Nimesulide

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Update Date 14/08/2020 . 5 mins read
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Uses

What is nimesulide used for?

Nimesulide is part of a class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs), specifically a selective cyclooxygenase (COX)-2 inhibitor. NSAIDs are used to 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-1 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 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 drug should be stored at room temperature (<25°C) and be protected from light and moisture. Do not store it in the refrigerator or freezer. Always check the label before using this product. For safety, keep out of the reach of children and pets.

Do not use if the printed expiration date has passed, the product seal has been broken, or the product has changed in color, odor, or consistency.

Do not dispose of this product by pouring it down the drain, toilet, or into the environment. Ask your pharmacist regarding the proper way and location of disposal.

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 medication, inform your doctor if:

  • You have ever had an allergic reaction to nimesulide or other NSAIDs
  • You have a history of allergy to other medications, food, or other substances
  • You are taking other medications, especially other NSAIDs and blood thinners
  • You have underlying health 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. This drug 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. This drug 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?

All drugs have the potential to elicit side effects even with normal use. Many side effects are dose-related and will resolve when it is adjusted or at the end of therapy.

Potential side effects while using this drug include:

  • Nausea
  • Diarrhea
  • Stomach upset
  • Abdominal pain
  • Indigestion
  • Headache
  • Dizziness
  • Allergic reaction
    • Rash
    • Pruritis
  • Bronchospasm
  • Blood abnormalities
    • Bleeding
    • Anemia
    • Thrombocytopenia
    • Leukopenia
    • Eosinophilia
  • 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
    • Myocardial infarction (heart attack)
    • Stroke
  • Gastrointestinal damage
    • Peptic ulceration
    • Bleeding
  • Severe hypersensitivity reaction
    • Fever
    • Toxic epidermal necrolysis (TEN) or Stevens-Johnson Syndrome (SJS)
    • Vasculitis
    • Serum sickness
  • Hepatitis
    • Jaundice
  • Nephrotoxicity
  • Hematologic abnormalities
    • Anemia
    • Thrombocytopenia
    • Leukopenia
    • Agranulocytosis
    • Pancytopenia
  • Seizures

You may experience some, none, or other side effects not mentioned above. If you have any concerns about a side effect or it becomes bothersome, consult your doctor or pharmacist.

Interactions

What drugs may interact with nimesulide?

This drug may interact with other medications. 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 inform your doctor and pharmacist.

Known drugs and their interactions with nimesulide include:

  • 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. Your dose may need to be adjusted, substituted with another drug, or discontinue using the drug.

Does food or alcohol interact with nimesulide?

The absorption rate is slightly decreased with food, however, taking it with a meal prevents gastrointestinal distress. This drug should not be taken with alcohol as it may increase the risk of gastrointestinal ulceration, bleeding, and hepatotoxicity.

Inform your doctor or pharmacist if you have any concerns regarding food-drug interactions.

What health conditions may interact with nimesulide?

This drug should be taken with caution if you have any of the following conditions or risk factors:

  • 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. You should ALWAYS consult with your doctor or pharmacist before using nimesulide.

What is the dose of nimesulide for an adult?

For acute pain, osteoarthritis, dysmenorrhea

  • Oral: take 100 mg two times a day.
  • Rectal: take 200 mg two times a day.
  • Use the lowest effective dose for the shortest possible duration (maximum of 15 days).

For pain and inflammation

  • Topical: apply a thin layer to the affected areas 2 to 3 times per day.
  • Treatment duration should be limited to a maximum of 15 days.

Dose adjustments for elderly patients

  • Use the lowest effective dose for the shortest possible duration

What is the dose of nimesulide for a child?

Children 12 years and older may receive the same dose as adults. This drug is not recommended for use in children under 12. Consult with a doctor or pharmacist for alternatives and 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

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 your nearest emergency room. Management is symptomatic treatment. Symptoms of overdose may include:

  • Lethargy
  • Drowsiness
  • Nausea, vomiting
  • Abdominal pain
  • Low-grade fever
  • Bleeding
  • Hypertension
  • Respiratory depression

What should I do if I miss a dose?

If you miss a dose of this drug, 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.

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