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, outside support is needed.
On the consumer pharmaceutical market of the Russian Federation there are hundreds of drugs designed to help a person cope with pain. All medicines have a 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 release form
Round tablets have a biconvex shape. The color can be light yellow or just yellow. The main active ingredient is the substance nimesulide, each tablet contains 100 mg. Others include microcrystalline cellulose, starch (corn), sodium starch glycolate, colloidal silicon dioxide.
In addition, the drug is offered to consumers in the form of powders forpreparation of suspension "Nimesulide". The composition is the same as for tablets, each sachet contains 100 mg of the main active ingredient.
Pharmacodynamics
Nimesulide selectively inhibits cyclooxygenase-2, with respect to cyclooxygenase-1 its effect is much less pronounced. In this regard, inhibition of the synthesis of prostaglandins, provoked by an inflammatory reaction, is observed. However, nimesulide has a barely perceptible effect on the formation of prostaglandins of the regulatory type, 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 are not affected by this substance. In the mechanism of the anti-inflammatory effect of the drug, its ability to suppress the release of myeloperoxidase also occupies a significant place (in many inflammatory diseases it can provoke tissue damage, it is one of the most accurate diagnostic characteristics indicating a possible risk of developing a heart attack or stroke).
Indications for use
The scope of the drug "Nimesulide" is quite wide. What helps this drug? Since the drug has a complex effect on the human body - antioxidant, analgesic, antipyretic and anti-inflammatory - it is prescribed for a number of inflammatorydiseases. The drug is also effective in the presence of osteoarthritis (chronic damage to the joints, articular cartilage is destroyed first of all), tendinitis (inflammatory damage and degeneration of tendon tissues), bursitis (inflammation of the mucous bags, predominant in the joints).
Good results are shown by "Nimesulide" in the treatment of rheumatoid arthritis, extra-articular rheumatic diseases. Successfully fights infectious diseases accompanied by inflammatory processes. Quite often, Nimesulide tablets are used in gynecology, 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. Do not prescribe the drug to those patients who have a history of hepatotoxic reactions and hypersensitivity reactions in the form of rhinitis, bronchospasm, urticaria (when taking aspirin or other members of the NSAID group).
A contraindication to the use of the drug 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).
Medication"Nimesulide" instructions prohibit 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 if the patient has a fever or other flu-like symptoms. In addition, it is unacceptable to take "Nimesulide" for children, pregnant and lactating women.
Possible adverse reactions to Nimesulide
The use of the drug can provoke a number of side effects from different 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.
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 talk about the reaction of the cardiovascular system if there is a steady increase in blood pressure, less often patients are worried about heart palpitations, hemorrhages, hot flashes, jumps in blood pressure.
The urinary system may react with the appearance of edema (not often), less often - urinary retention, hematuria, dysuria. Rarely, renal failure may develop.interstitial nephritis, oliguria.
Possible reactions from the central nervous system are most often manifested by dizziness, general malaise, asthenia. Less commonly, you can hear about headaches, the development of somnolence (similar to hypnotic sleep), Reye's syndrome (encephalopathy), hypothermia (decrease in body temperature below the level that is necessary to maintain normal metabolism). Occasionally, you can hear about such reactions to Nimesulide as nervousness, anxiety, nightmares.
As for the lymphatic system and the hematopoietic system, "Nimesulide" (instruction, reviews of he alth workers confirm this information) can occasionally provoke anemia, eosinophilia, thrombocytopenia, pancytopenic purpura develop even less often.
Rarely, but you can hear about violations of metabolic processes (hyperkalemia), immune system (hypersensitivity, anaphylaxis), organs of vision (impaired vision, blurred fields), respiratory organs, 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).
Dosing regimen and scheme of application
Adult patients are advised 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 a sufficient amount of water. If we are talking about powders for the preparation of a suspension, then the contents of one sachetdiluted in 100 ml of water. Adolescents over 12 years of age do not need to change the dose, and this medication is prohibited for babies. In the case of treatment of elderly patients, dose adjustment is not made.
For people suffering from hepatic insufficiency, with creatine clearance in the range of 30-80 ml / min, dosages are not adjusted. If this indicator is lowered (30 ml / min. or less), the medication is prohibited.
These are the main recommendations for taking Nimesulide. The dosage is selected to be minimally effective and for the shortest possible period, which will minimize the risk of negative effects. The maximum course of therapy with Nimesulide should not exceed 15 days.
Overdose: symptoms, treatment
When taking Nimesulide tablets, you must adhere to the dose recommended in the instructions or selected by your doctor. Self-administration of the 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 overdose is symptomatic and supportive. There is currently no antidote for nimesulide. If more than 4 hours have not passed since the overdose or taking a high dose of the drug, the patient is given a gastric lavage in the hospital, it is recommended to take an absorbent (for example,activated charcoal 60-100 mg for adults) and some kind of osmotic laxative.
During the entire period of treatment, the work of the liver and kidneys should be carefully monitored by he alth workers. Information on the possibility of removing nimesulide from the body using the hemodialysis procedure is not available. Due to the high degree of drug binding to proteins, forced diuresis will not be effective.
Special Instructions
Nimesulide, which does not require a prescription in pharmacies, should nevertheless be taken with caution. The concomitant use of the drug and any other non-steroidal anti-inflammatory drugs, concomitant analgesics should be avoided. With the development in patients of symptoms characteristic of liver damage (nausea, vomiting, anorexia, darkening of urine) or an increase in the level of hepatic transaminases, the use of Nimesulide should be abandoned. If fever or flu-like symptoms develop, therapy should be discontinued immediately.
Patients who, in parallel with Nimesulide, take medications that increase the risk of gastrointestinal ulceration and bleeding should be attentive to themselves. Prescribe the drug with caution to those people who suffer from ulcerative colitis or Crohn's disease, with a history of ulcers, elderly patients.
Persons who need to take "Nimesulide" in parallel with aspirin in cardiological doses should be prescribed 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.).
Nimesulide can only be prescribed to patients with various problems of the cardiovascular system if the expected benefit outweighs the risk of side effects.
The drug affects the degree of platelet activity. This information is important for patients suffering from 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 recorded, drug therapy should be discontinued.
The use of "Nimesulide" by pregnant women can provoke the closure of the ductus botulinum before it is necessary, a decrease in the volume of amniotic fluid. There may be an increased risk of intrauterine bleeding, weakening of labor, the appearance of edema. For these reasons, expectant mothers are not recommended to take Nimesulide during the first and second trimesters of pregnancy.
The answer to the question of whether Nimesulide and alcohol can be taken at the same time is obvious: such a combination is unacceptable!
Analogues
Under the analogues of "Nimesulide" means medicines from the group of NSAIDs containing as the mainactive ingredient nimesulide (the price for them will fluctuate approximately in the same range, but more on that below). The most famous and frequently prescribed analogues by he alth workers include the preparations "Nise" (gel, tablets, suspension), "Nimesil" (powders), "Nimika" (tablets), "Nimulid" (gel, tablets, suspension, lozenges).
All analogues are sufficiently effective and are prescribed to combat the widest range of inflammatory diseases.
Price range
The prices for Nimesulide itself and its analogues are approximately the same, although the medicine we are considering is more affordable for a wide range of buyers. Tablets "Nimesulide" (20 pieces in a pack) will cost 85-90 rubles per pack. The same number of Nyza tablets will cost 110-140 rubles, Nimiki (also 20 pcs.) - 115-134 rubles. A package of "Nimulid" of 30 tablets costs 180-220 rubles. The content of the main active ingredient (nimesulide) in all analogues is the same - 100 mg.
Instead of Nimesulide tablets (the lowest price), you can purchase, for example, a Nise suspension at a price of 200-300 rubles per 60 ml or Nimulide - 75-105 rubles for the same amount of the drug. Nimulid lozenges are also available for a wide range of consumers: 20 pieces at a price of 130-155 rubles per pack.
Perhaps the most expensive form of drug release with nimesulide as the main component is Nimesil powders. 30 bags (packing) will cost the consumer from 560 to 645 rubles.
For outdoorapplication, gels with nimesulide are quite effective. So, "Nise" will cost the buyer 120-145 rubles for a tube of 20 g or 215-275 rubles (50 g). Gel "Nimulid" is somewhat cheaper: 115-150 rubles for a tube of 30 g.
In conclusion, I would like to say the following. The decision to use Nimesulide, any of its analogues or any other NSAIDs should be made by the attending physician. Only a he alth worker can correctly assess the severity of his patient's he alth condition, 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.
