How to take Nimesil 100 powder. Nimesil drug: instructions for use, how to dilute the powder and how to take a suspension to suppress destructive processes in diseases of the musculoskeletal system

The active substance of this drug is nimesulide. Nimesil is manufactured in Spain, Italy and Germany. The drug is available in the form of a white powder in metered-dose packages. The drug helps to eliminate the inflammatory processes observed in the body, fever and pain. After taking Nimesil, it begins to act in just a quarter of an hour, and after two hours it reaches the peak of its effect. The drug is included in the category of non-steroidal anti-inflammatory drugs. Their action is to suppress enzymes that cause inflammation and pain. This material will tell you in detail what properties "Nimesil" has, instructions for use (powder), in which cases it is necessary to take the medication, and in which cases it should be abandoned, and also how to drink "Nimesil".

"Nimesil" instructions for use powder: indications and contraindications

Among the people, "Nimesil" is widely used as a remedy for the treatment of colds and flu, however, official indications in the instructions include the following items:

pain in the lower back and joints;
serious injuries, dislocations, sprains;
headache and toothache;
pain during menstruation;
osteoarthritis;
inflammatory processes accompanied by pain syndrome.

Also, the drug has many contraindications, so before using it is necessary to consult a specialist, and also carefully study the instructions. The guide indicates the following cases in which Nimesil should be abandoned:

Allergy to the components of the drug.
Taking other analgesics.
An increase in temperature above 38 degrees with SARS or influenza.
Diseases of the gastrointestinal tract in the acute phase.
Pathology of the heart and liver.
Plasma coagulation disorders.
Pregnancy.
The use of nonsteroidal drugs for a long time.
period of breastfeeding.
Addiction to alcohol, smoking and drugs.
Children's age up to 12 years and very old age.

Also, the drug is incompatible with some other drugs, it is not recommended to take it with type 2 diabetes and some somatic diseases. Due to the presence of such contraindications, Nimesil is a prescription medication. Therefore, before using it, it is necessary to visit the attending physician, who will determine the appropriateness of using the remedy, based on the individual characteristics of the patient.

"Nimesil" instructions for use powder: composition and side effects

Before studying in more detail the side effects that may occur when using the powder, it is necessary to consider the full composition of Nimesil. The medicinal product contains the following components:

The active substance is nimesulide (100 mg in one package of powder). Its main property is the suppression of cyclooxygenase, which causes inflammation and discomfort in the body.
Cetomacrogol 1000 is used as an emulsifier.
Maltodextrin - used as the basis for the powder.
Sugar, citric acid and orange flavor give the medicine a pleasant orange flavor.

Based on the analysis of the composition, we can conclude that the only active component of Nimesil is the first substance, which is the cause of a number of side effects of the drug. Among them, the guide highlights the following:

Rashes on the skin, which are accompanied by itching, sensitivity and redness.
Pathologies of the circulatory and cardiovascular systems.
Excessive sweating.
Drowsiness, malaise, headache, dizziness, feeling of fear and unstable nervous state.
Nightmares.
Visual disturbances.
Cough and shortness of breath.
Violations of the liver and kidneys.

The drug is not recommended to be taken while driving a car, as it can provoke violations of the muscular and somatic functions of the body. If such manifestations occur, it is necessary to stop taking the medication and contact a medical institution.

How to take "Nimesil" powder: instructions

Adults and adolescents over 12 years of age - one sachet of the drug twice a day after meals.
In old age - it is recommended to coordinate the dosage with your doctor.
For kidney problems, the dose cannot be adjusted. It is necessary to use the usual dosage of the drug under the mandatory supervision of a physician.

In case of an overdose, nausea, vomiting, clouding of consciousness, apathy may occur. In case of taking a large dose of the drug, it is recommended to induce vomiting and take a laxative. In order to avoid further health problems, an ambulance should be called.

"Nimesil" instructions for use powder: how to dilute

Taking this medication involves diluting the medicinal powder in water. The instructions contain clear recommendations "Nimesil" how to breed. To make the correct dosage of the drug, you must follow the following steps:

In any convenient way, you need to measure 100 ml of purified water. It is this volume of liquid indicated in the instructions for diluting the powder.
Pour the contents of one sachet of Nimesil into a cup.
Dissolve in water and stir thoroughly so that no sediment remains.
The result should be a clear yellowish liquid with an orange flavor.

The manufactured liquid does not imply long-term storage, it must be consumed immediately. It is recommended to store undiluted powder in a package for no more than two years in a dry place at a moderate temperature. The place must be inaccessible to children, since taking the drug under 12 years of age is highly undesirable.

"Nimesil": analogues of the drug

This medicine has many different analogues, which differ in price and country of origin. Among the most popular analogues of "Nimesil" are:

Tablets "Nimesid". These tablets have an identical active ingredient, but their composition differs from the composition of Nimesil. The manufacturer of the drug is India, so the cost of the drug is much lower than the cost of Nimesil: a package of 10 tablets will cost no more than 50 rubles. The shelf life of the tablets is four years.
"Nimedar". This drug is a generic Nimesil. It has exactly the same composition and powder form. This medicine differs only in price and country of origin: Nimedar is produced in Ukraine. Its cost is about 260 rubles per pack.
"Nimegesic". The drug is available in the form of tablets. The country of origin is India. A pack of ten dragees will cost about 60 rubles. It has many side effects and contraindications.

When prescribing Nimesil, the attending physician should not independently replace the drug with a cheaper one. This decision is best discussed with a specialist. To avoid buying fakes, you must carefully check the packaging of the drug for defects.

"Nimesil" instructions for use powder: reviews

This non-steroidal anesthetic has gained great popularity among compatriots. This is how Nimesil is spoken about online.

“This powder medicine was prescribed to me by a doctor for back pain. I drink the drug as indicated in the instructions, but I usually combine the intake with another well-known analgesic to enhance the effect. Nimesil helps me well with spasms of the spinal muscles, reduces inflammation and pain, but I did not notice the antipyretic effect of this drug. It is very simple to use, there is no need to count the dosage and carry out complex procedures.
Arina, 37 years old

“It so happened that recently I have often visited the dentist. That is why Nimesil lies at my house all the time. This is the only drug that quickly relieves pain after dental procedures. I cannot say that the powder is very cheap, but you can buy it in pharmacies by the piece. I also recommend that you familiarize yourself with contraindications: the doctor did not advise drinking it with alcohol and in the presence of bad habits, because the drug is quite toxic to the body.
George, 32 years old

“I want to warn everyone right away that this powerful pain reliever with a pleasant lemon taste can only be used as directed by a doctor. If you still decide to take Nimesil on your own, I recommend that you study the detailed instructions on the Internet, since when buying powder by the piece, you will not be provided with it. The medicine helps me with severe lower back pain, however, due to the long list of contraindications, I prefer to use it only in extreme cases.
Carolina, 25 years old

“Recently, my grandmother slipped and broke her leg. She was prescribed Nimesil for severe pain. The drug is prescribed in cases where other painkillers are already powerless. The medicine really relieves pain well, but for pensioners it can be a little expensive. "Nimesil" is also indicated for arthritis, myalgia, toothache and headaches. The remedy should not be taken during a cold, as some sources advise. In this case, it will not only be useless, but may cause side effects.
Elena, 31 years old

annotation

Nimesil (pln in Latin "Nimesulide") is an antipyretic, analgesic and anti-inflammatory medicine that is widely used by specialists in various fields. The medicine is prescribed to people of any age. No, it's not an antibiotic. The medicine belongs to NSAIDs. Information about the drug, its description, how to take it correctly and for how long is in the instructions. (Wikipedia)

What helps, composition, indications for use

Release form: powder in individual packaging, in sachets.

Active substance nimesulide. In 1 sachet it is 100 mg. Excipients: ketomacrogol, sucrose, maltodextrin, citric acid, flavor.

Pharmacological group: belongs to the group as a non-steroidal anti-inflammatory drug.

Nimesil, as a rule, appoint at many inflammatory processes, acute pain, interventions in the human body, with colds. Most often prescribed for colds, flu, toothache and headaches, fever (high temperature), menstruation, cystitis, after wisdom tooth removal, acute respiratory infections, back pain, osteochondrosis, hemorrhoids, gout , with flux, with sinusitis, with bronchitis, with tonsillitis, with otitis, it is recommended for inflammation of the joints.

When does it start acting like a pain reliever?

As an anesthetic, nimesil begins to act quickly, within an hour. And it works for 6-8 hours. The drug does not accumulate in the body. It is long acting.

Nimesil instructions for use powder, how to dilute

For adults, the drug is taken orally, after meals. The medicine must be dissolved. Dilute 1 sachet with warm water (about 100 ml) and drink. It is better to take after a meal, as the medicine has a bad effect on the stomach. If taken before meals, severe nausea and stomach pain may begin. Do not dilute in cold or hot water, the medicine may either not dissolve or lose honey. properties.

For the elderly, the dose should be adjusted by a specialist regarding interactions with other drugs. It can reduce effectively and give negative effects. But before replacing the medicine with others, consult a specialist.

How to take nimesil tablets?

There is no Nimesil in tablets. But there is nimesulide. It is available in different forms: tablets, children's syrup, gel, ointment. This is the same. 1 tablet contains 100 mg of active ingredient. Take as well as granules, 2 times a day, after meals.

From the head, the dose is used once. For other inflammations, the doctor prescribes the number of days of admission.
with flu, toothache, temperature prescribed?

Yes, nimesil is often prescribed for these diseases. It has an anti-inflammatory, analgesic effect, this is especially true for toothache. And with flu and colds, it brings down body temperature, treats inflammatory processes and improves the general condition of the body.

Dosage for children

The drug can only be taken by adults, as it has a strong toxic effect on the liver.

During pregnancy, contraindications

The drug is prohibited for pregnant and lactating mothers.

When planning, in the early stages, in any trimester, the medicine should not be taken, as it negatively affects the fetus, causes many side effects for the child. When breastfeeding (during lactation), the drug passes into breast milk, which can cause kidney failure in the child.

Contraindications

You can not give the drug to children. It is forbidden to use with ulcers, bleeding, heartburn, nausea, having problems with the kidneys, with pressure, with heart failure and type 2 diabetes.

Side effects

Usually well tolerated by adults. But at the beginning of the course of admission or later, there may be such a side effect as nausea, diarrhea, vomiting. Later, disorders of the central nervous system may occur, from the side of the cardiovascular, respiratory, gastrointestinal tract, liver and kidneys.

With an overdose, side effects become pronounced.

Reviews of doctors

Now the reviews of doctors about the drug are not unambiguous. It does its job well, but has many side effects. The main one is a negative effect on the liver and stomach. Often causes toxic hepatitis. Of course, immediately after the drug is discontinued, it disappears, but this effect is not pleasant. Komarovsky even wrote an article, the title of which is: “Nimesulide is prohibited!”, as it can give severe complications to the liver.

More detailed reviews on how to properly dilute the powder, what is the most similar substitute, whether injections are given, how long it lasts, photos and pictures can be found on the thematic page on the Internet.

Nimesil analogues are cheaper

In any pharmacy there are enough analogues of nimesil. Many of them have a price difference. Many are much cheaper and have fewer unpleasant consequences. These are movalis, nemulex, artiflex, analgin, nimesulide, nimid, diclofenac, oki, ketorol, ketanov, aertal and others. Some of these substitutes are produced in Russia and Ukraine. But, before you buy and replace nimesil, talk to your doctor.

Alcohol compatibility

Nimesil categorically should not be taken with alcohol or for a hangover. Not even beer. It turns out a double blow to the liver, which increases the risk of severe toxic reactions. And more medicine and alcohol can cause bleeding of the gastrointestinal tract. And due to the fact that a person is drunk, he cannot feel anything, which can lead to death.

How much is?

This medicine is not cheap. The cost for 30 packages (suspension in granules) reaches an average of 750-800 rubles. Of course, prices in different pharmacies can vary within 50 rubles. Made in Italy or Germany.

Does it help with menstruation?

Nimesil is used in gynecology for pain of various origins. Very effective for menstrual pain in the abdomen. How old can you take? Only in adulthood, at 18 years old. But regular treatment with nimesil causes severe harm to the body.

When breastfeeding

You can not use the medicine while breastfeeding. The drug is harmful to children and has a negative effect on the kidneys of the child.

NSAIDs. Selective COX-2 inhibitor

Active substance

Release form, composition and packaging

Granules for suspension for oral administration in the form of a light yellow granular powder with an orange smell.

Excipients: ketomacrogol 1000, sucrose, maltodextrin, anhydrous citric acid, orange flavor.

2 g - laminated paper bags (9) - packs of cardboard.
2 g - paper bags laminated (15) - packs of cardboard.
2 g - paper bags laminated (30) - packs of cardboard.

pharmachologic effect

Non-steroidal anti-inflammatory drug from the class of sulfonamides. It has anti-inflammatory, analgesic and antipyretic effects. Nimesulide acts as an inhibitor of the cyclooxygenase enzyme responsible for the synthesis of prostaglandins and inhibits mainly cyclooxygenase-2.

Pharmacokinetics

After oral administration, the drug is well absorbed from the gastrointestinal tract, reaching C max in the blood after 2-3 hours. Plasma protein binding is 97.5%. T 1/2 is 3.2-6 hours. Easily penetrates through histohematic barriers.

It is metabolized in the liver by cytochrome P450 (CYP) 2C9 isoenzyme. The main metabolite is the pharmacologically active parahydroxy derivative of nimesulide, hydroxynimesulide. Hydroxynimesulide is excreted in the bile in a metabolized form (found exclusively in the form of glucuronate - about 29%).

Nimesulide is excreted from the body, mainly by the kidneys (about 50% of the dose taken). The pharmacokinetic profile of nimesulide in the elderly does not change when prescribing single and multiple / repeated doses.

According to a pilot study conducted with the participation of patients with mild to moderate renal insufficiency (CC 30-80 ml / min) and healthy volunteers, Cmax of nimesulide and its metabolite in the plasma of patients did not exceed the concentration of nimesulide in healthy volunteers. AUC and T 1/2 in patients with renal insufficiency were higher by 50%, but within the pharmacokinetic values. With repeated administration of the drug, cumulation is not observed.

Indications

- treatment of acute pain (pain in the back, lower back; pain in the musculoskeletal system, including injuries, sprains and dislocations of the joints, tendinitis, bursitis; toothache);

- symptomatic treatment of osteoarthritis with pain syndrome;

- algomenorrhea.

The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use.

Contraindications

- a history of hyperergic reactions, for example, bronchospasm, rhinitis, urticaria associated with taking or other NSAIDs, incl. nimesulide;

- hepatotoxic reactions to nimesulide in history;

- concomitant (simultaneous) use of drugs with potential hepatotoxicity, for example, or other analgesic or non-steroidal anti-inflammatory drugs;

- inflammatory bowel disease (Crohn's disease, ulcerative colitis) in the acute phase;

- the period after coronary artery bypass grafting;

- fever in infectious and inflammatory diseases;

- full or partial combination of bronchial asthma, recurrent polyposis of the nose or paranasal sinuses with intolerance to acetylsalicylic acid and other NSAIDs (including history);

- peptic ulcer of the stomach and duodenum in the acute phase, the presence of an ulcer in history, perforation or bleeding in the gastrointestinal tract;

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

- severe blood clotting disorders;

- severe insufficiency;

- severe renal insufficiency< 30 мл/мин), подтвержденная гиперкалиемия;

- liver failure or any active liver disease;

- children's age up to 12 years;

- pregnancy and breastfeeding period;

- alcoholism, drug addiction;

- Hypersensitivity to the components of the drug.

Carefully: severe arterial hypertension, type 2 diabetes mellitus, heart failure, coronary heart disease, cerebrovascular disease, dyslipidemia/hyperlipidemia, peripheral arterial disease, smoking, CC< 60 мл/мин, анамнестические данные о наличии язвенного поражения ЖКТ, инфекции, вызванной Helicobacter pylori; пожилой возраст; длительное предшествующее использование НПВП; тяжелые соматические заболевания; сопустствующая терапия следующими препаратами: антикоагулянты (например, варфарин), антиагреганты (например, ацетилсалициловая кислота, клопидогрел), пероральные глюкокортикостероиды (например, преднизолон), селективные ингибиторы обратного захвата серотонина (например, циталопрам, флуоксетин, сертралин).

The decision to prescribe the drug Nimesil should be based on an individual risk-benefit assessment when taking the drug.

Dosage

Nimesil is taken orally, 1 sachet (100 mg of nimesulide) 2 times / day. The drug is recommended to be taken after meals. The contents of the sachet are poured into a glass and dissolved in about 100 ml of water. The prepared solution cannot be stored.

Nimesil is used only for the treatment of patients older than 12 years.

Patients with impaired renal function: based on pharmacokinetic data, there is no need to adjust the dose in patients with mild to moderate renal insufficiency (CC 30-80 ml / min).

Elderly patients: in the treatment of elderly patients, the need to adjust the daily dose is determined by the doctor based on the possibility of interaction with other drugs.

The maximum duration of treatment with nimesulide is 15 days.

To reduce the risk of unwanted side effects, the minimum effective dose should be used for the shortest possible course.

Side effects

From the side of the hematopoietic system: rarely - anemia, eosinophilia, hemorrhagic syndrome; very rarely - thrombocytopenia, pacitopenia, thrombocytopenic purpura.

allergic reactions: infrequently - itching, rash, excessive sweating; rarely - hypersensitivity reactions, erythema, dermatitis; very rarely - anaphylactoid reactions, urticaria, angioedema, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).

From the CNS: infrequently - dizziness; rarely - a feeling of fear, nervousness, nightmares; very rarely - headache, drowsiness, encephalopathy (Reye's syndrome).

From the organ of vision: rarely - blurred vision.

From the side of the cardiovascular system: infrequently - arterial hypertension, tachycardia, arterial pressure lability, hot flashes.

From the respiratory system: infrequently - shortness of breath; very rarely - exacerbation of bronchial asthma, bronchospasm.

From the digestive system: often - diarrhea, nausea, vomiting; infrequently - constipation, flatulence, gastritis; very rarely - abdominal pain, dyspepsia, stomatitis, tarry stools, gastrointestinal bleeding, ulcers and / or perforation of the stomach or duodenum; very rarely - hepatitis, fulminant hepatitis, jaundice, cholestasis, increased activity of liver enzymes.

From the urinary system: rarely - dysuria, hematuria, urinary retention; very rarely - renal failure, oliguria, interstitial nephritis.

General violations: rarely - malaise, asthenia; very rarely - hypothermia.

Other: rarely - hyperkalemia.

Overdose

Symptoms: apathy, drowsiness, nausea, vomiting, pain in the epigastric region. With maintenance therapy for gastropathy, these symptoms are usually reversible. Gastrointestinal bleeding may occur. In rare cases, it is possible to increase blood pressure, acute renal failure, respiratory depression and coma, anaphylactoid reactions.

Treatment: carry out symptomatic therapy. There is no specific antidote. If an overdose has occurred within the last 4 hours, it is necessary to induce vomiting and / or provide activated charcoal (adults from 60 to 100 g) and / or an osmotic laxative. Forced diuresis, hemodialysis are ineffective due to the high connection of the drug with proteins (up to 97.5%). Control of function of kidneys and a liver is shown.

drug interaction

Pharmacodynamic interactions:

When combined with glucocorticosteroids, the risk of gastrointestinal ulcers or bleeding increases.

When combined with antiplatelet agents and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, the risk of gastrointestinal bleeding increases.

NSAIDs may increase the effect of anticoagulants such as warfarin. Due to the increased risk of bleeding, this combination is not recommended and contraindicated in patients with severe coagulation disorders. If combination therapy still cannot be avoided, careful monitoring of blood coagulation parameters should be carried out.

Diuretics:

NSAIDs can weaken the effect of diuretics.

In healthy volunteers, nimesulide temporarily reduces sodium excretion under the action of furosemide, to a lesser extent, potassium excretion, and reduces the actual diuretic effect.

Co-administration of nimesulide and furosemide leads to a decrease (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 furomeside.

The co-administration of furosemide and nimesulide requires caution in patients with impaired renal and cardiac function.

ACE inhibitors and angiotensin II receptor antagonists:

NSAIDs may reduce the effect. In patients with mild to moderate renal insufficiency (CC 30-80 ml / min), with the joint appointment of ACE inhibitors, angiotensin II receptor antagonists or substances that suppress the cyclooxygenase system (NSAIDs, antiplatelet agents), further deterioration of renal function and the occurrence of acute renal failure are possible. which is usually reversible. These interactions should be considered in patients taking Nimesil in combination with ACE inhibitors or angiotensin II receptor antagonists. Therefore, the combined use of these drugs should be prescribed with caution, especially for elderly patients. Patients should be adequately hydrated and renal function should be closely monitored after initiation of concomitant therapy.

Pharmacokinetic interactions with other drugs:

There is evidence that NSAIDs reduce the clearance of lithium, which leads to an increase in the concentration of lithium in the blood plasma and its toxicity. When prescribing nimesulide to patients receiving lithium therapy, regular monitoring of plasma lithium concentrations should be carried out.

Clinically significant interactions with glibenclamide, theophylline, digoxin, cimetidine and antacids (for example, a combination of aluminum and magnesium hydroxides) were not observed.

Nimesulide inhibits the activity of the CYP2C9 isoenzyme. While 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 after taking methotrexate, caution is required, since in such cases the plasma level of methotrexate and, accordingly, the toxic effects of this drug may increase.

In connection with the action on renal prostaglandins, prostaglandin synthetase inhibitors, such as nimesulide, may increase the nephrotoxicity of cyclosporins.

Interaction of other drugs with nimesulide:

In vitro studies have shown that nimesulide is displaced from the binding sites by tolbutamide and valproic acid. Despite the fact that these interactions were determined in blood plasma, these effects were not observed during the clinical use of the drug.

special instructions

Unwanted side effects can be minimized by using the lowest effective dose of the drug for the shortest possible course.

Nimesil should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), since exacerbation of these diseases is possible.

The risk of gastrointestinal bleeding, ulceration or perforation of the ulcer increases with increasing dose of NSAIDs in patients with a history of ulcers, especially complicated by bleeding or perforation, as well as in elderly patients, so treatment should be started with the lowest possible dose. Patients receiving drugs that reduce blood clotting or inhibit platelet aggregation also increase the risk of gastrointestinal bleeding. In the event of gastrointestinal bleeding or ulcers in patients taking Nimesil, treatment with the drug should be discontinued.

Since Nimesil is partially excreted by the kidneys, its dosage for patients with impaired renal function should be reduced, depending on the level of urination.

There is evidence of the occurrence of rare cases of reactions from the liver. If there are signs of liver damage (skin itching, yellowing of the skin, nausea, vomiting, abdominal pain, dark urine, increased activity of "liver" transaminases), you should stop taking the drug and consult your doctor.

Despite the rarity of visual impairment in patients taking nimesulide simultaneously with other NSAIDs, treatment should be stopped immediately. If any visual disturbance occurs, the patient should be examined by an ophthalmologist.

The drug can cause fluid retention in the tissues, so patients with high blood pressure and cardiac disorders should use Nimesil with extreme caution.

In patients with renal or heart failure, Nimesil should be used with caution, as renal function may deteriorate. If the condition worsens, treatment with Nimesil should be discontinued.

Clinical studies and epidemiological data suggest that NSAIDs, especially at high doses and with long-term use, may lead to a small risk of myocardial infarction or stroke. There are not enough data to exclude the risk of such events when using nimesulide.

The composition of the drug includes sucrose, this should be taken into account for patients with diabetes mellitus (0.15-0.18 XE per 100 mg of the drug) and people on a low-calorie diet. Nimesil is not recommended for patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltose deficiency.

If there are signs of a "cold" or an acute respiratory viral infection during treatment with Nimesil, the drug should be discontinued.

Nimesil should not be used simultaneously with other NSAIDs.

Nimesulide can change the properties of platelets, so care must be taken when using the drug in people with hemorrhagic diathesis, but the drug does not replace the preventive effect of acetylsalicylic acid in cardiovascular diseases.

Elderly patients are particularly susceptible to adverse reactions to NSAIDs, including life-threatening gastrointestinal bleeding and perforations, deterioration of kidney, liver and heart function. When taking the drug Nimesil for this category of patients, proper clinical monitoring is necessary.

Like other NSAIDs that inhibit prostaglandin synthesis, nimesulide may adversely affect pregnancy and/or fetal development and may lead to premature closure of the ductus arteriosus, hypertension in the pulmonary artery system, impaired renal function, which may progress to renal failure. with oligodyramnia, to an increased risk of bleeding, a decrease in uterine contractility, the occurrence of peripheral edema. In this regard, nimesulide is contraindicated during pregnancy and lactation. The use of the drug Nimesil can adversely affect female fertility and is not recommended for women planning a pregnancy. When planning pregnancy, consultation with your doctor is necessary.

There is evidence of the occurrence in rare cases of skin reactions (such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) to nimesulide as well as to other NSAIDs. At the first sign of a skin rash, mucosal lesions or other signs of an allergic reaction, Nimesil should be discontinued.

The effect of the drug on the ability to drive vehicles and control mechanisms.

The effect of Nimesil on the ability to drive vehicles and control mechanisms has not been studied, therefore, during the period of treatment with Nimesil, care should be taken when driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Pregnancy and lactation

Like other NSAIDs that inhibit prostaglandin synthesis, nimesulide may adversely affect pregnancy and/or fetal development and may lead to premature closure of the ductus arteriosus, hypertension in the pulmonary artery system, impaired renal function, which may progress to renal failure. with oligodyramnia, to an increased risk of bleeding, a decrease in uterine contractility, the occurrence of peripheral edema. In this regard, the drug is contraindicated during pregnancy and during breastfeeding.

Application in childhood

The drug is contraindicated in children under the age of 12 years.

Teenagers (ages 12 to 18): based on the pharmacokinetic profile and pharmacodynamic characteristics of nimesulide, there is no need for dose adjustment in adolescents.

For impaired renal function

In patients with renal insufficiency, Nimesil should be used with caution, as renal function may deteriorate. If the condition worsens, treatment with Nimesil should be discontinued. The drug is contraindicated in severe renal insufficiency (CC< 30 мл/мин).

In patients with mild to moderate renal insufficiency (CC 30-80 ml / min), there is no need to adjust the dose.

For impaired liver function

The drug is contraindicated in liver failure or any active liver disease.

Use in the elderly

The drug is prescribed with caution to elderly patients. Elderly patients are particularly susceptible to adverse reactions to NSAIDs, including life-threatening gastrointestinal bleeding and perforations, deterioration of kidney, liver and heart function. When taking the drug Nimesil for this category of patients, proper clinical monitoring is necessary.

In the treatment of elderly patients, the need to adjust the daily dose is determined by the doctor based on the possibility of interaction with other drugs.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

Storage conditions:

List B. Store in a dry, dark place and out of the reach of children at a temperature not exceeding 25 ° C.

Best before date:

Do not use after the expiry date stated on the packaging.

Manufacturer: Berlin-Chemie AG / Menarini Group (Berlin-Chemie AG / Menarini Group) Germany

ATC code: M01AX17

Farm group:

Release form: Solid dosage forms. Granules.

General characteristics. Compound:

Active ingredient: nimesulide 100 mg;

Excipients: ketomacrogol 1000, sucrose, maltodextrin, anhydrous citric acid, orange flavor.

Pharmacological properties:

Pharmacodynamics. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) from the sulfonamide class. It has anti-inflammatory, analgesic and antipyretic effects. Nimesulide acts as an inhibitor of the cyclooxygenase enzyme responsible for the synthesis of prostaglandins and inhibits mainly cyclooxygenase 2.

Pharmacokinetics. After oral administration, the drug is well absorbed from the gastrointestinal tract, reaching a maximum plasma concentration in 2-3 hours; connection with plasma proteins - 97.5%; the half-life is 3.2-6 hours. Easily penetrates through histohematic barriers.

According to a pilot study conducted with the participation of patients with mild to moderate (creatinine clearance 30-80 ml / min) and healthy volunteers, the maximum concentration of nimesulide and its metabolite in the plasma of patients did not exceed the concentration of nimesulide in healthy volunteers. The area under the concentration-time curve (AUC) and half-life in patients with renal insufficiency were higher by 50%, but within the pharmacokinetic values. With repeated administration of the drug, cumulation is not observed.

Indications for use:

Treatment of acute pain (pain in the back, lower back; in the musculoskeletal system, including injuries, and joints; tendonitis, bursitis;);
.Symptomatic treatment of osteoarthritis with pain;
.Algodysmenorrhea.

The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use.

Important! Get to know the treatment

Dosage and administration:

Nimesil® is taken orally, 1 sachet (100 mg of nimesulide) twice a day. The drug is recommended to be taken after meals. The contents of the sachet are poured into a glass and dissolved in about 100 ml of water. The prepared solution cannot be stored.

Nimesil® is used only for the treatment of patients older than 12 years.

Adolescents (12 to 18 years of age): based on the pharmacokinetic profile and pharmacodynamic characteristics of nimesulide, there is no need for dose adjustment in adolescents.

Patients with impaired renal function: based on pharmacokinetic data, there is no need to adjust the dose in patients with mild to moderate renal insufficiency (creatinine clearance 30-80 ml / min).

Elderly patients: in the treatment of elderly patients, the need to adjust the daily dose is determined by the doctor based on the possibility of interaction with other drugs.

The maximum duration of treatment with nimesulide is 15 days.

To reduce the risk of unwanted side effects, the minimum effective dose should be used for the shortest possible course.

Application Features:

Unwanted side effects can be minimized by using the lowest effective dose of the drug for the shortest possible course.

Nimesil® should be used with caution in patients with a history of gastrointestinal diseases (peptic ulcer, Crohn's disease), since exacerbation of these diseases is possible.

Gastrointestinal tract disorders: often - nausea, vomiting; infrequently - , ; very rarely - abdominal pain, tarry stools, gastrointestinal bleeding, ulcer and / or perforation of the stomach or duodenum.

On the part of the liver and biliary system: very rarely - fulminant hepatitis, jaundice, increased activity of liver enzymes

Renal and urinary disorders: rarely - urinary retention; very rarely - renal failure, oliguria,.

General disorders: rarely - malaise, asthenia; very rarely - hypothermia.

Interaction with other drugs:

Pharmacodynamic interactions:

Glucocorticosteroids: increase the risk of gastrointestinal ulcers or bleeding.

Antiplatelet agents and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine: increase the risk of gastrointestinal bleeding.

Anticoagulants: NSAIDs may increase the effect of anticoagulants such as warfarin. Due to the increased risk of bleeding, this combination is not recommended and is contraindicated in patients with severe coagulation disorders. If combination therapy still cannot be avoided, careful monitoring of blood coagulation parameters should be carried out.

Diuretics:

NSAIDs may reduce the effect of diuretics.

In healthy volunteers, nimesulide temporarily reduces sodium excretion under the action of furosemide, to a lesser extent, potassium excretion, and reduces the actual diuretic effect.

The co-administration of furosemide and nimesulide requires caution in patients with impaired renal or cardiac function.

ACE inhibitors and angiotensin-II receptor antagonists:

NSAIDs may reduce the effect of antihypertensive drugs. In patients with mild to moderate renal insufficiency (creatinine clearance 30-80 ml / min), with the joint appointment of ACE inhibitors, angiotensin II receptor antagonists or substances that suppress the cyclooxygenase system (NSAIDs, antiplatelet agents), further deterioration of kidney function and the occurrence of acute renal failure, which is usually reversible. These interactions should be considered in patients taking Nimesil® in combination with ACE inhibitors or angiotensin II receptor antagonists. Therefore, the combined use of these drugs should be prescribed with caution, especially for elderly patients. Patients should be adequately hydrated and renal function should be closely monitored after initiation of concomitant therapy.

Pharmacokinetic interactions with other drugs:

Clinically significant interactions with glibenclamide, theophylline, digoxin, cimetidine and antacids (for example, a combination of aluminum and magnesium hydroxides) were not observed.

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

In connection with the action on renal prostaglandins, prostaglandin synthetase inhibitors, such as nimesulide, may increase the nephrotoxicity of cyclosporins.

Interaction of other drugs with nimesulide:

In vitro studies have shown that nimesulide is displaced from the binding sites by tolbutamide, salicylic acid and valproic acid. Despite the fact that these interactions were determined in blood plasma, these effects were not observed during the clinical use of the drug.

Contraindications:

Hypersensitivity to nimesulide or to one of the components of the drug.
.Hyperergic reactions (history) for example, bronchospasm, rhinitis, urticaria associated with taking acetylsalicylic acid or other non-steroidal anti-inflammatory drugs, including nimesulide.
.Hepatotoxic reactions to nimesulide (history).
.Concomitant (simultaneous) use of drugs with potential hepatotoxicity, such as paracetamol or other analgesic or non-steroidal anti-inflammatory drugs.
.Inflammatory bowel disease (Crohn's disease,) in the acute phase.
.Period after holding .
.Feverish syndrome with colds and acute respiratory viral infections.
.Complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose or paranasal sinuses with intolerance to acetylsalicylic acid and other NSAIDs (including history);
.Peptic ulcer of the stomach or duodenum in the acute phase, a history of ulcers, perforations or bleeding in the gastrointestinal tract.
.A history of cerebrovascular bleeding or other bleeding, as well as diseases accompanied by bleeding.
.Severe disorders of blood coagulation.
.Heavy .
.Severe renal failure (creatinine clearance<30 мл/мин), подтвержденная гиперкалиемия.
.Liver failure or any active liver disease.
.Children under the age of 12.
.Pregnancy and lactation.
.Alcoholism, drug addiction.

With caution: severe forms of arterial hypertension, type 2, heart failure, dyslipidemia / hyperlipidemia, peripheral arterial disease, smoking, creatinine clearance less than 60 ml / min.

Anamnestic data on the presence of ulcerative lesions of the gastrointestinal tract, infection caused by Helicobacter pylori; elderly age; long-term prior use of NSAIDs; severe somatic diseases.

Concomitant therapy with the following drugs: anticoagulants (eg, warfarin), antiplatelet agents (eg, acetylsalicylic acid, clopidogrel), oral glucocorticosteroids (eg, prednisolone), selective serotonin reuptake inhibitors (eg, citalopram, fluoxetine, paroxetine, sertraline).

The decision to prescribe the drug Nimesil® should be based on an individual risk-benefit assessment when taking the drug.

Overdose:

Symptoms: apathy, drowsiness, nausea, vomiting, pain in the epigastric region. With maintenance therapy, these symptoms are usually reversible. Gastrointestinal bleeding may occur. In rare cases, it is possible to increase blood pressure, respiratory depression and coma, anaphylactoid reactions.

Treatment: Symptomatic. There is no specific antidote. If an overdose has occurred within the last 4 hours, it is necessary to induce vomiting and / or provide activated charcoal (60 to 100 g per adult) and / or an osmotic laxative. , - are ineffective due to the high connection of the drug with proteins (up to 97.5%). Control of function of kidneys and a liver is shown.

Storage conditions:

List B. Store in a dry, dark place at a temperature not exceeding 25°C. Keep out of the reach of children! Shelf life 2 years. Do not use after the expiry date stated on the packaging.

Leave conditions:

On prescription

Package:

Granules for suspension for oral administration, 100 mg.

2 g of granulate in three-layer bags (paper / aluminum / polyethylene).

30 bags with instructions for use in a cardboard box.

A person in his life cannot do without doctors or without pharmacological agents designed to provide assistance in a variety of health-related situations. Some drugs are aimed at eliminating the source of the existing disease, and some help alleviate the symptoms of the ongoing process. A popular pain reliever today is the drug Nimesil, produced in a form convenient for taking.

Nimesil - an antibiotic or not?

This drug is based on a substance that belongs to the category of non-steroidal anti-inflammatory drugs, and it primarily has an anti-inflammatory and analgesic effect. The drug does not affect the development of bacteria negatively, which means that is not an antibiotic.

The composition and properties of the drug

The action of the drug in question is based on the substance nimesulide at a concentration of 100 mg per dose of granular powder (2 grams). Auxiliary components are sucrose, maltodextrin, citric acid, ketomacrogol and a flavoring agent to give a pleasant taste. The drug is produced in aluminum foil bags of 2 grams, which are packaged in packs of 9, 15 and 30 pieces.

Nimesil has a pronounced analgesic effect, and also relieves elevated body temperature and helps to minimize inflammatory processes. The principle of operation is based on the suppression of the synthesis of inflammatory mediators - prostaglandins, as a result of which the symptoms accompanying the process are quickly removed. The properties of the powder form allow you to achieve a quick result, and the resulting effect lasts an average of 6 hours. Also, the drug is suitable for long-term therapy and is well tolerated by patients.

What is prescribed for: indications for use

A non-steroidal anti-inflammatory agent based on nimesulide can be used in the following problems:

pain syndrome of any localization, the remedy is used for headache, postoperative and toothache;
therapy of discomfort during menstruation;
infectious and inflammatory processes formed after surgical interventions or traumatic injuries;
degenerative diseases of the musculoskeletal system, which are accompanied by the appearance of inflammation and severe pain (arthritis, osteochondrosis, bursitis, etc.);
gynecological and urological diseases, including powder, are prescribed as part of therapy for cystitis;
from temperature with colds and flu and other ailments that are accompanied by an increase in body temperature.

The tool can be equally effectively used both for a one-time dulling of pain, and as part of a comprehensive long-term treatment.

Instructions for use Nimesil and dosage

The analgesic and antipyretic agent in question must be used strictly according to the rules described in the instructions, otherwise you can harm your condition. Let's find out the main aspects of the use of the powder.

How to properly dilute granules

The drug is used orally, that is, before taking it, it is required to dilute the granular powder from the sachet in a liquid. This will require clean warm water in an amount of up to 100 ml. You just need to pour the contents of the whole sachet into it and mix well until completely dissolved - a lot of effort is not required for this. The resulting suspension is completely ready for use.

How to drink the drug

Suspension with nimesulide should be drunk after meals, just drinking diluted granules. The drug is well absorbed in the stomach and intestines, actively overcoming barriers. The powder is prescribed by a doctor, especially when it comes to long-term complex therapy of the disease, and the specialist can prescribe individual dosages depending on the patient's condition. From a headache or with disturbing menstruation, a single dose of the drug is allowed - it will be enough to drink the powder only once, and if after 6-7 hours the sensations do not return, then you do not need to repeat the dose.

How long does it take and how often to take?

The recommended daily dosage is 200 mg (that is, one sachet twice a day). Significant relief of the patient's condition is observed approximately 15-20 minutes after taking the product, and the effect lasts up to 6 hours. In order to minimize the risk of side effects, the course of therapy should not exceed two weeks, subject to a minimum dose of two sachets per day.

At what age and how to give medicine to children?

It should immediately be noted that Nimesil is not prescribed in childhood. Its use is possible only for patients over 12 years of age, and in the same dosage as for adults - 100 mg of the active ingredient twice a day. Reception is carried out according to the same rules: the powder is dissolved in warm water and drunk after the next meal.

Overdose and side effects

The use of the drug may result in the development of side effects, among which the manufacturer notes the following:

on the part of the digestive tract, heartburn, short-term pain in the stomach area (it is this symptom that usually does not require the withdrawal of the drug, as it is transient), tarry stools, etc .;
an allergic reaction, which can manifest itself as a rash on the body, redness of the tissues;
on the part of the central uneven system, there is a possibility of a headache, increased drowsiness and dizziness;
also in rare cases, there may be an accumulation of fluid (puffiness of a local and systemic nature), petechial hemorrhages under the skin.

In order to avoid the risk of developing adverse reactions of the body, it is better to use the drug in the lowest possible course in small dosages.

Symptoms of an overdose of non-steroidal anti-inflammatory drugs are usually manifested by such conditions: drowsiness, an apathetic attitude to what is happening around, pain in the stomach, as well as nausea and severe vomiting. There is also a risk of bleeding from the digestive tract. In situations where the overdose is significant, more serious consequences can occur - acute renal failure, respiratory depression and coma. In case of overdose, symptomatic therapy is required, since there is no specific antidote. If the case of overdose occurred less than 4 hours ago, then it is required to induce vomiting and take activated charcoal.

Contraindications to drug treatment

As for contraindications to the use of the powder, it will have to be abandoned in the following situations:

children's age up to 12 years;
during pregnancy and lactation (the drug may affect the developing fetus and the course of pregnancy);
ulcerative lesions in the digestive tract;
intestinal bleeding;
type 2 diabetes;
pathology of kidney function;
hypersensitivity to the components of the composition;
heartburn, nausea, diarrhea;
with congestive type of heart failure;
high blood pressure.

It is also worth noting that it is forbidden to use Nimesil powder and alcohol together in any amount, even the minimum.

Interaction with other drugs

The drug has a pronounced effect on the body, and when it is prescribed by a doctor or used independently, other pharmacological products that are currently used by the patient must be taken into account. Nimesulide can exhibit the following forms of drug interaction:

simultaneous use with glucocorticosteroids or antiplatelet agents is an increased risk of intestinal bleeding;
the effect of anticoagulants may be enhanced, which also increases the risk of bleeding;
non-steroidal anti-inflammatory drugs weaken the activity of diuretics;
also, the powder can reduce the effectiveness of drugs used for high blood pressure;
use simultaneously with lithium preparations can lead to an increase in the concentration of the component in the blood and its toxicity.
All options for interaction with other agents must be taken into account, otherwise the risk of developing dangerous complications is high.

What can replace Nimesil: analogues

When prescribing a powder by a doctor, you can use a preparation based on nimesulide, but only under a different name, if Nimesil itself could not be found, or it did not fit the cost, because there are substitutes at a much lower price. So, Nimesil's synonyms can be called drugs Nise (tablets, gel for topical application, suspension), Nimid, Nimulid (powder, tablets, lozenges, gel), Aponil (in the form of tablets), Aktasulide, Aulin, Kokstral, Mesulid, Novolid , Prolid, Flolid and Sulaidin. All of these drugs belong to the category of non-steroidal anti-inflammatory drugs and are based on the substance nimesulide.

Video: how to use Nimesil in a bag

In order to apply Nimesil powder, it must first be prepared, namely, dissolved in pure water to obtain a medicinal suspension. It is very simple to do this, which this video will help you to see - it clearly demonstrates how to dilute the powder.