is relevant as a means for long-term therapy and can be used to dull the pain syndrome.
Contraindications
Nimesil powder should not be taken if a person has certain pathological processes or physiological conditions, which include:
- The patient's age is less than 12 years.
- Individual intolerance to any of the components of the drug.
- Recovery period after coronary artery bypass surgery.
- A history of diseases accompanied by increased bleeding, hemorrhagic stroke of the brain.
- Severe disorders, accompanied by a violation of blood coagulation (decrease in the functional activity of the hemostasis system).
- A pronounced decrease in the functional activity of the heart (severe heart failure).
- The combined use of drugs that have a negative effect on the state of the liver (hepatotoxic drugs).
- Past gastrointestinal bleeding, including on the background of peptic ulcer.
- Hypersensitivity (hypersensitization) of the body to acetylsalicylic acid, including those suffered in the past and accompanied by bronchospasm (allergic bronchitis), inflammation of the nasal mucosa, urticaria.
- Severe renal or hepatic failure.
- Chronic alcoholism or drug addiction.
- Pregnancy or the period of breastfeeding (lactation) in a woman.
- Non-infectious inflammatory chronic bowel diseases in the acute stage (ulcerative colitis).
- Feverish conditions, accompanied by an increase in body temperature, in particular in acute respiratory viral pathology, bacterial infections.
- The presence of allergic diseases, including a combination of polynosis, bronchial asthma, as well as intolerance to acetylsalicylic acid, which is non-steroidal anti-inflammatory drugs.
- A peptic ulcer characterized by a violation of the integrity of the mucous membrane of the stomach or duodenum. This is due to the fact that the drug Nimesil partially reduces the level of prostaglandins, which are responsible for protecting the mucous membrane of the upper gastrointestinal tract from aggressive factors (hydrochloric acid of gastric juice).
With caution, Nimesil powder is used for concomitant type 2 diabetes mellitus, high blood pressure (arterial hypertension), coronary heart disease, clopidogrel, heparin and its analogues), as well as hormonal anti-inflammatory drugs (glucocorticosteroids), peripheral arterial pathology, smoking, concomitant use of drugs that reduce blood clotting (non-steroidal anti-inflammatory drugs.
Dosage and method of application
The instructions for use indicate that Nimesil is taken orally, 1 sachet (100 mg of nimesulide) 2 times / day. The drug is recommended to be taken after meals. The contents of the sachet are poured into a glass and dissolved in about 100 ml of water. The prepared solution cannot be stored.
Nimesil is used only for the treatment of patients older than 12 years.
- Adolescents (aged 12 to 18 years): based on the pharmacokinetic profile and pharmacodynamic characteristics of nimesulide, there is no need for dose adjustment in adolescents.
- Patients with impaired renal function: based on pharmacokinetic data, there is no need to adjust the dose in patients with mild to moderate renal insufficiency (CC 30-80 ml / min).
- Elderly patients: in the treatment of elderly patients, the need to adjust the daily dose is determined by the doctor based on the possibility of interaction with other drugs.
The maximum duration of treatment with nimesulide is 15 days.
To reduce the risk of unwanted side effects, the minimum effective dose should be used for the shortest possible course.
How to breed Nimesil?
To prepare the solution, take 1 sachet and pour the contents into a glass. Then pour it with 100 ml of water. Stir thoroughly so that the mixture acquires a more pronounced color. The dosage of the drug can be adjusted by the doctor, focusing on the severity of the pathology and the general condition of the patient.
Side effects
The use of the drug Nimesil can cause the following side effects:
- Sense organs: blurred vision.
- Respiratory system: bronchospasm, exacerbation of asthma, shortness of breath.
- Bile system and liver: fulminant hepatitis, hepatitis, cholestasis, jaundice.
- Cardiovascular system: tachycardia, hypertension, hot flashes, pressure lability.
- CSC: feeling of fear, dizziness, nightmares, nervousness, drowsiness, headache, encephalopathy.
- Lymphatic and circulatory system: eosinophilia, anemia, thrombocytopenia, hemorrhages, thrombocytopenic purpura, pancytopenia.
- Allergic reactions: rash, itching, hypersensitivity reactions, increased sweating, dermatitis, erythema, urticaria, anaphylactoid reactions, erythema multiforme, angioedema, Lyell's syndrome, Stevens-Johnson syndrome.
- Gastrointestinal tract: nausea, diarrhea, constipation, vomiting, gastritis, flatulence, stomach pain, stomatitis, dyspepsia, bleeding in the stomach, tarry stools, ulcer.
- Urinary system and kidneys: hematuria, dysuria, renal failure, urinary retention, interstitial nephritis, oliguria.
Overdose
Nimesil quickly relieves pain and its effect lasts up to six to eight hours. With severe inflammation and unbearable pain, more frequent use is allowed - up to 3-4 times a day. But such use of it cannot last more than one day. If an overdose occurs, and the body reacts with bloating, vomiting or hives, it is necessary to wash the stomach and drink activated charcoal.
With severe symptoms of poisoning, when home methods do not help, you should consult a doctor.
special instructions
Before you start using the drug, read the special instructions:
- Nimesil should not be used simultaneously with other NSAIDs.
- If there are signs of a “cold” or an acute respiratory viral infection during treatment with Nimesil, the drug should be discontinued.
- Unwanted side effects can be minimized by using the lowest effective dose of the drug for the shortest possible course.
- Nimesil should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), since exacerbation of these diseases is possible.
- Since Nimesil is partially excreted by the kidneys, its dosage for patients with impaired renal function should be reduced, depending on the level of urination.
- The risk of gastrointestinal bleeding, ulceration or perforation of the ulcer increases with increasing dose of NSAIDs in patients with a history of ulcers, especially complicated by bleeding or perforation, as well as in elderly patients, so treatment should be started with the lowest possible dose. Patients receiving drugs that reduce blood clotting or inhibit platelet aggregation also increase the risk of gastrointestinal bleeding. In the event of gastrointestinal bleeding or ulcers in patients taking Nimesil, treatment with the drug should be discontinued.
- Despite the rarity of visual impairment in patients taking nimesulide simultaneously with other NSAIDs, treatment should be stopped immediately. If any visual disturbance occurs, the patient should be examined by an ophthalmologist.
- There is evidence of the occurrence of rare cases of reactions from the liver. If signs of liver damage appear (skin itching, yellowing of the skin, nausea, vomiting, abdominal pain, darkening of urine, increased activity of “liver” transaminases), you should stop taking the drug and consult your doctor.
- In patients with renal or heart failure, Nimesil should be used with caution, as renal function may deteriorate. If the condition worsens, treatment with Nimesil should be discontinued.
- The drug can cause fluid retention in the tissues, so patients with high blood pressure and cardiac disorders should use Nimesil with extreme caution.
- The composition of the drug includes sucrose, this should be taken into account for patients suffering from diabetes mellitus (0.15-0.18 XE per 100 mg of the drug) and people on a low-calorie diet. Nimesil is not recommended for patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltose deficiency.
- Clinical studies and epidemiological data suggest that NSAIDs, especially at high doses and with long-term use, may lead to a small risk of myocardial infarction or stroke. There are not enough data to exclude the risk of such events when using nimesulide.
- Nimesulide can change the properties of platelets, so care must be taken when using the drug in people with hemorrhagic diathesis, but the drug does not replace the preventive effect of acetylsalicylic acid in cardiovascular diseases.
- Elderly patients are particularly susceptible to adverse reactions to NSAIDs, including life-threatening gastrointestinal bleeding and perforations, deterioration of kidney, liver and heart function. When taking the drug Nimesil for this category of patients, proper clinical monitoring is necessary.
- There is evidence of the occurrence in rare cases of skin reactions (such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) to nimesulide as well as to other NSAIDs. At the first sign of a skin rash, mucosal lesions or other signs of an allergic reaction, Nimesil should be discontinued.
- Like other NSAIDs that inhibit prostaglandin synthesis, nimesulide may adversely affect pregnancy and/or fetal development and may lead to premature closure of the ductus arteriosus, hypertension in the pulmonary artery system, impaired renal function, which may progress to renal failure. with oligodyramnia, to an increased risk of bleeding, a decrease in uterine contractility, the occurrence of peripheral edema. In this regard, nimesulide is contraindicated during pregnancy and lactation. The use of the drug Nimesil can adversely affect female fertility and is not recommended for women planning a pregnancy. When planning pregnancy, consultation with your doctor is necessary.
The effect of Nimesil on the ability to drive vehicles and control mechanisms has not been studied, therefore, during the period of treatment with Nimesil, care should be taken when driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
drug interaction
When using the drug, it is necessary to take into account the interaction with other drugs:
- Nimesulide is able to stimulate the nephrotoxicity of cyclosporins.
- Anti-inflammatory non-steroidal drugs can weaken the effects of diuretics.
- With simultaneous use with glucocorticosteroids, the risk of ulcers or bleeding from the stomach and intestines increases.
- Anti-inflammatory non-steroidal drugs can enhance the effects of anticoagulants, so this combination is not recommended for people with severe coagulation disorders. If this combination still can not be avoided, it is necessary to carefully monitor the parameters of blood clotting.
- When used with antiplatelet agents and selective serotonin reuptake inhibitors, the likelihood of bleeding from the stomach or intestines is also increased.
- Nimesulide is able to temporarily reduce the evacuation of sodium and potassium under the influence of Furosemide and thereby weaken the diuretic effect of the latter. It must also be remembered that such co-administration of drugs requires caution in individuals with impaired renal and cardiac function.
- Anti-inflammatory non-steroidal drugs reduce the clearance of lithium, which causes an increase in the level of the latter in the blood.
- When prescribing Nimesil less than a day before or after the use of Methotrexate, care must be taken, since in such cases the content of Methotrexate in the blood and its toxic effects may increase.
- Anti-inflammatory non-steroidal agents may weaken the effect of antihypertensive agents. In persons with compensated renal insufficiency, while prescribing ACE blockers, angiotensin receptor antagonists of the second type, or agents that suppress cyclooxygenase, progression of deterioration in kidney function and the development of reversible acute renal failure is possible.
- Latin name: Nimesil
- ATX code: M01AX17
- Active substance: Nimesulide (Nimesulide)
- Manufacturer: Laboratorios MENARINI (Spain)
Composition of Nimesil
The preparation contains nimesulide in the amount of 100 mg per 1 sachet.
Additional substances: sucrose, ketomacrogol, citric acid, orange flavor, maltodextrin.
Release form
The medicine Nimesil is a granule for the manufacture of oral suspension in the form of a light yellow powder with an orange smell.
- 2 grams of Nimesil in a paper bag;
- 9, 30 or 15 sachets in a carton.
pharmachologic effect
Antipyretic, anti-inflammatory, analgesic effect.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Anti-inflammatory nonsteroidal drug from the group sulfonamides . It has anti-inflammatory, antipyretic and analgesic effects.
Wikipedia indicates that the active substance acts as a blocker cyclooxygenase type II responsible for biosynthesis.
Pharmacokinetics
After administration, it is well absorbed in the intestine, reaching the highest concentration in 2-3 hours later. Reaction with plasma proteins is 97.5%. The half-life is 4-5 hours. Quickly penetrates through histohematic barriers.
Transformed in the liver by cytochrome P450 . The main active is hydroxynimesulide , which is excreted in the bile in a glucuronidated form. Excreted from the body, mainly by the kidneys (about half of the accepted dose).
Indications for the use of Nimesil powder
The drug serves for symptomatic therapy, relief of inflammation and pain at the time of use.
Indications for Nimesil's use:
- symptomatic therapy of pain syndrome against the background;
- relief of acute pain (pain in the lower back and back; pain syndrome in injuries, tendonitis , sprains and dislocations; toothache);
- algomenorrhea .
Contraindications for Nimesil
Contraindications for use:
- hepatotoxic reactions , caused by the active substance in history;
- bronchospasm associated with the use or other in history;
- co-administration of drugs with potential hepatotoxicity;
- condition after coronary artery bypass grafting ;
- inflammatory bowel disease ( nonspecific ulcer, Crohn's disease ) in the acute stage;
- an increase in body temperature in diseases of an infectious and inflammatory nature;
- exacerbation, history, perforation or bleeding in the organs of the digestive tract;
- combination , nasal polyposis and intolerance non-steroidal anti-inflammatory drugs ;
- bleeding of cerebrovascular or other localizations; diseases accompanied by pathological bleeding;
- decompensated heart failure ;
- severe disorders of blood coagulation;
- decompensated, hyperkalemia ;
- liver disease;
- liver failure;
- , drug addiction;
- or ;
- age under 12;
- to the ingredients of the drug.
The abstract recommends using Nimesil with caution if severe forms are present. second type or ; ischemic disease, heart failure, dyslipidemia , cerebrovascular disease, peripheral arterial disease, old age; peptic ulcer in the past, infections associated with Helicobacter pylori; prolonged prior use non-steroidal anti-inflammatory drugs ; decompensated somatic diseases; smoking and concomitant medication anticoagulants, oral glucocorticosteroids, antiplatelet agents, selective serotonin reuptake blockers.
Side effects
Treatment of overdose is symptomatic. There is no electoral. If no more than 4 hours have passed since the overdose, it is necessary to wash the stomach and provide enterosorbenes what is used or osmotic laxative . Shows control over the work of the kidneys and liver.
Interaction
When used simultaneously with glucocorticosteroids increases the risk of ulcers or bleeding from the stomach and intestines.
When used with antiplatelet agents and selective reuptake inhibitors it also increases the chance of bleeding from the stomach or intestines.
may enhance the effects anticoagulants therefore, this combination is not recommended for persons with severe disorders coagulation . If this combination still can not be avoided, it is necessary to carefully monitor the parameters of blood clotting.
Anti-inflammatory nonsteroidal drugs able to mitigate the effects diuretics .
Nimesulide able to temporarily reduce evacuation sodium and potassium under the influence and thereby weaken the diuretic effect of the latter. It must also be remembered that such co-administration of drugs requires caution in individuals with impaired renal and cardiac function.
Anti-inflammatory nonsteroidal drugs may weaken the effect antihypertensive drugs . In persons with compensated kidney failure with simultaneous appointment ACE blockers ,type 2 angiotensin receptor antagonists or means of suppressingcyclooxygenase , progression of deterioration in kidney function and the development of reversible kidney failure acute type.
Anti-inflammatory nonsteroidal drugs reduces ground clearance lithium , which causes an increase in the level of the latter in the blood.
When prescribing Nimesil less than a day before or after use, care must be taken, since in such cases the content Methotrexate in the blood and its toxic effects may increase.
Nimesulide can stimulate nephrotoxicity cyclosporins .
Terms of sale
Over the counter.
Storage conditions
Store in a dry, dark place at room temperature. Keep away from children.
Shelf life
special instructions
Side effects can be minimized by using the lowest effective dosage of the drug for the shortest possible course.
The medicine in Nimesil powder should be used with caution in individuals with a history of gastrointestinal diseases, since an exacerbation of these diseases is not excluded.
Since the drug is partially evacuated by the kidneys, its dosage for people with impaired renal function should be reduced depending on the amount of urination.
When the first symptoms of liver damage appear (itching, yellowing of the skin, nausea, abdominal pain, vomiting, dark urine, an increase in the content of "liver" transaminases), it is necessary to stop taking the medication and consult a doctor.
If any signs of visual impairment appear during drug therapy, the patient should be examined by an ophthalmologist.
Nimesil is able to provoke fluid retention in the body, so people with high blood pressure and heart disease should use the drug with extreme caution.
If symptoms of an acute respiratory infection of a viral nature occur during drug therapy, Nimesil should be stopped.
Nimesil should not be used simultaneously with other anti-inflammatory nonsteroidal drugs .
Nimesulide is able to change the characteristics, so care must be taken when using the drug in patients with hemorrhagic diathesis . It is worth remembering that the medicine does not replace the preventive effect. acetylsalicylic acid in diseases of the circulatory system.
Nimesil's analogs
Coincidence in the ATX code of the 4th level:The price of Nimesil analogues is usually lower than that of the described remedy. The following are drugs with an identical composition, which can replace Nimesil: Ameolin (tablets), (tablets), Affida Fort (granules for suspension), Mesulid (pills), (tablets, suspension), Negan (tablets), (tablets, suspension), Nimesin (tablets), (tablets, gel), (tablets, granules), Nimujet (injection solution), (tablets, suspension, injection solution, gel), Nimuspaz (pills), Pansulid (pills), Remesulid (pills), Sulidin (gel), Taro-Sanovel (pills).
Nise or Nimesil - which is better?
nise and Nimesil are analogues. The main difference between the drugs is that the first is available in the form of a gel for topical use and tablets, and the cost Naiza an order of magnitude lower. The choice should be made based on the recommendations of the doctor, the type of indication and economic considerations.
Nimesil for children
Nimesil (like tablets or ointment based on nimesulide ) should not be used in children under 12 years of age. The instructions for the drug for children indicate that the method of using Nimesil (how to use and how to dilute the powder) in other age groups does not differ. How to use the powder, how to dilute Nimesil in powder, and how to drink Nimesil in powder, is described in the section "Instructions for using Nimesil (Method and dosage)"
Can Nimesil be given to children at a temperature?
This medicine is not the drug of choice for lowering body temperature, although it has a mild antipyretic effect. Nimesil should be used only for the purpose of stopping mild and moderately mild pain. Prohibited for the treatment of children under 12 years of age.
Alcohol compatibility
Nimesil and alcohol are incompatible, since both substances are hepatotoxic. Their simultaneous use can lead to severe disorders of the liver and irreversible consequences, especially against the background of already present diseases of the hepatobiliary system.
Nimesil during pregnancy and lactation
Use of the drug during pregnancy or breastfeeding is strictly prohibited, as nimesulide other anti-inflammatory nonsteroidal drugs can adversely affect the course of pregnancy and the development of the child.
Manufacturer: Berlin-Chemie AG / Menarini Group (Berlin-Chemie AG / Menarini Group) Germany
ATC code: M01AX17
Farm group:
Release form: Solid dosage forms. Granules.
General characteristics. Compound:
Active ingredient: nimesulide 100 mg;
Excipients: ketomacrogol 1000, sucrose, maltodextrin, anhydrous citric acid, orange flavor.
Pharmacological properties:
Pharmacodynamics. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) from the sulfonamide class. It has anti-inflammatory, analgesic and antipyretic effects. Nimesulide acts as an inhibitor of the cyclooxygenase enzyme responsible for the synthesis of prostaglandins and inhibits mainly cyclooxygenase 2.
Pharmacokinetics. After oral administration, the drug is well absorbed from the gastrointestinal tract, reaching a maximum plasma concentration in 2-3 hours; connection with plasma proteins - 97.5%; the half-life is 3.2-6 hours. Easily penetrates through histohematic barriers.
It is metabolized in the liver by cytochrome P450 (CYP) 2C9 isoenzyme. The main metabolite is the pharmacologically active parahydroxy derivative of nimesulide, hydroxynimesulide. Hydroxynimesulide is excreted in the bile in a metabolized form (found exclusively in the form of glucuronate - about 29%).
Nimesulide is excreted from the body, mainly by the kidneys (about 50% of the dose taken). The pharmacokinetic profile of nimesulide in the elderly does not change when prescribing single and multiple / repeated doses.
According to a pilot study conducted with the participation of patients with mild to moderate (creatinine clearance 30-80 ml / min) and healthy volunteers, the maximum concentration of nimesulide and its metabolite in the plasma of patients did not exceed the concentration of nimesulide in healthy volunteers. The area under the concentration-time curve (AUC) and half-life in patients with renal insufficiency were higher by 50%, but within the pharmacokinetic values. With repeated administration of the drug, cumulation is not observed.
Indications for use:
Treatment of acute pain (pain in the back, lower back; in the musculoskeletal system, including injuries, and joints; tendonitis, bursitis;);
.Symptomatic treatment of osteoarthritis with pain;
.Algodysmenorrhea.
The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use.
Important! Get to know the treatment
Dosage and administration:
Nimesil® is taken orally, 1 sachet (100 mg of nimesulide) twice a day. The drug is recommended to be taken after meals. The contents of the sachet are poured into a glass and dissolved in about 100 ml of water. The prepared solution cannot be stored.
Nimesil® is used only for the treatment of patients older than 12 years.
Adolescents (12 to 18 years of age): based on the pharmacokinetic profile and pharmacodynamic characteristics of nimesulide, there is no need for dose adjustment in adolescents.
Patients with impaired renal function: based on pharmacokinetic data, there is no need to adjust the dose in patients with mild to moderate renal insufficiency (creatinine clearance 30-80 ml / min).
Elderly patients: in the treatment of elderly patients, the need to adjust the daily dose is determined by the doctor based on the possibility of interaction with other drugs.
The maximum duration of treatment with nimesulide is 15 days.
To reduce the risk of unwanted side effects, the minimum effective dose should be used for the shortest possible course.
Application Features:
Unwanted side effects can be minimized by using the lowest effective dose of the drug for the shortest possible course.
Nimesil® should be used with caution in patients with a history of gastrointestinal diseases (peptic ulcer, Crohn's disease), since exacerbation of these diseases is possible.
Gastrointestinal tract disorders: often - nausea, vomiting; infrequently - , ; very rarely - abdominal pain, tarry stools, gastrointestinal bleeding, ulcer and / or perforation of the stomach or duodenum.
On the part of the liver and biliary system: very rarely - fulminant hepatitis, jaundice, increased activity of liver enzymes
Renal and urinary disorders: rarely - urinary retention; very rarely - renal failure, oliguria,.
General disorders: rarely - malaise, asthenia; very rarely - hypothermia.
Interaction with other drugs:
Pharmacodynamic interactions:
Glucocorticosteroids: increase the risk of gastrointestinal ulcers or bleeding.
Antiplatelet agents and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine: increase the risk of gastrointestinal bleeding.
Anticoagulants: NSAIDs may increase the effect of anticoagulants such as warfarin. Due to the increased risk of bleeding, this combination is not recommended and is contraindicated in patients with severe coagulation disorders. If combination therapy still cannot be avoided, careful monitoring of blood coagulation parameters should be carried out.
Diuretics:
NSAIDs may reduce the effect of diuretics.
In healthy volunteers, nimesulide temporarily reduces the excretion of sodium under the action of furosemide, to a lesser extent - the excretion of potassium, and reduces the actual diuretic effect.
Co-administration of nimesulide and furosemide leads to a decrease (approximately 20%) in the area under the concentration-time curve (AUC) and a decrease in the cumulative excretion of furosemide without changing the renal clearance of furosemide.
The co-administration of furosemide and nimesulide requires caution in patients with impaired renal or cardiac function.
ACE inhibitors and angiotensin-II receptor antagonists:
NSAIDs may reduce the effect of antihypertensive drugs. In patients with mild to moderate renal insufficiency (creatinine clearance 30-80 ml / min), with the joint appointment of ACE inhibitors, angiotensin II receptor antagonists or substances that suppress the cyclooxygenase system (NSAIDs, antiplatelet agents), further deterioration of kidney function and the occurrence of acute renal failure, which is usually reversible. These interactions should be considered in patients taking Nimesil® in combination with ACE inhibitors or angiotensin II receptor antagonists. Therefore, the combined use of these drugs should be prescribed with caution, especially for elderly patients. Patients should be adequately hydrated and renal function should be closely monitored after initiation of concomitant therapy.
Pharmacokinetic interactions with other drugs:
There is evidence that NSAIDs reduce the clearance of lithium, which leads to an increase in the concentration of lithium in the blood plasma and its toxicity. When prescribing nimesulide to patients receiving lithium therapy, regular monitoring of plasma lithium concentrations should be carried out.
No clinically significant interactions have been observed with glibenclamide, theophylline, digoxin, cimetidine, and antacids (eg, a combination of aluminum and magnesium hydroxides).
Nimesulide inhibits the activity of the CYP2C9 isoenzyme. While taking drugs that are substrates of this enzyme with nimesulide, the concentration of these drugs in plasma may increase.
When prescribing nimesulide less than 24 hours before or after taking methotrexate, caution is required, since in such cases the plasma level of methotrexate and, accordingly, the toxic effects of this drug may increase.
In connection with the action on renal prostaglandins, prostaglandin synthetase inhibitors, such as nimesulide, may increase the nephrotoxicity of cyclosporins.
Interaction of other drugs with nimesulide:
In vitro studies have shown that nimesulide is displaced from the binding sites by tolbutamide, salicylic acid and valproic acid. Despite the fact that these interactions were determined in blood plasma, these effects were not observed during the clinical use of the drug.
Contraindications:
Hypersensitivity to nimesulide or to one of the components of the drug.
.Hyperergic reactions (history) for example, bronchospasm, rhinitis, urticaria associated with taking acetylsalicylic acid or other non-steroidal anti-inflammatory drugs, including nimesulide.
.Hepatotoxic reactions to nimesulide (history).
.Concomitant (simultaneous) use of drugs with potential hepatotoxicity, such as paracetamol or other analgesic or non-steroidal anti-inflammatory drugs.
.Inflammatory bowel disease (Crohn's disease,) in the acute phase.
.Period after holding .
.Feverish syndrome with colds and acute respiratory viral infections.
.Complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose or paranasal sinuses with intolerance to acetylsalicylic acid and other NSAIDs (including history);
.Peptic ulcer of the stomach or duodenum in the acute phase, a history of ulcers, perforations or bleeding in the gastrointestinal tract.
.A history of cerebrovascular bleeding or other bleeding, as well as diseases accompanied by bleeding.
.Severe disorders of blood coagulation.
.Heavy .
.Severe renal failure (creatinine clearance<30 мл/мин), подтвержденная гиперкалиемия.
.Liver failure or any active liver disease.
.Children under the age of 12.
.Pregnancy and lactation.
.Alcoholism, drug addiction.
With caution: severe forms of arterial hypertension, type 2, heart failure, dyslipidemia / hyperlipidemia, peripheral arterial disease, smoking, creatinine clearance less than 60 ml / min.
Anamnestic data on the presence of ulcerative lesions of the gastrointestinal tract, infection caused by Helicobacter pylori; elderly age; long-term prior use of NSAIDs; severe somatic diseases.
Concomitant therapy with the following drugs: anticoagulants (eg, warfarin), antiplatelet agents (eg, acetylsalicylic acid, clopidogrel), oral glucocorticosteroids (eg, prednisolone), selective serotonin reuptake inhibitors (eg, citalopram, fluoxetine, paroxetine, sertraline).
The decision to prescribe the drug Nimesil® should be based on an individual risk-benefit assessment when taking the drug.
Overdose:
Symptoms: apathy, drowsiness, nausea, vomiting, pain in the epigastric region. With maintenance therapy, these symptoms are usually reversible. Gastrointestinal bleeding may occur. In rare cases, it is possible to increase blood pressure, respiratory depression and coma, anaphylactoid reactions.
Treatment: Symptomatic. There is no specific antidote. If an overdose has occurred within the last 4 hours, it is necessary to induce vomiting and / or provide activated charcoal (60 to 100 g per adult) and / or an osmotic laxative. , - are ineffective due to the high connection of the drug with proteins (up to 97.5%). Control of function of kidneys and a liver is shown.
Storage conditions:
List B. Store in a dry, dark place at a temperature not exceeding 25°C. Keep out of the reach of children! Shelf life 2 years. Do not use after the expiry date stated on the package.
Leave conditions:
On prescription
Package:
Granules for suspension for oral administration, 100 mg.
2 g of granulate in three-layer bags (paper / aluminum / polyethylene).
30 bags with instructions for use in a cardboard box.
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