Nimesulide, tablets 100 mg 20 pcs

Pharmgroup:

NSAIDs.

Pharmic action:

NSAIDs, has anti-inflammatory, analgesic, antipyretic and antiaggregant effects.

Unlike other NSAIDs it selectively inhibits COX-2, inhibits synthesis of Pg in inflamed area; less pronounced inhibitory effect on COX-1 (causes side effects connected with inhibition of Pg synthesis in healthy tissues less frequently).

Indications

Rheumatoid arthritis, joint syndrome with gout exacerbation, psoriatic arthritis, ankylosing spondylitis, osteochondrosis with radicular syndrome, osteoarthritis, myalgia of rheumatic and non-rheumatic genesis, ligament inflammation, tendons, bursitis, including post-traumatic inflammation of soft tissues, pain syndrome of different genesis (including in the post-operative period, trauma, algodysmenorrhea, toothache, headache, arthralgia, lumboishalgia), febrile syndrome in infectious and inflammatory diseases.

Active ingredient

Composition

Active substance:

Nimesulide 100 mg

How to take, the dosage

Adults and children over 12 years of age (body weight over 40 kg) prescribe 1 tablet 2 times a day.

The tablets are taken after meals with enough water. The maximum daily dose is 200 mg.

Interaction

The effect of drugs that reduce blood clotting is increased when they are used simultaneously with nimesulide.

Nimesulide may reduce the effect of furosemide. Reduces the therapeutic effect of antihypertensive drugs. Nimesulide may increase the possibility of side effects when concomitant use of methotrexate.

The level of lithium in plasma is increased when concomitant use of lithium and nimesulide. Due to the high degree of binding of nimesulide to plasma proteins, patients who are simultaneously treated with hydantoin and sulfonamides should be monitored by a physician, undergoing examinations at short intervals. Nimesulide may increase the effect of cyclosporine on the kidneys.

The use with glucocorticosteroids, serotonin reuptake inhibitors increases the risk of GI bleeding.

Special Instructions

Nimesulide should be used with caution in patients with a tendency to bleeding, patients with diseases of the upper gastrointestinal tract or patients receiving drugs that reduce blood clotting or drugs that inhibit platelet aggregation.

Because Nimesulide is partially excreted by the kidneys, its dosage for patients with impaired renal function should be reduced, depending on the level of urinary excretion. Given the reports of visual impairment in patients who have taken other NSAIDs, treatment should be stopped immediately if any visual impairment appears and the patient should be examined by an ophthalmologist.

The drug may cause fluid retention in tissues, so patients with high blood pressure and with cardiac disorders should use Nimesulide with extreme caution. Patients should be regularly monitored by a physician if along with nimesulide they take drugs that are characterized by their effect on the gastrointestinal tract. Patients whose work requires concentration (constant attention) should be aware that the drug may cause drowsiness or dizziness.

In order to reduce the risk of gastrointestinal adverse events, the lowest effective dose should be used for the shortest possible course.

Contraindications

Hypersensitivity, complete or incomplete combination of bronchial asthma, recurrent nasal or paranasal sinus polyposis and intolerance to ASA and others. NSAIDs (including in anamnesis), erosive and ulcerative lesions of the mucous membrane of the stomach and duodenum, active gastrointestinal bleeding, cerebrovascular or other bleeding, inflammatory bowel diseases (Crohn’s disease, ulcerative colitis) in the acute phase, hemophilia, etc. bleeding disorders, decompensated CHF, hepatic insufficiency or any active liver disease, hepatotoxic reactions when using nimesulide in anamnesis, alcoholism, drug abuse, marked CVD (CKR less than 30 ml/min), advanced renal disease, confirmed hyperkalemia, period after coronary artery bypass grafting, concomitant use of other hepatotoxic drugs, pregnancy, lactation, children under 12 years.

With caution. CHD, CHD, dyslipidemia/hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, renal insufficiency (CK 30-60 ml/min), anamnestic data about peptic ulcer disease, Helicobacter pylori infection, elderly age, long-term use of NSAIDs, alcoholism, severe systemic diseases, simultaneous use of anticoagulants (including anticonvulsants – warfarin, anticoagulant therapy).anticoagulants (including warfarin), antiplatelet agents (including ASA, clopidogrel), oral GCS, selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline).

Side effects

Gastrointestinal tract: frequently – diarrhea, nausea, vomiting; infrequently – constipation, flatulence, gastritis; very rarely – abdominal pain, stomatitis, tarry stools, gastrointestinal bleeding, ulcer and/or perforation of the stomach or duodenum.

Central nervous system: infrequent – dizziness; rare – feeling of fear, nervousness, nightmares; very rare – headache, drowsiness, encephalopathy (Reye syndrome).

Respiratory system: infrequent – shortness of breath; very rare – bronchial asthma, bronchospasm. Cardiovascular system: infrequent – arterial hypertension; rarely – tachycardia, hemorrhages, “hot flashes”.

Sensory organs: rarely – blurred vision, very rarely – dizziness.

The skin and mucous membranes: infrequent – itching, rash, increased sweating, rare – erythema, dermatitis, very rare – hives, angioedema, swollen face, erythema multiforme, including Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell’s syndrome).

Liver and biliary system: often – increase of “liver” transaminases; very rarely – hepatitis, hepatitis fulminant, jaundice, cholestasis.

Kidney and urinary system: infrequent – edema; rare – dysuria, hematuria, urinary retention, hyperkalemia; very rare – renal failure, oliguria, interstitial nephritis.

Hematopoietic organs: rarely – anemia, eosinophilia; very rarely – thrombocytopenia, pancytopenia, purpura, prolongation of bleeding time.

Allergic reactions: rare – hypersensitivity reactions; very rare -anaphylactoid reactions.

General reactions: rarely – general weakness; very rare – hypothermia. If you experience any other side effects not mentioned above, or if you feel unwell, please talk to your doctor immediately.

Overdose

Symptoms: apathy, drowsiness, nausea, vomiting. These are usually reversible with supportive care. Gastrointestinal bleeding, arterial hypertension, acute renal failure, and respiratory depression may occur.

Treatment: symptomatic treatment and supportive care of the patient is required. There is no specific antidote. If overdose occurred within the last 4 hours it is necessary to induce vomiting, provide intake of activated charcoal (60-100 g per adult), osmotic laxatives. Forced diuresis and hemodialysis are ineffective due to high protein binding of the drug.

Similarities