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Indications and Dosage
Oral
Acute pain, Dysmenorrhoea Adult: As 2nd-line treatment: 100 mg bid. Max: 200 mg daily. Treatment duration: Up to 15 days. Use the lowest effective dose for the shortest possible duration. Dosage and treatment recommendations may vary among countries and between individual products (refer to specific product guidelines).
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Other Known Brands
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Renal Impairment
Severe: Contraindicated.
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Hepatic Impairment
Contraindicated.
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Administration
Nimesulide Should be taken with food.
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Contraindications
Hypersensitivity. History of asthma, urticaria or allergic-type reactions after receiving aspirin or other NSAIDs. Active gastrointestinal ulcer, history of gastrointestinal or cerebrovascular bleeding or other bleeding disorders; severe heart failure; alcoholism, substance use disorder; fever or flu-like symptoms, suspected dengue fever. Hepatic and severe renal impairment. Children <12 years. Pregnancy and lactation. Concomitant use with known hepatotoxic agents.
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Special Precautions
Patient with gastrointestinal disorders (e.g. ulcerative colitis, Crohn's disease, history of peptic ulceration), CV disease, fluid retention, hypertension. Patient taking anticoagulants or platelet aggregation inhibitors. Mild to moderate renal impairment. Elderly.
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Adverse Reactions
Significant: Increased risk of gastrointestinal bleeding or ulceration; oedema, anaphylactoid reactions; decreased platelet aggregation, prolonged bleeding time; may cause serious skin reactions (e.g. Stevens-Johnson syndrome).
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain, pyrosis, melaena. Nervous system disorders: Headache, dizziness, drowsiness. Renal and urinary disorders: Oliguria. Skin and subcutaneous tissue disorders: Rash, urticaria. Potentially Fatal: Hepatotoxicity (e.g. liver failure). |
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Monitoring Parameters
Monitor hepatic function (periodically), renal function, CBC and occult blood loss.
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Drug Interactions
May reduce the oral bioavailability of furosemide. May displace fenofibrate, tolbutamide, and salicylic acid from plasma protein binding.
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Food Interaction
May increase the risk of gastrointestinal bleeding with alcohol.
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Action
Description:
Mechanism of Action: Nimesulide is an NSAID that exhibits antipyretic, analgesic and anti-inflammatory properties. It selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, thereby reducing the synthesis of prostaglandins. Onset: Analgesia: Approx 15 minutes. Duration: 6-8 hours. Pharmacokinetics: Absorption: Rapidly and completely absorbed. Time to peak plasma concentration: 1-2 hours. Distribution: Plasma protein binding: >97.5%. Metabolism: Extensively metabolised in the liver by CYP2C9; main metabolite is M1 (pharmacologically active). Excretion: Elimination half-life: 1.8-4.7 hours; 2.9-8.7 hours (M1 metabolite). |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4495, Nimesulide. https://pubchem.ncbi.nlm.nih.gov/compound/Nimesulide. Accessed Sept. 23, 2024. |
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Storage
Store at 25°C.
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ATC Classification
M01AX17 - nimesulide ; Belongs to the class of other non-steroidal antiinflammatory and antirheumatic products.
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References
Brayfield A, Cadart C (eds). Nimesulide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/09/2024. Nidol Tablet (Eurodrug Laboratories). MIMS Hong Kong. http://www.mims.com/hongkong. Accessed 19/09/2024. Nidol Tablet (Eurodrug Laboratories). MIMS Thailand. http://www.mims.com/thailand. Accessed 05/09/2024. Nimesulide. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 05/09/2024.
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