NIMESULIDE

Nimesulide is a nonsteroidal anti-inflammatory drug (NSAID) with pain medicine and fever reducing characteristics. Its indications are the remedy of acute pain, the symptomatic treatment of osteoarthritis, and dysmenorrhoea in adolescents and adults above 12 years old. It has a multifactorial mode of action and is characterised through a rapid onset of action.

It works through blockading the production of prostaglandins (a chemical associated with pain), thereby relieving pain and inflammation.

Nimesulide is equivalent in gastrointestinal safety to other NSAIDs.

It can be used to treat acute (short term) pain, and primary dysmenorrhea (period pains). Nimesulide should not be taken long-term, as for long term conditions such as arthritis. This is due to its association with liver toxicity, together with fulminant hepatic failure.

Nimesulide should not be given to people who have the following:

  • Hypersensitivity
  • GI bleeding
  • Active peptic ulcer disease
  • Severe renal and heart failure
  • Hepatic impairment or known liver disease
  • Coagulation disorders
  • Pregnancy
  • Children <12 yr

Side Effects

Continuous use of nimesulide (more than 15 days) may cause the following side effects:

  • Diarrhea
  • Vomiting
  • Skin rash
  • Itchiness
  • Dizziness
  • Bitterness in mouth

Women should use the drug with caution during lactation; Nimesulide is contraindicated during pregnancy.

Due to concerns about the risk of hepatotoxicity, nimesulide has been withdrawn from market in several countries (Spain, Finland, Belgium, and Ireland).

Other side effects that may result include:

  • Gastrointestinal: Abdominal discomfort, heartburn, abdominal cramps, nausea, vomiting and diarrhea
  • Central Nervous System: Headache, dizziness and drowsiness
  • Genitourinary: Blood in urine, decrease in urination and kidney failure

Precautions

Caution should be exercised in patients with the following:

  • History of stomach problem
  • High blood pressure
  • Fluid retention
  • Elderly
  • During pregnancy and breast-feeding

 

Interactions

This drug has additive hepatotoxic effects with known hepatotoxins:

  • Anti-convulsants (e.g. valproic acid)
  • Anti-fungals (e.g. ketoconazole)
  • Anti-tuberculous drugs (e.g. isoniazid)
  • Tacrine
  • Pemoline
  • Amiodarone
  • Methotrexate
  • Methyldopa
  • Amoxicillin/clavulanic acid

This drug may decrease the oral bioavailability of furosemide and the natriuretic and diuretic response to furosemide.

There are increased risks of GI and hepatic adverse effects with other NSAIDs, including aspirin.

Nimesulide may increase anti-coagulant effect of warfarin. It potentiates the action of phenytoin. It may be displaced from binding sites with fenofibrate, salicylic acid, and tolbutamide.

Interactions between NSAIDs and lithium, probenecid and ciclosporin, have been documented.

Overdosage of this drug can give rise to the following:

  • Epigastric pain
  • Nausea
  • Vomiting
  • Drowsiness
  • Lethargy
  • GI haemorrhage
  • Seizures
  • Hypertension
  • Apnoea
  • Coma
  • Anaphylactic reactions
  • Renal failure

Treatment is supportive.

 

Available Brands:

Sulidin Gel/Sulidin Thermo

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