Title: Nimesil: instructions for use for adults, reviews, analogs, powder, tablets

pharmachologic effect

Anti-inflammatory, antipyretic, analgesic.

Pharmacokinetics

Nimesulide is well absorbed from the gastrointestinal tract (GIT).

The maximum concentration in blood plasma (Cmax) after oral administration of a single dose of nimesulide, amounting to 100 mg, is achieved on average after 2 - 3 hours and is 3-4 mg / l. Area under the concentration-time curve (AUC) and a decrease in the cumulative excretion of furosemide without changing the renal clearance of furosemide.

The simultaneous use of furosemide and nimesulide requires caution in patients with renal or heart failure.

ACE inhibitors and angiotensin II receptor antagonists. NSAIDs may reduce the effect of antihypertensive drugs. In patients with mild to moderate renal failure (creatinine clearance 30-80 ml/min), with simultaneous use of ACE inhibitors, angiotensin II receptor antagonists and drugs that suppress the cyclooxygenase system (NSAIDs, antiplatelet agents), further deterioration of renal function and the occurrence of acute renal failure, which is usually reversible. These interactions should be considered in patients taking nimesulide in combination with ACE inhibitors or angiotensin II receptor antagonists. Therefore, the simultaneous use of these drugs should be used with caution, especially in elderly patients. Patients should remain adequately hydrated and renal function should be closely monitored after concomitant use is initiated.

Mifepristone. Theoretically, it is possible to reduce the effectiveness of mifepristone and prostaglandin analogues when used simultaneously with NSAIDs (including acetylsalicylic acid) due to the antiprostaglandin action of the latter. Limited data indicate that use of an NSAID on the same day as a prostaglandin analogue does not adversely affect the effects of mifepristone or a prostaglandin analogue on cervical dilatation, uterine contractility, or reduce the clinical effectiveness of medical abortion.

There is evidence that NSAIDs reduce the clearance of lithium, which leads to increased plasma lithium concentrations and its toxicity. When using nimesulide in patients undergoing lithium therapy, the concentration of lithium in the blood plasma should be regularly monitored.

No clinically significant interactions were observed with glibenclamide, theophylline, digoxin, cimetidine and antacid drugs (for example, a combination of aluminum and magnesium hydroxides).

Nimesulide inhibits the activity of the CYP2C9 isoenzyme. When drugs that are substrates of this enzyme are used simultaneously with nimesulide, the concentration of the latter in plasma may increase.

When prescribing nimesulide less than 24 hours before or after using methotrexate, caution is required, since in such cases the concentration of methotrexate in the blood plasma and, accordingly, the toxic effects may increase.

Due to their effect on renal prostaglandins, inhibitors of prostaglandin synthetase, such as nimesulide, may increase the nephrotoxicity of cyclosporines.

Analogs

The following drugs are similar in composition to the active substance nimesulide: Nemulex, Actasulide, Aponil, Ameolin, Aulin, Nimesulide, Nimulid, Sulaydin, etc. Some of them have a much lower cost with the same effectiveness as Nimesil.

The difference between granules for preparing a suspension and tablets (cheaper) is only that the effect occurs a little faster, due to faster absorption of the suspension, but the effectiveness remains the same.

Nimesil dosage

Inside. The contents of the sachet are dissolved in approximately 100 ml of water at room temperature (a white or light yellow suspension is formed).

The prepared solution cannot be stored.

The drug Nimesil® is used only for the treatment of patients over 12 years of age.

Adults and children over 12 years old: 1 sachet twice a day, after meals.

Elderly patients: when treating elderly patients, the need to adjust the daily dose is determined by the doctor based on the possibility of interaction with other drugs.

Patients with renal insufficiency: in patients with mild to moderate renal insufficiency (creatinine clearance 30-60 ml/min) no dose adjustment is required, while in patients with severe renal insufficiency (creatinine clearance <30 ml/min) Nimesil ® is contraindicated.

Patients with liver failure:

The use of Nimesil® in patients with liver failure is contraindicated.

To reduce the likelihood of side effects, it is recommended to take the minimum effective dose for the shortest possible time.

The maximum daily dose for adults and children over 12 years of age is 200 mg.

The maximum duration of treatment is 15 days.

Release form, composition

The drug Nimesil is available in a dosage form, 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 scent. The main active component of the drug is nimesulide, its content in 1 sachet of powder is 100 mg. The drug also contains additional compounds, which include:

Sucrose.
Orange flavor.
Ketomacrogol.
Anhydrous citric acid.
Maltodextrin.

Nimesil powder is packaged in aluminum foil bags of 2 g each. A cardboard pack contains 9, 15 or 30 bags.

Overdose

Symptoms: apathy, drowsiness, nausea, vomiting, pain in the epigastric region. These symptoms are usually reversible with symptomatic and supportive therapy. Possible increased blood pressure, gastrointestinal bleeding, acute renal failure, respiratory depression, coma, anaphylactoid reactions.

Treatment: Symptomatic and supportive therapy. There is no specific antidote. If an overdose has occurred within the last 4 hours, it is necessary to induce vomiting and/or take activated carbon (60 to 100 g for an adult) and/or an osmotic laxative. Forced diuresis, hemodialysis, hemoperfusion, and urine alkalization are ineffective due to the high degree of binding of nimesulide to plasma proteins (up to 97.5%). It is necessary to monitor the state of kidney and liver function.

Reviews from doctors and people

Svetlana Kharkovaya, dentist. Toothache can be quite severe and should not be tolerated. Taking Nimesil can help the patient. Of course, it is very important to pay attention to possible side effects and contraindications - not everyone can take the medicine. In some cases, I recommend Nimesil to relieve pain after treatment or tooth extraction. And I can say with confidence that during my long practice, no one complained that Nimesil did not help or that it made me feel ill.
Ekaterina Menshikova. Nimesil became a real salvation for me at the time when I was treating my teeth. The pain was unbearable, both before visiting the doctor and in the first days after treatment (two teeth had to be removed due to inflammation). The advantage of this medicine is that it is easily diluted and begins to act very quickly. Of course, there are cheaper analogues - but I don’t want to experiment, since Nimesil has already been tested by time.

Precautionary measures

Carefully

Arterial hypertension, diabetes mellitus, compensated heart failure, coronary heart disease, cerebrovascular diseases, dyslipidemia/hyperlipidemia, peripheral arterial disease, hemorrhagic diathesis, smoking, creatinine clearance 30-60 ml/min.

History of ulcerative lesions of the gastrointestinal tract; history of infection caused by Helicobacter pylori; elderly age; long-term previous use of NSAIDs; severe somatic diseases.

Concomitant use with the following drugs: anticoagulants (for example, warfarin), antiplatelet agents (for example, acetylsalicylic acid, clopidogrel), oral glucocorticosteroids (for example, prednisolone), selective serotonin reuptake inhibitors (for example, citalopram, fluoxetine, paroxetine, sertraline).

Note!

The description of the drug Nimesil on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). 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 to prescribe the drug, as well as determine the dose and methods of its use.

Properties

Nimesulide is a selective antagonist of cyclooxygenase-2, which has an inhibitory effect on its activity. In response to the formation and development of pathological processes in the form of inflammation, cyclooxygenase-2 provokes a reaction to convert arachidonic acid into prostaglandins, which are the main causative agents of the inflammatory reaction produced by the immune system.

A decrease in the amount of prostaglandins provokes a decrease in the severity of inflammation, and also relieves pain and swelling of tissues, eliminating blood stagnation in the microvasculature.

The active component, when taken as a suspension based on Nimesil, is quickly and effectively absorbed into the bloodstream. Nimesulide distributes evenly throughout the tissues, providing a pronounced therapeutic effect. The active substance is metabolized in the liver through the production of inactive substances, which are subsequently excreted in the urine. The half-life of the drug from the body occurs approximately 6 hours after taking Nimesil.

How long does it take for Nimesil to start working is interesting to many.

Indications

A suspension based on Nimesil powder is taken to reduce the intensity of the inflammatory process, as well as to eliminate pain in certain diseases, including:

Pain syndrome in the back, namely the lumbar region, against the background of an inflammatory process.
Pathologies of bone and muscle structures, including various injuries, tendonitis, sprains, subluxations and dislocations of joints, etc.
Toothache.
Head pain of various origins, including migraine in varying degrees of intensity of its manifestation.
Pain during menstrual bleeding.

At what age can Nimesil be taken?

"Nimesil" is used from the age of 12 exclusively as symptomatic treatment of pain and inflammation. However, the cause of the symptoms is not eliminated.

special instructions

Side effects can be minimized by using the lowest effective dosage of the drug in a minimally short course.

Nimesil powder medicine should be used with caution in persons with a history of gastrointestinal diseases, since exacerbation of these diseases is possible.

Since the drug is partially evacuated by the kidneys, its dosage for persons with impaired renal function should be reduced depending on the volume of urine excreted.

When the first symptoms of liver damage appear (itching, yellowing of the skin, nausea, abdominal pain, vomiting, dark urine, increased liver transaminases), you must 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 can 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 non-steroidal drugs.

Nimesulide can change the characteristics of platelets , 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 of acetylsalicylic acid for diseases of the circulatory system.

Adverse reactions

When taking a suspension made from Nimesil powder, the following undesirable reactions may appear on the part of some organs and systems of the body:

Digestive system: nausea with periodic vomiting, diarrhea, sometimes bloating, pain in the abdominal area, constipation, bleeding, accompanied by darkening and tarry texture of the stool.
Heart and vascular system: increased pressure in the arteries, tachycardia, accompanied by rapid heart rate, hot flashes.
Biliary system and liver: inflammation of the liver, hepatitis with a rapid course, accompanied by icteric syndrome, increased activity of liver transminases, showing damage to organ cells, the so-called hepatocytes.
Nervous system: headache, nervousness, dizziness, nightmares, feelings of fear and anxiety.
Respiratory system: shortness of breath, in rare cases exacerbation of bronchial asthma.
Urinary system: the appearance of blood in the urine or hematuria, painful urination or dysuria.
Sense organs: deterioration of visual function.
Blood and bone marrow: anemia, eosinophilia, thrombocytopenia and other changes in blood parameters.
Allergies: rash and itching of the skin, increased sweating, rarely urticaria, anaphylactic shock, Quincke's edema, etc. If the latter symptoms appear, you should take immediate medical care, give antihistamines and call an ambulance.

Side effects and contraindications of Nimesil are described in detail in the instructions.

The appearance of the described symptoms while taking the suspension indicates intolerance to the components of the drug and the need for urgent discontinuation of this drug.