Nise - instructions for use. The drug "Nise" (tablets): composition, properties and indications for use Nise active substance

Instructions

The drug Nise 100 is used to prevent and eliminate inflammation and pain of various origins. Considering that its active ingredient is safe for the body, the medication can be given not only to adults, but also to children over 3 years old.

Name

Tradename

International nonproprietary name

Nimesulide (Nimesulide).

Latin name

Pharmacological group

COX-2 inhibitors. NSAIDs (non-steroidal anti-inflammatory drugs).

Release forms and composition

The anti-inflammatory drug is produced in tablet form. Each tablet contains 100 mg of nimesulide, which is the active ingredient of the medicine. Additionally it contains:

3 mg magnesium stearate;
2 mg colloidal silicon dioxide;
1 mg talc;
35 mg sodium carboxymethyl starch;
54 mg corn starch;
40 mg microcrystalline cellulose;
75 mg calcium hydrogen phosphate.

Mechanism of action

Pharmacodynamics

The drug belongs to the group of sulfonanilides. Suppresses the production of prostaglandins in the inflammatory focus. The medication has antipyretic, analgesic and anti-inflammatory effects.

The drug has a high level of absorption after oral administration. Food inhibits this process, but does not affect its severity.

The maximum concentration of nimesulide in blood plasma is achieved in 1.5-3 hours. It binds 95% to plasma proteins, up to 1% to lipoproteins, and 2% to erythrocytes.

Pharmacokinetics

The half-life is from 1.5 to 5 hours. Excreted in bile and urine. In elderly patients, children and people with kidney failure, the pharmacokinetic properties of the drug change slightly.

What are Nise 100 tablets for?

NSAIDs are used by patients with the following pathologies and conditions:

rheumatic and non-rheumatic forms of myalgia;
osteoarthritis;
osteochondrosis accompanied by radicular syndrome;
spondylitis of ankylosing type;
arthritis (psoriatic);
acute stage of gout, accompanied by inflammation of the joints;
bursitis, inflammation of tendons, ligaments;
pain of various origins.

Contraindications

The main restrictions on taking NSAIDs:

age under 3 years;
severe liver disorders and renal failure;
gastrointestinal bleeding;
exacerbation of peptic ulcer disease;
skin damage;
individual intolerance to nimesulide and additional ingredients of the anti-inflammatory drug.

The medicine is prescribed with caution to persons with a history of peptic ulcers, ulcerative colitis and Crohn's disease.

Directions for use and dosage Nise 100

Adults are prescribed dosages of 100 mg twice a day. The maximum amount of medication per day is 400 mg.

Considering that food intake slows down the absorption of the active substance, it is better to use the drug 30-50 minutes after eating. The tablets can be dissolved in a teaspoon of clean and warm water.

Children from 3 to 12 years old medicine prescribed in an amount of 3-5 mg per 1 kg of weight two to three times a day. The maximum daily dose is 5 mg per 1 kg of body weight in 2-3 doses.

For adolescents whose body weight exceeds 40 kg, the medicine is prescribed in the same dosage as for adults.

Does Nise 100 cause side effects?

NSAIDs sometimes cause the following negative effects:

digestive system: abdominal pain, diarrhea, increased activity of transaminases in the liver, toxic form of hepatitis, heartburn, nausea;
nervous system: dizziness, migraine;
hematopoietic system: anemia, thrombocytopenia, agranulocytosis;
SSS: increase blood pressure;
immunity: Quincke's edema, itching and rashes on the skin, bronchial spasms;
others: prolongation of bleeding, fluid retention in the body, hematuria.

Overdose

May manifest as vomiting, fatigue and apathy. Negative symptoms are eliminated with supportive treatment measures. There is a risk of respiratory depression, exacerbation of kidney failure, development of arterial hypertension and bleeding in the intestines.

Therapy is supportive and symptomatic. The medicine does not have an antidote substance. Hemodialysis and forced diuresis do not have the desired effect.

special instructions

In cases of visual and renal impairment, NSAIDs are prescribed with caution.

Long-term drug therapy requires regular monitoring of the condition of the kidneys and liver.

During pregnancy and lactation

The use of NSAIDs is contraindicated during pregnancy. If there is a need to take it during lactation, then from breastfeeding should be refused.

In childhood

NSAIDs are prescribed to children from 3 years of age.

In old age

For impaired renal function

Prescribed with caution.

For liver dysfunction

In such patients, NSAIDs are used with caution.

Effect on concentration

Given that NSAIDs can cause dizziness and fatigue, you need to be vigilant when using automobile transport and other mechanisms.

Drug interactions

With other drugs

A mutual enhancement of the pharmacotherapeutic effect is possible when NSAIDs are combined with anticoagulants, antihypertensive drugs, diuretics, Digoxin, lithium drugs, Phenytoin, Methotrexate, Cyclosporine, oral hypoglycemics and other non-inflammatory anti-inflammatory drugs.

Alcohol compatibility

The drug is incompatible with alcohol, so you should refrain from drinking such drinks during the treatment period.

Storage conditions and periods

Tablets should be stored at room temperature, away from moisture and light. Their shelf life is 2 years.

Conditions for dispensing from pharmacies

Is it sold without a prescription?

A prescription is required to purchase NSAIDs.

What is the price?

From 196 rub. for 20 tablets.

Analogs

In Russian pharmacies you can find the following anti-inflammatory drug substitutes:

Nise nimesulide;
Nimesan;
Nemulex;
Nimika;
Nimulid;
Nimesil.

"Nise" is a non-steroidal anti-inflammatory drug. The medicine is an effective antipyretic and analgesic drug. “Nise” in tablets, the instructions for use recommend taking it for pain in the joints, after injuries, painful dental and menstrual symptoms. The medication is used to reduce temperature during infectious pathologies.

Composition and varieties

The product is produced in the form of tablets, gel and suspension. The active element of the drug "Nise" is. The tablet form of the drug contains 50 or 100 mg of the active substance. It comes to pharmacies in blisters containing 10 regular or dispersible tablets, complete with instructions for use.

Gel "Nise" contains 10 mg of nimesulide in each gram. Designed for outdoor use. Sold in aluminum tubes of 20 g. The suspension is intended for internal use. Produced in 60 ml bottles with a dispenser cap.

Pharmacology

The popularity is due to the analgesic, anti-inflammatory and antipyretic effect that “Nise” tablets have, which helps the drug with inflammation, pain and high temperature. The properties of the drug are manifested due to the ability of the active component to stop the action of the enzyme cyclooxygenase, which promotes the reproduction of leukotrienes and prostaglandins. These substances provoke inflammation in the body, causing pain and swelling. Cell death in a patient leads to intoxication, which causes an increase in temperature.

The medicine "Nise" counteracts the harmful effects of leukotrienes and prostaglandins, facilitating the functioning of affected organs. The remedy acts regardless of the location of the inflammation and the factors that caused the pain symptoms. Thanks to this, Nise tablets help relieve pain in many diseases and conditions:

menstruation;
headache;
dental;
neuralgia;
injuries;
joint pathologies.

The drug reduces the severity of inflammation regardless of the cause that caused it: injury, infection, autoimmune abnormalities. In terms of antipyretic effect, Nise tablets are superior to drugs like Aspirin, Ibuprofen, Paracetamol, and in anti-inflammatory effect - Piroxicam, Diclofenac, Indomethacin. Thanks to the existence of the external form, the range of use of the medicine is expanding. For pain in muscles and joints, use the gel. And to enhance the effect, supplement with oral administration of the drug.

The drug also has antiplatelet properties and reduces the likelihood of blood clots due to the suppression of platelet activity. In this way, “Nise” resembles the effect of the drug “Acetylsalicylic acid”.

What does Nise help with?

Tablets, as well as suspension and gel are prescribed for the following indications and conditions:

painful menstruation;
radiculitis;
toothache;
arthritis with psoriasis and rheumatism;
headache;
ankylosing spondylitis;
inflammation of tendons and ligaments;
acute articular syndrome due to gout or rheumatism;
bursitis;
sciatica;
pain after surgery;
osteochondrosis;
post-traumatic pain;
lumbago;
ligament rupture;
arthritis of various etiologies;
febrile conditions caused by inflammation, infection and other factors;
myalgia;
osteoarthritis;
arthralgia;
inflammations caused by bruises, injuries, soft tissue ulcers.

Instructions for use

Adults should take Nise tablets or suspension 2 times a day in a volume of 100 mg. The maximum daily dose should not exceed 0.4 g. Therapy is carried out for 10 days. Take the medicine before meals. Dispersible capsules are dissolved in a spoon of water and consumed after meals.

Children under 3 years of age are given the medicine “Nise” only in the form of a suspension. Until the age of 12, suspensions and dispersible capsules are prescribed; after 12 years, you can take regular tablets. The dosage for children, all of whom are less than 40 kg, is calculated according to their body weight. Per 1 kg of weight there should be from 3 to 5 mg of medication. For heavier weights, an adult dosage of 100 mg is prescribed. Take the medicine 2-3 times a day.

Nise gel is applied to the affected areas in a thin layer and rubbed in with soft circular movements until absorption. No more than 30 mg of ointment can be used per day. Treatment is carried out for 10 days.

Contraindications

“Nise” in tablets and suspensions should not be taken if:

hypersensitivity to the composition;
bronchial asthma;
aspirin triad, nasal polyposis;
exacerbation peptic ulcer stomach and intestines;
hemophilia;
renal failure;
blood clotting abnormalities;
liver dysfunction and concomitant diseases;
bleeding of the stomach or intestines;
decompensatory heart failure;
acute intestinal inflammation;
hyperkalemia;
after coronary artery bypass surgery (2-3 months);
alcoholism or drug addiction;
children under 2 years old;
pregnant and nursing mothers.

Side effect

When using the drug "Nise" in various forms Negative reactions of the body may be observed:

stomach pain;
vomiting and nausea;
toxic hepatitis;
heartburn;
ulcers and erosions of the stomach or intestines;
diarrhea;
bronchospasm;
hematuria;
headache;
agranulocytosis;
leukopenia;
fluid retention;
dizziness;
thrombocytopenia;
anemia;
anaphylactic shock.

The gel may cause skin reactions, itching, discoloration and flaking. When used over large areas, systemic side effects may occur.

Analogues and price

The following drugs have identical active substances: Nimesulide, Prolide, Aulin, Kokstral, Aktasulide. Medicines have a similar effect: “Diclofenac”, “Ketonal”, “”, “”. You can buy Nise tablets, the price of which is about 200 - 300 rubles, at the pharmacy. The gel costs 300 – 400 rubles.

Conditions of release and storage

Nise can be purchased without a doctor's prescription.

Shelf life: 2 years. The medicine should be stored at room temperature, in a dry, dark place, out of the reach of children.

Patient opinions

Most reviews about Nise tablets are positive. Patients indicate the high effectiveness of the drug. Patients confirm that after taking the drug, muscle pain, neuralgia, and radiculitis are left for 8 to 12 hours. This allows you to feel normal by taking a tablet in the morning and before bed. Reviews also speak of the high effectiveness of the medicine at elevated temperatures.

Doctors recommend giving the drug to children with fever only if Paracetamol and Ibuprofen do not produce results. The medication should not be abused. However, compared to the lytic mixture, “Nise” is less harmful to the child. People give full information about the use of the gel positive reviews, indicating that it shows good analgesic and anti-inflammatory results.

Nimesulide is an active substance that has anti-inflammatory, analgesic and antipyretic properties. Nimesulide selectively inhibits COX-2 and inhibits the synthesis of prostaglandins at the site of inflammation. Nimesulide inhibits the release of the enzyme myeloperoxidase, and also inhibits the formation of free oxygen radicals, without affecting the processes of phagocytosis and chemotaxis, and inhibits the formation of tumor necrosis factor and other inflammatory mediators.
After oral administration, nimesulide is quickly absorbed into the gastrointestinal tract. The maximum concentration in the blood plasma is determined after 2-3 hours. The binding of nimesulide to plasma proteins reaches 97.5%.
The drug is metabolized in the liver, the main product of metabolism is hydroxynimesulide, a pharmacologically active substance. About 65% of the administered dose of nimesulide is excreted in the urine, the remaining 35% in feces.

Indications for use of the drug Nise

Acute pain; symptomatic treatment of osteoarthritis with pain syndrome; primary dysmenorrhea.

Use of the drug Nise

In order to prevent the occurrence and to reduce the severity of adverse reactions, the drug should be taken for the shortest possible time and in the minimum effective dose. The drug should be prescribed only after a careful assessment of the risk/benefit ratio.
The drug is taken orally after meals and washed down with a sufficient amount of liquid.
For adults and children over 12 years old - 1 tablet (100 mg) 2 times a day - morning and evening.
The suspension is prescribed to adults and children over 12 years of age at a dose of 100 mg (10 ml) 2 times a day after meals. The maximum daily dose is 200 mg.
The maximum duration of treatment is 15 days.
For elderly patients, this dosage regimen does not require correction.

Contraindications to the use of the drug Nise

peptic ulcer and duodenum in the acute stage; severe liver dysfunction (liver failure) and a history of hepatotoxic reactions to taking the drug, simultaneous use with potentially hepatotoxic drugs; severe renal dysfunction (creatinine clearance less than 30 ml/min), severe blood clotting disorders; severe heart failure; hypersensitivity to nimesulide or any other component of the drug, as well as a history of hypersensitivity reactions to other NSAIDs; period of pregnancy (III trimester) and breastfeeding; children under 12 years of age; alcoholism, drug addiction; elevated body temperature, flu-like condition, suspicion of acute surgical pathology.

Side effects of the drug Nise

When using the drug, the following side effects may occur, mainly during the 1st week from the start of treatment:
from the skin: most often - rash, itching, increased sweating, erythema, dermatitis; in some cases - angioedema, facial edema, erythema multiforme, urticaria, Stevens-Johnson syndrome and toxic epidermal necrolysis;
from the gastrointestinal tract: nausea, gastritis, abdominal pain, diarrhea, constipation, flatulence; in some cases - stomatitis, melena, peptic ulcer of the stomach or duodenum, perforation of the ulcer or gastrointestinal bleeding;
from the liver: jaundice, cholestasis, increased levels of liver transaminases, sometimes cases of acute hepatitis are possible, even with a fatal outcome;
from the central nervous system: drowsiness, headache, dizziness, encephalopathy (Reye's syndrome);
mental disorders: feeling of anxiety, nervousness, nightmares;
from the kidneys: edema, dysuria, hematuria, urinary retention, isolated cases of oliguria, interstitial nephritis and renal failure;
from the blood system: anemia, eosinophilia, isolated cases of pancytopenia, purpura and thrombocytopenia;
from the immune system: hypersensitivity reactions, anaphylaxis;
from the respiratory system: dyspnea, in some cases - asthma, bronchospasm, especially in patients with hypersensitivity to acetylsalicylic acid and other NSAIDs;
from the cardiovascular system: tachycardia, hypertension (arterial hypertension), rarely - bleeding, hot flashes, blood pressure fluctuations. Also, while taking the drug, blurred vision, asthenia, hypothermia, and hyperkalemia are possible.

Special instructions for the use of the drug Nise

To reduce the risk of developing side effects it is necessary to use the minimum effective dose with the shortest duration of treatment. If the patient's condition does not improve, treatment should be stopped.
If liver enzyme levels increase or signs of liver damage are detected (for example, anorexia, nausea, vomiting, abdominal pain, feeling tired, dark urine), the drug should be discontinued. Such patients are prohibited from further prescribing nimesulide.
During treatment with nimesulide, it is recommended to avoid simultaneous use hepatotoxic drugs, analgesics, other NSAIDs, and also refrain from drinking alcohol.
Gastrointestinal bleeding or ulcer/perforation may develop at any time while using the drug, with or without warning symptoms, with or without a history of gastrointestinal complications. If gastrointestinal bleeding or ulcers occur, the drug should be discontinued.
Nimesulide should be prescribed with caution to patients with gastrointestinal disorders, ulcerative colitis or Crohn's disease in history.
The drug should be prescribed with caution to patients with renal or heart failure, as its use may lead to deterioration of renal function. If renal function decreases, the drug must be discontinued.
Elderly patients most often develop side effects due to taking the drug, including gastrointestinal bleeding, perforation, dysfunction of the heart, kidneys and liver. Therefore, regular clinical monitoring of the patient's condition is recommended.
Since nimesulide can increase platelet function in patients with hemorrhagic diathesis, it should be used with caution and under constant monitoring.
The use of NSAIDs may mask the increase in body temperature associated with an underlying bacterial infection. If your body temperature rises or flu-like symptoms appear, you should stop taking the drug.
Children
The drug is contraindicated in children under 12 years of age. Dosing for children over 12 years of age is the same as for adults.
Use during pregnancy or breastfeeding
The use of nimesulide is contraindicated in the last trimester of pregnancy.
The use of nimesulide may interfere with female fertility and is therefore not recommended for women who are planning to become pregnant. Like other NSAIDs that inhibit prostaglandin synthesis, nimesulide can cause premature closure of the ductus botalus, pulmonary hypertension, oliguria, and oligohydramnios. The risk of bleeding, uterine atony and peripheral edema increases. Considering also the lack of data regarding the use of the drug during pregnancy, it is not recommended to prescribe nimesulide in the 1st and 2nd trimester of pregnancy.
Since it is unknown whether nimesulide passes into breast milk, its use is contraindicated during breastfeeding.
The ability to influence reaction speed when driving a vehicle or working with other mechanisms
During treatment, caution must be exercised when driving vehicles and engaging in other potentially dangerous species activities that require increased concentration and speed of psychomotor reactions.

Nise drug interactions

When used simultaneously with warfarin and similar anticoagulants, acetylsalicylic acid, there is an increased risk of bleeding.
The simultaneous use of nimesulide and furosemide requires caution when treating patients with impaired renal and cardiac function.
NSAIDs reduce the clearance of lithium, which leads to increased plasma lithium concentrations and increased toxicity. Therefore, when using nimesulide and lithium simultaneously, it is necessary to carefully monitor the concentration of lithium in the blood plasma.
When nimesulide was used simultaneously with digoxin, theophylline, glibenclamide, ranitidine, and antacids, no clinically significant interaction was observed.
Nimesulide inhibits the action of the CYP2C9 enzyme. Therefore, the plasma concentration of drugs that are affected by this enzyme can be increased when used simultaneously with nimesulide.
Caution should be exercised if the drug is taken less than 24 hours after or 24 hours before the use of methotrexate, since the concentration of methotrexate in the blood serum and its toxicity increases.
Increased nephrotoxicity of cyclosporines is possible when used simultaneously with nimesulide.

Nise drug overdose, symptoms and treatment

symptoms: lethargy, drowsiness, nausea, vomiting, pain in the epigastric region, gastrointestinal bleeding, hypertension (arterial hypertension), acute renal failure, respiratory depression, anaphylactoid reactions and coma may also occur.
Treatment. There is no specific antidote. In case of overdose, symptomatic therapy should be carried out. During the first 4 hours, patients need to rinse their stomach and take activated charcoal. Hemodialysis is not effective. Careful monitoring of liver and kidney function is necessary.

Storage conditions for the drug Nise

In a dry place, protected from light, at a temperature of 15-25 ° C.

List of pharmacies where you can buy Nise:

Saint Petersburg

Instructions

Tradename

International nonproprietary name

Nimesulide

Dosage form

Tablets 100 mg

Compound

One tablet contains

active substance- nimesulide 100 mg

Excipients: calcium hydrogen phosphate , microcrystalline cellulose (grade 114), corn starch, sodium starch glycolate (type A), magnesium stearate, colloidal anhydrous silicon, purified talc

Description

Tablets from white to white with a yellowish tint, round biconvex shape and smooth surface

Pharmacotherapeutic group

Nonsteroidal anti-inflammatory drugs are others. Nimesulide.

ATX code M01AX17

Pharmacological properties

Pharmacokinetics

Absorption when taken orally is high. Eating reduces the rate of absorption without affecting its extent. The time to reach the maximum concentration of the active substance in the blood plasma is 1.5 - 2.5 hours. Communication with plasma proteins is 95%, with erythrocytes - 2%, with lipoproteins - 1%, with acidic alpha1-glycoproteins - 1%. The dose of the drug does not affect the degree of its binding to blood proteins. The maximum concentration of nimesulide in blood plasma reaches 3.5 - 6.5 mg/l. Volume of distribution: 0.19 - 0.35 l/kg. Penetrates into the tissues of the female genital organs, where after a single dose its concentration is about 40% of the concentration in plasma. Penetrates well into the acidic environment of the inflammation site (40%) and synovial fluid (43%). Easily penetrates histohematic barriers. Metabolized in the liver by tissue monooxygenases. The main metabolite, 4-hydroxynimesulide (25%), has similar pharmacological activity.

The half-life of nimesulide is 1.56 - 4.95 hours, 4-hydroxynimesulide - 2.89 - 4.78 hours. 4-hydroxynimesulide is excreted by the kidneys (65%) and bile (35%).

In patients with renal failure (creatinine clearance 1.8 - 4.8 l/h or 30-80 ml/min), as well as in children and the elderly, the pharmacokinetic profile of nimesulide does not change significantly.

Pharmacodynamics

Non-steroidal anti-inflammatory drug (NSAID) from the sulfonanilide class. It is a selective competitive inhibitor of cyclooxygenase-2 (COX-2), an enzyme involved in the synthesis of prostaglandins - mediators of edema, inflammation and pain. It has anti-inflammatory, analgesic and antipyretic effects. Reversibly inhibits the formation of prostaglandin E2, both at the site of inflammation and in the ascending pathways of the nociceptive system, including the pathways of pain impulses in the spinal cord. Reduces the concentration of short-lived prostaglandin H2, from which prostaglandin E2 is formed under the action of prostaglandin isomerase. A decrease in the concentration of prostaglandin E2 leads to a decrease in the degree of activation of EP type prostanoid receptors, which is expressed in analgesic and anti-inflammatory effects. It has a slight effect on COX-1, practically without interfering with the formation of prostaglandin E2 from arachidonic acid under physiological conditions, thereby reducing the number of side effects of the drug. Inhibits the release of tumor necrosis factor α, which causes the formation of cytokinins. It has been shown that nimesulide is able to suppress the synthesis of interleukin-6 and urokinase, thereby preventing the destruction of cartilage tissue. Inhibits the synthesis of metalloproteases (elastase, collagenase), preventing the destruction of proteoglycans and collagen of cartilage tissue. Interacts with glucocorticoid receptors, activating them through phosphorylation, which also enhances the anti-inflammatory effect of the drug

Indications for use

Treatment of acute pain

Symptomatic treatment of pain in osteoarthritis

Primary dysmenorrhea.

Nise® should be prescribed only as a second-line drug. The decision to treat with nimesulide should be made based on an assessment of all the risks for a particular patient.

Directions for use and doses

Adults: 1 tablet (100 mg) orally 2 times a day. The maximum daily dose for adults is 200 mg. The duration of treatment is no more than 5 days.

The tablets are taken with sufficient water, preferably before meals.

Side effects

often (≥ l/100,

- diarrhea, nausea, vomiting (bloody vomiting, ulcerative stomatitis)

- increased levels of liver enzymes, exacerbation of colitis and Crohn's disease

sometimes (≥ l/l,000,

- dizziness

- hypertension, heart failure

- shortness of breath

- constipation, flatulence, gastritis

- itching, rash, increased sweating

- swelling

rarely (≥ l/10,000,

- anemia, eosinophilia

- increased sensitivity

- hyperkalemia

- feeling of fear, nervousness, nightmares

- blurred vision

- tachycardia

- hemorrhage, blood pressure lability, hot flashes

- erythema, dermatitis

- dysuria, hematuria, urinary retention

- weakness, asthenia

very rarely (

- thrombocytopenia, pancytopenia, purpura

- anaphylaxis

- headache, drowsiness, encephalopathy (Reye's syndrome)

- vertigo

- visual impairment

- asthma, bronchospasm

- abdominal pain, dyspepsia, stomatitis, tarry stools, gastrointestinal bleeding, ulcer and perforation of the duodenum, ulcer and perforation of the stomach

- myocardial infarction or stroke

- hepatitis, fulminant hepatitis (including deaths), jaundice, cholestasis

- urticaria, angioedema, facial edema, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis

- renal failure, oliguria, interstitial nephritis

- hypothermia

Contraindications

- hypersensitivity to nimesulide or to one of the excipients of the drug

- history of hyperergic reactions (eg bronchospasm, rhinitis, urticaria) in connection with the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs

- history of hepatotoxic reactions to nimesulide in the past

-concomitant use of other substances with potential hepatotoxicity

- alcoholism, drug addiction

- gastric or duodenal ulcer in the acute phase, a history of ulcers, perforation or bleeding in the gastrointestinal tract

- a history of cerebrovascular bleeding or other hemorrhages, as well as diseases accompanied by bleeding

- serious blood clotting disorders

- serious heart failure

- severe renal failure (creatinine clearance 30 ml/min)

- liver failure

- patients with cold or flu symptoms

- hereditary fructose intolerance, glucose-galactose malabsorption, sucrase-isomaltose deficiency

- for liver diseases and elevated liver enzymes

- children under 18 years of age

- pregnancy and lactation period

Drug interactions

Concomitant use of Nimesulide with corticosteroids, antiplatelet agents and selective serotonin reuptake inhibitors (SSRIs) increases the risk of gastrointestinal ulcer or bleeding.

In patients using warfarin or similar anticoagulants, as well as acetylsalicylic acid, there is an increased risk of bleeding when used simultaneously with Nimesulide. Therefore, this combination is not recommended, and in severe forms of bleeding disorders it is contraindicated. If such a combination cannot be avoided, regular monitoring of the state of the blood coagulation system is necessary.

Nimesulide may reduce the effect of diuretics and other antihypertensive drugs. In some patients with impaired renal function, when Nimesulide is co-administered with ACE inhibitors, angiotensin II antagonists or substances that suppress the cyclooxygenase system, further deterioration of renal function and the occurrence of acute renal failure, which is usually reversible, may occur. Therefore, coadministration of these drugs should be used with caution, especially in elderly patients. Patients should be kept adequately hydrated and renal function should be closely monitored after initiating combination therapy.

In healthy volunteers, nimesulide may temporarily reduce the diuretic effect of furosemide and the excretion of sodium, and to a lesser extent, potassium, therefore, when using nimesulide and furosemide simultaneously, patients with impaired renal or cardiac function should be careful special caution. Co-administration of nimesulide and furosemide leads to a decrease (by approximately 20%) in the area under the concentration-time curve (AUC) and a decrease in the cumulative excretion of furosemide without changing the renal clearance of furosemide.

Nimesulide may reduce the clearance of lithium, which leads to increased plasma lithium levels and its toxicity. When prescribing Nimesulide to patients receiving lithium therapy, plasma lithium levels should be monitored frequently.

When used simultaneously with glibenclamide, theophylline, warfarin, digoxin, cimetidine and antacids, no clinically significant interactions were observed.

Nimesulide inhibits the activity of the CYP2C9 enzyme. When taking drugs that are substrates of this enzyme with Nimesulide, the concentration of these drugs in plasma may increase.

When prescribing Nimesulide less than 24 hours before or less than 24 hours after taking methotrexate, caution is required, since in such cases the level of methotrexate in plasma and, accordingly, the toxic effects of this drug may increase.

When used simultaneously with cyclosporine, the nephrotoxicity of the latter may increase.

Research in vitro showed that nimesulide is displaced from binding sites by tolbutamide, salicylic acid and valproic acid. Although these interactions were determined in blood plasma, these effects were not observed during clinical use of the drug.

During treatment with Nimesulide, simultaneous use with drugs that have a hepatotoxic effect, as well as alcohol abuse, should be avoided, since these substances may increase the risk of adverse reactions from the liver.

special instructions

To reduce the risk of side effects, it is necessary to use the drug in the minimum effective dose with the shortest duration of treatment. If the patient's condition does not improve, treatment should be stopped.

Use in patients with impaired liver function

In patients with severe liver dysfunction, the metabolism of Nise is disrupted, clearance decreases and the concentration of nimesulide in the blood increases, which can lead to drug accumulation. There are also reports of liver dysfunction occurring while taking Nise, ranging from moderate to severe, including death. Therefore, Nise® is not recommended for use in patients with liver pathology.

If patients taking Nise® develop symptoms suggestive of liver damage (eg, anorexia, nausea, vomiting, abdominal pain, fatigue, dark urine) or abnormal results of liver function tests, the drug should be discontinued. Such patients are not recommended to be prescribed Nise® in the future.

Use in patients with impaired renal function

Carefully the drug should be used in patients with impaired renal function (creatinine clearance less than 30 ml/min), since in such patients the half-life of nimesulide increases.

Since Nise® may affect platelet function, it should be prescribed with caution to patients with bleeding diathesis. However, Nise® does not replace acetylsalicylic acid in the prevention of cardiovascular diseases.

There have been reports of very rare cases of serious skin reactions to non-steroidal anti-inflammatory drugs, some of which can be fatal. Including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrosis. Patients are at very high risk of such reactions if, with a previously prescribed course of treatment, the onset of the reaction in most cases occurred during the first month of treatment. Nise® should be discontinued at the first signs of a skin rash, damage to the mucous membranes and other signs of an allergic reaction.

Features of influence medicine the ability to drive vehicles or potentially dangerous machinery

Patients whose activities require increased attention and speed of psychomotor reactions should be warned about the possibility of drowsiness or dizziness.

Overdose

Symptoms Acute NSAID overdose is usually limited to the following: apathy, drowsiness, nausea, vomiting and epigastric pain. With maintenance therapy, these symptoms are usually reversible. Possible increased blood pressure, acute renal failure, respiratory depression and coma. Anaphylactoid reactions have been reported when taking therapeutic doses of NSAIDs and when overdosing such drugs.

Treatment: In case of NSAID overdose, treatment is symptomatic and supportive. There is no specific antidote. There is no data regarding the elimination of nimesulide by hemodialysis, however, based on the high level of binding to plasma proteins (up to 97.5%), it can be concluded that dialysis is ineffective in case of drug overdose. If there are symptoms of overdose or after taking a large dose of the drug within 4 hours after administration, patients may be prescribed: inducing vomiting and/or taking activated carbon(60-100 grams for adults) and/or taking an osmotic laxative. Forced diuresis, urine alkalinization, hemodialysis or hemoperfusion may be ineffective due to the high level of drug binding to blood proteins. Kidney and liver functions should be monitored.

Release form and packaging

10 tablets are packed in a blister pack made of PVC film and aluminum foil.

2 or 3 contour packages together with instructions for medical use in the state and Russian languages are placed in a cardboard box

Storage conditions

I tried Nice and Pentalgin and Nurofen for migraines - all in one place. My head was still pounding. Then my daughter advised me to take Nalgesin. I had little faith in this drug, I thought it was just another useless NSAID, but I was wrong. During the next attack, I appreciated Nalgesin. Already after taking 1 tablet the pain... I tried Nice and Pentalgin and Nurofen for migraines - all in one place. My head was still pounding. Then my daughter advised me to take Nalgesin. I had little faith in this drug, I thought it was just another useless NSAID, but I was wrong. During the next attack, I appreciated Nalgesin. After taking 1 tablet, the pain went away and did not return for a long time.

I keep Nimesan for emergencies, for example, when cervical osteochondrosis does not even allow you to raise your hand or even turn your head to look around. We must pay tribute to this drug - it works instantly. I keep Nimesan for emergencies, for example, when cervical osteochondrosis does not allow me to even raise my arm or even turn my head to look around. We must pay tribute to this drug - it works instantly.

Nimesan is an excellent drug. My wrist hurt after playing tennis. It’s so strong that it’s impossible to tolerate. took a pill. It started working within a minute. But my wrist turned out to be dislocated; then I went to get it treated. Nimesan is an excellent drug. My wrist hurt after playing tennis. It’s so strong that it’s impossible to tolerate. took a pill. It started working within a minute. But my wrist turned out to be dislocated; then I went to get it treated.

I have been suffering from osteochondrosis for several years now. It starts with a pain in the neck and develops into a headache that makes you feel sick. I tried Nise, it didn’t help. Friends suggested trying Nimesan. I suffered so much that I would have agreed to an axe. But surprisingly, Nimesan turned out to be very effective. An hour later I only had slight discomfort... I have been suffering from osteochondrosis for several years now. It starts with a pain in the neck and develops into a headache that makes you feel sick. I tried Nise, it didn’t help. Friends suggested trying Nimesan. I suffered so much that I would have agreed to an axe. But surprisingly, Nimesan turned out to be very effective. An hour later I only had slight discomfort in my neck. I no longer have wild pains and sleepless nights.

At work it was necessary to move a lot, including stairs. So the pain in my knee was just killing me. I went to the doctor and he recommended Nimesan. An excellent drug. Now I can run all day and not worry about pain. Thank you doctor for good recipe. At work it was necessary to move a lot, including stairs. So the pain in my knee was just killing me. I went to the doctor and he recommended Nimesan. An excellent drug. Now I can run all day and not worry about pain. Thanks to the doctor for the good recipe.

At work I usually sit haphazardly. And now I’ve finished it. It hurt my lower back. I thought he would let me go quickly. But no, it hurt so much that I could barely walk. On the way, I went to the pharmacy and bought Nimesan - I’ve known it for a long time, it helps a lot. By the time I got home, the pain had already passed. The product is good, but you need to do something about your sedentary... At work I usually sit haphazardly. And now I’ve finished it. It hurt my lower back. I thought he would let me go quickly. But no, it hurt so much that I could barely walk. On the way, I went to the pharmacy and bought Nimesan - I’ve known it for a long time, it helps a lot. By the time I got home, the pain had already passed. The product is good, but you need to do something about your sedentary lifestyle.

A couple of years ago, my sister and I were walking down the street and she felt pain in her back. She went into the pharmacy all in tears and asked for at least something to help with the pain. They gave me Nimesan. But I didn’t expect such an effect. After a couple of minutes she felt better. And after half an hour she practically forgot about... A couple of years ago, my sister and I were walking down the street and she felt pain in her back. She went into the pharmacy all in tears and asked for at least something to help with the pain. They gave me Nimesan. But I didn’t expect such an effect. After a couple of minutes she felt better. And after half an hour she practically forgot about the pain. Of course, you can’t neglect your back and you need to go to a doctor and get examined. But it was so urgent suitable option.

I am only 32 years old, but I suffer from constant neck pain. The doctors all say their own things as usual. I got hooked on painkillers and, of course, tried almost everything that was available in pharmacies. So I’m sharing my expert experience: “Nimesan” is “numero uno” for me at the moment. It always works effectively, helps a lot, and the price... I am only 32 years old, but I suffer from constant neck pain. The doctors all say their own things as usual. I got hooked on painkillers and, of course, tried almost everything that was available in pharmacies. So I’m sharing my expert experience: “Nimesan” is “numero uno” for me at the moment. It always works effectively, helps a lot, and the price is several times lower than its analogues. What do you say: who has what experience?

Got into a car accident. No big deal, it just flew into the driver's door. He himself is unharmed, only the blow landed in his leg. In general, the leg caused some inconvenience later. Until my sister almost forcefully pushed Nimesan into me. At first I didn’t want to - I thought it was triangular bullshit, some kind of dietary supplement. It turned out that it helps. I took it until it went away... Got into a car accident. No big deal, it just flew into the driver's door. He himself is unharmed, only the blow landed in his leg. In general, the leg caused some inconvenience later. Until my sister almost forcefully pushed Nimesan into me. At first I didn’t want to - I thought it was triangular bullshit, some kind of dietary supplement. It turned out that it helps. I took it until my leg healed and I felt good.

Just recently, if something hurts, I put up with it until it goes away. My brother always drank Nimesan for pain. And recently I read an article that pain cannot be tolerated. Now I’m just starting to treat myself with Nimesan. Works great and is not expensive. Has anyone taken it? Just recently, if something hurts, I put up with it until it goes away. My brother always drank Nimesan for pain. And recently I read an article that pain cannot be tolerated. Now I’m just starting to treat myself with Nimesan. Works great and is not expensive. Has anyone taken it?

I advise everyone to take Nimesan. He injured his elbow while playing badminton in the yard. It seems that the elbow was treated, but for some reason inflammation began. My elbow hurt incredibly. The doctor prescribed Nimesan. I drank it and there was no pain at all. Plus I took antibiotics, so soon the elbow went away. I advise everyone to take Nimesan. He injured his elbow while playing badminton in the yard. It seems that the elbow was treated, but for some reason inflammation began. My elbow hurt incredibly. The doctor prescribed Nimesan. I drank it and there was no pain at all. Plus I took antibiotics, so soon the elbow went away.