Tablets "Nimesulide." Instructions for use, reviews, analogues

Painful sensations are a kind of attempt of an organism to attract the attention of a person, the call for help. So, something is wrong in the "Danish kingdom", and the body's resources are not enough to solve the problem, we need outside support.

On the consumer pharmaceutical market in Russia are hundreds of drugs designed to help people cope with the pain. All medicines have different composition, scope and mechanism of influence. One of the most effective are medicines from the group of non-steroidal anti-inflammatory drugs. Among them there is a suspension and tablets "Nimesulide".

Composition and form of release

Round tablets have a biconvex shape. By color can be light yellow or just yellow. The main active ingredient is the substance nimesulide, in each tablet - 100 mg. Of a number of additional can be called microcrystalline cellulose, starch (corn), sodium starch glycolate, colloidal silicon dioxide.

In addition, the preparation is offered to consumers in the form of powders for the preparation of the Nimesulide suspension. The composition is the same as that of the 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 degree. In connection with this, inhibition of the synthesis of prostaglandins, provoked by an inflammatory reaction, is observed. However, the formation of prostaglandins of the regulatory type of nimesulide has a barely perceptible effect, which leads to minimal side effects on the part of the digestive system.

In addition, the effective action of nimesulide is manifested by inhibiting 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 (in many inflammatory diseases it can provoke tissue damage, 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 Nimesulide medication is quite wide. What helps with this drug? Since the drug has a complex effect on the human body - antioxidant, analgesic, antipyretic and anti-inflammatory, - it is prescribed for a variety of inflammatory diseases. The drug is also effective in the presence of osteoarthritis (chronic joint damage, articular cartilage is destroyed first), tendonitis (inflammatory defeat and dystrophy of tendon tissues), bursitis (inflammation of mucous bags, predominates in the joint region).

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, in the treatment of injuries of various origins. Patients speak about effective elimination of pain syndrome in the period of postoperative rehabilitation.

Contraindications for taking Nimesulide

Since the drug belongs to the group of modern PVNS, it has a fairly extensive list of contraindications to use. "Nimesulide" (from which the drug helps - it was considered earlier) should not be taken by people with hypersensitivity to any component in its composition. Do not prescribe the drug to patients who have a history of hepatotoxic reactions and hypersensitivity reactions in the form of rhinitis, bronchospasm, urticaria (with aspirin or other representatives of the NSAID group).

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).

The "Nimesulide" medication is forbidden for 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 when the patient has a fever or other symptoms of influenza. In addition, it is unacceptable to take Nimesulide to children, pregnant and lactating women.

Possible adverse reactions to Nimesulide

The use of a medicament can provoke a number of side effects from different organs and systems of the human body.

The most frequent reactions are fixed on the part of the digestive system, and they are manifested by nausea, vomiting, diarrhea, the development of meteorism and gastritis. Gastrointestinal bleeding, ulcers, up to perforation occur less often. 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 increasing the level of liver enzymes, less often in the development of hepatitis (including fulminant), cholestatic jaundice.

About the reaction of the cardiovascular system can be said, if there is a steady increase in blood pressure, less often patients are worried about heart palpitations, hemorrhages, hot flashes, blood pressure hops.

The urinary system can respond with the appearance of edema (not often), less often - with urine retention, hematuria, dysuria. It is very rare to develop renal failure, interstitial nephritis, oliguria.

Possible reactions from the central nervous system are most often manifested by dizziness, general malaise, asthenia. You can hear less about headaches, development of somnolence (similarity to hypnotic sleep), Reye's syndrome (encephalopathy), hypothermia (lowering of body temperature below the level necessary to maintain normal metabolism). Occasionally you can hear about such reactions to "Nimesulide", as nervousness, anxiety, nightmarish dreams.

With regard to the lymphatic system and hematopoiesis system, Nimesulid (instruction, reviews of health workers confirm this information) occasionally can provoke anemia, eosinophilia, even less often thrombocytopenia develops, pancytopenic purpura.

Rarely, but you can hear about metabolic disorders (hyperkalemia), the immune system (hypersensitivity, anaphylaxis), vision (blurred vision, clouding of fields), respiratory organs, mediastinum (shortness of breath, bronchospasm, asthmatic attacks). There were reactions of skin and subcutaneous tissue (increased sweating, itching, dermatitis, urticaria, erythema, very rarely - toxic epidermal necrolysis, Stevens-Johnson syndrome).

Dosage regimen and scheme of application

For adult patients, Nimesulide tablets are recommended to take one piece (100 mg) twice a day. It is preferable to do this after eating and drink the medicine with enough water. If we are talking about powders for the preparation of a suspension, the contents of one sachet are diluted in 100 ml of water. Teenagers over the age of 12 do not need to change the dose, and the kids are not allowed to take this medication. In the case of treatment of elderly patients, dose adjustment is not performed.

For people suffering from hepatic insufficiency, when creatine clearance is within 30-80 ml / min, dosages are not corrected. If this indicator is lowered (30 ml / min and less) - the medicine is prohibited for admission.

These are the main recommendations for taking Nimesulide. Dosage is selected minimally effective and for the shortest possible period, which minimizes the risk of negative effects. The maximum course of therapy with the use of "Nimesulide" should not exceed 15 days.

Excessive dose: symptoms, treatment

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 most common symptomatology is: nausea, vomiting, gastrointestinal bleeding, drowsiness, apathy, hypertension (high blood pressure), respiratory depression, acute renal failure.

Treatment in case of an overdose is symptomatic, has a supporting character. The antidote of nimesulide is currently absent. If more than 4 hours have not passed since the overdose or taking a high dose of the medicine, the stomach is washed in the hospital, absorption of the absorbent (for example activated carbon in the amount of 60-100 mg for adults) and some laxative osmotic-type preparation is recommended.

During the entire period of treatment, the health workers should carefully monitor the work of the liver and kidneys. Information on the possibility of removing nimesulide from the body through the procedure of hemodialysis 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, nevertheless must be taken with caution. Parallel use of the drug and any other non-steroidal anti-inflammatory drugs, concomitant analgesics should be avoided. When patients develop symptoms that are characteristic of liver damage (nausea, vomiting, anorexia, darkening of urine) or an increase in the level of hepatic transaminases from the use of Nimesulide should be discarded. If there is a fever or flu-like symptoms, therapy should be discontinued immediately.

Attentive to themselves should be patients who in parallel with the "Nimesulide" take medications that increase the risk of gastrointestinal ulceration and bleeding. With caution appoint the drug to people who suffer from ulcerative colitis or Crohn's disease, having a history of sores, elderly patients.

Individuals who need to take Nimesulide in parallel with aspirin in cardiac doses should be assigned a 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 thromboembolic events (stroke, myocardial infarction, etc.).

Patients with various cardiovascular problems "Nimesulide" can be appointed only if the expected benefit exceeds the risk of side effects.

Medication 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 mucous membranes becomes noticeable or any other manifestations of intolerance are fixed, therapy with medication should be discontinued.

The use of "Nimesulide" by pregnant women can provoke the closure of the botulinum duct before it is necessary, reducing the volume of amniotic fluid. Possible increased risk of intrauterine bleeding, weakened labor, the appearance of edema. For these reasons, future mothers during the first and second trimesters of pregnancy are not recommended for taking Nimesulide.

Should be, the answer to the question of whether Nimesulide and alcohol can be taken simultaneously is obvious: such a combination is unacceptable!

Analogues

"Nimesulide" analogs refer to medicines from the NSAID group containing nimesulide as the main active ingredient (the price for them will fluctuate approximately in the same range, but this is a little lower). The most famous and often prescribed medications to analogs include drugs "Nyz" (gel, tablets, suspension), "Nimesil" (powders), "Nimika" (tablets), "Nimulide" (gel, tablets, suspension, resorption tablets) .

All analogues have sufficient effectiveness and are assigned to combat the widest spectrum of diseases that are inflammatory.

Price range

Prices for the "Nimesulide" itself and its analogs are approximately the same, although the medication we are considering is more affordable for a wide range of customers. Tablets "Nimesulide" (20 pieces in a pack) will cost 85-90 rubles per package. The same number of tablets "Naise" will cost 110-140 rubles, "Nimiki" (also 20 pieces) - in 115-134 rubles. Packaging "Nimulida" of 30 tablets costs 180-220 rubles. The content of the main active substance (nimesulide) in all analogs is the same - 100 mg.

Instead of Nimesulide tablets (the lowest price), you can buy, for example, a suspension of Naise at a price of 200-300 rubles per 60 ml or Nimulid - 75-105 rubles for the same amount of the drug. Also available for a wide range of consumers are Nimulide resorption tablets: 20 pieces at a price of 130-155 rubles per package.

Perhaps the most expensive form of release of a drug with nimesulide as the main component is the powders "Nimesil". 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, "Nyz" will cost the buyer 120-145 rubles for a tube of 20 g or 215-275 rubles (50 g). Gel "Nimulide" is somewhat cheaper: 115-150 rubles per tube in volume of 30 g.

In conclusion, I want to say the following. The decision to apply Nimesulide, any of its analogs or any other NSAIDs should be made by the attending physician. Only a health professional can correctly assess the severity of his patient's health condition, take into account all the accompanying diseases, pick up a medicine, choose a dosage and develop a treatment regimen in order to minimize the chance of side effects and get the most positive result.