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Nimesulide (NSAID, pain reliever)

Uses|Precautions & warnings|Side effects|Interactions|Dosage

Nimesulide is a nonsteroidal anti-inflammatory drug (NSAID), specifically a selective cyclooxygenase (COX)-2 inhibitor. NSAIDs treat various causes of pain, inflammation, and swelling. It can also aid in reducing fever.

COX inhibitors work by blocking the action of either or both the COX-1 and COX-2 enzymes. These enzymes are responsible for converting arachidonic acid into prostaglandin, which are a group of substances that regulate many cellular processes such as platelet aggregation, vasodilation, gastric mucus secretion, and proinflammatory mediators.

nimesulide

Uses

What is nimesulide used for?

Nimesulide is mainly indicated to treat the following conditions:

  • Mild-to-moderate acute pain
  • Inflammation
  • Fever

How should I take nimesulide?

Nimesulide is available as oral capsules, granules for suspension, topical gels, and rectal suppositories. The oral capsule should be taken by mouth without chewing or crushing it. The granules for suspension should be mixed with a glass of water before taking it. The oral dosage forms should be taken with food to prevent gastric irritation.

The topical gel should be applied as an even layer on the affected areas several times a day, as directed by your doctor. The rectal suppository should be used when taking oral dosage forms is difficult or contraindicated. Do not take or give these dosage forms by mouth.

How do I store nimesulide?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using nimesulide?

Because of the selective inhibition of COX-2, nimesulide is less likely to cause gastric distress or ulceration. However, the risk still exists and should be taken with caution in patients who are at risk. This risk is further increased in older patients usually over 60 years of age, those taking blood thinners, and those with blood clotting disorders.

Nimesulide should be prescribed and taken with caution as there are reports of an increased risk of hepatotoxicity compared to other NSAIDs. This medication should be reserved for short-term treatment to avoid this complication.

Some groups of people with conditions like asthma or heart failure may experience an exacerbation of symptoms after using NSAIDs.

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

This drug is not recommended for use during pregnancy and is contraindicated for use during the 3rd trimester. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as determined by your doctor.

This drug may be excreted in breast milk. It should be used while breastfeeding only if the potential benefit justifies the potential risk to the child, as determined by your doctor.

Side effects

What side effects can occur when using nimesulide?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Nausea
  • Diarrhea
  • Stomach upset
  • Abdominal pain
  • Indigestion
  • Headache
  • Dizziness
  • Allergic reaction
    • Rash
    • Pruritus
  • Bronchospasm
  • Blood abnormalities
  • Edema
  • Eye irritation
  • Photosensitivity
  • Malaise
  • Tinnitus
  • Drowsiness
    • Do not take before driving or operating machinery

Seek medical attention immediately if you experience any of these serious, potentially fatal drug reactions:

  • Arterial thrombotic events
  • Gastrointestinal damage
  • Severe hypersensitivity reaction (anaphylactic reactions)
  • Hepatitis, jaundice
  • Nephrotoxicity
  • Seizures

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with nimesulide?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

  • Other NSAIDs
    • GI distress
    • Ulceration
  • Salicylates
    • GI distress
  • Anticoagulants
    • Prolonged bleeding
  • Cyclosporin
    • Nephrotoxicity
  • Corticosteroids
    • GI bleeding
  • Quinolones
    • Convulsions/seizures
  • Lithium
    • Decreased elimination
  • Diuretics
    • Decreased sodium excretion
  • Methotrexate
    • Increased toxicity
  • Antihypertensives
    • Decreased control of blood pressure
  • Selective serotonin reuptake inhibitors (SSRIs)
    • GI bleeding

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with nimesulide?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Take this drug with food to reduce gastric irritation. Do not drink alcohol while taking it because it may increase the risk of ulceration. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with nimesulide?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Active bronchial asthma
  • Uncontrolled hypertension
  • Congestive heart failure (CHF)
  • Other cardiovascular diseases
  • Gastrointestinal diseases
    • Peptic ulcer disease (PUD)
    • Gastroesophageal reflux disease (GERD)
  • Conditions that require surgery
  • Renal or hepatic impairment
  • Women with fertility issues or are undergoing treatment
  • Elderly patients over the age of 60
  • CYP2C9 poor metabolizers

Inform your doctor or pharmacist if you have any concerns regarding specific health conditions.

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Acute pain, osteoarthritis, dysmenorrhea

  • Take 100 mg, two times a day.
  • For rectal suppositories, insert 200 mg two times a day.
  • Only use this drug for up to 15 days.

Pain and inflammation

  • For topical gels, apply a thin layer to the affected areas 2 to 3 times per day.
  • Only use this drug for up to 15 days.

What is the dose for a child?

There is no established pediatric dose for children under 12. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is nimesulide available?

This drug is available in the following brands, dosage forms, and strengths:

  • Sulidin gel 10 mg/g
  • Sulidin Thermo gel (nimesulide + capsaicin) 10 mg/g
  • Suppository, Rectal: 100 mg
  • Suspension, Oral: 50 mg/mL
  • Tablet, Oral: 100 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Nimesulide https://www.mims.com/philippines/drug/info/nimesulide?mtype=generic Accessed June 23, 2021

Nimesulide https://www.ema.europa.eu/en/medicines/human/referrals/nimesulide-1 Accessed June 23, 2021

Nimesulide https://pubchem.ncbi.nlm.nih.gov/compound/Nimesulide Accessed June 23, 2021

Nimesulide https://www.ncbi.nlm.nih.gov/books/NBK547948/ Accessed June 23, 2021

Nimesulide. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed June 23, 2021. http://online.lexi.com

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Written by Stephanie Nicole Nera, RPh, PharmD Updated 4 weeks ago
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