Nise adult instructions for use. What could be the negative effects. The cost of the drug and the opinion of patients

In this article, you can read the instructions for using the drug nise. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Nise in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Nise in the presence of existing structural analogues. Use for the treatment of pain and inflammation in the joints and muscles in adults, children, and during pregnancy and lactation.

nise- non-steroidal anti-inflammatory agent. Selective inhibitor of COX-2 - an enzyme involved in the synthesis of prostaglandins - mediators of edema, inflammation and pain. The drug has anti-inflammatory, analgesic and antipyretic effects.

It reversibly inhibits the formation of prostaglandin E2, both in the focus of inflammation and in the ascending pathways of the nociceptive system, including the pathways for conducting 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.

To a small extent, it acts on COX-1, practically does not prevent the formation of prostaglandin E2 from arachidonic acid under physiological conditions, thereby reducing the number of side effects of the drug.

Nise inhibits platelet aggregation by inhibiting the synthesis of endoperoxides and thromboxane A2, inhibits the synthesis of platelet aggregation factor. Suppresses the release of histamine, and also reduces the degree of bronchospasm caused by the effects of histamine and acetaldehyde.

It has been shown that nimesulide (the active substance of Nise) 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 in cartilage tissue.

It has antioxidant properties, inhibits the formation of toxic oxygen decay products by reducing the activity of myeloperoxidase. Interacts with glucocorticoid receptors, activating them by phosphorylation, which also enhances the anti-inflammatory effect of the drug.

When applied topically, it causes a weakening or disappearance of pain at the site of application of the gel, incl. pain in the joints at rest and during movement, reduces morning stiffness and swelling of the joints. Helps increase range of motion.

Pharmacokinetics

After oral administration, Nise is well absorbed from the gastrointestinal tract. Eating reduces the rate of absorption without affecting its degree. It penetrates into the tissues of the female genital organs, where, after a single dose, the concentration of nimesulide is about 40% of the plasma concentration. It penetrates well into the acidic environment of the focus of inflammation (40%), synovial fluid (43%). Easily penetrates through histo-hematic barriers. The metabolite is excreted by the kidneys (65%) and bile (35%).

Indications

rheumatoid arthritis;
articular syndrome with rheumatism and exacerbation of gout;
psoriatic arthritis;
ankylosing spondylitis;
osteochondrosis with radicular syndrome;
radiculitis;
sciatica;
lumbago;
osteoarthritis;
arthritis of various etiologies;
arthralgia;
myalgia of rheumatic and non-rheumatic origin;
inflammation of ligaments, tendons, bursitis;
post-traumatic inflammation of soft tissues and the musculoskeletal system (damages and ruptures of ligaments, bruises);
pain syndrome of various origins (including in the postoperative period, with injuries, algomenorrhea, toothache, headache);
fever of various origins (including with infectious and inflammatory diseases).

Release form

Tablets 100 mg.

50 mg dispersible tablets (can be used to prepare a suspension or syrup, by dissolving in water, this form is convenient for use in childhood).

Gel for external use 1%.

Instructions for use and dosage

Tablets

Inside, adults are prescribed 100 mg 2 times a day. The maximum daily dose is 400 mg.

It is preferable to take the drug in the form of a suspension before meals, but if you feel discomfort in the stomach, you can take it at the end or after a meal.

The drug in the form of dispersible tablets should be taken at the end or after a meal. Before taking 1 tablet is dissolved in 5 ml (1 teaspoon) of water.

For children over the age of 2 years, the drug is prescribed in the form of a suspension, for children over the age of 3 years - in the form of dispersible tablets or suspensions, for children over the age of 12 years the drug can be prescribed in the form of tablets (100 mg 2 times a day). The recommended dose is 3-5 mg/kg of body weight 2-3 times a day. The maximum dose is 5 mg / kg per day in 2-3 doses. Adolescents with a body weight of more than 40 kg are prescribed 100 mg 2 times a day.

The maximum dose is 5 mg/kg of body weight per day. The duration of the drug is 10 days.

Gel

Before applying the gel, wash and dry the surface of the skin. With a uniform thin layer, without rubbing, a strip of gel about 3 cm long is applied to the area of \u200b\u200bmaximum pain 3-4 times a day.

The amount of gel and the frequency of its application (no more than 4 times a day) varies depending on the size of the treated skin area and the patient's response.

The maximum dose is 5 mg/kg per day (30 g per day). Duration of use of the drug - no more than 10 days without consulting a doctor.

Side effect

heartburn;
nausea, vomiting;
pain in the stomach;
diarrhea;
erosive and ulcerative lesions of the gastrointestinal tract;
headache;
dizziness;
thrombocytopenia, leukopenia, anemia, agranulocytosis;
skin rash;
anaphylactic shock;
bronchospasm;
fluid retention;
prolongation of bleeding time;
hematuria (blood in the urine);
when applying the gel - itching, urticaria, peeling, transient discoloration of the skin (does not require discontinuation of the drug).

Contraindications

erosive and ulcerative lesions of the gastrointestinal tract in the acute phase;
bleeding from the gastrointestinal tract;
"aspirin triad";
liver dysfunction;
severe renal insufficiency (CK<30 мл/мин);
pregnancy;
lactation (breastfeeding);
dermatosis, damage to the epidermis, skin infections in the area of application (for gel);
children's age up to 2 years;
hypersensitivity to nimesulide and other components of the drug, acetylsalicylic acid and other NSAIDs.

Use during pregnancy and lactation

Nise is contraindicated for use during pregnancy.

If necessary, the use of the drug during lactation should decide on the termination of breastfeeding.

special instructions

With caution, Nise should be prescribed to patients with impaired renal function, visual impairment.

With prolonged use, it is necessary to monitor the functions of the liver and kidneys.

When using the drug in elderly patients, correction of the dosing regimen is not required.

Influence on the ability to drive vehicles and control mechanisms

Due to the fact that Nise, when taken orally, can cause dizziness and drowsiness, the drug should be used with caution in patients engaged in potentially hazardous activities that require increased concentration and rapid psychomotor reactions.

drug interaction

There may be manifestations of drug interactions (due to drug competition for protein binding) while ingesting Nise with digoxin, phenytoin, lithium preparations, diuretics, antihypertensive drugs, other NSAIDs, anticoagulants, cyclosporine, methotrexate, oral hypoglycemic agents.

Analogues of the drug Nise

Structural analogues for the active substance:

Actasulide;
Ameolin;
Aponil;
Aulin;
Cockstral;
Mesulide;
Nemulex;
Nimegesik;
Nimesil;
Nimesulide;
Nimesulide-Pharmaplant;
Nimika;
Nimulid;
Novolid;
Prolid;
Sulaidin;
Florida.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

The composition of Nise in tablets: 1 tablet 100 mg nimesulide . Calcium hydrogen phosphate, cellulose, corn starch, magnesium stearate, sodium carboxymethyl starch, talc, silicon dioxide as excipients.

Gel composition: 1 g contains 10 mg nimesulide . N-methyl-2-pyrrolidone, macrogol, propylene glycol, purified water, carbomer-940, isopropanol, butylhydroxyanisole, thiomersal, potassium dihydrogen phosphate, flavoring as excipients.

Release form

Tablets dispersed 50 mg.
Tablets 100 mg.
Gel 1% 20 g or 50 g in a tube.

pharmachologic effect

Anti-inflammatory , antipyretic , analgesic .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

What is this medicine for? The active substance - nimesulide - is a non-steroidal anti-inflammatory drug, a derivative of sulfonanilide . Wikipedia and pharmaceutical guides contain a description of its action. Anti-inflammatory action due to the suppression of the COX-2 enzyme involved in the synthesis of prostaglandins, which play a role in the development of inflammation and pain. At the same time, it has other mechanisms of action: it affects the activity of cartilage metalloproteases, reduces the release of ROS by neutrophils, and reduces the formation of cytokines, which makes it promising in the treatment of rheumatological diseases.

Renders fast analgesic effect , the beginning of which is fixed after 15 minutes. after taking. Effective concentrations in plasma and synovial fluid are determined after 30 minutes. after taking. The analgesic effect of the drug is not inferior and and surpasses the effect Rofecoxib . It inhibits the formation of enzymes that destroy cartilage tissue, therefore it does not have a damaging effect on it. Unlike reduces the release of histamine, reducing bronchospasm. It is justified to use it in bronchial asthma, when other NSAIDs are contraindicated or acetylsalicylic acid .

Indications for the use of the drug also include children's age. Only two preparations of nimesulide ( and nise ) are approved for use in children from 2 years of age, since they have a dosage form intended for them.

Preferential blocking of COX-2 and an insignificant effect on COX-1 determine a high level of safety in relation to the gastrointestinal tract and explain the rare occurrence of other side effects. When taking nimesulide, the incidence of side effects from the gastrointestinal tract is less than when taking Diclofenac 2 times 1.8 times - 2.1 times.

Pharmacokinetics

Absorption is high. The maximum concentration is determined after 1.5–2 hours. The binding to albumin is 95%. It penetrates well into the focus of inflammation, synovial fluid, into the tissues of the genital organs of women. It is metabolized in the liver, and the main metabolite has a similar activity. T1 / 2 is 1.5-4.7 hours, but the blocking of COX-2 still lasts up to 8 hours and up to 12 hours in the synovial fluid. In severe kidney damage, it is prescribed with caution.

The components of the gel quickly penetrate into the muscle tissue and into the joint cavity. The concentration reaches the therapeutic level, which causes an analgesic and anti-inflammatory effect. The active component is found in small quantities in the bloodstream, so it practically does not have a systemic effect. The clinical effect occurs after 4 weeks.

Indications for use Nise

Indications for the use of Nise tablets - symptomatic treatment:

gouty and psoriatic arthritis ;
osteochondrosis with pain syndrome;
tendonitis , ;
pain syndrome in injuries in the postoperative period, thrombophlebitis , gynecological diseases;
toothache and headache;
fevers of various origins.

Ointment Nise is used for local treatment:

lumbago ;
rheumatoid arthritis ;
psoriatic arthritis ;
aankylosing spondylitis ;
osteochondrosis with the presence of radicular syndrome;
tendovaginitis ;
sciatica ;
ligament damage;
myositis ;
bruises and injuries.

Contraindications

peptic ulcer in the acute stage;
hypersensitivity;
pronounced renal and liver failure ;
pregnancy, lactation.

Use caution when prescribing to patients with arterial hypertension , , . Due to possible drowsiness, there are restrictions when driving a car.

Side effects

Side effects of tablets are manifested by nausea, vomiting, , pain in the stomach, , itchy, bronchospasm . There is a risk of developing thrombocytopenia , drowsiness, petechiae , oliguria and hematuria , fluid retention.

Cream (gel) may cause local reactions in the form of a temporary change in skin color, itching, hives , peeling. When used on large areas of the skin or with prolonged use, systemic reactions may develop: stomach pain, heartburn , vomit, diarrhea , headache, fluid retention, blood changes, allergic reactions.

Instructions for use Nise (Method and dosage)

The drug has several forms of release, the features of the use of which will be discussed below.

Tablets Nise, instructions for use

The usual dose for adults and children over 12 years of age is 100 mg twice daily. Nise tablets are best taken before meals with liquid. If there is discomfort in the stomach area, the medicine is taken at the end of a meal. Dispersible (soluble) tablets of 50 mg are convenient to use, which are dissolved in 5 ml of water before taking. The dosage can be adjusted for various conditions: 50 mg for algodysmenorrhea or 200 mg twice a day for severe pain, given that the maximum dose is 400 mg per day.

In case of impaired renal function, the dose is reduced. If symptoms of liver dysfunction appear (increased "liver" transaminases, itching, nausea, vomiting, dark urine), the drug is stopped. After 2 weeks of use, biochemical parameters of liver function are monitored.

For children, the drug is prescribed at the rate of 3 mg / kg of body weight 2-3 times a day. The maximum DM for children is not more than 5 mg / kg. The use of Nise tablets is contraindicated for children under 12 years of age. From the age of 7, it is possible to take dispersible tablets, and for children from 2 years old, it is preferable to use a children's syrup (suspension), which is available in 60 ml vials and contains 50 mg of the active substance in 5 ml. Children from 2 to 5 years old are prescribed children's Nise 2.5 ml 2-3 times a day, from 5 years old - 5 ml 2-3 times a day. Treatment is carried out up to 5 days.

Gel Nise, instructions for use

Any cream, gel or ointment based on nimesulide has a pronounced analgesic effect. It is noted that the gel base is well absorbed and provides maximum diffusion of the components. 3 cm of gel is applied to the skin in the place of pain 2-3 times a day, distributed in a thin layer, not rubbed. The course is not more than 10 days. The amount of gel may vary depending on the size of the skin area and the patient's response. The maximum dose is 30 g per day.

The drug should be applied to dry, intact skin. The gel should not be used under airtight dressings and should not be allowed to get into the eyes. After applying the gel, hands should be washed with soap and water. The use of the drug in tablets and in the form of a gel makes the treatment complex. There are injections with the same active substance - Nimulid. Ampoules of 2 ml contain 75 mg of the drug.

Overdose

It is manifested by an increase in the severity of adverse reactions. There is drowsiness, apathy, nausea, sometimes gastrointestinal bleeding, acute renal failure, increased blood pressure.
Treatment begins with gastric lavage, appointment sorbents and osmotic laxatives .

Interaction

Enhances nephrotoxicity cyclosporins .

Application with GKS , other NSAIDs increase the risk of gastrointestinal bleeding.

Terms of sale

Tablets and suspension are dispensed by prescription. Gel without a prescription.

Storage conditions

At temperatures up to 25 °C.

Best before date

Gel - 2 years.

Tablets - 3 years.

Nise's analogs

Coincidence in the ATX code of the 4th level:

Cheap analogues of tablets - (Replekpharm JSC, Macedonia) can be purchased for 68-94 rubles, (Medochemi, Cyprus) for 130-147 rubles.

Nise gel analogs: gels , Sulaidin , , diclofenac .

Nise during pregnancy

Since NSAIDs cross the placenta, there is a possibility of congenital pathology in the fetus. have the greatest teratogenic effect. salicylates , indomethacin , aminophenazone .

The annotation for this drug also contains a warning about the contraindication of taking during pregnancy, since there is evidence that in newborns whose mothers took the tablet preparation, it was noted nephrotoxic action . Nimesulide can cause premature closure of the botal duct in the fetus. In a pregnant woman, it can cause pulmonary hypertension , oliguria , peripheral edema and oligohydramnios . It also increases the risk of bleeding and uterine atony . The gel during pregnancy is also not recommended, despite the low level of systemic action.

The use of the drug is also contraindicated during breastfeeding. If necessary, breastfeeding is stopped. The use of the drug adversely affects female fertility, so its use is not recommended when planning a pregnancy.

Nise and alcohol

Forum visitors are interested in the compatibility with alcohol of this drug. Indeed, not all instructions mention this. Given the hepatotoxic effect of alcohol and the drug (monitoring of liver function is necessary with prolonged use), their simultaneous administration is undesirable. In addition, the use of other hepatotoxic drugs (other NSAIDs, analgesics) should also be avoided.

Reviews about Nise

Many users who are not familiar with Nise are wondering what these pills are for? Non-steroidal anti-inflammatory drugs, to which this drug belongs, with a combination of analgesic, antipyretic and anti-inflammatory effects, are commonly used drugs. These drugs are widely used for self-medication. There are a lot of situations when we are forced to take painkillers, among which are Nise tablets.

What is the most common use for this drug? Patients use it as a remedy for headaches, with painful menstruation, with toothache, because this drug has a rapidly advancing and pronounced analgesic effect. Its effectiveness has been shown by multiple studies.

Reviews about Nise in tablets are positive. The analgesic effect when taken orally occurs after 20 minutes and lasts 5 hours. However, it must be remembered that Nise tablets for toothache should be used as an ambulance when it is not possible to immediately contact a dentist. The drug Nise will not solve dental problems, but only temporarily anesthetize.

There are reviews of patients who took the drug for a long time about rheumatological diseases. It should be noted that the drug Nise has less gastro- and nephrotoxicity compared to other "traditional" NSAIDs due to the predominant inhibition of COX-2. An important factor is that nimesulide has a chondroprotective effect. All this allows you to take the drug for a long time without harm to health. Thus, the duration of continuous administration of the drug in adolescents with juvenile arthrosis was 1-8 months, while no serious adverse reactions were noted. All adverse reactions were reversible and were eliminated by dose reduction.

Reviews of the Nise gel, often used for osteochondrosis, are also positive. Patients note a pronounced analgesic (pain quickly decreased) and anti-inflammatory effect. There were no changes in the skin at the site of application of the gel. Gel Nise as monotherapy was used for moderate pain syndrome. With a pronounced pain syndrome, injections were prescribed, for example, Nimulid, and as an additional therapy, an ointment was applied externally. The gel is consumed sparingly, quickly absorbed, leaving no residue on the skin. It quickly penetrates into the periarticular tissues (the effect occurred after 30 minutes), and the duration of action is 4-6 hours. Since the concentration in the blood is very low when applied topically, systemic adverse reactions appear much less frequently.

For children, there is a convenient form of release - syrup, which is indicated for the treatment of symptoms of fever and inflammation that occur with infections of the upper respiratory tract. Russia has accumulated many years of successful experience in the use of dosage forms of nimesulide for children. Nise suspension is allowed from the age of 2 and no serious adverse reactions have been noted during its use. Different forms of Diclofenac are approved for use in children from 6, 12, or 15 years of age. Meloxicam is used after 15 years, and some - after 18 years.

Nise price, where to buy

You can buy the drug by prescription at any pharmacy.

How much do the pills cost? To date, the price of Nise in tablets of 100 mg No. 20 ranges from 198-225 rubles. The cost of the gel depends on the volume of the tube. So, the price of Nise gel 20 mg is 157-175 rubles, and the ointment in a 50 mg tube can be purchased for 280-387 rubles.

Internet pharmacies in Russia Russia
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WER.RU

Nizilat tablets 600 mg 20 pcs.

Nise gel 1% 50 g Dr. Reddy's Laboratories [Dr. Reddy's Laboratories]

Nise gel 1% 20 g Dr. Reddy's Laboratories [Dr. Reddy's Laboratories]

Nise (NISE, NICE, nimesulide, nimesil) is a non-steroidal anti-inflammatory drug (NSAID) of the second generation of inhibitors used to relieve pain syndromes of various etiologies.

Pharmacological action of Nise

The active component of Nise is a specific or highly selective isoform of the cyclooxygenase (COX) enzyme - COX-2, a class of bellows-anilines. The drug has an anti-inflammatory, analgesic and antipyretic effect, while it has an improved gastrointestinal safety profile.

Nise according to the instructions reversibly inhibits (restrains):

The formation of prostaglandin E2 in the focus of inflammation and in the structures of the central and peripheral nervous system - a decrease in the concentration of E2 inhibits the activity of prostanoid EP-type receptors, which gives an anti-inflammatory and analgesic effect;
Synthesis of endoperoxides and thromboxane A2 - inhibits thrombosis;
Release of histamine - reduces the degree of bronchial spasms;
Synthesis of interleukin-6, urokinase, metalloproteases (collagenase, elastase) - prevents the destruction of proteoglycans and, as a result, the destruction of cartilage tissue collagen;
Myeloperoxidase activity - inhibits the formation of oxygen decay toxins, gives an antioxidant effect.

To reduce the number of side effects allows a slight effect of Nise on the natural formation of prostaglandin E2 from arachidonic acid. By phosphorylation, Nise activates glucocorticoid receptors. This enhances the anti-inflammatory effect of the drug.

Nise has a high degree of absorption, while eating, without affecting the degree of absorption, reduces its speed. The maximum concentration of the drug in the blood plasma is fixed after 1.5-2 hours from the intake.

Release form Nise

The undoubted advantage of the drug is the various forms of release. This significantly expands the circle of people using the drug, and increases the list of painful conditions in which Nise brings relief.

Release forms:

Tablets Nise. Contains 100 mg of nimesulide. There are 10 pieces in a blister;
Nise dispersible tablets. Contains 50 mg of nimesulide. There are 10 pieces in a blister;
Suspension Nise oral. Contains 50 mg of nimesulide in 5 ml. 60 ml bottle, special dosing cap;
Gel Nise 1% for external use. Contains 10 mg of nimesulide per 1 g. Tube 20 g and 50 g.

Nise tablets are recommended for adults to take in case of pain syndromes of various origins. Nise suspension is convenient for pain relief in children. When topical NSAIDs are needed, Nise Gel is an excellent choice. The composition of the gel does not include warming components, so it is recommended to use it during exacerbations of osteochondrosis, osteoarthritis, sciatica. According to reviews, Nise gel helps well with inflammation of the ligaments and tendons, post-traumatic inflammation of soft tissues, bursitis and bruises.

Indications for use Nise

Nise, according to the instructions, is indicated for use in the treatment of:

Arthritis of various etiologies - rheumatoid, psoriatic and ankylosing spondylitis, gout;
arthralgia;
Articular syndrome with exacerbation of gout or rheumatism;
Myalgia of rheumatic and non-rheumatic origin;
Bursitis, inflammation of the tendons and ligaments;
Osteoarthritis, osteochondrosis, radiculopathy;
Radiculitis, lumbago, sciatica;
Post-traumatic bruises and inflammation of the musculoskeletal system and soft tissues, ruptures and sprains;
Pain syndromes of various origins - traumatic, postoperative, as well as headache and toothache, algomenorrhea;
fever;
Infectious and inflammatory diseases.

Contraindications for use

Contraindications to the use of Nise, according to the instructions, are:

Peptic ulcer of the gastrointestinal tract in the acute phase;
Liver failure;
kidney failure;
Aspirin triad;
congestive heart failure;
Type 2 diabetes;
Hypersensitivity to the components of the drug;
Arterial hypertension;
Pregnancy, lactation.

Children under the age of 2 years are categorically contraindicated in the use of the drug in any form. Children under 12 years of age should not take Nise in tablets, but only in the form of a suspension.

It is necessary to use Nise gel only on areas of skin with intact epidermis, without dermatoses and various skin infections in the area of application.

Method of application and dosage of Nise

Depending on age, there are various schemes for using Nise:

Children over 2 years old - suspension at the rate of 3-5 mg per kg of body weight 2-3 times a day, duration of administration - 5 days;
Children over 3 years old - suspension or dispersible tablets at the rate of 3-5 mg per kg of body weight 2-3 times a day, duration of administration - 5 days;
Children over 12 years of age or weighing more than 40 kg - adult dosage;
Adults - Nise tablets or dispersible tablets, 100 mg twice a day, maximum (in case of severe pain) - no more than 400 mg per day, duration of administration - 5-10 days.

Suspension and Nise tablets should be taken before meals, if you feel discomfort in the stomach, they can be taken according to the dispersible scheme. Dispersible tablets - dissolve one tablet in a teaspoon (5 ml) of warm water, take at the end of a meal or immediately after a meal.

The surface of the skin before applying the gel should be washed and dried thoroughly. A gel column of about 3 cm is applied to the area of pain, evenly distributing over the surface, but not rubbing. Use 3-4 times a day, the maximum dose is 5 mg per 1 kg of body weight, the duration of use is 10 days.

Side effects of Nise

Nise, according to reviews, can cause various disorders:

Digestive system - nausea, vomiting, heartburn, diarrhea, ulcerative erosive lesions of the gastrointestinal tract;
Central nervous system - dizziness, headaches;
Hematopoietic system - thrombocytopenia, agranulocytosis, anemia;
Allergic manifestations - bronchospasm, skin rashes, anaphylactic shock.

In places where the gel is applied, local skin reactions (urticaria, itching, redness) are possible. Cancellation of the drug is optional.

An overdose of Nise can cause impaired renal function, liver failure, increased blood pressure, respiratory depression, convulsions.

If you are taking other medicines, you should consult with your doctor before taking Nise. The drug can increase both the effectiveness of other drugs and their toxicity. Nimesulide interacts in the body with digoxin, phenytoin, antihypertensive agents, diuretics, anticoagulants, other non-steroidal anti-inflammatory drugs, lithium preparations, hypoglycemic agents.

According to reviews, Nise was very widespread. Many prefer this drug because it relieves various types of pain and reduces the temperature for a long time. With short-term use, side effects are practically not manifested.

"Nise", what does this analgesic, antipyretic and anti-inflammatory drug help with? The drug is used to treat diseases of the joints, to reduce pain of various origins. Instructions for use "Nise" indicates that it helps with sciatica, bursitis, osteoarthritis.

Release form and composition

The active element is nimesulide. Pharmacies receive medication in the form of tablets - regular and dispersible with the entry of 100 and 50 mg of the active substance into the composition. They also produce the medicine "Nise", which helps with joint pain, in the form of a 1% gel and a suspension, in 5 ml of which there is 50 mg of nimesulide.

Therapeutic properties

Due to the entry of nimesulide, the drug has antipyretic, anti-inflammatory and analgesic properties. The medicine shows a good result in the appearance of edema, pain and inflammation. Tablets "Nise" reduce the manifestations of bronchospasm caused by histamine, and also counteracts platelet aggregation, showing antiaggregatory properties.

It is also known about the antioxidant effect created by the drug, from which it is able to slow down intoxication in the body. The drug reduces swelling and pain in the joints, reduces stiffness in the morning.

Medicine "Nise": what helps

Indications for the use of the drug include the following diseases and conditions:

headache and toothache;
radiculitis;
bruises, inflammation of soft tissues after injuries;
psoriatic arthritis;
myalgia;
ligament ruptures;
ankylosing spondylitis;
osteoarthritis;
postoperative pain;
rheumatoid arthritis;
feverish conditions;
painful menstruation;
sciatica;
arthralgia;
bursitis;
osteochondrosis;
lumbago;
arthritis of various etiologies;
inflammation of ligaments and tendons.

What else do Nise tablets help with? The medicine is able to lower the elevated body temperature, relieve fever during colds of viral diseases.

Contraindications

It is forbidden to use the drug for:

heart failure (only under the supervision of a specialist);
pregnancy;
ulcers of the stomach and intestines;
hypersensitivity to the composition;
bleeding from the stomach and intestines in history;
bronchial asthma;
aspirin triad and asthma;
kidney or liver failure;
children under 2 years old.

The drug "Nise": instructions for use

Suspension or tablets for adult patients are recommended to be taken orally before meals in a volume of 100 mg twice a day. The maximum daily dosage should not exceed 400 mg. The medicine is taken for 10 days. Dispersible tablets "Nise" instructions for use recommend using after meals, having previously dissolved them with a spoonful of water.

Babies from 2 to 3 years old are allowed to give only a suspension, up to 12 years old you can add dispersible capsules, after 12 any form of medication is prescribed. A one-time amount of the drug is determined based on the weight of the child, 4 mg of the drug should be per 1 kg. The medicine is given to children 2-3 times a day. If the body weight of the child is above 40 kg, it is allowed to take the medication at a dosage for adults.

Gel "Nise" is applied to painful inflamed areas of the body with light circular movements. Rub the ointment should not be. The number of applications reaches 4 per day. The daily dose should not exceed 30 g. Use the gel for a decade.

Side effects

The drug "Nise", reviews and instructions for use confirms this, can provoke negative reactions of the body. Side effects include:

thrombocytopenia;
heartburn;
hematuria;
bronchospasm;
nausea or vomiting;
diarrhea;
skin rash;
pain in the abdomen;
anemia;
toxic hepatitis;
anaphylactic shock;
dizziness;
leukopenia;
erosion and ulcers of the stomach,
intestines;
headache;
agranulocytosis.

In the form of a gel, "Nise" can cause local allergic reactions: peeling, itching of the skin, urticaria, a change in the shade of the body surface. In case of an overdose, an increase in pressure, dysfunction of the liver or kidneys, convulsive conditions, and respiratory depression are observed.

Price and analogues

The following drugs can replace Nise: Nimesulide, Nimulide, Nimid, Nimesil. The listed medicines have an identical active substance and have a similar therapeutic effect. You can buy Nise tablets, the price of which reaches 200 rubles for 20 pieces, without a prescription. The cost of a tube of gel 20 g starts from 165 rubles.

Patient opinions

People who used Nise tablets give positive reviews about the treatment. The drug quickly relieves pain symptoms, inflammation, lowers the temperature. Women talk about its effectiveness with painful periods.

For many, the drug helps with headaches, and the effect of the remedy is long. Reviews of elderly patients indicate that the Nise gel relieves pain in the joints and back. Patients talk about side effects in rare cases.

nise- a synthetic drug used in the treatment of joint diseases and the reduction of pain of various etiologies.

When applied topically, Nise is said to relieve pain and swelling in the joints and reduce morning stiffness. The active substance of the drug Nise has an analgesic, anti-inflammatory and antipyretic effect. The drug is effective in processes associated with pain, inflammation and swelling. Nise inhibits platelet aggregation and reduces bronchospasm, which is caused by the action of histamine and acetaldehyde. Also, the drug has an antioxidant effect and slows down the formation of toxins.

Pharmacological properties

Pharmacodynamics. Non-steroidal anti-inflammatory drug (NSAID) from the sulfonanilide class. It is a selective competitive inhibitor of cyclooxygenase-2 (COX-2), inhibits the synthesis of prostaglandins in the focus of inflammation. The inhibitory effect on COX-1 is less pronounced (rarely causes side effects associated with inhibition of prostaglandin synthesis in healthy tissues). It has anti-inflammatory, analgesic and pronounced antipyretic effect.

Pharmacokinetics. Absorption when taken orally is high (food intake reduces the rate of absorption without affecting its degree). The time to reach the maximum concentration (TCmax) is 1.5-2.5 hours. The connection with plasma proteins is 95%, with erythrocytes - 2%, with lipoproteins - 1%, with acid alpha 1-glycoproteins - 1%. Changing the dose does not affect the degree of binding. The value of the maximum concentration (Cmax) is 3.5-6.5 mg / l. The volume of distribution is 0.19-0.35 l / kg. It penetrates into the tissues of the female genital organs, where, after a single dose, its concentration is about 40% of the plasma concentration. It penetrates well into the acidic environment of the focus of inflammation (40%), synovial fluid (43%). Easily penetrates through histohematic barriers.

Metabolized in the liver by tissue monooxygenases. The main metabolite, 4-hydroxynimesulide (25%), has a similar pharmacological activity, but due to a decrease in the size of the molecules, it is able to quickly diffuse through the COX-2 hydrophobic channel to the active site of binding the methyl group. 4-hydroxynimesulide is a water-soluble compound that does not require glutathione and conjugation reactions of the II phase of metabolism (sulfation, glucuronidation, and others) to be eliminated. The half-life (T1 / 2) of nimesulide is 1.56-4.95 hours, 4-hydroxynimesulide is 2.89-4.78 hours. 4-hydroxynimesulide is excreted by the kidneys (65%) and with bile (35%), undergoes enterohepatic recycling. In patients with renal insufficiency (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.

Indications for use Nise

Rheumatoid arthritis; articular syndrome during exacerbation; psoriatic arthritis; ankylosing spondylitis; osteochondrosis with radicular syndrome; osteoarthritis; myalgia of rheumatic and non-rheumatic origin; inflammation of ligaments, tendons, bursitis, including post-traumatic inflammation of soft tissues; pain syndrome of various origins (including in the postoperative period, with injuries, algomenorrhea, toothache, headache, arthralgia, lumbar ischialgia). The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use, does not affect the progression of the disease.

Dosage and administration

The lowest effective dose should be used for the shortest possible course. Tablets are taken with sufficient water, preferably after meals. Adults and children over 12 years old - inside 1 tablet 2 times a day. In the presence of diseases of the gastrointestinal tract, it is advisable to take the drug at the end of a meal or after a meal. The maximum daily dose for adults is 200 mg. Patients with chronic renal failure require a reduction in the daily dose to 100 mg.

Application features

Since Nise® is partially excreted by the kidneys, its dose for patients with impaired renal function should be reduced, depending on the indicators of creatinine clearance. Given reports of visual impairment in patients taking other NSAIDs, treatment should be stopped immediately if any visual impairment occurs and 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 Nyz should be used with extreme caution. Patients should undergo regular medical supervision if they take medications along with nimesulide, which are characterized by an effect on the gastrointestinal tract. If signs of liver damage appear (skin itching, yellowing of the skin, nausea, vomiting, abdominal pain, dark urine, increased levels of "liver" transaminases), you should stop taking the drug and consult your doctor. Do not use the drug simultaneously with other NSAIDs. The drug can change the properties of platelets, but does not replace the preventive action of acetylsalicylic acid in cardiovascular diseases. The use of the drug may adversely affect female fertility and is not recommended for women planning a pregnancy. After 2 weeks of using the drug, it is necessary to control the biochemical parameters of liver function. This dosage form is contraindicated for children under 12 years of age, but if it is necessary to use nimesulide in children over 7 years of age, 50 mg dispersible tablets and suspension can be used in strict accordance with the instructions for medical use attached to them. Since the drug can cause drowsiness, dizziness and blurred vision, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Side effects

The frequency of side effects is classified according to the frequency of occurrence of the case: often (1-10%), sometimes (0.1-1%), rarely (0.01-0.1%), very rarely (less than 0.01%) , including individual messages. Allergic reactions: rarely - hypersensitivity reactions; very rarely - anaphylactoid reactions. From the side of the central nervous system: infrequently - dizziness; rarely - a feeling of fear, nervousness, nightmares; very rarely - headache, drowsiness, encephalopathy (Reye's syndrome). On the part of the skin: infrequently - itching, rash, increased sweating; rarely: erythema, dermatitis; very rarely: urticaria, angioedema, swelling of the face, erythema multiforme exudative, including Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome). From the urinary system: infrequently - edema; rarely - dysuria, hematuria, urinary retention, hyperkalemia; very rarely - renal failure, oliguria, interstitial nephritis. From the gastrointestinal tract: often - diarrhea, nausea, vomiting; infrequently - constipation, flatulence, gastritis; very rarely - abdominal pain, stomatitis, tarry stools, gastrointestinal bleeding, ulcer and / or perforation of the stomach or duodenum. From the side of the liver and biliary system: often - an increase in "liver" transaminases; very rarely - hepatitis, fulminant hepatitis, jaundice, cholestasis. On the part of the hematopoietic organs: rarely - anemia, eosinophilia; very rarely - thrombocytopenia, pancytopenia, purpura, prolongation of bleeding time. From the respiratory system: infrequently - shortness of breath; very rarely - exacerbation of bronchial asthma, bronchospasm. From the senses: rarely - blurred vision. From the side of the cardiovascular system: infrequently - arterial hypertension; rarely - tachycardia, hemorrhages, hot flashes. Others: rarely - general weakness; very rarely - hypothermia.

Interaction with other drugs

The effect of drugs that reduce blood clotting is enhanced by their simultaneous use with nimesulide. Nimesulide may reduce the effect of furosemide. Nimesulide may increase the possibility of side effects while taking methotrexate. The level of lithium in plasma increases with the simultaneous administration of lithium preparations and nimesulide. Nimesulide may enhance the effect of cyclosporine on the kidneys. Use with glucocorticosteroids, serotonin reuptake inhibitors increases the risk of gastrointestinal bleeding.

Contraindications

Hypersensitivity to the active substance or auxiliary components; complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose or paranasal sinuses and intolerance to acetylsalicylic acid and other NSAIDs (including history); erosive and ulcerative changes in the mucous membrane of the stomach and duodenum (duodenum), active gastrointestinal bleeding, cerebrovascular or other bleeding; inflammatory bowel disease (Crohn's disease, ulcerative colitis) in the acute phase; hemophilia and other bleeding disorders; decompensated heart failure; liver failure or any active liver disease; anamnestic data on the development of hepatotoxic reactions when using nimesulide preparations; concomitant use of potentially hepatotoxic substances; alcoholism, drug addiction; severe renal failure (creatinine clearance less than 30 ml / min), progressive kidney disease, confirmed hyperkalemia; the period after coronary artery bypass grafting; pregnancy, lactation; children's age up to 12 years.

Carefully. Ischemic heart disease, cerebrovascular disease, congestive heart failure, dyslipidemia/hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, creatinine clearance less than 60 ml/min. History of gastrointestinal ulceration, presence of Helicobacter pylori infection, older age, long-term use of NSAIDs, frequent alcohol use, severe physical illness, concomitant therapy with anticoagulants (eg, warfarin), antiplatelet agents (eg, acetylsalicylic acid, clopidogrel), oral glucocorticosteroids ( eg prednisolone), selective serotonin reuptake inhibitors (eg citalopram, fluoxetine, paroxetine, sertraline).

Overdose

Symptoms: apathy, drowsiness, nausea, vomiting. Gastrointestinal bleeding, increased blood pressure, acute renal failure, respiratory depression may occur. Treatment: Symptomatic treatment of the patient and supportive care is required. There is no specific antidote. If an overdose has occurred within the last 4 hours, it is necessary to induce vomiting, provide activated charcoal (60-100 g per adult), osmotic laxatives. Forced diuresis, hemodialysis are ineffective due to the high connection of the drug with proteins.

Questions and answers on the topic "Nise"

Question:Hello! If you take Nise tablets while intoxicated, will there be any side effects?

Answer: Both alcohol and nize increase the load on the liver, and when used together, this load is increased significantly. Therefore, it is strictly forbidden to take the drug while intoxicated. The average time for the disintegration of alcohol in the blood, depending on the serving, the strength of the drink and the weight of the person, is 5-12 hours.

Question:Hello! I am 8 weeks pregnant, I am 34 years old. I would like to give birth, but not knowing that I was pregnant, I took the drug Nise during pregnancy. For the entire period, about 4 tablets. And drank red wine. How might this affect the fetus? Thanks a lot!

Answer: Nise is contraindicated for use during pregnancy. If necessary, the use of the drug during lactation should decide on the termination of breastfeeding. There is no official information about the effect of nise on pregnancy. The effect of alcohol on the fetus depends on the amount and time of its intake.

Question:Hello. I took Nise for several days as a pain reliever. For the second day I feel a spasmodic headache and dizziness. Can I overdose? If yes, what should I do in this situation?

Answer: If the symptoms are associated with taking the drug, then most likely this is not an overdose, but a side effect. The maximum daily dose for adults is 400 mg. Overdose symptoms: apathy, drowsiness, nausea, vomiting. Possible side effects - dizziness, very rarely - headache. It is necessary to stop taking the drug and consult a doctor to select a replacement.

Question:Hello. Why does a gynecologist prescribe Nise to girls if he negatively affects fertility? What can replace Nise without harm?

Answer: The active ingredient in Nise is nimesulide, a non-steroidal anti-inflammatory drug. I don’t know where you got the information about the effect on fertility, but this group of medicines is actively used in the treatment of inflammatory diseases of the female genital organs, with algomenorrhea and with some forms of metrorrhagia. So you can't replace it.