Non-steroidal anti-inflammatory drugs are a special class of drugs with three significant effects: anti-inflammatory, antipyretic and analgesic. Due to such pharmacodynamic features, this group of drugs is widely used in practical medicine. Let's look at the features of the use of the drug "Nimesulide", patient reviews about this drug, as well as possible adverse effects and dosage features.
Pharmacodynamic features
Nimesulide is a representative of a group of non-steroidal anti-inflammatory drugs. In its group, the drug belongs to selective inhibitors of the enzyme cyclooxygenase-2, which effectively suppresses the production of prostaglandins in the focus of inflammation.
Another distinctive feature in the mechanism of action of the drug "Nimesulide" is its ability to inhibit the release of an enzyme called myeloperoxidase, which significantly inhibits the production of free radicals without affecting the processes of chemo- and thymotaxis, as well as phagocytosis. In addition, Nimesulide helps to inhibit the formation of tumor necrosis factor and other mediators involved in inflammatory reactions of the body.
Pharmacokinetic features
The main route of administration of this drug is oral, due to the high bioavailability of the drug, the rate at which the maximum plasma concentration of patients is reached. Thus, the highest concentration is achieved after 120-180 minutes after administration, and the degree of binding of the drug to blood plasma proteins is close to 98% of the initially administered amount of the Nimesulide drug (reviews of patients and doctors confirm this).
The main organ in which the drug is metabolized is the liver. In the process of biotransformation, an active metabolite is formed under the name of hydroxy-nimesulide. The main route of drug excretion is its urinary excretion (about 65% of the drug is excreted in this way), about 35% of the drug is excreted in the fecal mass.
Almost all patients are interested in taking any additional information about Nimesulide before taking it. Instructions for use, analogues, indications and contraindications, side effects are the most frequently asked questions.
Indications for use
Indications for the appointment of the drug "Nimesulide" is not so much. Among them, it is worth noting an acute pain syndrome, primary osteoarthritis with a pain syndrome, as well as a primary occurring dysmenorrhea. In pediatric practice, the use of the drug is also effective. This is evidenced by the reviews left about taking Nimesulide. For children under 12 years of age, it is not recommended to purchase it - this should be remembered.
Contraindications
Like all non-steroidal anti-inflammatory drugs, Nimesulide is contraindicated in the presence of peptic ulcer or duodenal ulcer (duodenal ulcer) in the acute stage, decreased liver detoxification function, while prescribing a drug with hepatotoxic drugs. The drug is contraindicated for use in individuals with a significant decrease in renal excretory function (creatinine clearance less than 30 ml / min), hematological disorders and problems of the blood coagulation system, in patients with impaired cardiovascular system.
"Nimesulide" is contraindicated in patients with surgical pathology, pregnant and breastfeeding, as well as children under 12 years of age due to the high likelihood of adverse reactions. Do not prescribe Nimesulide for the treatment of influenza and flu-like conditions, hyperthermia.
Side effects
This tool is characterized not only by high anti-inflammatory activity, but also by a high incidence of adverse reactions. They occur, as a rule, during the first week of therapy with the drug "Nimesulide." Reviews regarding the occurrence of side effects leave much to be desired.
On the part of the skin and skin, side effects are associated with allergic manifestations and reactions to the drug, which are manifested in the form of skin itching and rash, dermatitis, redness, urticaria. Side effects such as toxic epidermal necrolysis and Stevens-Johnson syndrome are much less common.
From the gastrointestinal tract, the occurrence of bleeding, perforation of ulcerative defects is quite rare. More often, pain occurs in the epigastric region, nausea, vomiting, diarrhea, or constipation.
From the side of the central nervous system, the occurrence of apathy, excessive drowsiness, constant headaches and unreasonable dizziness, vestibular disorders can occur.
On the part of the hematopoietic system and the cardiovascular system, the development of eosinophilia, thrombocytopenia and pancytopenia, anemic syndrome, tachycardia, increased blood pressure, and development of hyperkalemia are possible.
The use of Nimesulide and reviews
The use of Nimesulide has firmly taken its place in the clinical practice of rheumatological diseases of the musculoskeletal system. Despite significant limitations in the indications for the drug "Nimesulide", reviews about it are positive due to its high effectiveness in the treatment of rheumatic diseases. This is due to the specificity of the effect on cyclooxygenase-2 and a high degree of selectivity for this enzyme.
special instructions
What should I be wary of when taking a drug like Nimesulide? Instructions for use, patient reviews inform about some warnings. An important point in the appointment of the drug "Nimesulide" is the use of the minimum therapeutic dose of the drug. In the absence of the effectiveness of the drug with minimal dosing, the drug should be stopped.
In the case of the development of the hepatotoxic effect of the drug (which is monitored by biochemical blood parameters), the drug should also be stopped immediately. This group of patients (who develop cellular liver damage) is further prohibited from prescribing Nimesulide. It should be noted that even in the absence of side effects from the liver, the drug should not be combined with hepatotoxic drugs, other non-steroidal anti-inflammatory drugs, analgesics. It is also worth refraining from drinking alcohol.
Nimesulide should be used with caution in patients with hepatic or renal failure to avoid the risk of their progression.
Particular attention should be paid to the appointment of the drug to patients with flu-like symptoms. This is due to the fact that Nimesulide has an antipyretic effect and is able to mask the manifestations of a bacterial infection.
Drug interactions
Due to the high ability of the drug to cause intestinal bleeding, Nimesulide should not be combined with anticoagulants such as Warfarin, as there is a high risk of side effects.
The ability of the drug to disrupt the function of cytochrome P450 is known. Due to the inhibition of the functional activity of this enzyme, the dose of drugs metabolized by this cytochrome should be revised downward.
Nimesulide: analogues, reviews
The main analogues (according to the active substance) are Nimid, Nimesil, Remesulide, Toro-Sanovel. The drug is available in tablet form, sachet of 100 mg or in gel form of 10 mg (in 1 g of gel). The therapeutic activity of the analogues of the drug is good, therefore, patients' reviews about them are also positive. Patients leaving reviews about Nimesulide, tablets get less than the drug in the form of sachets.
Conclusion
Nimesulide is a powerful anti-inflammatory drug for the treatment of inflammatory diseases, mainly the musculoskeletal system. Due to the high risk of side effects, it is imperative to consult with your doctor about taking Nimesulide. The reviews of the doctors prescribing this drug and the patients taking it are positive, since it helps to quickly reduce the symptoms of the disease.