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MUSCULO-SKELETAL SYSTEM › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS › Other antiinflammatory and antirheumatic agents, non-steroids
nimesulide
M01AX17
Forms & Strengths
- Tablet: 100 mg
- Granules for oral suspension: 100 mg
- Topical gel: 1%
Adult Dosing
- 100 mg orally twice daily after meals
- Maximum duration of treatment: 15 days per course
Pediatric Dosing
- Not recommended for children under 12 years of age
- Pediatric oral suspension (if used off-label in specific regions): 1.5 mg/kg body weight twice daily
Indications
- Treatment of acute pain
- Symptomatic treatment of osteoarthritis
- Primary dysmenorrhea
Mechanism of Action
- Preferential inhibitor of cyclooxygenase-2 (COX-2)
- Decreases synthesis of pro-inflammatory prostaglandins
- Exhibits additional pharmacological properties including scavenging of free radicals, inhibition of histamine release, and suppression of neutrophil superoxide anion production
Contraindications
- Hypersensitivity to nimesulide or excipients
- History of hypersensitivity reactions to acetylsalicylic acid or other NSAIDs
- Active peptic ulceration or history of recurrent ulcer/hemorrhage
- Hepatic impairment or active liver disease
- Concurrent administration of hepatotoxic substances
- Severe renal impairment
- Severe coagulation disorders
- Third trimester of pregnancy and lactation
Adverse Reactions
- Hepatotoxicity (including fatal hepatic failure)
- Gastrointestinal adverse effects (diarrhea, nausea, vomiting, dyspepsia, gastric ulcer)
- Dermatological reactions (rash, pruritus, sweating, Stevens-Johnson syndrome)
- Central nervous system effects (dizziness, vertigo, headache)
- Renal effects (oliguria, edema, hematuria)
Drug Interactions
- Anticoagulants and antiplatelet agents (increased risk of bleeding)
- Diuretics, ACE inhibitors, and Angiotensin II Receptor Blockers (increased risk of nephrotoxicity and reduced antihypertensive efficacy)
- Lithium (increased plasma levels of lithium due to reduced renal clearance)
- Methotrexate (increased plasma concentrations and toxicity of methotrexate)
- Hepatotoxic drugs and alcohol (significantly increased risk of severe liver damage)
Curated Content: Needs Vetting Before Put to Clinical Use