Nimesil is a branded drug representing the group of non-steroidal anti-inflammatory drugs, which was first registered in Italy and has been used for 35 years to relieve attacks of acute pain and inflammation.
The composition of the drug includes nimesulide, which belongs to sulfonamide derivatives and has a threefold pharmacological effect:
- anti-inflammatory;
- painkillers;
- antipyretic.
Nimesil is the first drug that selectively inhibits the activity of the enzyme cyclooxygenase-2, which is formed in an inflamed lesion after damage to an organ or tissue, which leads to a slowdown in the synthesis of prostaglandins and a decrease in inflammation, attacks of pain and a decrease in temperature.
For what diseases do you need to take nimesil?
The drug is used as prescribed by a doctor as a “second-line” medication and is added to therapy additionally when other drugs fail to relieve an attack of pain and relieve symptoms of inflammation that are caused by:
- toothache;
- painful menstruation and inflammation of the genital organs in women and men;
- damage to joints and ligaments that occur due to injuries, dislocations, fractures, sprains;
- pain in the spine and back;
- degenerative changes in joints with osteoarthritis.
How to take Nimesil?
The drug is prescribed to adults and adolescents from 12 years of age, 1 sachet twice a day after meals.
The granules are dissolved in half a glass of warm water, mixed and drunk immediately, since the medicine is prepared before use.
Nimesil for toothache reduces the patient's suffering within 20 minutes, reduces temperature and reduces swelling in tissues during inflammatory diseases in the oral cavity. The drug is used to relieve the symptoms of the disease, so the patient needs to see a dentist.
Nimesil for headaches is used to relieve attacks that are caused by migraines and occur due to changes in weather conditions, fatigue or stressful situations. A single dose is enough for the patient; improvement occurs within 40 minutes and lasts 12 hours.
Nimesil in gynecology is prescribed for premenstrual syndrome, inflammation of the female organs, and endometriosis. The dosage form in powder form is absorbed and acts faster than tablets. A decrease in inflammation symptoms occurs on the second day of treatment.
Nimesil during menstruation is used on the first day of the cycle or two days before the start of menstruation and helps a woman prevent or cope with painful sensations after 25 minutes. The effect of the medicine lasts 6 hours.
Nimesil for cystitis is used in complex treatment and reduces temperature and pain during urination, reduces inflammation. The medication alleviates the symptoms of the disease in women 30 minutes after administration and lasts for seven hours.
Nimesil for osteochondrosis is the most effective drug in the fight against pain and inflammation, which is caused by depletion and deformation of articular cartilage. The medicine is used according to a standard regimen as prescribed by a doctor. The course of treatment should not exceed two weeks.
pharmachologic effect
Pharmacotherapeutic group:
non-steroidal anti-inflammatory drugs (NSAIDs).
Pharmacological properties
Pharmacodynamics Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) from the sulfonamide class. 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 maximum concentration in blood plasma after 2-3 hours; connection with plasma proteins - 97.5%; The half-life is 3.2-6 hours. Easily penetrates histohematic barriers.
Metabolized in the liver using the 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 elderly people does not change when administered single and multiple/repeated doses.
According to an experimental study conducted in patients with mild to moderate renal failure (creatinine clearance 30-80 ml/min) and healthy volunteers, the maximum concentration of nimesulide and its metabolite in the plasma of patients did not exceed the concentration of nimesulide in healthy volunteers. The area under the concentration-time curve (AUC) and half-life in patients with renal impairment were 50% higher, but within the pharmacokinetic range. When taking the drug again, no accumulation is observed.
Contraindications and side effects
Nimesil should not be prescribed for:
- individual intolerance in patients to nimesulide and excipients of the drug;
- stomach and duodenal ulcers;
- inflammation of the digestive system and bleeding;
- the occurrence of bronchospasm and runny nose while taking aspirin or other NSAIDs;
- coronary artery bypass surgery that the patient underwent;
- high blood pressure;
- pregnancy and breastfeeding;
- diabetes mellitus, which belongs to type II.
Taking the drug is prohibited for adolescents under 12 years of age and is not recommended for patients with impaired renal function, since the removal of the drug from the body can lead to a deterioration in their function.
The medicine should not be used for more than two weeks, because the drug is hepatotoxic and leads to a weakening of the protective function of the liver.
When prescribing Nimesil, side effects occur rarely and include:
- increased blood pressure and increased heart rate
- allergies - sweating, itching, skin rashes, dermatitis and urticaria
- decreased levels of hemoglobin or platelets in the blood
- malfunction of the nervous system - sleep and vision disturbances, anxiety and weakness
- disorders of the digestive system - nausea, vomiting, diarrhea, bloating and exacerbation of gastritis
- depression of respiratory functions - shortness of breath, increased frequency of attacks of bronchial asthma.
Nimesil®
Undesirable side effects can be minimized by using the drug in the minimum effective dose with the minimum duration of use necessary to relieve pain.
There is evidence of very rare cases of serious reactions from the liver, including cases of death, associated with the use of nimesulide-containing drugs. If symptoms similar to signs of liver damage appear (anorexia, itching, yellowing of the skin, nausea, vomiting, abdominal pain, dark urine, increased activity of liver transaminases), you should immediately stop using the drug Nimesil® and consult a doctor. Repeated use of Nimesil® in such patients is contraindicated.
Liver reactions, which are in most cases reversible, have been reported with short-term use of the drug.
While using the drug Nimesil®, the patient should refrain from taking other analgesics, including NSAIDs (including selective COX-2 inhibitors).
The drug 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, peptic ulcer/perforation of the stomach or duodenum increases in patients with a history of gastrointestinal ulceration (ulcerative colitis, Crohn's disease), as well as in elderly patients, with an increase in the dose of NSAIDs, so treatment should begin with the lowest possible dose. In such patients, as well as in patients who require the simultaneous use of low doses of acetylsalicylic acid or other drugs that increase the risk of complications from the gastrointestinal tract, it is recommended to additionally prescribe gastroprotectors (misoprostol or proton pump blockers). Patients with a history of gastrointestinal disease, especially older patients, should report new gastrointestinal symptoms (especially symptoms that may indicate possible gastrointestinal bleeding) to their physician.
Nimesil should be administered with caution to patients taking drugs that increase the risk of ulceration or bleeding (oral corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors or antiplatelet agents such as acetylsalicylic acid).
If gastrointestinal bleeding or gastrointestinal ulceration occurs in patients taking Nimesil®, treatment with the drug must be stopped immediately.
Given reports of visual impairment in patients taking other NSAIDs, if any visual impairment occurs, the use of Nimesil should be immediately discontinued and an ophthalmological examination performed.
The drug may cause fluid retention, therefore, in patients with arterial hypertension, renal and/or heart failure, Nimesil® should be used with extreme caution. 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 is insufficient data to exclude the risk of such events when using nimesulide.
Patients with arterial hypertension, renal and/or heart failure, coronary heart disease, peripheral arterial disease and/or cerebrovascular diseases, with risk factors for the development of cardiovascular diseases (for example: hyperlipidemia, diabetes mellitus, smokers) should take Nimesil® use with extreme caution. If the condition worsens, treatment with Nimesil® should be discontinued.
The drug contains sucrose, this should be taken into account by patients suffering from diabetes mellitus (0.15-0.18 XE per 100 mg of the drug) and those on a low-calorie diet. The drug Nimesil® is not recommended for use in patients with fructose intolerance, sucrose-isomaltose deficiency or glucose-galactose malabsorption syndrome.
If signs of a “cold” or acute respiratory viral infection occur while using the drug Nimesil®, the drug should be discontinued. Nimesulide can change the properties of platelets, so caution must be exercised when using the drug in people with hemorrhagic diathesis, however, the drug does not replace the preventive effect of acetylsalicylic acid in cardiovascular diseases.
Elderly patients are especially susceptible to adverse reactions to NSAIDs, including the risk of life-threatening gastrointestinal bleeding and perforation, and decreased renal, liver, and cardiac function. When taking Nimesil® for this category of patients, proper clinical monitoring is necessary.
There is evidence of rare cases of skin reactions (such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) when taking NSAIDs, including nimesulide. At the first manifestations of a skin rash, damage to the mucous membranes or other signs of an allergic reaction, taking Nimesil® should be stopped immediately.
Popular questions about Nimesil:
Nimesil how to take the drug?
Adults and adolescents over 12 years of age are prescribed 1 sachet orally twice a day after meals.
How to dilute Nimesil?
The powder from the bag is dissolved in half a glass of warm water, mixed and the finished solution is drunk.
How to take Nimesil for toothache?
An adult and a teenager are prescribed to drink 1 sachet, which is dissolved in half a glass of water and taken twice a day. The time interval between doses is 12 hours. The single dose is not increased.
How often can you take nimesil?
Doctors prescribe the drug in a short course to eliminate pain and symptoms of inflammation. The medicine should not be taken for more than two weeks.
Interactions of the drug Nimesil
Patients using warfarin or other indirect anticoagulants, or acetylsalicylic acid, have an increased risk of bleeding when using Nimesil simultaneously, so this combination is not recommended, and in severe forms of bleeding disorders it is contraindicated. If such a combination cannot be avoided, regular monitoring of the state of the blood coagulation system is necessary. In healthy individuals, nimesulide temporarily reduces the diuretic effect of furosemide and the excretion of sodium and, to a lesser extent, potassium, therefore, when using nimesulide and furosemide simultaneously in cases of impaired renal or cardiac function, special caution should be exercised. There is evidence that NSAIDs reduce the clearance of lithium, which leads to increased plasma lithium levels and increased toxicity. If Nimesil is prescribed to a patient receiving lithium preparations, frequent monitoring of lithium levels in the blood plasma is required. When used simultaneously with glibenclamide, theophylline, warfarin, digoxin, cimetidine and antacids, no clinically significant interactions were observed. Caution should be exercised if nimesulide is prescribed less than 24 hours before or after taking methotrexate, since it is possible to increase the level of the latter in the blood plasma and increase its toxicity. When used simultaneously with cyclosporine, the nephrotoxicity of the latter may increase.
Note!
The description of the drug Nimesil on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
