Nimesil : instructions for use , contraindications , side effects , analogs

Nimesil is an analgesic and antipyretic drug with a pronounced anti-inflammatory effect.It belongs to a group of non-hormonal anti-inflammatory drugs in the class of sulfonamides.

nimesil active substance is nimesulide exerts a powerful systemic effect.It is effective in the treatment of inflammatory fevers, infections and rheumatic processes, expressed pain syndrome of various etiologies.

Outperforms action popular drugs from the group of NSAIDs (ibuprofen, diclofenac), working directly in the inflammation, but it has a number of contraindications and side effects.

should be understood that, for all its high efficiency Nimesil for symptomatic treatment, acting at the time of use, and without affecting the etiological cause of the disease.

FarmGruppa: NSAIDs - non-steroidal anti-inflammatory drugs.

Formulation

  • Active substance: Nimesulide 100 mg;
  • Excipients: sucrose, ketomakrogol 1000 maltodextrin, anhydrous citric acid, orange flavor.

Product form

Nimesil available in granular fo

rm granules for suspension for oral administration having a light yellow color and orange scent.In a paper bag laminated - 2 grams of powder.Carton packs of 9, 15, 30 sachets.

Price:

  • 1 sachet 22-40 rubles,
  • 30 bags of 611-890 rubles.

Pharmacological action

Nimesulide has a pronounced effect on the metabolism of arachidonic acid by inhibiting primarily cyclooxygenase-2.As a result of these processes decreases the biosynthesis of prostaglandins, which are mediators of inflammatory and allergic reactions, and affect the smooth muscles of bodies.

drug quickly blocks the output of histamine from mast cells, slows synthesize metalloproteinases, collagenase and elastase, thus preventing cartilage from breaking down.It suppresses the release of tumor necrosis factor alpha, reducing the effects of kinins, causing expansion of the vascular wall.It reduces the production of superoxide anions by neutrophils and formation of free radicals, which play an important role in the development of inflammatory reactions.

Due to the peculiarities of the dosage form of nimesulide nimesil efficiency develops quickly and lasts for 6 hours.

Pharmacokinetics

According to the instructions for use nimesil after receiving a suspension of the drug is quickly absorbed through the gastrointestinal tract, reaching the maximum therapeutic concentration in 2-3 hours.Characterized by high connection to blood proteins, to 97.5%, easily passes through the blood-tissue barriers.

drug metabolism occurs in the liver through P450 (CYP) 2C9: isoenzyme cytochrome.The main metabolite - hydroxynimesulide pharmacologically active derivative of nimesulide.Displayed through the bile in the form of metabolizing.


About 50% of the amount taken nimesil excreted by the kidneys.

Indications

  • Treatment of osteoarthritis, rheumatoid arthritis as a symptomatic therapy.
    • headache;
    • pain, back;
    • myalgia;
    • pain that accompanies injury, sprains, inflammation of joints and sprains;
    • toothache;
    • postoperative period.
  • Treatment of acute pain symptoms
  • Algomenorrhea.
  • Symptomatic treatment of gynecological, cardiovascular and ENT diseases.
  • inflammatory disease with fever (except for common cold and SARS events).

Contraindications

Contraindications:

be prescribed with care in the following pathologies and factors:

  • Hypersensitivity to the active base (nimesulide) or an auxiliary component of the drug.
  • hyperergic reaction of the body in history: rhinitis, urticaria, bronchospasm, laryngospasm associated with taking any medication from the group of NSAIDs, including nimesulide.
  • Hepatotoxic reactions to nimesulide history.
  • Simultaneous treatment with other drugs having hepatotoxic (especially NPPS group).
  • inflammatory processes in the intestine in the acute phase (b-Hb Crohn's, ulcerative colitis).
  • recovery period after coronary artery bypass grafting.
  • fever that accompanies colds and SARS.
  • combination of asthma, polyposis, paranasal sinuses or nose with recurrent and intolerance to NSAIDs in history;
  • aggravation of gastric ulcer and 12 duodenal ulcer;
  • ulcer bleeding or perforation in history;
  • Cerebrovascular or other bleeding history;
  • diseases, accompanied by bleeding;
  • clotting heavy nature of the blood;
  • severe heart failure;
  • Renal failure in severe;
  • Confirmed hyperkalemia;
  • liver disease in the acute phase;
  • Liver failure;
  • Children up to 12 years;
  • Pregnancy, lactation;
  • Drug addiction, alcoholism.
  • heart failure of any degree;
  • hypertension severe;
  • diabetes type 2;
  • CHD;
  • hereditary fructose intolerance;
  • glucose-galactose malabsorption;
  • failure sucrose-isomaltose;
  • disk or hyperlipidemia;
  • cerebrovascular pathology;
  • severe somatic diseases;
  • artery disease (peripheral);
  • infection caused by Helicobacter pylori;
  • creatinine clearance less than 60 mL / min;
  • long-term treatment of NSAID;
  • old age;
  • smoking.

Dosage

Before applying the contents of the sachet (pellets) are poured into a beaker and add about 100 ml of water and stirred until a homogeneous suspension.Store can not be a ready solution, so it is prepared immediately before use.

  • Take after a meal, 1 sachet (pre-dissolved) 2 times a day.
  • maximum duration of receiving nimesil is 15 days, but in order to avoid the risk of adverse reactions is optimal assignment of short-course treatment (5-7 days).
  • Teens from 12 to 18 years old receive a dose Nimesil recommended above.
  • decision on dose adjustment in elderly patients is taken individually.

Patients with renal impairment (mild to moderate) does not require dose adjustment and reception intervals.In clinical trials in these patients have elongated twice the time interval to achieve maximum blood concentration of nimesulide in the half-life and the metabolites of the active substance, but keeping within the limits of the pharmacokinetic values.


Side effects

  • hematopoietic system: may develop anemia and eosinophilia, hemorrhagic syndrome;very rarely - patsitopeniya, thrombocytopenia and thrombocytopenic purpura.
  • Allergic reactions: likely itching, skin rash, excessive sweating;rarely develop stronger hypersensitivity reactions - dermatitis, erythema, urticaria, angioedema, anaphylactoid reactions, Stevens-Johnson syndrome and toxic epidermal necrolysis.
  • CNS: dizziness;less developed - the feeling of fear, night nightmares, nervousness, somnolence, headache, encephalopathy.
  • bodies of: rarely noted blurred vision.
  • CCC: likely tachycardia, hypertension, labile blood pressure, feeling the tides.
  • Respiratory: sometimes marked shortness of breath;rarely - bronchospasm, exacerbation of asthma.
  • Ingestion: often develop nausea and vomiting as well as diarrhea, constipation and rarely marked flatulence, gastropathy, dyspepsia, abdominal pain, tarry stools nature, stomatitis.Very rarely have gastro-intestinal bleeding, ulcerative lesion develops gastrointestinal mucosa, hepatitis, cholestasis, jaundice, increased liver enzymes.
  • Urinary system: rarely hematuria, dysuria, urinary retention;very rarely formed renal failure, interstitial nephritis, oliguria.
  • General disorders: discomfort, asthenic condition, at least - hypothermia.
  • blood Changing : very rarely observed hyperkalemia.

Overdose

Symptoms of overdose are: drowsiness, lethargy, nausea and vomiting, pain in the epigastric region, may develop gastrointestinal bleeding.In rare cases, there is an increase in blood pressure, develop acute renal failure, respiratory depression up to coma and develop other anaphylactoid reactions.At the time started symptomatic treatment of all phenomena are reversible.

Drug Interactions

requires an individual assessment of the risk-benefit Nimesilom therapy while receiving angikoagulyantov (warfarin), antiplatelet agents (Clopidogrel), corticosteroids (prednisolone), a selective inhibitor of serotonin reuptake SSRIs (citalopram, sertraline).

preparation Group

Possible reactions when combined with Nimesilom

Glucocorticosteroids Increased gastrointestinal bleeding and the risk of developing ulcers
Antiplatelet agents, SSRIs Increased risk of gastrointestinalintestinal bleeding
Anticoagulants Increased risk of bleeding
Diuretics Weakening action
Antihypertensive drugs Easing actions, deterioration in renal function
lithium preparations The decrease lithium clearance
Substrates isoenzyme CYP2C9 concentration decrease in blood
Cytostatics Increased toxic effects
Cyclosporins Increased nephrotoxicity

Cautions

By nimesil instructions when a patient has risk of ulcers, gastrointestinal bleeding, as well as simultaneous treatment of the above preparations, Nimesilom therapy begins with the lowest dose, observing the condition of the patient.At the slightest adverse reactions or adverse treatment ceased.

  • As part nimesil has sucrose, which should be considered in patients with diabetes: 1 sachet 0.15-0.18 XE.
  • In the event of SARS and the common cold events during therapy Nimesilom treatment ceased.
  • Caution should be exercised during treatment Nimesilom while driving and precise, dangerous work.

Shelf life

in hermetically sealed packages - 2 years.With package integrity violation of the drug can not be used.

Analogs

analogous in composition to the active ingredient nimesulide, are the following drugs:. Nemuleks, Aktasulid, upon, Ameolin, Aulin, Nimesulide, NIMULID, Sulaydin, etc. Some of them have a fraction of the cost with the same efficiency with Nimesilom.Unlike granules for suspension from tablets (cheaper) only in the fact that the effect is a little faster due to faster absorption slurry, and the efficiency is the same.

Nimesulide 100 mg.20 pcs.70 rubles.

Nimesulide Teva 100 mg.20 pcs.170 rubles.

  • Nise

100 mg.20 pcs.200 rubles.

  • Nemuleks

granules for suspension 100 mg.30 pcs.500 rubles.

  • NIMULID

Table.for sucking 100 mg.20 pcs.200-250 rub., The suspension 60 ml.200-300 rub.

  • upon

100 mg.20 pcs.170 rubles.

  • Niemiec

100 mg.20 pcs.230 rubles.