A person in his life can not do without doctors or without pharmacological agents designed to provide assistance in a variety of situations related to health. Some drugs are aimed at eliminating the source of the existing disease, and some help alleviate the symptoms of the ongoing process. A popular pain reliever today is the drug Nimesil, produced in a form convenient for taking.
Nimesil - an antibiotic or not?
This drug is based on a substance that belongs to the category of non-steroidal anti-inflammatory drugs, and it primarily has an anti-inflammatory and analgesic effect. The drug does not affect the development of bacteria negatively, which means that is not an antibiotic.
The composition and properties of the drug
The action of the drug in question is based on the substance nimesulide at a concentration of 100 mg per dose of granular powder (2 grams). Auxiliary components are sucrose, maltodextrin, citric acid, ketomacrogol and a flavoring agent to give a pleasant taste. The drug is produced in aluminum foil bags of 2 grams, which are packaged in packs of 9, 15 and 30 pieces.
Nimesil has a pronounced analgesic effect, and also relieves elevated body temperature and helps to minimize inflammatory processes. The principle of operation is based on the suppression of the synthesis of inflammatory mediators - prostaglandins, as a result of which the symptoms accompanying the process are quickly removed. The properties of the powder form allow you to achieve a quick result, and the resulting effect lasts an average of 6 hours. Also, the drug is suitable for long-term therapy and is well tolerated by patients.
What is prescribed for: indications for use
A non-steroidal anti-inflammatory agent based on nimesulide can be used in the following problems:
- pain syndrome of any localization, the remedy is used for headache, postoperative and toothache;
- therapy of discomfort during menstruation;
- infectious and inflammatory processes formed after surgical interventions or traumatic injuries;
- degenerative diseases of the musculoskeletal system, which are accompanied by the appearance of inflammation and severe pain (arthritis, osteochondrosis, bursitis, etc.);
- gynecological and urological diseases, including powder, are prescribed as part of therapy for cystitis;
- from temperature with colds and flu and other ailments that are accompanied by an increase in body temperature.
The tool can be equally effectively used both for a single dulling of pain, and as part of a comprehensive long-term treatment.
Instructions for use Nimesil and dosage
The analgesic and antipyretic agent in question must be used strictly according to the rules described in the instructions, otherwise you can harm your condition. Let's find out the main aspects of the use of the powder.
How to properly dilute granules
The drug is used orally, that is, before taking it, it is required to dilute the granular powder from the sachet in a liquid. This will require clean warm water in an amount of up to 100 ml. You just need to pour the contents of the whole sachet into it and mix well until completely dissolved - a lot of effort is not required for this. The resulting suspension is completely ready for use.
How to drink the drug
Suspension with nimesulide should be drunk after meals, just drinking diluted granules. The drug is well absorbed in the stomach and intestines, actively overcoming barriers. The powder is prescribed by a doctor, especially when it comes to long-term complex therapy of the disease, and the specialist can prescribe individual dosages depending on the patient's condition. From a headache or with disturbing menstruation, a single dose of the drug is allowed - it will be enough to drink the powder only once, and if after 6-7 hours the sensations do not return, then you do not need to repeat the dose.
How long does it take and how often to take?
The recommended daily dosage is 200 mg (that is, one sachet twice a day). Significant relief of the patient's condition is observed approximately 15-20 minutes after taking the product, and the effect lasts up to 6 hours. In order to minimize the risk of side effects, the course of therapy should not exceed two weeks, subject to a minimum dose of two sachets per day.
At what age and how to give medicine to children?
It should immediately be noted that Nimesil is not prescribed in childhood. Its use is possible only for patients over 12 years of age, and in the same dosage as for adults - 100 mg of the active ingredient twice a day. Reception is carried out according to the same rules: the powder is dissolved in warm water and drunk after the next meal.
Overdose and side effects
The use of the drug may result in the development of side effects, among which the manufacturer notes the following:
- on the part of the digestive tract, heartburn, short-term pain in the stomach area (it is this symptom that usually does not require discontinuation of the remedy, as it is transient), tarry stools, etc .;
- an allergic reaction, which can manifest itself as a rash on the body, redness of the tissues;
- on the part of the central uneven system, there is a possibility of a headache, increased drowsiness and dizziness;
- also in rare cases, there may be an accumulation of fluid (puffiness of a local and systemic nature), petechial hemorrhages under the skin.
In order to avoid the risk of developing adverse reactions of the body, it is better to use the drug in the lowest possible course in small dosages.
Symptoms of an overdose of non-steroidal anti-inflammatory drugs are usually manifested by such conditions: drowsiness, apathetic attitude to what is happening around, pain in the stomach, as well as nausea and severe vomiting. There is also a risk of bleeding from the digestive tract. In situations where the overdose is significant, more serious consequences can occur - acute renal failure, respiratory depression and coma. In case of overdose, symptomatic therapy is required, since there is no specific antidote. If the case of overdose occurred less than 4 hours ago, then it is required to induce vomiting and take activated charcoal.
Contraindications to drug treatment
As for contraindications to the use of the powder, it will have to be abandoned in the following situations:
- children's age up to 12 years;
- during pregnancy and lactation (the drug may affect the developing fetus and the course of pregnancy);
- ulcerative lesions in the digestive tract;
- intestinal bleeding;
- type 2 diabetes;
- pathology of kidney function;
- hypersensitivity to the components of the composition;
- heartburn, nausea, diarrhea;
- with congestive type of heart failure;
- high blood pressure.
It is also worth noting that it is forbidden to use Nimesil powder and alcohol together in any amount, even the minimum.
Interaction with other drugs
The drug has a pronounced effect on the body, and when it is prescribed by a doctor or used independently, other pharmacological products that are currently used by the patient must be taken into account. Nimesulide can exhibit the following forms of drug interaction:
- simultaneous use with glucocorticosteroids or antiplatelet agents is an increased risk of intestinal bleeding;
- the effect of anticoagulants may be enhanced, which also increases the risk of bleeding;
- non-steroidal anti-inflammatory drugs weaken the activity of diuretics;
- also, the powder can reduce the effectiveness of drugs used for high blood pressure;
- use simultaneously with lithium preparations can lead to an increase in the concentration of the component in the blood and its toxicity.
- All options for interaction with other agents must be taken into account, otherwise the risk of developing dangerous complications is high.
What can replace Nimesil: analogues
When a doctor prescribes a powder, you can use a preparation based on nimesulide, but only under a different name, if Nimesil itself could not be found, or it did not fit the cost, because there are substitutes at a much lower price. So, Nimesil's synonyms can be called drugs Nise (tablets, gel for topical application, suspension), Nimid, Nimulid (powder, tablets, lozenges, gel), Aponil (in the form of tablets), Aktasulide, Aulin, Kokstral, Mesulid, Novolid , Prolid, Flolid and Sulaidin. All of these drugs belong to the category of non-steroidal anti-inflammatory drugs and are based on the substance nimesulide.
Video: how to use Nimesil in a bag
In order to apply Nimesil powder, it must first be prepared, namely, dissolved in pure water to obtain a medicinal suspension. It is very simple to do this, which this video will help you to see - it clearly demonstrates how to dilute the powder.
The description is up to date 13.10.2019
- 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
Without recipe.
Storage conditions
Store in a dry, dark place at room temperature. Keep away from children.
Best before date
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 (tablets), (tablets, suspension), Negan (tablets), (tablets, suspension), Nimesin (tablets), (tablets, gel), (tablets, granules), Nimujet (injection solution), (tablets, suspension, injection solution, gel), Nimuspaz (tablets), Pansulid (tablets), Remesulid (tablets), Sulidin (gel), Taro-Sanovel (tablets).
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 instruction for the drug for children indicates 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 the use of 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 and others anti-inflammatory nonsteroidal drugs can adversely affect the course of pregnancy and the development of the child.
Nimesil (active ingredient nimesulide) is a non-steroidal anti-inflammatory drug (NSAID) belonging to the class of sulfonamides. In addition to, in fact, anti-inflammatory, it has an analgesic and antipyretic (antipyretic) effect. It is used mainly as a symptomatic remedy to reduce pain and relieve inflammation. Pain is the most unpleasant sign of any disease, which has a significant impact on life prognosis. At the same time, one of the most common causes of disability is chronic pain caused by diseases of the musculoskeletal system. Chronic pain is closely associated with depression, somnological disorders, and cardiovascular diseases. In this regard, the rapid and complete elimination of pain is rightfully considered one of the priorities of the pharmacotherapy of most diseases, and from the patient's point of view, it is the most important task. One of the most commonly used drugs for this purpose are NSAIDs. They are distinguished from the general series by exhaustively confirmed efficacy, predictability of therapeutic action, accessibility and ease of use. NSAIDs play an important role in the complex treatment of rheumatic diseases, because. Only this group of drugs is characterized by a combination of analgesic, anti-inflammatory and antipyretic effects, which allows to stop almost all the key symptoms of damage to the spine and joints. Nimesil is one of the most popular NSAIDs in Russia. It is very effective in relieving acute pain syndrome. Unlike a number of other NSAIDs, the molecule of the active substance nimesil is endowed with "alkaline" properties, which does not allow it to penetrate into the mucous membrane of the upper digestive tract, significantly reducing the risk of contact irritation. In this case, the drug easily penetrates and accumulates in the organs and tissues affected by inflammation (for example, in the joints). Nimesil has a high bioavailability. Already half an hour after oral administration, the concentration of the drug in the blood plasma is up to 80% of the maximum, which predetermines a rapid analgesic effect.
The maximum concentration of nimesil and the peak of its therapeutic activity falls on 1-3 hours. The mechanism of action of the drug is associated with its ability to block cyclooxygenase-2 (COX-2), an enzyme actively produced by inflammatory response trigger cells and responsible for the synthesis of prostaglandins, mediators of pain and inflammation. As for the side effects characteristic of NSAIDs, primarily associated with the gastrointestinal tract, they are mainly determined by the blockade of COX-1. Nimesil selectively affects COX-2, having only a slight activity against COX-1, blocking it only in inflammatory foci. The indisputable advantages of nimesil over other NSAIDs include its ability to “veto” the synthesis of pro-inflammatory cytokines (interleukins 1, 6, 8, tumor necrosis factor α), inhibit the activity of matrix metalloproteinases (these enzymes destroy cartilage tissue in deforming osteoarthritis), and exhibit antihistamine effect and block phosphodiesterase-4, thereby reducing the activity of macrophages and neutrophils that are aggressive in inflammation. The fast and strong analgesic and anti-inflammatory effect of nimesil has been well demonstrated in numerous clinical trials. A strong evidence of the validity of its appointment for emergency pain relief was the successful experience of using the drug, in particular, in anesthetic practice. Nimesil is widely used to relieve spinal pain, gouty arthritis and osteoarthritis.
Nimesil is available in granules for the preparation of a suspension for oral administration. This drug is recommended to take 1 sachet 2 times a day. The best time to take it is after a meal. The method of preparing the suspension is extremely simple: the contents of the sachet are poured into a mug or glass and dissolved in 100 ml of water. The resulting solution should be used immediately after preparation.
Pharmacology
Non-steroidal anti-inflammatory drug from the class of sulfonamides. 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 C max in blood plasma after 2-3 hours. Plasma protein binding is 97.5%. T 1/2 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 renal insufficiency (CC 30-80 ml / min) and healthy volunteers, Cmax of nimesulide and its metabolite in the plasma of patients did not exceed the concentration of nimesulide in healthy volunteers. AUC and T 1/2 in patients with renal insufficiency were higher by 50%, but within the pharmacokinetic values. With repeated administration of the drug, cumulation is not observed.
Release form
Granules for suspension for oral administration in the form of a light yellow granular powder with an orange smell.
Excipients: ketomacrogol 1000, sucrose, maltodextrin, anhydrous citric acid, orange flavor.
2 g - laminated paper bags (9) - packs of cardboard.
2 g - paper bags laminated (15) - packs of cardboard.
2 g - paper bags laminated (30) - packs of cardboard.
Dosage
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.
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.
Overdose
Symptoms: apathy, drowsiness, nausea, vomiting, pain in the epigastric region. With maintenance therapy for gastropathy, these symptoms are usually reversible. Gastrointestinal bleeding may occur. In rare cases, it is possible to increase blood pressure, acute renal failure, respiratory depression and coma, anaphylactoid reactions.
Treatment: carry out symptomatic therapy. 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 (adults from 60 to 100 g) and / or an osmotic laxative. Forced diuresis, hemodialysis 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.
Interaction
Pharmacodynamic interactions:
When combined with glucocorticosteroids, the risk of gastrointestinal ulcers or bleeding increases.
When combined with antiplatelet agents and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, the risk of gastrointestinal bleeding increases.
NSAIDs may increase the effect of anticoagulants such as warfarin. Due to the increased risk of bleeding, this combination is not recommended and 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 can weaken the effect of diuretics.
In healthy volunteers, nimesulide temporarily reduces sodium excretion under the action of furosemide, to a lesser extent, potassium excretion, 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 furomeside.
The co-administration of furosemide and nimesulide requires caution in patients with impaired renal and 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 (CC 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 renal function and the occurrence of acute renal failure are possible. 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.
Clinically significant interactions with glibenclamide, theophylline, digoxin, cimetidine and antacids (for example, a combination of aluminum and magnesium hydroxides) were not observed.
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.
Side effects
From the side of the hematopoietic system: rarely - anemia, eosinophilia, hemorrhagic syndrome; very rarely - thrombocytopenia, pacitopenia, thrombocytopenic purpura.
Allergic reactions: infrequently - itching, rash, excessive sweating; rarely - hypersensitivity reactions, erythema, dermatitis; very rarely - anaphylactoid reactions, urticaria, angioedema, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).
From the side of the central nervous system: infrequently - dizziness; rarely - a feeling of fear, nervousness, nightmares; very rarely - headache, drowsiness, encephalopathy (Reye's syndrome).
On the part of the organ of vision: rarely - blurred vision.
From the side of the cardiovascular system: infrequently - arterial hypertension, tachycardia, arterial pressure lability, hot flashes.
From the respiratory system: infrequently - shortness of breath; very rarely - exacerbation of bronchial asthma, bronchospasm.
From the digestive system: often - diarrhea, nausea, vomiting; infrequently - constipation, flatulence, gastritis; very rarely - abdominal pain, dyspepsia, stomatitis, tarry stools, gastrointestinal bleeding, ulcers and / or perforation of the stomach or duodenum; very rarely - hepatitis, fulminant hepatitis, jaundice, cholestasis, increased activity of liver enzymes.
From the urinary system: rarely - dysuria, hematuria, urinary retention; very rarely - renal failure, oliguria, interstitial nephritis.
General disorders: rarely - malaise, asthenia; very rarely - hypothermia.
Other: rarely - hyperkalemia.
Indications
- treatment of acute pain (pain in the back, lower back; pain in the musculoskeletal system, including injuries, sprains and dislocations of the joints, tendonitis, bursitis; toothache);
- symptomatic treatment of osteoarthritis with pain syndrome;
- algomenorrhea.
The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use.
Contraindications
- hyperergic reactions in history, for example, bronchospasm, rhinitis, urticaria associated with taking acetylsalicylic acid or other NSAIDs, incl. nimesulide;
- hepatotoxic reactions to nimesulide in history;
- concomitant (simultaneous) use of drugs with potential hepatotoxicity, for example, paracetamol or other analgesic or non-steroidal anti-inflammatory drugs;
- inflammatory bowel disease (Crohn's disease, ulcerative colitis) in the acute phase;
- the period after coronary artery bypass grafting;
- fever in infectious and inflammatory diseases;
- complete or partial 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 and duodenum in the acute phase, the presence of an ulcer in history, perforation or bleeding in the gastrointestinal tract;
- a history of cerebrovascular bleeding or other bleeding, as well as diseases accompanied by bleeding;
- severe blood clotting disorders;
- severe heart failure;
- severe renal failure (CK< 30 мл/мин), подтвержденная гиперкалиемия;
- liver failure or any active liver disease;
- children's age up to 12 years;
- pregnancy and breastfeeding period;
- alcoholism, drug addiction;
- hypersensitivity to the components of the drug.
With caution: severe forms of arterial hypertension, type 2 diabetes mellitus, heart failure, coronary heart disease, cerebrovascular disease, dyslipidemia / hyperlipidemia, peripheral arterial disease, smoking, CC< 60 мл/мин, анамнестические данные о наличии язвенного поражения ЖКТ, инфекции, вызванной Helicobacter pylori; пожилой возраст; длительное предшествующее использование НПВП; тяжелые соматические заболевания; сопустствующая терапия следующими препаратами: антикоагулянты (например, варфарин), антиагреганты (например, ацетилсалициловая кислота, клопидогрел), пероральные глюкокортикостероиды (например, преднизолон), селективные ингибиторы обратного захвата серотонина (например, циталопрам, флуоксетин, сертралин).
The decision to prescribe the drug Nimesil should be based on an individual risk-benefit assessment when taking the drug.
Application features
Use during pregnancy and lactation
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, the drug is contraindicated during pregnancy and during breastfeeding.Application for violations of liver function
The drug is contraindicated in liver failure or any active liver disease.Application for violations of kidney function
In patients with renal insufficiency, Nimesil should be used with caution, as renal function may deteriorate. If the condition worsens, treatment with Nimesil should be discontinued. The drug is contraindicated in severe renal insufficiency (CC< 30 мл/мин).
In patients with mild to moderate renal insufficiency (CC 30-80 ml / min), there is no need to adjust the dose.
Use in children
The drug is contraindicated in children under the age of 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.
special instructions
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.
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.
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.
There is evidence of the occurrence of rare cases of reactions from the liver. If there are signs of liver damage (skin itching, yellowing of the skin, nausea, vomiting, abdominal pain, dark urine, increased activity of "liver" transaminases), you should stop taking the drug and consult your doctor.
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.
The drug can cause fluid retention in the tissues, so patients with high blood pressure and cardiac disorders should use Nimesil with extreme caution.
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.
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.
The composition of the drug includes sucrose, this should be taken into account for patients with 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.
If there are signs of a "cold" or an acute respiratory viral infection during treatment with Nimesil, the drug should be discontinued.
Nimesil should not be used simultaneously with other NSAIDs.
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.
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.
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.
The effect of the drug on the ability to drive vehicles and control mechanisms.
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.
Nimesil is an effective anti-inflammatory agent for pain relief, suppression of destructive processes in diseases of the musculoskeletal system. Many pathologies of the spine and back accompany painful syndromes, inflammation accelerates the destruction of bone and cartilage structures.
After taking the drug Nimesil, the production of enzymes that cause pain is reduced in the body. It is important to properly dilute the powder for the preparation of the suspension, take the drug of the sulfonamide group strictly according to the instructions.
Composition and form of release
Nimesulide is the active ingredient in a non-steroidal pain and inflammation medication. Each sachet (2 g of powder) contains the active ingredient in an amount of 100 mg.
The light yellow powder has a slight orange odor. On the basis of the agent with the addition of water, a suspension is prepared for oral administration. There are 15 or 30 paper bags in a carton pack, pharmacies also receive package No. 9 of Nimesil.
Action on the body
The active substance blocks the synthesis of cyclooxygenase (to a greater extent COX-2), inhibits the production of prostaglandins. The result is a manifestation of a pronounced analgesic, powerful anti-inflammatory, noticeable antipyretic effect. Suspension based on nimesulide helps with pain syndrome against the background of damage to the joints, vertebral structures, injuries of various kinds.
Despite the active therapeutic effect, the drug has many contraindications and side effects. For this reason You should always consult your doctor before starting Nimesil. The active substance quickly penetrates the histohematic barrier, metabolism occurs in the liver. About half of the received dose of nimesulide is excreted by the kidneys.
On the page, read about how and how to treat spondyloarthrosis of the lumbosacral spine.
Nimesil: analogues
How to replace the medicine Nimesil? In diseases of the spine, rheumatic pains, osteoarthritis, post-traumatic syndrome, sprains, other diseases and conditions that provoke acute discomfort, NSAIDs of similar action can be used.
When choosing a substitute, you need to take into account the tolerance of nimesulide, restrictions, age, and a tendency to allergies. In case of an acute reaction to the active substance, it is necessary to select an NSAID with another active ingredient.
Analogues of the drug Nimesil:
- Nise.
- Ameolin.
- Negan.
- Nimujet.
- Sulidin.
- Nimuspaz.
- Pansulid.
- Nimesulide.
- Mesulid.
- Taro-Sanovel.
Nimesil is a powerful pain reliever. It helps with sprains, dislocations, joint, muscle and toothaches, lowers body temperature. If you drink Nimesil with alcohol, then the side effects will intensify and there will be a violation in the digestive system.
Description of the drug
The drug is produced in granules for the preparation of a solution that is taken orally. It has a lemon or orange flavor. The product is packaged in sachets weighing 1 gram. It contains the active substance - nimesulide, as well as additional components:
- Flavoring for a pleasant aftertaste.
- Ketomacrogol.
- Citric acid.
- Maltodextrin.
- Sucrose.
Pharmacological properties
Nimesil refers to 
anti-inflammatory non-steroidal drugs of the sulfonamide group. Its pharmacological properties include the ability to block the enzymes metalloproteinase, phosphodiesterase, which are involved in the activation of immune system cells - phagocytes. These qualities allow the use of preparations containing nimesulide for the treatment of joint diseases: rheumatic and gouty arthritis, osteoarthritis.
When taken orally, the therapeutic concentration is reached after 3 hours, and the half-life from the human body is 6 hours. Metabolism occurs in the liver, the drug is excreted only by the kidneys.
Indications for use
The main indications for taking Nimesil inside are:
- Menstrual pains.
- Diseases of the musculoskeletal system.
- Violation of the integrity of the ligamentous apparatus.
- Inflammation of the joints.
- Back pain.
- Lumbar diseases.
- Acute dental pain.
- Dislocations of the joints.
- Pain caused by trauma.
Before drinking the medicine, it must be diluted in warm water. The pain should subside after a few minutes.
Contraindications and side effects
Contraindications to the use of this drug are:
- Pregnancy.
- Age under 12 years old.
- Alcoholism and hangover.
- Heart diseases.
- Diseases of the hematopoietic organs.
- Renal failure.
- Colitis and gastric ulcer.
- Diseases of the liver.
- Allergic manifestations to the components of the drug.
Particular care should be taken in patients with the following pathologies or factors:
How much exactly you need to drink medicines throughout the day, the doctor will tell based on the results of the examination. But there are still limitations: you can drink no more than 2 sachets per day, while the interval between doses should be 12 hours. As soon as you prepare the solution, it must be consumed immediately. Do not store the dissolved drug.
Most often, the negative effect of Nimesil on the body is manifested from the digestive tract. The patient vomits and develops indigestion. Sometimes there may be intestinal and gastric bleeding, gastritis. Very rarely, perforation of the stomach can occur.
Taking Nimesil less often affects the respiratory and cardiovascular systems. It can cause the following effects:
- Bronchospasm.
- Shortness of breath.
- A sharp drop in blood pressure.
- Increased heart rate - tachycardia.
- anemia.
From the nervous system may appear:
- encephalopathy.
- Nightmares.
- Fear.
- Nervousness.
- Dizziness.
- Sweating.
There may be loss of visual acuity, hematuria, oliguria, symptoms of renal failure, urinary retention. There were cases when symptoms of dermatitis and urticaria appeared. In severe cases, anaphylactic shock and angioedema may develop.
In addition to the phenomena listed above, patients can be observed a decrease in temperature below normal, malaise and general weakness. To reduce the risk of side effects, experts prescribe the minimum amount of the drug that is necessary for effective treatment. If the side effect still manifested itself, then the drug is canceled and further treatment is adjusted.
Rules and frequency of admission
Suspension with nimesulide is drunk after eating, drinking the powder diluted in water. The drug is well absorbed in the intestines and stomach, overcoming all barriers. This remedy must be prescribed by a specialist. It also determines how long it will take for treatment and dosage of the drug. If you are going to drink Nimesil for menstrual or headache, then a single dose will be enough if the pain does not return after 6 hours.
200 milligrams allowed per day. The patient can feel relief within 15 minutes after taking the drug. To avoid side effects, it is necessary to take Nimesil for no more than 14 days when using the minimum dose.
Nimesil and alcohol
Nimesil catalyzes the destructive effect of alcohol on the liver, thereby causing granuloma, and can lead to cirrhosis of the liver or acute hepatitis.
The main destructive effect of taking alcohol together with the drug is manifested interference with the stomach. Alcohol provokes ulcers, gastritis, irritation of the mucosa. A life-threatening condition may occur. It appears from the gastrointestinal tract. With perforation of the wall of the digestive organs, internal bleeding is formed. Internal bleeding can be suggested by high ESR and black, tarry stools.
Uncontrolled intake of the drug, which contains nimesulide, adversely affects female fertility.
When suppressing the synthesis of prostaglandins, Nimesil:
- It leads to dysfunction of the fallopian tubes and postpartum complications.
- It makes it impossible for a fertilized egg to implant in the uterus.
- Prevents the rupture of the wall of the follicle and disrupts the process of ovulation.
The compatibility of Nimesil, which is prohibited during pregnancy, and alcohol can lead to serious consequences and the birth of a baby with congenital malformations.
The drug inhibits the synthesis of prostaglandins, thereby causing the fetus to close the ductus arteriosus, which should normally close in the first 24 hours after birth. If this vessel closes ahead of time, then this leads to congenital heart disease in the baby.
If you want to relieve a headache with a hangover, then it is better to use some other drugs that do not have the same effect when they are compatible with alcohol.
When can you drink alcohol
Since Nimesil and alcohol are incompatible, you must first find out How long does it take for them to leave the human body?. After all, their withdrawal times are completely different. The half-life of Nimesil is 6 hours, which means that it is only half excreted from the body. Approximately this time should elapse for the withdrawal of the remaining amount. Adding these numbers, we will see that the total time the drug leaves the body is 12 hours.
After analyzing this fact, we can conclude that if you are not going to take the drug again, then after 12 hours you can drink alcohol.
If you drank alcohol, then you will need to wait until it leaves the body and only then drink Nimesil. And this will happen only after 24 hours.
Effect on the circulatory system
The drug affects the water-salt balance and causes fluid retention. Ethyl alcohol has the same effect. Their combined use can cause increased blood pressure, edema, disturbances in cardiac work - a change in the frequency and rhythm of myocardial contractions.
Hot flashes are one of the side effects of Nimesil. The acetaldehyde in the blood also acts: the metabolism of ethanol causes hot flashes, a feeling of heat and redness of the face.
By suppressing the synthesis of prostaglandins, nimesulide increases blood pressure. Drinking alcohol leads to hypertension. If you combine these two substances, then a stroke or hypertensive crisis may occur.
Compatibility with other drugs
Nimesil has a pronounced effect on the body, and when using it, other pharmacological products that the patient drinks at the time of treatment should be taken into account. Nimesulide exhibits the following drug interactions:
Analogues
Today you can find many drugs in which the main active ingredient is nimesulide. They are produced in various forms, so that the patient himself chooses which method of application is more convenient for him. Analogues of the drug are such drugs:
- Aulin in the form of tablets and powder.
- Mesulide, which is also available in powder and tablets.
- Nimulide: it is available in the form of a gel, suspension and tablets (sublingual and conventional).
- Nemulex, available in powder form.
- Nymika, which is produced in the form of soluble tablets.
- Nimesulide - tablets.
- Nise: It is produced in the form of a suspension, gel and tablets.
All of the above drugs are based on nimesulide, but the form of their release is different. This will allow the patient to choose the most comfortable.
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