Naiz, 100 mg 2 g 9 pcs.

Acute pain (pain in the back, lower back;

Active ingredient

How to take, the dosage

Interaction

Glucocorticosteroids: increase risk of gastrointestinal ulceration or bleeding.

Antiplatelet agents and selective serotonin reuptake inhibitors: increase the risk of gastrointestinal bleeding.

Anticoagulants: NSAIDs may increase the effect of anticoagulants such as warfarin.

Because of 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 clotting parameters is necessary.

Diuretics: NSAIDs may decrease the effect of diuretics. In healthy volunteers, nimesulide temporarily reduces sodium excretion under the effect of furosemide, to a lesser extent – potassium excretion, and reduces the diuretic effect itself.

The co-administration of nimesulide and furosemide results in 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 decrease the effect of hypotensive drugs.

. In patients with mild to moderate renal insufficiency (creatinine clearance 30-80 ml/min) when ACE inhibitors, angiotensin II receptor antagonists or substances that inhibit cyclooxygenase system (NSAIDs, antiaggregants) are prescribed together, further deterioration of renal function and acute renal failure may occur, which is usually reversible.

These interactions should be considered in patients taking nimesulide in combination with ACE inhibitors or angiotensin-II receptor antagonists. Therefore, co-administration of these drugs should be prescribed with caution, especially for elderly patients.

Patients should receive adequate fluids, and renal function should be closely monitored after initiation of coadministration.

There is evidence that NSAIDs decrease lithium clearance, which leads to increased plasma lithium concentrations and toxicity.

When nimesulide is prescribed to patients receiving therapy with lithium drugs, plasma lithium concentrations should be monitored regularly.

Clinically significant interactions with glibenclamide, theophylline, digoxin, cimetidine and antacids (e.g., aluminum and magnesium hydroxide combination) have not been observed.

Nimesulide inhibits the activity of CYP2C9 isoenzyme. When concomitant use of drugs metabolized with nimesulide, plasma concentrations of these drugs may increase.

In concomitant use with antiepileptic drugs (valproic acid), antifungal drugs (ketoconazole), anti-tuberculosis drugs (isoniazid), amiodarone, methotrexate, methyldopa, amoxicillin in combination with clavulanic acid an additive hepatotoxic effect is possible.

Because of the high degree of binding of nimesulide to plasma proteins, patients simultaneously taking sulfonamides should be under medical supervision and be examined at short intervals.

When nimesulide is prescribed less than 24 hours before or after methotrexate, caution is required,

because in these cases the plasma concentration of methotrexate and therefore the toxic effects of this drug may increase.

In connection with action on renal prostaglandins, inhibitors of prostaglandin synthetases, such as nimesulide, may increase nephrotoxicity of cyclosporines.

In vitro studies have shown that nimesulide is displaced from binding sites by tolbutamide, salicylic acid.

While these interactions have been determined in plasma, these effects were not observed during clinical use of the drug.

Special Instructions

Contraindications

Side effects

Overdose

Symptoms: apathy, drowsiness, nausea, vomiting, epigastric pain. Gastrointestinal bleeding may occur.

In rare cases, increased blood pressure, acute renal failure, respiratory depression and coma, anaphylactoid reactions are possible.

Treatment: Symptomatic. There is no specific antidote. If overdose occurred within the last 4 hours,

Please induce vomiting and/or ensure intake of activated charcoal (60 to 100 g per adult) and/or osmotic laxative. Forced diuresis, hemodialysis are ineffective because of the high binding of the drug to proteins.

Pregnancy use

Similarities