Nimesil instructions for use after 50 years. Nimesil ® (Nimesil ®). Application during pregnancy and during breastfeeding

Nimesil is a medical product that belongs to the group of anti-inflammatory non-hormonal agents. The active ingredient is nimesulide - a substance that relieves pain, lowers temperature, and fights inflammation.

In its effect, Nimesil can be compared with drugs such as, for example, Ibuprofen, Diclofenac. All medicines in this group have a powerful systemic effect, but these pills have much less effect on the state of the gastrointestinal tract. Nimesil is used to treat both adults and children for pain caused by trauma, rheumatic and infectious lesions, and febrile conditions.

pharmachologic effect

Pharmacodynamics. Nimesulide is an anti-inflammatory nonsteroidal drug (NSAID) from the sulfonamide group. Creates antipyretic, analgesic and anti-inflammatory effect... The tablets act as an inhibitor of cyclooxygenase extracts, which is responsible for the formation of prostaglandins and inhibits mainly cyclooxygenase-2.

Pharmacokinetics:

• After ingestion, the drug is well absorbed in the gastrointestinal tract, reaching the highest concentration in the circulatory system after a few hours.
• Interaction with plasma proteins - 97.6%.
• The half-life is 3.3–5.5 hours.

Easily passes through the histohematological protection. In the liver, it is metabolized due to the cytochrome isoenzyme. The main metabolite is hydroxynimesulide, which comes out with bile in a metabolized form (only in the form of glucuronate).

Nimesulide is usually excreted from the body only by the kidneys (approximately 52% of the dosage used). The pharmacokinetic profile of the tablets in the elderly does not change with any dose.

Indications for use

Nimesil tablets are indicated for the following diseases:

Dosage and method of use

Nimesil is indicated for oral administration, 1 tablet twice a day. The medicine is recommended to be taken after a meal. A drug stir with water, approx. 100 ml. Nimesil is only used to treat people over 12 years of age.

Features of use

The drug must be used with caution in people with gastrointestinal diseases (Crohn's disease, ulcerative colitis), as it is possible exacerbation of these diseases... The risk of bleeding in the stomach, ulcers increases with an increase in the dosage of NSAIDs in people with a history of ulcers, all the more complicated by perforation or bleeding, as well as in the elderly, so treatment should be started with the minimum effective dose.

In people taking drugs that suppress platelet aggregation or reduce blood clotting, and also increase risk of bleeding in the stomach... If an ulcer or bleeding occurs, treatment with Nimesil should be discontinued. Since the tablets are partially excreted by the kidneys, doses for people with impaired renal function should be reduced, taking into account the degree of urination.

There is evidence of a negative liver reaction to the drug. If symptoms of liver dysfunction appear (yellowing of the skin, itching, vomiting, nausea, dark urine, stomach pain), it is necessary to stop taking the tablets and consult a doctor.

Despite the rare occurrence of visual impairments in people who use Nimesulide together with other drugs, treatment must be stopped immediately. Tablets can retain fluids in the tissues, therefore, people with high blood pressure and heart problems need to use Nimesil very carefully.

Epidemiological data and clinical studies have shown that NSAIDs, with higher doses and prolonged use, lead to negligible risk of stroke or a heart attack.

Nimesil contains sucrose, this must be taken into account for people who suffer from diabetes and patients on a low-calorie diet. A drug it is undesirable to appoint people with rare diseases such as a lack of sucrose-isomaltose, malabsorption of galactose-glucose or fructose intolerance.

The drug can change the properties of platelets, because you need to be careful patients with hemorrhagic diathesis, while the drug does not replace the prophylactic effect of acetylsalicylic acid in cardiovascular diseases.

Like all drugs of the NSAID group that inhibit the formation of prostaglandins, Nimesulide can negatively affect the course of pregnancy and lead to the following consequences:

• pulmonary artery hypertension;
• closure of the ductus arteriosus;
• an increased risk of bleeding;
• impaired renal function;
• the appearance of peripheral edema;
• decrease in the contractility of the uterus.

Therefore, Nimesulide prohibited during pregnancy and while breastfeeding. The use of Nimesil negatively affects the fertility of women and is not desirable for patients who are planning a pregnancy.

Side effects of Nimesil

Side effects from various systems:

interaction with other drugs

Nimesulide, when interacting with other drugs, can cause:

1. Selective serotonin inhibitors and antiplatelet drugs such as fluoxetine: increase the risk of stomach bleeding.
2. Glucocorticosteroids: increase the risk of bleeding and stomach ulcers.
3. Diuretics: The drug may reduce the effects of diuretics.
4. Anticoagulants: The drug may increase the effects of anticoagulants, such as warfarin. Due to the high risk of bleeding, taking these drugs together is undesirable and contraindicated in people with abnormal coagulation function. If a complex combination is still impossible to avoid, it is necessary to control the level of blood coagulation.

Contraindications to the use of the drug

Contraindications include the following conditions:

Care must be taken if there are:

• severe forms of diabetes;
• arterial hypertension, ischemic disease, heart failure;
• creatinine clearance less than 60 ml / min, hyperlipidemia / dyslipidemia, cerebrovascular diseases;
• smoking, peripheral arterial disease, infections caused by Helicobacter pylori, severe somatic diseases, history of gastrointestinal ulcer;
• long-term previous use of NSAIDs, advanced age.

Concomitant treatment allowed by such drugs: antiplatelet agents (for example, clopidogrel, acetylsalicylic acid), anticoagulants (for example, warfarin), reuptake inhibitors (for example, fluoxetine, citalopram, sertraline, paroxetine), oral glucocorticosteroids (for example, prednisolone).

The decision to use Nimesil must be based on the patient's personal assessment of the "risk-benefit" during the use of this drug.

Drug overdose

Signs: epigastric pain, drowsiness, apathy, vomiting, nausea... These symptoms are usually reversible during maintenance treatment of gastropathy. Bleeding in the stomach is possible. Sometimes respiratory depression, severe renal failure, increased blood pressure, anaphylactoid reactions, coma are likely.

Treatment: There is no specific antidote. In the case when an overdose happened within 5 hours, you need to induce artificial vomiting and take an osmotic laxative or activated carbon (70-120 gr. for an adult). Hemodialysis, forced diuresis are ineffective due to the increased connection of Nimesil with proteins (up to 97.6%). Monitoring of the liver and kidneys is required.

Treatment with the drug Nimesil requires control and a serious attitude on the part of the doctor, if it is used simultaneously with diuretics and anti-inflammatory drugs, as well as with medical drugs that correct pressure.

Nimesil can have effective anti-inflammatory and analgesic effects. However, it must be used not on the advice of friends and relatives, but only after a doctor's recommendation... Only in this way you will not allow negative consequences, you need to clearly control the dosage of this drug.

The instructions for use are for informational purposes only, and are written in simplified non-medical language for better understanding. It is forbidden to base your own treatment on the instructions read and take the medicine. Reviews of the results obtained as a result of taking the medication are not entitled to be advisory in nature. If you experience symptoms of the disease, you should seek a doctor's prescription.

Instructions for use

Nimesil is an anti-inflammatory non-steroidal drug of the sulfonamide class. It has an analgesic, antipyretic and anti-inflammatory effect on the body. The active ingredient in the composition of the drug is nimesulide, which is an inhibitor of the cyclooxygenase enzyme, which is responsible for the synthesis of prostaglandins in the body. The drug is available in several forms: granules (powder), packed in paper pots weighing 2 grams, dispersible tablets, lozenges, children's soluble tablets, suspension.

Nimesil is taken in powder by mouth, first it should be diluted with warm water. The drug is well absorbed in the stomach and intestines, penetrating the histohematogenous barriers. The main metabolic processes occur in the liver. The drug is excreted 50% by the kidneys.

Indications for use

• sharp;
• joint and muscle pain;
• injuries, sprains, dislocations of the joints;
• with toothache;
• with sharp pains;
• for colds to relieve symptoms.

Mode of application

It is recommended to drink Nimesil 2 times a day, one soshe after meals. Nimesil is not prescribed for children under 12 years of age. Teens 12-18 years old take a standard dosage. For people with impaired renal function and mild renal failure, a standard dosage is also prescribed. For elderly people, the daily rate is adjusted depending on the combination with other medications.

The minimum course of treatment is 15 days and to prevent the appearance of undesirable side effects, the minimum dosage is used with the minimum course.

In case of an overdose, the following symptoms are observed:

• apathy;
• nausea;
• drowsiness;
• pain in the stomach;
• vomit;
• in isolated cases, gastric bleeding occurs;
• increased pressure;
• renal failure exacerbation;
• difficulty breathing;
• coma;
• anaphylactic shock.

At the minimum therapeutic dose, these phenomena are reversible; in other cases, symptomatic treatment is prescribed. If no more than 4 hours have passed after an overdose, you should induce a gag reflex and empty the stomach, then take activated charcoal or a laxative. During the administration of the drug, the activity of the kidneys and liver should be monitored.

While taking any other medications, you should consult with your doctor about the necessity and advisability of taking Nimesil.

Side effects and contraindications

Nimesil, as a rule, is well tolerated, but at the beginning of treatment and at high doses, the following disorders may appear:

1. Hematopoietic system - anemia, hemorrhagic syndrome, eosinophilia, thrombocytopenic purpura, thrombocytopenia.
2. Allergic manifestations - rash, itching, excessive sweating, hypersensitivity, dermatitis, erythema, urticaria, anaphylactic shock, angioedema, Stevens-Johnson syndrome,.
3. Central nervous system - nervousness, dizziness, fear, nightmares, headache, encephalopathy, drowsiness.
4. The organs of vision are blurred, blurred.
5. Cardiovascular system - hypertension, hot flashes, blood pressure lability.
6. Respiratory system - shortness of breath, bronchospasm, recession of bronchial asthma.
7. Digestive system - diarrhea, vomiting, nausea, constipation, gastritis, flatulence, abdominal pain, tarry stools, dyspepsia, stomatitis, stomach ulcer, gastric and intestinal bleeding, jaundice.
8. Urinary system - hematuria, dysuria, urinary retention, oliguria, interstitial nephritis, renal failure.

Contraindications are as follows:

• bronchospasm, urticaria, rhinitis;
• negative reactions to nimesulide from the liver;
• combined use of Nimesil with or other analgesics or anti-inflammatory nonsteroidal drugs;
• intestinal inflammation - in the acute stage;
• postoperative period after coronary artery bypass grafting;
• fever in infectious diseases;
• ulcer of the stomach and duodenal ulcer at the stage of exacerbation;
• a history of ulcer and gastrointestinal bleeding;
• history of cerebrovascular bleeding;
• blood clotting disorders;
• hyperkalemia;
• heart failure;
• renal failure;
• during pregnancy and lactation;
• liver failure;
• children under 12 years old;
• when taking alcohol and drugs;
• individual intolerance to the components.

The effect of the drug on the ability to drive a car and operate machinery has not been established. Therefore, it is recommended to take Nimesil with caution when driving vehicles, as well as when engaging in hazardous activities, in which increased attention is required.

What is Nimesil® and what it is used for

Nimesil® is a non-steroidal anti-inflammatory drug ("NSAID") with analgesic properties. It is used to treat acute pain and pain during menstruation.
Before prescribing Nimesil®, your doctor will assess the benefits and risks of side effects when using this drug.
If symptoms worsen or do not improve, see your doctor.

The use of the drug is contraindicated in the following cases

Hypersensitivity (allergy) to nimesulide or to one of the excipients of Nimesil®;
- past allergic reactions (such as bronchospasm, rhinitis, urticaria) in connection with the intake of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs;
- past toxic effects on the liver when taking nimesulide;
- taking other drugs that have a toxic effect on the liver, for example, paracetamol or other pain relievers or NSAIDs;
- taking drugs that are addictive or have habits that make you dependent on drugs or other substances;
- regular intake of alcoholic beverages in large quantities;
- pre-existing gastrointestinal bleeding or perforation associated with previous NSAID therapy
- with liver disease or increased levels of liver enzymes;
- in the presence of a peptic ulcer (stomach or duodenal ulcer) at present or in the past;
- with established gastric or intestinal bleeding;
- with established cerebral hemorrhage (stroke);
- if you have other bleeding or problems caused by a bleeding disorder;
- with heart failure or impaired renal function (renal failure) or any liver pathology;
- a cold or flu (feeling of general weakness, malaise, chills or shivering, or having a fever);
- during the last three months of pregnancy;
- during breastfeeding.
Children and adolescents
It is not recommended to prescribe Nimesil® to children under 12 years of age.

Warnings and Precautions

Before taking Nimesil®, you should consult your doctor or pharmacist
Side effects can be minimized by using the lowest effective dose for the shortest duration of use necessary to control the symptoms of the disease.
- If you have an intolerance to certain types of sugar, you should see your doctor before taking this drug.
- If you are taking any of the drugs listed below that may interact with Nimesil®:
- drugs that reduce blood viscosity (anticoagulants, acetylsalicylic acid or other salicylates);
- other NSAIDs, including COX-2 inhibitors (cyclooxygenase-2 inhibitors);
- diuretics (diuretics) used for heart failure or high blood pressure, as well as other antihypertensive drugs;
- lithium preparations used to treat depression and similar conditions;
- methotrexate;
- cyclosporine.
Before taking Nimesil®, make sure your doctor or pharmacist knows that you are taking these drugs.
- If symptoms appear that indicate possible liver damage, therapy with Nimesil® should be discontinued and immediately consult a doctor. Symptoms suggesting liver damage include poor appetite, nausea, vomiting, stomach pain, persistent fatigue, and dark urine. If you have ever had a peptic ulcer, bleeding in the stomach or intestines, ulcerative colitis or Crohn's disease, you should inform your doctor before taking Nimesil®.
- If during treatment with Nimesil® you develop symptoms similar to a cold or flu (feeling of general weakness, malaise, chills or tremors), you should stop taking the drug and inform your doctor about the symptoms that have arisen.
- If you suffer from heart or kidney disease, you must inform your doctor about it before you start taking Nimesil®; because your kidney function may deteriorate with this drug.
- If you are planning a pregnancy, you should inform your doctor about it, as the drug Nimesil® can reduce fertility.
Elderly patients
For older patients, the doctor may make frequent follow-up visits to make sure that Nimesil® is not adversely affecting the stomach, kidneys, heart or liver. Elderly patients have an increased incidence of side effects with NSAIDs, especially life-threatening gastrointestinal bleeding or perforation.
Effects on the cardiovascular system
Taking drugs such as Nimesil® may be associated with a slightly increased risk of heart attack (myocardial infarction) or stroke. The risk of these diseases is most likely with the use of high doses and long-term drug treatment. Do not exceed your doctor's recommended dose or duration of treatment.
If you have heart disease, a previous heart attack, or if you think you may be at risk for these diseases (for example, if you have high blood pressure, diabetes or high blood cholesterol levels, if you smoke), discuss possible treatment with your doctor. or a pharmacy worker.
Also, caution should be exercised in patients with a history of high blood pressure and / or heart failure, since fluid retention and edema have been reported when taking NSAIDs.
Nimesulide may impair platelet function; therefore, patients prone to bleeding should take Nimesil® with caution. Nimesil® is not a substitute for taking acetylsalicylic acid to prevent heart and vascular diseases.
Safety for the gastrointestinal tract
Gastrointestinal bleeding, ulcer and perforation
Gastrointestinal bleeding, ulcer and ulcer perforation can be life-threatening if there is a medical history of such problems when taking any NSAID during treatment (no statute of limitations), with or without dangerous symptoms, or with a history of serious gastrointestinal tract disorders.
The risk of gastrointestinal bleeding, ulcers or ulcer perforation increases with an increase in the dose of a non-steroidal anti-inflammatory drug, in patients with a history of ulcers, especially those complicated by hemorrhage or perforation (see section "Contraindications to the drug"), as well as in elderly patients ... For these patients, treatment should be started at the lowest dose possible.
For these patients, as well as for patients requiring concomitant therapy with low doses of acetylsalicylic acid or other drugs that increase the risk of gastrointestinal disease, combination therapy with protective agents (for example, misoprostol or proton pump inhibitors) should be considered.
Patients with a history of gastrointestinal side effects, especially the elderly, should report any unusual symptoms in the abdomen (especially gastrointestinal bleeding) to their doctor. This is most important in the initial stages of treatment.
Special care should be taken with concomitant medications that may increase the risk of ulcers or bleeding, such as: oral corticosteroids (drugs taken for inflammatory conditions), anticoagulants such as warfarin, selective serotonin reuptake inhibitors used to treat depression , or anticoagulants such as acetylsalicylic acid (see the section “Taking other medicines”).
If gastrointestinal bleeding or ulcers occur while taking Nimesil®, treatment with the drug should be canceled.
Nonsteroidal anti-inflammatory drugs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), since these diseases may worsen (see Warnings and Precautions).
Skin reactions
There is evidence of very rare cases of severe skin reactions, accompanied by skin redness and blistering, to nonsteroidal anti-inflammatory drugs, including life-threatening reactions (exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis / Lyell's syndrome) (see section "Possible Side Effects"). Patients have a very high risk of such reactions if, with a previously prescribed course of treatment: the onset of a reaction in most cases occurred during the first month of treatment. When the first signs of a skin rash, lesions of the mucous membranes or other signs of hypersensitivity appear, you should stop using the drug Nimesil and consult a doctor.

Nimesil® and other drugs

Concomitant use of corticosteroids and Nimesil® may increase the risk of ulcers or bleeding in the gastrointestinal tract (see section "Warnings and Precautions").
NSAIDs can enhance the action of anticoagulants such as warfarin (see Warnings and Precautions). Therefore, the combination of these drugs is not recommended and should not be prescribed for patients with severe blood coagulation disorders. If the combined treatment with drugs cannot be avoided, then the anticoagulant activity should be carefully monitored.
In the case of concomitant use of Nimesil® and antiplatelet drugs and selective serotonin reuptake inhibitors (SSRIs), there is an increased risk of gastrointestinal bleeding (see section "Warnings and Precautions").
Nimesil weakens the effect of furosemide (a diuretic used to treat high blood pressure and heart failure) and other antihypertensive drugs.
The combined use of Nimesil® and lithium preparations (drugs for the treatment of psychiatric diseases) can lead to an increase in the concentration of lithium in the blood. Serum lithium levels should be checked.
Prescribing Nimesil® within 24 hours before or after using methotrexate (a drug for the treatment of rheumatism and cancer) may lead to an increase in the concentration of methotrexate in the blood and increase the side effects of this drug.
Non-steroidal anti-inflammatory drugs (such as nimesulide) can increase the unwanted effects of cyclosporine (a drug used to suppress the immune response, used, for example, after organ transplantation) on the kidney.
Please contact your doctor or pharmacist if you are taking or have recently taken other medicines, including over-the-counter medicines.

Pregnancy, lactation and fertility

In this case, before using any medicinal product, you should seek the advice of your doctor or pharmacist.
If you are pregnant or breastfeeding, or if you are likely to be pregnant or planned to become pregnant, ask your doctor or pharmacist for advice before taking this drug.
Pregnancy
Nimesil® can only be taken during the first six months of pregnancy after consulting a doctor. Due to the increased risk to the mother and child, Nimesil® should not be used in the last three months of pregnancy (see section "Contraindications to the use of Nimesil®").
Fertility
Nimesulide can make pregnancy difficult. If you are planning a pregnancy or you have problems with the onset of pregnancy, you should inform your doctor about it.
Lactation
Nimesil® should not be taken during breastfeeding.

Influence on the ability to drive vehicles and service mechanisms

You should not drive or operate machinery if you feel dizzy, disoriented or drowsy after taking Nimesil®.

How to take the drug

This drug should always be taken strictly as directed by your doctor. If in doubt, consult your doctor or pharmacist. The usual dose is 1 sachet of 100 mg (dissolve the contents in a glass of water) twice a day after meals. Nimesil® should be used for the shortest possible period of time, a single course of treatment should not exceed 15 days.
If you take more Nimesil® than you should
Symptoms of an acute NSAID overdose are usually limited to the following: apathy, drowsiness, nausea, vomiting, and epigastric pain. Gastrointestinal bleeding may occur. In rare cases, an increase in blood pressure, acute renal failure, respiratory depression and coma are possible. Serious allergic reactions have been reported, both with the usual doses of NSAIDs and with an overdose of these drugs.
Measures when skipping the next dose of Nimesil®
If you forget to take a dose of Nimesil®, then take the next dose of the drug the next time.
Do not take a double dose to make up for a missed dose.
If you stop taking Nimesil®
Your condition may get worse if you stop taking this drug Nimesil® without your doctor's advice.

Possible side effects

Like all medicines, this medicine can cause side effects, although not all people get them.
The most commonly observed side effects of NSAIDs are related to gastrointestinal reactions. Possible development of peptic ulcers, perforation or bleeding, sometimes fatal, especially in elderly patients (see section "Warnings and Precautions"). The following reactions to the drug have been reported: nausea, vomiting, diarrhea, flatulence (bloating), constipation, complaints of digestion, abdominal pain, tarry stools, bloody vomiting, ulcerative stomatitis, exacerbation of colitis and Crohn's disease (see Warnings and precautionary measures"). Gastritis was less common.
It has been reported about the occurrence of edema, increased blood pressure and heart failure in connection with the intake of non-steroidal anti-inflammatory drugs.
There is evidence of very rare cases of serious skin reactions to NSAIDs, accompanied by skin redness and blistering, including Stevens-Johnson syndrome and toxic epidermal necrolysis.
Taking drugs such as Nimesil® may be associated with a slightly increased risk of heart attack (myocardial infarction) or stroke.
The following values ​​are taken as a basis for assessing the incidence of side effects:
Very common: may affect more than 1 in 10 patients
Common: may affect 1-10 out of 100 patients
Occasionally: May affect 1-100 out of 1000 patients
Rare: may affect 1-10 patients in 10,000
Very rare: may affect up to 1 in 10,000 patients
Not known: frequency cannot be estimated from available data
Side effects:

Disturbances from the circulatory and lymphatic systems	Rarely	Decreased red blood cell count (anemia) Increased levels of certain white blood cells (eosinophilia)
	Very rarely	Thrombocytopenia (a decrease in the level of platelets in the blood) Decreased levels of all types of blood cells (pancytopenia) Localized cutaneous bleeding (purpura)
Immune system disorders	Rarely	Allergic reactions
	Very rarely	Severe allergic reaction (anaphylaxis)
Metabolic and Nutritional Disorders	Rarely	Increased potassium levels in the blood (hyperkalemia)
Psychiatric disorders	Rarely	Feeling of fear * Nervousness * Nightmare dreams
Nervous system disorders	Sometimes	Dizziness
	Very rarely	Headache Drowsiness Some form of brain disease (encephalopathy, including Reye's syndrome)
Violations of the organs of vision	Rarely	Blurry vision
	Very rarely	Visual impairment
Hearing and labyrinth disorders	Very rarely	Dizziness
Heart disease	Rarely	Rapid pulse (tachycardia)
Vascular disorders	Sometimes	High blood pressure
	Rarely	Hemorrhage Blood pressure lability "Tides"
Respiratory, thoracic and mediastinal diseases	Sometimes	Labored breathing
	Very rarely	Asthma Bronchospasm
Digestive system disorders	Often	Diarrhea Nausea Vomit
	Sometimes	Constipation Flatulence Gastrointestinal bleeding Duodenal or gastric ulcer and perforation
	Very rarely	Inflammation of the stomach lining (gastritis) Abdominal pain Indigestion Inflammation of the oral mucosa, including ulceration Black chair
Liver and biliary tract disorders (see Warnings and Precautions section)	Often	Elevated liver enzymes
	Very rarely	Inflammation of the liver (hepatitis) Fulminant and severe hepatitis (including deaths) Jaundice Bile excretion disorders (cholestasis)
Pathology of the skin and subcutaneous tissue	Sometimes	Itching Rash Excessive sweating
	Rarely	Erythema Dermatitis
	Very rarely	Hives Tissue edema (angioedema) Swelling of the face Severe skin reactions (erythema polymorphic, Stephen-Jones syndrome, toxic epidermal necrolysis)
Kidney and urinary tract disorders	Rarely	Difficulty urinating Blood in urine
	Very rarely	Retention of urine Renal failure Oliguria Inflammation of the kidney tissue (interstitial nephritis)
General disorders and local reactions to the drug	Sometimes	Accumulation of fluid in tissues (edema)
	Rarely	Malaise Weakness
	Very rarely	Abnormally low body temperature (hypothermia)

If any of the side effects becomes serious or if you find side effects not noted in this leaflet, please consult your doctor or pharmacist. Description up to date on 13.10.2019

• Latin name: Nimesil
• ATX code: M01AX17
• Active substance: Nimesulide
• Manufacturer: Laboratorios MENARINI (Spain)

Nimesil's composition

The preparation includes 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 granules for the preparation of an oral suspension in the form of a light yellow powder with an orange scent.

• 2 grams of Nimesil in a paper bag;
• 9, 30 or 15 sachets in a cardboard box.

pharmachologic effect

Antipyretic, anti-inflammatory, analgesic effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Anti-inflammatory non-steroidal drug from the group sulfonamides ... Has anti-inflammatory, antipyretic and analgesic effects.

Wikipedia indicates that the active substance acts as a blocker cyclooxygenase of the second type responsible for biosynthesis.

Pharmacokinetics

After administration, it is well absorbed in the intestines, reaching the highest concentration in 2-3 hours. The reaction with plasma proteins is 97.5%. The half-life is 4-5 hours. Quickly penetrates the histohematogenous barriers.

Transformed in the liver by cytochrome P450 ... The main active is hydroxynimesulide , which is excreted in the bile in a glucuronized form. It is excreted from the body mainly by the kidneys (about half of the dose taken).

Indications for the use of Nimesil powder

The drug is used for symptomatic therapy, relief of inflammation and pain at the time of use.

Indications for the use of Nimesil:

• symptomatic therapy of pain syndrome in the background;
• relief of acute pain (pain in the lower back and back; pain syndrome in trauma, tendenitis , sprains and dislocations; toothache);
• algodismenorrhea .

Contraindications to Nimesil

Contraindications for use:

• hepatotoxic reactions caused by a history of the active substance;
• bronchospasm related to the use or other history;
• joint administration of drugs with potential hepatotoxicity;
• condition after coronary artery bypass grafting ;
• inflammatory bowel disease ( nonspecific ulcerative, Crohn's disease ) in the stage of exacerbation;
• an increase in body temperature in diseases of an infectious and inflammatory nature;
• exacerbation, history, perforation or bleeding in the digestive tract;
• combination, polyposis of the nose and intolerance non-steroidal anti-inflammatory drugs ;
• bleeding of cerebrovascular or other localizations; diseases accompanied by pathological bleeding;
• decompensated heart failure ;
• severe blood clotting disorders;
• decompensated, hyperkalemia ;
• liver disease;
• liver failure;
• , drug addiction;
• or ;
• age under 12;
• to the components of the drug.

Abstract recommends the use of 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; when smoking and concomitant treatment anticoagulants, oral glucocorticosteroids, antiplatelet agents, selective serotonin reuptake blockers.

Side effects

Overdose treatment is symptomatic. There is no election. If no more than 4 hours have passed since the overdose, it is necessary to rinse the stomach and ensure the intake enterosorbens , what is used for or osmotic laxative ... Control over the work of the kidneys and liver is shown.

Interaction

When used simultaneously with glucocorticosteroids the risk of appearance ulcers or bleeding from the stomach and intestines.

When used with antiplatelet agents and selective reuptake inhibitors it also increases the likelihood of bleeding from the stomach or intestines.

can enhance effects anticoagulants , therefore, this combination is not recommended for persons with severe disorders coagulation ... If this combination still cannot be avoided, careful monitoring of blood clotting parameters should be carried out.

Anti-inflammatory non-steroidal drugs able to weaken the effects diuretics .

Nimesulide able to temporarily reduce evacuation sodium and potassium under the influence and thereby weaken the diuretic effect of the latter. You also need to remember that such a joint prescription of drugs requires caution in persons with impaired kidney and heart function.

Anti-inflammatory non-steroidal drugs can weaken the action antihypertensive drugs ... In persons with compensated renal failure with simultaneous appointment ACE blockers ,type II angiotensin receptor antagonists or means suppressingcycloxygenase , possible progression of deterioration in kidney function and the development of reversible renal failure by the acute type.

Anti-inflammatory non-steroidal drugs reduces 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 able to stimulate nephrotoxicity cyclosporins .

Terms of sale

Over the counter.

Storage conditions

Store in a dry, dark place at room temperature. Keep out of the reach of children.

Shelf life

special instructions

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

The medicine in powder Nimesil should be used with caution in persons with a history of gastrointestinal diseases, since an 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 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), you must stop taking the medication and consult a doctor.

If any signs of visual impairment appear during drug therapy, then the patient should be examined by an ophthalmologist.

Nimesil is capable of provoking fluid retention in the body, therefore, the drug should be used with extreme caution in people with high blood pressure and heart disease.

If symptoms of an acute respiratory infection of a viral nature occur during drug therapy, Nimesil should be stopped.

Do not use Nimesil at the same time as other anti-inflammatory nonsteroidal drugs .

Nimesulide is capable of changing characteristics, therefore, care must be taken when using the drug in patients with hemorrhagic diathesis ... It is worth remembering that a medicine does not replace a prophylactic effect. acetylsalicylic acid with diseases of the circulatory system.

Nimesil's analogs

Matching ATX level 4 code:

The price of Nimesil analogues is usually lower than that of the described product. Below are medicines with an identical composition, which can replace Nimesil: Ameolin (pills), (pills), Affida Fort (granules for suspension preparation), Mesulid (pills), (tablets, suspension), Negan (tablets), (tablets, suspension), Nimesin (tablets), (tablets, gel), (tablets, granules), Nimujet (injection solution), (tablets, suspension, injection solution, gel), Nimuspaz (pills), Pansulid (pills), Remesulid (pills), Sulidin (gel), Tarot-Sanovel (pills).

Nise or Nimesil - which is better?

Nise and Nimesil are analogues. The main difference between the drugs is that the first is produced 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.

I have given to children

Nimesil (like tablets or ointment based nimesulide ) it is forbidden to use for treatment 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) does not differ in other age groups. How to use the powder, how to dilute Nimesil in powder, as well as 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 relieving mild and moderately mild pain syndrome. Forbidden for the treatment of children under 12 years of age.

Alcohol compatibility

Nimesil and alcohol are incompatible, since both substances are hepatotoxic. Their simultaneous intake can lead to severe liver disorders and irreversible consequences, especially against the background of already present diseases of the hepatobiliary system.

Nimesil during pregnancy and lactation

It is strictly prohibited to use the drug during pregnancy or breastfeeding, as nimesulide other anti-inflammatory nonsteroidal drugs can negatively affect the course of pregnancy and the development of the child.

Nimesil is a fairly serious drug that should only be taken as directed by a doctor. However, practice shows that no one is immune from medical error, therefore, when prescribing any drug and before taking it, it is recommended that you carefully study the instructions for it yourself. In this article, we will try to understand the features of this drug in order to prevent possible negative consequences as a result of its use.

Nimesil's composition

Nimesil Is a synthetic drug, the main active ingredient in which is nimesulide. It contains as auxiliary substances: sucrose, citric acid, flavor, maltodextrin, ketomacrogol 1000.

Nimesil is available in powder form, packed in sachets of 2 g (9, 15 or 30 pieces per package). One sachet of the drug contains 100 mg of active ingredient.

Indications for the use of Nimesil and its action

Nimesil has a strong analgesic, antipyretic, and anti-inflammatory pharmacological effect. After oral administration, the active substance of nimesil is rapidly absorbed by the gastrointestinal tract, broken down by the liver and excreted mainly through the kidneys. The drug is eliminated by 98% per day, and with prolonged use, it does not accumulate in the body. The duration of action of nimesil is up to approximately 8 hours.

Nimesil is prescribed in the following cases:

• acute pain syndrome;
• post-traumatic pain;
• inflammatory diseases, accompanied by an increase in body temperature;
• pain syndrome in the postoperative period;
• diseases of the musculoskeletal system (osteoarthritis, rheumatoid arthritis, tendonitis, etc.);
• myalgia;
• pain and inflammation in gynecological diseases;
• infectious and inflammatory diseases, etc.

Nimesil for toothache

Nimesil can be used to eliminate pain symptoms and suppress the progression of the inflammatory process in caries, gum disease and other processes that cause toothache. However, it should be understood that the main purpose of taking this drug is to reduce acute pain. That is, nimesil does not take part in the treatment of the main cause that led to the onset of pain syndrome, but only temporarily eliminates the symptoms of the disease.

Method of using Nimesil

Nimesil in the form of a powder for internal use is used to prepare a suspension. To do this, pour the contents of the sachet into a glass (250 ml) of water and mix thoroughly.

The drug is used only after meals, 100 mg twice a day (average dosage). The interval between taking a single dose is 12 hours. If necessary, the dose of the drug can be increased, taking into account the severity of the patient's condition and the effectiveness of the drug in a particular case. The drug can be used in a course of no more than 15 days. Treatment with nimesil should be discontinued if there is no positive clinical effect from taking it.

Contraindications to taking Nimesil

The drug is prescribed only for adults, as well as for children from 12 years old, taking into account the assessment of the ratio of benefits and harms of the drug (risk). Nimesil is contraindicated during pregnancy, as well as during lactation, because can cause significant harm to the fetus and baby. If this drug is prescribed during breastfeeding, then it should be discontinued during the treatment period.