Pain is a kind of attempt by the body to attract the attention of a person, a call for help. This means that something is wrong "in the Danish kingdom", and the body’s resources are not enough to fix the problem, external support is needed.
The consumer pharmaceutical market of the Russian Federation has hundreds of drugs designed to help people cope with pain. All medicines have different composition, scope and mechanism of influence. One of the most effective are drugs from the group of non-steroidal anti-inflammatory drugs. Among them there is a suspension and Nimesulide tablets.
Composition and form of release
Round tablets are biconvex. The color may be light yellow or just yellow. The main active ingredient is the substance nimesulide, in each tablet - 100 mg. Among a number of additional ones, microcrystalline cellulose, starch (corn), sodium starch glycolate, colloidal silicon dioxide can be called.
In addition, the drug is offered to consumers in the form of powders for the preparation of Nimesulide suspension. The composition is the same as that of tablets, in each bag 100 mg of the main active ingredient.
Pharmacodynamics
Nimesulide selectively inhibits cyclooxygenase-2, with respect to cyclooxygenase-1 its effect is manifested to a much lesser extent. In this regard, inhibition of prostaglandin synthesis, provoked by an inflammatory reaction, is observed. However, nimesulide has a barely noticeable effect on the formation of regulatory type prostaglandins, which leads to minimal side effects from the digestive system.
In addition, the effective action of nimesulide is manifested in the inhibition of the formation of free radicals. However, the processes of hemostasis and phagocytosis do not experience the effects of this substance. In the mechanism of the anti-inflammatory effect of the drug, a significant place is also played by its ability to suppress the release of myeloperoxidase (it can provoke tissue damage in many inflammatory diseases, is one of the most accurate diagnostic characteristics indicating a possible risk of heart attack or stroke).
Indications for use
The scope of the drug Nimesulide is wide enough. What helps this drug? Since the drug has a complex effect on the human body - antioxidant, analgesic, antipyretic and anti-inflammatory, then it is prescribed for a number of inflammatory diseases. The drug is also effective in the presence of osteoarthritis (chronic joint damage, especially articular cartilage is destroyed), tendonitis (inflammatory damage and degeneration of tendon tissues), bursitis (inflammation of the mucous bags, predominates in the joints).
Good results are shown by Nimesulide in the treatment of rheumatoid arthritis, extra-articular rheumatic diseases. Successfully fights against infectious diseases accompanied by inflammatory processes. Quite often, Nimesulide tablets are used in gynecology and in the treatment of injuries of various origins. Patients talk about the effective elimination of pain during postoperative rehabilitation.
Contraindications for taking "Nimesulide"
Since the drug belongs to the group of modern PVNS, it has a fairly extensive list of contraindications for use. "Nimesulide" (from which the medicine helps - was discussed earlier) should not be taken by people with hypersensitivity to any component in its composition. The drug is not prescribed for those patients who have a history of hepatotoxic reactions and hypersensitivity reactions in the form of rhinitis, bronchospasm, urticaria (when taking aspirin or other representatives of the NSAID group).
A contraindication to the use of the medication is the presence of any erosive and ulcerative lesions of the digestive system, a tendency to develop bleeding of any origin (i.e., deviations in the functioning of the blood coagulation system).
The medicine "Nimesulide" instruction prohibits taking patients suffering from renal, hepatic, heart failure. Patients with "aspirin" asthma, alcohol and drug dependence should also not take the drug.
Do not prescribe medication in cases where the patient has a fever or other flu symptoms are observed. In addition, it is unacceptable to take Nimesulide for children, pregnant and lactating women.
Possible adverse reactions to Nimesulide
The use of the medication can provoke a number of side effects from various organs and systems of the human body.
The most frequent reactions are recorded from the digestive system, and they are manifested by nausea, vomiting, diarrhea, the development of flatulence and gastritis. Less common are bleeding of the gastrointestinal tract, ulcers up to perforation. Occasionally, you can hear about dyspepsia, stomatitis, abdominal pain.
It is able to cause “Nimesulide” side effects from the hepatobiliary system, most often expressed in an increase in the level of liver enzymes, less often in the development of hepatitis (including fulminant), cholestatic jaundice.
We can speak about the reaction of the cardiovascular system if there is a steady increase in blood pressure, less often patients are concerned about heart palpitations, hemorrhages, hot flashes, and jumps in blood pressure.
The urinary system can react with the appearance of edema (not often), less often with urinary retention, hematuria, dysuria. Very rarely, the development of renal failure, interstitial nephritis, oliguria.
Possible reactions from the central nervous system are most often manifested by dizziness, general malaise, asthenia. Less commonly, one can hear about headaches, the development of doubt (the likeness of hypnotic sleep), Reye's syndrome (encephalopathy), and hypothermia (a decrease in body temperature below the level that is necessary to maintain normal metabolism). Occasionally one can hear about such reactions to Nimesulide as nervousness, anxiety, and nightmares.
As for the lymphatic system and the hematopoietic system, Nimesulide (instructions, reviews of health workers confirm this information) can occasionally provoke anemia, eosinophilia, thrombocytopenia, pancytopenic purpura develops even less often.
Rarely, but you can hear about metabolic disorders (hyperkalemia), the immune system (hypersensitivity, anaphylaxis), the organs of vision (blurred vision, blurred fields), the respiratory system, the mediastinum (shortness of breath, bronchospasm, asthmatic attacks). There have been reactions of the skin and subcutaneous tissue (increased sweating, itching, dermatitis, urticaria, erythema, very rarely toxic epidermal necrolysis, Stevens-Johnson syndrome).
Dosage regimen and application schedule
Adult patients are recommended to take Nimesulide tablets one at a time (100 mg) twice a day. It is preferable to do this after a meal and drink the medicine with enough water. If we are talking about powders for the preparation of a suspension, then the contents of one sachet are diluted in 100 ml of water. Adolescents over 12 years old do not need to change the dose, and this medication is forbidden for kids. In the case of treatment of elderly patients, dose adjustment is not performed.
For people suffering from liver failure, with creatine clearance in the range of 30-80 ml / min., The dosage is not adjusted. If this indicator is lowered (30 ml / min. Or less) - the medication is prohibited for use.
These are the main recommendations for taking Nimesulide. The dosage is selected minimally effective and for the shortest possible period, which will minimize the risk of negative effects. The maximum course of therapy with the use of Nimesulide should not exceed 15 days.
Exceeding the permissible dose: symptoms, treatment
When taking Nimesulide tablets, one must adhere to the dose recommended in the instructions or selected by the attending physician. Self-medication and (or) its uncontrolled use can lead to an overdose. In this case, the following symptoms are most often observed: nausea, vomiting, bleeding of the gastrointestinal tract, drowsiness, apathy, hypertension (high blood pressure), respiratory depression, acute renal failure.
Treatment in case of an overdose is symptomatic, is supportive in nature. Nimesulide antidote is currently absent. If more than 4 hours have passed since the overdose or taking a high dose of the medication, the patient undergoes gastric lavage in the hospital, it is recommended to take an absorbent (for example, activated carbon in the amount of 60-100 mg for adults) and some osmotic type laxative.
Throughout the entire period of treatment, health workers should carefully monitor the work of the liver and kidneys. Information on the possibility of removing nimesulide from the body using the hemodialysis procedure is not available. Due to the high degree of binding of the drug to proteins, forced diuresis will not be effective.
Special instructions
Nimesulide, a prescription for the purchase of which is not required in pharmacies, should nevertheless be taken with caution. The parallel use of the medication and any other non-steroidal anti-inflammatory drugs, concomitant analgesics should be avoided. If patients develop symptoms characteristic of liver damage (nausea, vomiting, anorexia, dark urine) or an increase in hepatic transaminases, the use of Nimesulide should be abandoned. If a fever or flu-like symptoms appear, therapy should be discontinued immediately.
Patients should be attentive to themselves who, along with Nimesulide, are taking medications that increase the risk of developing gastrointestinal ulcerations and bleeding. With caution, the drug is prescribed to those people who suffer from ulcerative colitis or Crohn’s disease, who have a history of ulcers, in elderly patients.
Persons who need to take Nimesulide in parallel with aspirin in cardiac doses should be given combination therapy with gastroprotectors.
The use of Nimesulide (or any other NSAIDs) in large volumes and over a long period of time leads to a slight increase in the risk of developing thromboembolic events (stroke, myocardial infarction, etc.).
Patients with various problems of the cardiovascular system "Nimesulide" can be prescribed only if the expected benefit will exceed the degree of risk of side effects.
The medication affects the degree of platelet activity. This information is important for patients with hemorrhagic diathesis. Severe skin lesions most often develop with prolonged use of Nimesulide. As soon as skin rashes appear, damage to the mucous membranes becomes noticeable or any other manifestations of intolerance are fixed, drug therapy should be discontinued.
The use of Nimesulide by pregnant women can provoke the closure of the botallal duct before it is necessary, a decrease in the volume of amniotic fluid. Perhaps an increase in the risk of intrauterine bleeding, a weakening of labor, the appearance of edema. For these reasons, expectant mothers during the first and second trimesters of pregnancy are not recommended to take "Nimesulide."
There must be an answer to the question of whether Nimesulide and alcohol can be taken at the same time: this combination is unacceptable!
Analogs
By analogs of “Nimesulide” we mean medicines from the NSAID group that contain nimesulide as the main active substance (the price of them will fluctuate in approximately the same range, but more on that below). The most well-known and often prescribed analogues by medics are Nise drugs (gel, tablets, suspension), Nimesil (powders), Nimica (tablets), Nimulide (gel, tablets, suspension, lozenges) .
All analogues are sufficiently effective and are prescribed to combat the widest range of inflammatory diseases.
Price range
Prices for Nimesulide itself and its analogues are approximately the same, although the medication we are considering is more affordable for a wide range of customers. Nimesulide tablets (20 pcs. In a pack) will cost 85-90 rubles per pack. The same amount of Niza tablets will cost 110-140 rubles, Nimiki (also 20 pcs.) - 115-134 rubles. Packaging "Nimulida" of 30 tablets costs 180-220 rubles. The content of the main active substance (nimesulide) in all analogues is the same - 100 mg.
Instead of Nimesulide tablets (the lowest price), you can buy, for example, a suspension of Nise at a price of 200-300 rubles per 60 ml or Nimulide - 75-105 rubles for the same volume of the drug. Nimulide resorption tablets are also available for a wide range of consumers: 20 units at a price of 130-155 rubles per pack.
Perhaps the most expensive form of the drug with nimesulide as the main component is Nimesil powders. 30 bags (packaging) will cost the consumer in the amount of 560 to 645 rubles.
For external use, gels with nimesulide are quite effective. So, “Nise” will cost the buyer 120-145 rubles per tube of 20 g or 215-275 rubles (50 g). Nimulid gel is slightly cheaper: 115-150 rubles per tube of 30 g.
In conclusion, I want to say the following. The decision on the use of Nimesulide, any analogue of it, or any other NSAIDs should be made by the attending physician. Only a health worker can correctly assess the severity of his patient’s health status, take into account all concomitant diseases, choose a drug, choose a dosage and develop a treatment regimen in order to minimize the likelihood of side effects and get the most positive result.