Nimesil is a medical drug that belongs to the group of anti-inflammatory non-hormonal agents. The active ingredient is nimesulide - a substance that relieves pain, lowers the temperature, fights the inflammatory process.
By its effect, Nimesil can be compared with such drugs as, for example, Ibuprofen, Diclofenac. All medicines in this group have a powerful systemic effect, but, these pills have much less effect on the state of the gastrointestinal tract. Nimesilom treats both adults and children with pain caused by injuries, rheumatic and infectious lesions, and feverish conditions.
Content
pharmachologic effect
Pharmacodynamics. Nimesulide is an anti-inflammatory nonsteroid drug (NSAID) from the sulfonamide group. Creates antipyretic analgesic and anti-inflammatory effect. Tablets act as an inhibitor of cyclooxygenase extracts, which is responsible for the formation of prostaglandins and inhibits mainly cyclooxygenase-2.
Pharmacokinetics:
- After ingestion, the drug is well absorbed in the digestive tract, reaching the highest concentration in the circulatory system after a few hours.
- Interaction with plasma proteins - 97.6%.
- The half-life of 3.3–5.5 hours.
Easily passes through histohematosis protection. It is metabolized in the liver due to the cytochrome isoenzyme. The main metabolite is hydroxynimesulidewhich comes out with bile in a metabolized form (is only in the form of glucuronate).
Nimesulide is excreted from the body, as a rule, only by the kidneys (approximately 52% of the dosage used). The pharmacokinetic profile of the pill in the elderly does not change while taking any doses.
Indications for use
Nimesil tablets is indicated for the following diseases:
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treatment of osteoarthritis symptoms; - treatment of acute painful sensations (back pain, back pain, pain in the muscular and skeletal system, toothache, bursitis, tendens);
- reduces inflammation and pain at the time of admission;
- algomenorrhea.
Dosage and method of use
Nimesil is indicated for ingestion, 1 tablet twice a day. The drug is recommended to use after meals. A drug stir with water, approximately 100 ml. Nimesil is only used to treat people over 12 years old.
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Adolescents (12–18 years): taking into account the pharmacodynamic characteristics and pharmacokinetic profile of nimesulide, there is no need for adolescent dosage adjustment. - People with impaired renal function: taking into account the pharmacokinetic profile, there is no need for dosage adjustment in people with moderate and mild renal insufficiency.
- People of old age: the need for adjusting the daily dose is determined by the doctor taking into account the interaction with other medicines. The maximum duration of the course is 2 weeks. To reduce the risk of side effects, you must take the minimum effective dose of medication.
Features of use
The drug should be used with caution in people with diseases of the gastrointestinal tract (Crohn's disease, ulcerative colitis), as possible exacerbation of these diseases. The risk of bleeding in the stomach, ulcers increases with increasing NSAID dosage in people with an ulcer history, especially complicated by perforation or bleeding, as well as in elderly people, because treatment must begin with the minimum effective dose.
In people taking drugs that inhibit platelet aggregation or reduce blood clotting, it also increases risk of stomach bleeding. If ulcers or bleeding occur, Nimesilom treatment should be stopped. Since the tablets partially come out with the help of the kidneys, the doses for people with impaired kidney function must be reduced, taking into account the degree of urination.
There is evidence of a negative reaction of the liver to the drug. If symptoms of a liver malfunction occur (yellowing of the skin integument, itching, vomiting, nausea, dark urine, stomach pain), it is necessary to finish taking the pills and consult a doctor.
Despite the rare occurrence of visual impairment in people who use Nimesulide together with other drugs, treatment should be immediately stopped. Tablets can retain fluid in the tissues, because people with high blood pressure and with impaired heart function Nimesil must be used very carefully.
Epidemiological data and clinical studies have shown that NSAIDs, with higher doses and prolonged use, lead to a slight at risk of stroke or heart attack.
Nimesil contains sucrose, which should be taken into account by people who have diabetes and patients on a low-calorie diet. A drug it is undesirable to appoint people with rare diseases such as lack of sucrose-isomaltose, malabsorption of galactose-glucose, or fructose intolerance.
The drug can change the properties of platelets, because care must be taken patients with hemorrhagic diathesis, and the drug does not replace the preventive effects of acetylsalicylic acid in cardiovascular diseases.
Like all NSAID drugs that inhibit the formation of prostaglandins, Nimesulide may adversely affect the course of pregnancy and lead to the following consequences:
- pulmonary artery hypertension;
- closure of the ductus arteriosus;
- increased risk of bleeding;
- renal impairment;
- the appearance of peripheral puffiness;
- lower uterine contractility.
Therefore, Nimesulide banned during pregnancy and during breastfeeding. The use of Nimesil adversely affects the fertility of women and is not desirable for patients who are planning a pregnancy.
Side effects Nimesila
Side effects from various systems:
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Allergic reactions: rash, itching, hypersensitivity reactions, excessive sweating, dermatitis, erythema, urticaria, anaphylactoid reactions, erythema multiforme, angioedema, Lyell's syndrome, Stevens-Johnson syndrome. - Lymphatic and circulatory system: eosinophilia, anemia, thrombocytopenia, hemorrhage, thrombocytopenic purpura, pancytopenia.
- Sense organs: blurred vision.
- CNTs: fear, dizziness, nightmares, nervousness, drowsiness, headache, encephalopathy.
- Respiratory system: bronchospasm, exacerbation of asthma, shortness of breath.
- Cardiovascular system: tachycardia, hypertension, hot flushes, pressure lability.
- Biliary system and liver: fulminant hepatitis, hepatitis, cholestasis, jaundice.
- Gastrointestinal tract: nausea, diarrhea, constipation, vomiting, gastritis, flatulence, stomach pain, stomatitis, dyspepsia, stomach bleeding, tarry stools, ulcers.
- The urinary system and kidneys: hematuria, dysuria, renal failure, urinary retention, interstitial nephritis, oliguria.
interaction with other drugs
Nimesulide when interacting with other drugs may cause:
- Selective serotonin inhibitors and antiplatelet drugs, for example, fluoxetine: increase the risk of bleeding in the stomach.
- Glucocorticosteroids: increase the risk of bleeding and stomach ulcers.
- Diuretics: the drug can reduce the effects of diurethins.
- Anticoagulants: the drug may increase the effects of anticoagulants, for example, warfarin. Due to the high risk of bleeding, co-administration of these drugs is undesirable and is contraindicated for people with improper coagulation function. If the complex combination is still impossible to avoid, you need to control the level of blood clotting.
Contraindications to the use of the drug
Contraindications include the following conditions:
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Hyperargic symptoms (in history), for example, urticaria, rhinitis, bronchospasm associated with the use of acetylsalicylic acid or other NSAIDs, including Nimesulide. Hypersensitivity to nimesulide or to any of the substances that is in the preparation. - The simultaneous use of drugs with severe hepatotoxicity, for example, paracetamol or other nonsteroidal or analgesic anti-inflammatory drugs.
- Hepatotoxic (in the anamnesis) symptoms on Nimesulide. Time in the process of coronary artery bypass surgery. The processes of inflammation or bowel disease, ulcerative colitis, Crohn's disease during the acute stage.
- Full or partial combination of recurrent polyposis of the paranasal sinuses or nose, bronchial asthma with acetylsalicylic acid immunity and other NSAIDs.
- Fever syndrome in acute respiratory infections and the common cold. The presence of cerebrovascular bleeding or other bleeding, diseases that are accompanied by bleeding.
- Duodenal ulcer or stomach ulcer at the stage of exacerbation, history of bleeding in the gastrointestinal tract, perforation or ulcer.
- Chronic heart failure. Weak blood coagulation. Hepatic failure or some kind of active liver disease. Chronic renal failure, hyperkalemia.
- Pregnancy and breastfeeding time. Children age less than 12 years. Drug addiction and alcoholism.
Caution must be taken if observed:
- severe diabetes;
- hypertension, coronary heart disease, heart failure;
- creatinine clearance less than 60 ml / min, hyperlipidemia / dyslipidemia, cerebrovascular diseases;
- smoking, peripheral artery disease, infections caused by Helicobacter pylori, severe somatic diseases, history of gastrointestinal ulcer;
- prolonged previous use of NSAIDs, old age.
Concomitant treatment allowed by such drugs: antiplatelet agents (for example, clopidogrel, acetylsalicylic acid), anticoagulants (for example, warfarin), reuptake inhibitors (for example, fluoxetine, citalopram, sertralin, paroxetine), oral glucocorticosteroids (for example, prednisone).
The decision to use Nimesil must be based on the patient's personal “risk-benefit” assessment during the use of this remedy.
Drug overdose
Signs: pain in the epigastric region, drowsiness, apathy, vomiting, nausea. During supportive treatment of gastropathy, these symptoms are usually reversible. There may be bleeding in the stomach. Sometimes respiratory depression, severe renal failure, increased blood pressure, anaphylactoid reactions, coma are likely.
Treatment: There is no specific antidote. In the case where an overdose occurred over a period of 5 hours, artificial vomiting should be induced and take osmotic laxative or activated carbon (70–120 g. for an adult).Hemodialysis, forced diuresis are ineffective due to the increased Nimesil bond with proteins (up to 97.6%). Requires monitoring of the liver and kidneys.
Treatment with Nimesil requires control and a serious attitude on the part of the doctor, if it is used simultaneously with diuretic and anti-inflammatory drugs, as well as with medical medicines that correct pressure.
Nimesil can have an effective anti-inflammatory and analgesic effect. However, it is necessary to use it not on the advice of friends and relatives, but only after doctor's recommendation. Only in this way you will not allow negative consequences, you need to clearly control the dosage of this drug.
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