In this article, you can read the instructions for use of the drug. Nimesil. Presented reviews of visitors to the site – consumers of this medicine, as well as the opinions of doctors of specialists on the use of Nimesil in their practice. A big request to add your feedback on the drug more actively: the medicine helped or did not help to get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogs of Nimesil in the presence of available structural analogues. Use for the treatment and relief of pain in various diseases in adults, children, as well as during pregnancy and breastfeeding. The composition and interaction of the drug with alcohol.
Nimesil – nonsteroidal anti-inflammatory drug from the class of sulfonamides. It has anti-inflammatory, analgesic and antipyretic effects. Nimesulide acts as an inhibitor of the enzyme cyclooxygenase, which is responsible for the synthesis of prostaglandins, and inhibits mainly cyclooxygenase 2.
Nimesulide + excipients.
After ingestion, the drug is well absorbed from the gastrointestinal tract. Easily penetrates histohematogenous barriers. Nimesulide (active ingredient of the drug Nimesil) is excreted from the body, mainly by the kidneys (about 50% of the dose taken). When re-taking the drug cumulation is not observed.
- treatment of acute pain (pain in the back, lower back; pain in the musculoskeletal system, including injuries, sprains and dislocations of the joints, tendenitis, bursitis; toothache);
- symptomatic treatment of osteoarthritis with pain;
The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use.
Forms of release
Powder or granules for the preparation of suspensions for oral administration of 100 mg.
Forms in the form of tablets at the time of the description of the drug in the directory did not exist.
Instructions for use and regimen
Nimesil is accepted inside, on 1 bag (100 mg of Nimesulide) 2 times a day. The drug is recommended to be taken after meals. The contents of the bag pour into a glass and dissolved in approximately 100 ml of water. The prepared solution is not subject to storage.
Nimesil is used only for the treatment of patients over 12 years old.
Adolescents (aged 12 to 18 years): based on the pharmacokinetic profile and pharmacodynamic characteristics of nimesulide, there is no need to adjust the dose in adolescents.
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, use the minimum effective dose of the minimum short course.
- hemorrhagic syndrome;
- thrombocytopenic purpura;
- excessive sweating;
- anaphylactoid reactions;
- blurred vision;
- arterial hypertension;
- exacerbation of bronchial asthma;
- diarrhea, constipation;
- nausea, vomiting;
- stomach ache;
- tarry stools;
- gastrointestinal bleeding;
- an ulcer and / or perforation of the stomach or duodenum;
- hematuria (blood in the urine);
- urinary retention;
- history of hyperergic reactions, for example, bronchospasm, rhinitis, urticaria associated with taking acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs (NSAIDs), in
Use during pregnancy and lactation
Like other NSAID drugs that inhibit prostaglandin synthesis, Nimesil can negatively affect pregnancy and / or embryo development and can lead to premature closure of the ductus arteriosus, hypertension in the pulmonary artery, impaired kidney function, which can lead to renal failure with oligodiramia, to increased risk of bleeding, reduced uterine contractility, the occurrence of peripheral edema. In this regard, the drug is contraindicated during pregnancy and during breastfeeding.
Undesirable side effects can be minimized by using the minimum effective dose of the drug with the shortest possible short course.
Nimesil should be used with caution in patients with gastrointestinal diseases in history (ulcerative colitis, Crohn’s disease), since exacerbation of these diseases is possible.
The risk of gastrointestinal bleeding, ulcer or perforation of the ulcer increases with an increase in the dose of NSAIDs in patients with an ulcer history that is 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 suppress platelet aggregation, also increases the risk of gastrointestinal bleeding. In the event of gastrointestinal bleeding or ulcers in patients taking Nimesil, treatment with the drug should be canceled.
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 (itching, yellowing of the skin, nausea, vomiting, abdominal pain, dark urine, increased activity of liver transaminases), stop taking the drug and consult your doctor.
Despite the rare occurrence of visual impairment in patients who took nimesulide simultaneously with other NSAIDs, treatment should be immediately discontinued. If any visual impairment occurs, the patient should be examined by an optometrist.
The drug can cause fluid retention in the tissues, so Nimesil should be used with extreme caution in patients with high blood pressure and with impaired cardiac activity.
In patients with renal or heart failure, Nimesil should be used with caution, as renal function may deteriorate. In case of deterioration, treatment with Nimesil must be stopped.
Clinical studies and epidemiological data suggest that NSAIDs, especially in high doses and with prolonged use, can lead to a slight risk of myocardial infarction or stroke. To eliminate the risk of such events when using nimesulide data is not enough.
The preparation contains sucrose, it should be considered for patients with diabetes mellitus (
Do not use Nimesil concurrently 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 action of acetylsalicylic acid in cardiovascular diseases.
Elderly patients are particularly susceptible to adverse reactions to NSAIDs, including the occurrence of gastrointestinal bleeding and perforations that threaten the patient’s life, deterioration of kidney, liver and heart function. When taking the drug Nimesil for this category of patients requires proper clinical monitoring.
Like other NSAID drugs that inhibit prostaglandin synthesis, nimesulide can adversely affect pregnancy and / or embryo development and can lead to premature closure of the ductus arteriosus, hypertension in the pulmonary artery, impaired kidney function, which can lead to renal failure with oligodiramia, to increased risk of bleeding, reduced uterine contractility, the occurrence of peripheral edema. In this regard, nimesulide is contraindicated during pregnancy and lactation. The use of the drug Nimesil may adversely affect female fertility and is not recommended for women planning a pregnancy. When planning a pregnancy, consultation with your doctor is necessary.
Simultaneous use of the drug Nimesil with alcohol is prohibited due to the risk of bleeding from the gastrointestinal tract.
There is evidence of the occurrence in rare cases of skin reactions (such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) on nimesulide as well as on other NSAIDs. At the first signs of skin rash, mucosal lesions or other signs of an allergic reaction, Nimesil should be stopped.
The influence of the drug on the ability to drive vehicles and control mechanisms
The effect of the drug Nimesil on the ability to drive vehicles and control mechanisms has not been studied, therefore, during the treatment with Nimesil, care should be taken when driving vehicles and practicing potentially hazardous activities that require increased concentration and psychomotor speed.
When combined with glucocorticosteroids increases the risk of gastrointestinal ulcers or bleeding.
When used together with antiplatelet agents and selective serotonin reuptake inhibitors (SSRIs), for example, fluoxetine, the risk of gastrointestinal bleeding increases.
NSAIDs can enhance the effects of anticoagulants such as warfarin. Due to the increased risk of bleeding, this combination is not recommended and is contraindicated in patients with severe coagulation disorders. If combination therapy cannot be avoided, it is necessary to carefully monitor blood clotting rates.
NSAIDs may weaken the effect of diuretics.
In healthy volunteers, nimesulide temporarily reduces sodium excretion under the action of furosemide, to a lesser extent – excretion of potassium, and reduces the actual diuretic effect.
The combined use of Nimesil and furosemide results in a decrease (approximately by 20%) of the area under the concentration-time curve (AUC) and a decrease in the cumulative excretion of furosemide without altering the renal clearance of furosemide.
The joint appointment of furosemide and nimesulide requires caution in patients with impaired renal and cardiac function.
ACE inhibitors and angiotensin 2 receptor antagonists
NSAIDs can reduce the effect of antihypertensive drugs. In patients with mild and moderate renal failure (CC 30-80 ml / min) with the joint appointment of ACE inhibitors, angiotensin 2 receptor antagonists or substances that suppress the cycloxygenase system (NSAIDs, antiplatelet agents), further deterioration of kidney function and the occurrence of acute renal failure which is usually reversible. These interactions should be considered in patients taking Nimesil in combination with ACE inhibitors or angiotensin 2 receptor antagonists. Therefore, joint administration of these drugs should be prescribed with caution, especially for elderly patients. Patients should receive a sufficient amount of fluid, and renal function should be carefully monitored after the start of joint therapy.
Pharmacokinetic interactions with other drugs
There is evidence that NSAIDs reduce lithium clearance, which leads to an increase in plasma concentration of lithium and its toxicity. In the appointment of nimesulide to patients receiving therapy with lithium preparations, it is necessary to regularly monitor the concentration of lithium in the plasma.
Clinically significant interactions with glibenclamide, theophylline, digoxin, cimetidine, and antacid drugs (for example, a combination of aluminum and magnesium hydroxides) were not observed.
When prescribing nimesulide less than 24 hours before or after taking methotrexate, care must be taken, since in such cases, the level of methotrexate in the plasma and, accordingly, the toxic effects of this drug may increase.
In connection with the action on renal prostaglandins, prostaglandin synthetase inhibitors, such as nimesulide, can increase the nephrotoxicity of cyclosporins.
The interaction of other drugs with nimesulide
Studies have shown that nimesulide is displaced from binding sites by tolbutamide, salicylic acid, and valproic acid. Despite the fact that these interactions were determined in the blood plasma, these effects were not observed during the clinical use of the drug.
Analogs of the drug Nimesil
Structural analogues of the active substance: