Nise is an excellent drug belonging to the anti-inflammatory group. Easily relieves fever, has anesthetic, antiplatelet effect. Nise reduces foci of inflammation, it is recommended for many diseases of the musculo-ligamentous apparatus and joint pain.

Composition, release form, packaging

The main component of the drug is nimesulide. It has good absorption, its maximum amount appears in the blood after 1-2 hours. It is excreted from the body almost completely through bile and kidneys.

Also, the drug includes additional elements:

• calcium phosphate;
• cellulose;
• starch (usually corn);
• talc;
• magnesium stearate;
• flavoring additives;
• aspartame;
• sodium glycolate;
• silicon dioxide (colloidal).

Nise is a convex tablet, round on both sides, containing 100 mg of the main element. One blister consists of 10 pieces. It can also be supplied in the form of granules for suspension, ointment or gel. All types of medicinal products are packed in a cardboard box.

In the photo of the release form of the drug Nise

Manufacturer

Nise is an Indian drug manufactured by Dr. Reddy's Laboratories Limited. It is recognized by medical professionals as one of the best drugs for the treatment of inflammation and pain relief.

Indications

The drug is prescribed for many diseases associated with the musculoskeletal system. This could be:

• rheumatic pains;
• arthritis and spondyloarthritis;
• radiculitis, myalgia;
• inflammation of muscle tissue and tendons;
• bruises and other soft tissue injuries;
• different trends;
• fever for any disease.

Indications for the use of Nise in our video:

Contraindications

Like other medicines, Nise is contraindicated in some diseases. It is strictly forbidden to take it with exacerbations of the existing duodenum, stomach, and others. Do not use the specified drug during pregnancy, as well as breastfeeding. Contraindications also include:

• , hepatic,;
• children less than 12 years old;
• diabetes;
• individual intolerance to the components.

When using the gel, additional contraindications include skin irritation, open wounds and foci of infection. It is inadmissible to get the gel on the mucous membranes, as well as in the eyes.

Mechanism of action

Nise should be prescribed to patients engaged in hazardous activities (drivers, machinists, etc.) with extreme caution, since the drug can provoke drowsiness and. When using the drug in elderly patients, there is no need to adjust the dosage.

Drug interactions

When Nise is taken together with medications that can reduce blood clotting, it is possible to enhance the effect of the latter. Also, the drug reduces the effect and is able to several times increase the possibility of unpleasant side effects when taken. Use with corticosteroids can significantly increase the risk of gastric bleeding.

In the course of treatment with this drug, it is necessary to avoid the simultaneous use of drugs that have a hepatotoxic effect. Strongly, it also increases the risk of adverse reactions.

Instructions for using the drug Nise:

Nise is a non-steroidal anti-inflammatory agent with analgesic and antipyretic action.

Release form and composition

Nise is available in the following forms:

• Dispersible tablets: in the shape of the letter "D", the edges are beveled, on one side there is an embossing "NK", the other side is smooth, the color is light yellow (10 pieces in blisters, in a cardboard box of 1, 2 or 10 blisters);
• Suspension for oral administration: yellow, with a characteristic taste and pleasant odor, redispersible when shaken (60 ml in dark glass vials, in a cardboard box 1 vial complete with a dosage cap);
• Gel for external use 1%: transparent, yellow or light yellow, without foreign particles (20 g and 50 g in tubes of laminated aluminum, in a cardboard box 1 tube).

Active ingredient: nimesulide - 50 mg in 1 tablet; 50 mg in 5 ml of suspension; 10 mg in 1 g of gel.

Auxiliary components:

• Dispersible tablets: calcium phosphate, sodium carboxymethyl starch, talc, aspartame, microcrystalline cellulose, corn starch, magnesium stearate, colloidal silicon dioxide, pineapple flavor;
• Oral suspension: propylparaben, methylparaben, citric acid, sorbitol, polysorbate 80, xanthan gum, glycerol, pineapple flavor, quinoline yellow dye WS, purified water;
• Gel for external use: propylene glycol, isopropanol, carbomer 940, thiomersal, N-methyl-2-pyrrolidone, macrogol, butylhydroxyanisole, potassium dihydrogen phosphate, purified water, flavor (Narciss-938).

Indications for use

• Psoriatic arthritis;
• Osteochondrosis with radicular syndrome;
• Sciatica;
• Radiculitis;
• Rheumatoid arthritis;
• Ankylosing spondylitis;
• Articular syndrome with exacerbation of gout and rheumatism;
• Arthralgia;
• Lumbago;
• Myalgia of rheumatic and non-rheumatic origin;
• Osteoarthritis;
• Bursitis, inflammation of tendons, ligaments;
• Arthritis of various origins;
• Pain syndrome of various etiologies (including trauma, in the postoperative period, headache, toothache, algomenorrhea);
• Post-traumatic inflammation of the musculoskeletal system and soft tissues (bruises, ruptures and damage to the ligaments);
• Fever of various origins (including infectious and inflammatory diseases).

Contraindications

Absolute:

• Bleeding from the gastrointestinal tract;
• Exacerbation of erosive and ulcerative lesions of the gastrointestinal tract;
• Severe renal failure;
• Liver dysfunction;
• "Aspirin triad";
• Skin infections, dermatoses and damage to the epidermis in the area of ​​application (for gel);
• The period of pregnancy and breastfeeding;
• Children under 2 years of age (for suspension), up to 3 years (for tablets), up to 7 years (for gel);
• Hypersensitivity to the main or auxiliary components of the drug Nise and other non-steroidal anti-inflammatory drugs.

Relative:

• Arterial hypertension;
• Heart failure;
• Renal and / or hepatic impairment;
• Type 2 diabetes mellitus;
• Elderly and children's age.

Method of administration and dosage

Nise in the form of tablets and suspensions is administered orally. The recommended dose for adult patients is 100 mg 2 times a day. The maximum dose per day is 400 mg.

The suspension is preferable to take before meals, however, in case of discomfort in the stomach, it is possible to take the drug at the end of a meal or after a meal.

Dispersible tablets are taken at the end of a meal or after a meal, after dissolving one tablet in a teaspoon (5 ml) of water.

For children, the drug is prescribed at the rate of 3-5 mg per kg of body weight 2-3 times a day. The maximum daily dose is 5 mg / kg in 2-3 doses. For adolescents weighing more than 40 kg, Nise is prescribed 2 times a day, 100 mg each.

The duration of treatment is 10 days.

Elderly patients do not need to adjust the dosage regimen.

The drug in the form of a gel is used externally. Before applying the product, the surface to be treated should be washed and dried. Then it is necessary to squeeze out a column of gel about 3 cm long and apply it with an even thin layer on the area of ​​maximum pain, do not rub. Frequency rate of application - 3-4 times a day.

The frequency of application (no more than 4 times a day) and the amount of gel can vary and depend on the patient's response and the size of the treated area. Without consulting a doctor, Nise gel is used for no more than 10 days.

Side effects

Systemic adverse reactions:

• Digestive system: nausea, vomiting, diarrhea, heartburn, erosive and ulcerative lesions of the gastrointestinal tract, pain in the stomach, toxic hepatitis, increased activity of hepatic transaminases;
• Hematopoietic system: leukopenia, agranulocytosis, anemia, thrombocytopenia;
• Central nervous system: dizziness, headache;
• Allergic reactions: bronchospasm, anaphylactic shock, skin rash;
• Others: hematuria, prolonged bleeding time, fluid retention.

Local reactions that can occur when Nise gel is applied:

• Hives;
• Transient discoloration of the skin (drug withdrawal is not required);
• Peeling.

With prolonged use of the gel on large areas of the skin, systemic side reactions are possible, typical for the drug in the form of tablets and suspensions.

special instructions

Nise is prescribed with caution to patients with visual impairment.

With prolonged use, kidney and liver function should be monitored.

Patients who are engaged in potentially dangerous activities requiring the speed of psychomotor reactions and increased concentration of attention, due to the possible development of such adverse reactions as drowsiness and dizziness, the drug is prescribed with caution.

Nise in the form of a gel is not recommended to be applied to open wounds and damaged skin areas. It should also avoid contact with mucous membranes and eyes. Do not use under airtight dressings. After the application procedure, you must tightly close the tube and wash your hands with soap and water.

Drug interactions

Nise is prescribed with caution together with phenytoin, digoxin, methotrexate, cyclosporine, diuretics, lithium preparations, hypoglycemic and antihypertensive drugs and other non-steroidal anti-inflammatory drugs.

Terms and conditions of storage

Store in a dry, dark place at a temperature not exceeding 25 ° C. Keep out of the reach of children. Do not freeze (for gel).

The shelf life of dispersible tablets and suspensions is 3 years, of a gel - 2 years.

When there is severe pain in the back, lower back, joints, of course, first of all, it is necessary to determine the cause of its occurrence. If this is a lumbago from hypothermia, lumbago, or pinching of the sciatic nerve, intervertebral hernia, etc., you should definitely be examined by a neurologist, osteopath, and possibly a gynecologist, urologist, gastroenterologist, since back pain can be not only from spasm of muscles and ligaments , but also for some diseases of internal organs. After a thorough diagnosis, the doctor may prescribe as part of complex therapy - NSAIDs, B vitamins in injections for back pain.

Table of contents [Show]

What are the remedies that relieve back pain in injections?

NSAIDs

Today, medicine finds new principles and algorithms in the treatment of acute pain in the lumbar region and back, compared to 50 years ago. The main emphasis in the fight against pain is on the elimination of pain with NSAIDs - non-steroidal anti-inflammatory drugs that suppress inflammation and reduce pain, as well as muscle blockade.

And after the removal of severe spasms, it is recommended to refuse to immobilize the patient, that is, to carry out physiotherapy exercises, massage. Most doctors insist that a person during pain syndromes in the back not limit their activity as much as possible.

B vitamins

Also, the appointment of combined vitamin complexes, which can have a moderate analgesic effect, has become popular and effective, these are vitamins B12, B6, and B1. It is believed that vitamin B12 has more significant analgesic properties. Why these vitamins?

Recently, these drugs have come to be considered in medicine as mild analgesics, since they are neurotropic - they normalize the innervation of the muscles, participate in the transmission of excitement, in the metabolism of mediators, affect the metabolism, on the processes in the nervous system, and contribute to the restoration of damaged nerves.

Over 90 different studies have proven that the use of B vitamins in clinical practice led to a significant reduction in pain in the acute phases of inflammation in complex treatment. Therefore, they can be used both individually and in the form of complex preparations of B vitamins.

The majority of complex drugs in this group contain the anesthetic lidocaine, which enhances the local analgesic effect. However, it should be remembered that the use of this group of vitamins makes sense only for acute pain in the back, joints, alcoholic polyneuropathy, myasthenia gravis B12 for 10-14 days, and for chronic recurrent diseases they already become ineffective.

Blockade

In cases where pain relievers do not help, specialists can offer the patient a method of injection and stretching. It consists in the following: after the patient lies on his stomach, the most painful seals or points where the pain is most intense are found in the muscles, and an injection is made exactly perpendicularly with a solution of novocaine.

Immediately after the injection, passive stretching of the muscle is performed, after which a hot compress is placed on this place. Then, when the compress is removed, the patient should make active movements, maximally exposing the painful muscle to movements.

The purpose of the novocaine blockade is to "turn off" the nerve. Therefore, the injection points should be as close as possible to the nerve exit points, for example, the sciatic - at the greater trochanter of the thigh, with intercostal neuralgia - into the corresponding intercostal space, with osteochondrosis - at the outer edge of the extensor of the back, etc. It is also advisable to carry out epidural blockade for chronic pain syndrome, for example, with herniated intervertebral discs.

Below is a list of drugs that are prescribed by the attending physician according to indications. Only a doctor determines the appropriateness of the use of B vitamins, NSAIDs, muscle relaxants, chondoprotectors. The information below is for informational purposes only, the course of treatment and dosage is determined by a specialist.

When your back or joints hurt, injections of B vitamins should help

Vitamins of group B can be taken in tablet form, but of course, intramuscular administration of drugs is considered more effective. Consider what drugs of this group exist on the modern pharmaceutical market, their general indications, contraindications, side effects, methods of application and comparative prices in pharmacies:

Milgamma Milgamma 5 amp. the price in pharmacies is 220 rubles, 10 amp. RUB 400 25 amp. RUB 900 The composition of all these drugs is the same: Lidocaine, Thiamine, Pyridoxine Cyanocobalamin. Indications: It is used for neurological diseases and syndromes of disorders of the nervous system in complex therapy: Neuritis, facial nerve paresis, trigeminal neuralgia Back pain caused by diseases of the spine, neurological manifestations (radiculopathy, lumboischialgia, muscular-tonic lumbar, cervical, cervico-shoulder syndromes, intercostal neuralgia, radicular syndrome due to degenerative changes in the spine) nocturnal muscle cramps, alcoholic, diabetic polyneuropathy, shingles.

Kombilipen Combilipen 5 amp. 100 -120 rubles, 10 amp. RUB 170-210 Complimentary 160 rubles. Contraindications: It is impossible to carry out treatment at: Pregnancy, lactation acute, severe types of heart failure hypersensitivity to the components of the combined B vitamins due to lack of research - children's age

Neurobion 3 amp. 220 rubles - Neurobion does not contain lidocaine in its composition Side effects: Tachycardia, increased sweating, rarely - allergic reactions - rash, itching, urticaria, skin reactions, shortness of breath, anaphylactic shock. In case of overdose - nausea, vomiting, dizziness, tachycardia.

Trigamma 5 amp. about 100 rubles Application: All of the above injections for back pain are injected deeply intramuscularly in 2 ml 1r / day for 5-10 days, then you should switch to 2-3 r / week for 14-21 days. or taking vitamins by mouth.

Effectiveness, contraindications and side effects of NSAIDs

Painkillers, of course, are used only as symptomatic therapy, they help to eliminate pain in the joints, back, but do not eliminate the cause of its occurrence, in addition, 50% of patients may experience various side effects.

In over 50 studies aimed at identifying the best pain reliever, the researchers found that no NSAID drug was more effective than other pain relievers, and some of them are very expensive drugs. The only thing to look for when choosing is that some generics (Russian diclofenac, for example) are significantly inferior in effectiveness to original drugs (European Diclofenac).

Also, these studies were aimed at determining the drug with the least side effects. As a result, it was found that Ibuprofen is the least toxic of all NSAIDs.

Manufacturers of the new Cox-2 inhibitor, Celebrex, have claimed that it has the least side effects, but studies have not found convincing evidence of this fact.

Therefore, when choosing a non-steroidal anti-inflammatory drug, it should be remembered that they have almost the same anesthetic property, the same side effects, but different frequency, intensity, severity of side effects, harmful effects, and, importantly, different prices. For example, Meloxicam has less effect on the stomach and intestines than aceclofenac (Aertal). Indomethacin has a pronounced analgesic effect, but it destroys cartilage with prolonged use and is now used less and less.

Moreover, doubling the dose does not reduce the intensity of the pain, and in the case when one non-steroidal drug does not help (if it is not a fake), replacing it with another does not make sense. Moreover, based on research, it can also be concluded that they are not much more effective than conventional paracetamol. You can learn more about all ointments for back pain from our article.

Choice of pain medications

For chronic pain, before prescribing an anesthetic, the doctor determines the causes and nature of chronic pain - reflected, neuropathic or central, and prescribes appropriate treatment.

If the pain is acute, then the doctor determines the risk of side effects on the gastrointestinal tract, cardiovascular complications, if the risks are not great, and:

• no dyspepsia - then any NSAID
• dyspepsia is - better ibuprofen (or diclofenac, naproxen), nimesulide (or myloxicam)

If the risk of cardiovascular complications is high, then NSAIDs should be avoided, and Paracetamol, opioids should be used. At moderate risk, it is possible to prescribe nimesulide, provided that blood pressure is adequately corrected (amlodipine, see drugs for lowering blood pressure).

If the risk of gastrointestinal bleeding is high - NSAIDs + necessarily proton pump inhibitors (omeprazole). It is understood that taking NSAIDs is in itself a sufficient risk even with a single dose, therefore, according to the standard, all NSAIDs are taken in combination with proton pump blockers, regardless of the risks of gastroduodenal bleeding.

With a combination of the risks of the gastrointestinal tract of side effects and complications of CVS - Nimesulide + acetylsalicylic acid + omeprazole.

If the pain subsides within 5-7 days, then continue treatment until it stops completely.
If the acute pain does not subside within a week, then muscle relaxants and local anesthetics are prescribed. Local administration of corticosteroids is possible if the diagnosis is excluded - tuberculosis of the joints or spine. With very severe pain and the absence of the effect of painkillers, the infectious nature of the pain should be excluded (tuberculosis pathology - consultation and examination at the anti-tuberculosis dispensary), joint pain with gonorrhea, syphilis or other infection.

See How to inject yourself intramuscularly and Ointments for back pain.

An overview of pain relievers in injections

All known NSAIDs in injections, with their general contraindications and side effects, average prices in pharmacies are presented in the table:

Meloxicam Movalis(3 amp. 530 rub.) Amelotex(3 amp. - 280 rubles) Arthrosan(3 amp. 190 rubles) Indications for use of NSAIDs: Symptomatic treatment of ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, elimination of pain - musculoskeletal, back pain of any etiology, postoperative and other pain sensations.

Ketoprofen Artrosilene(6 amp. 170 rub.) Ketonal(10 amp. 200 rubles) Flamax(5 amp. 110 rubles). Flexen(6 amp. 280 rub.) Contraindications: Hypersensitivity to any component of the drug, heart failure, pregnancy and lactation, severe hepatic or renal failure, aspirin asthma, children under 16-18 years of age, inflammatory bowel disease, exacerbations of gastric ulcer, gastrointestinal bleeding. Cerebrovascular diseases, coronary heart disease, any serious diseases of the cardiovascular system, joint intake of antiplatelet agents (clopidogrel, acetylsalicylic acid) prednisolone, liver dysfunction, severe somatic diseases. With care: gastrointestinal diseases, the presence of Helicobacter pylori infection, edema, fluid retention, diabetes mellitus, prolonged use of NSAIDs.

Ketorolac Ketorol(10 amp. 130-150 rubles), Ketanov(10 amp. 100 rubles) Ketorolac(10 amp 70-90 rubles) Application: Solution for injections for back pain should be injected deep intramuscularly in a dosage selected by the doctor depending on the patient's age, pain intensity. Up to 65 years of age, a single dose of 10-30 mg is prescribed. i / m every 4-6 hours. Persons with impaired renal function or over 65 years of age at a dose of 10-15 mg / m once, or every 4-6 hours. The maximum daily dose should not exceed 60-90 mg. and the duration of therapy is no more than 5 days.

Diclofenac Diclofenac(5 amp. 40 rubles) Voltaren(5 amp. 270 rubles.) Naklofen(5 amp. 50 rubles), Ortofen(10 amp. 40 rub.) Side effects: Digestive system: often - diarrhea, gastralgia, constipation, vomiting, nausea, heartburn, hepatitis, acute pancreatitis. Urinary system: frequent urination, nephritis, edema, acute renal failure. Respiratory system: shortness of breath, laryngeal edema, allergic rhinitis, difficulty breathing. CNS: dizziness, headache, drowsiness, hyperactivity, psychosis, hearing loss, depression, visual impairment. CVS: fainting, increased blood pressure, pulmonary edema. Hematopoietic organs: eosinophilia, anemia, leukopenia. Blood coagulation: rectal, nasal, gastric bleeding, from a postoperative wound. Dermatological manifestations: urticaria, skin rash, peeling of the skin, Lyell's syndrome, Stevens-Johnson syndrome. Allergic reactions: swelling of the eyelids, wheezing, shortness of breath, discoloration of the skin of the face, itching of the skin, rash, heaviness in the chest. Others: often - an increase in body weight, swelling of the ankles, face, fingers, legs, increased sweating.

Lornoxicam Ksefokam(5 amp. 700-720 rub.) Tenoxicam Texamen 1 bottle. RUB 200 Overdose: vomiting, nausea, abdominal pain, the occurrence of peptic stomach ulcers, metabolic acidosis, renal dysfunction. Interaction: The simultaneous use of NSAIDs with acetylsalicylic acid or other non-steroidal pain relievers, as well as corticosteroids, calcium preparations, ethanol, can lead to gastrointestinal bleeding and the formation of gastrointestinal ulcers. Simultaneous reception with paracetamol increases the risk of nephrotoxicity.

Painkillers in pills

When the back hurts badly, the doctor may prescribe anti-inflammatory, pain relievers in tablets, previously it was believed that oral administration slows down the onset of action, reduces effectiveness and leads to stronger side effects from the gastrointestinal tract. Today, it is believed that intramuscular and oral administration give the same bioavailability of the drug. Side effects from the gastrointestinal tract are realized through the suppression of the arachidonic acid system, that is, not with direct contact with the mucous membrane, but after absorption into the blood. Therefore, the side effects are almost the same when taken orally and with injections.

Essential NSAIDs in Tablets

• Celebrex (active substance celecoxib 10 pcs. 400-420 rubles)
• Arcoxia (active substance etoricoxib 7 pcs. 520 -600 rubles)
• Texamen (active ingredient tenoxicam 10 pcs. 200-250 rubles)
• Nise, Nimulid, Nimika (active ingredient nimesulide price 20 pcs. 80-140 rubles)
• Nalgezin (active ingredient naprxen 10 pcs. 110-130 rubles)
• Movalis, Artrozan, Meloxicam (substance Meloxicam price 20 tab. 40 rubles, Movalis 20 tab. 250 rubles)
• Ketanov, Ketarol, Ketorolac (Ketorolac substance price 20 tab. 40-60 rubles)
• Naproxen, Nalgezin (Naproxen substance, 120-260 rubles)
• Artrozilen, Bystrumcaps, Ketonal, Flexen (ketoprofen substance 20 pcs. 150 rubles, Bysrumcaps 10 pcs. 250-270 rubles, Flexen 30 pcs. 170 rubles)
• Burana, Nurofen, Faspik, Ibuprofen (substance Ibuprofen price 20 pcs. 15 rubles, Nurofen 12 pcs. 110 rubles, Faspik 6 pcs. 100 rubles, Burana 10 pcs. 80 rubles)
• Voltaren, Diklak, Naklofen, Ortofen, (Diclofenac substance price 20 pcs. 40 rubles, Voltaren 20 pcs. 200 rubles, Ortofen 30 pcs. 20 rubles, Diklak 10 pcs. 70-100 rubles)
• Aertal 20 tab. RUB 400 - active ingredient Aceclofenac.
• Ksefokam 10 pcs. 130-200 rubles. - Lornoxicam.

Combined pain relievers

Dolaren, Panoxen (20 pcs 120 rubles) - diclofenac + paracetamol.

• Neurodiclovitis (30 pcs. 300 rubles) - diclofenac + B vitamins.
• Next (120-170 rubles) - paracetamol and ibuprofen.

Muscle relaxants

Most of the pain is based on muscle spasm, which itself pulls the nerve root and causes a secondary radicular syndrome, therefore, in many cases, muscle relaxants are prescribed as an anesthetic:

• Tolperisone - peripheral action, Midocalm (instructions for use, tablets, injections of 30 tablets, 50 and 150 mg each 300-400 rubles), Tolperisone 30 pcs. RUB 150-200
• Hydroxyzin - central with inhibition of the central nervous system, suitable for severe pain, Atarax 25 pcs. 300 rubles, Hydroxyzin 25 pcs. RUB 200
• Baclofen is also centrally acting, Baklosan.
• Tizanidine - centrally acting, Sirdalud (2 mg 30 pcs. 230 rubles, 4 mg. 30 pcs. 330 rubles), Tizanil (2 mg. 30 pcs. 170 rubles, 4 mg. 30 pcs. 250 rubles), Tizalud (2 mg. 30 pcs. . 140 rubles), Tizanidine 4 mg. 30 pcs. RUB 150-200

Hondoprotectors

Chondroitin sulfate Mucosat(5 amp. 250-500 rubles), Hondroguard(10 amp. 600 rubles), Chondrolone(10 amp. 800-1100 rubles), Artradol(10 amp. 700 rubles) Chondroitin sulfate - this drug belongs to anti-inflammatory drugs, which is prescribed for the treatment of diseases of the joints and spine. It slows down the resorption of bone tissue, improves calcium-phosphorus metabolism in cartilage tissues, stops the destruction of connective and cartilaginous tissue, and accelerates recovery processes. Reduces painful sensations and increases the mobility of the spine and joints. It has a structural similarity to heparin, therefore it prevents the formation of blood clots in the subchondral and synovial bed.

Alflutop Alflutop (10 amp. 1400-1500 rub.) This is a modern preparation, which is a concentrate from small sea fish, which regulates the metabolism of cartilage tissue. The bioactive concentrate contains amino acids, potassium, sodium, copper, iron, calcium and zinc ions, as well as mucopolysaccharides, peptides. This agent stimulates the processes of cartilage tissue restoration, inhibits the destruction of bone and cartilage tissue structures, which provides a moderate analgesic effect. The drug is prescribed only for adults with osteochondrosis or polyosteoarthritis, it should be administered intramuscularly deeply 1 ml / day for a course of 20 days. If large joints are affected, it is possible to inject the drug into the joint once every 3-4 days, 1-2 ml, with a course of 5-6 injections.

Video how to give an injection intramuscularly.

Video how to quickly relieve back pain with exercise.

In this article, you can read the instructions for using the medicinal product. Nise... The 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 more actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, which may not have been declared by the manufacturer in the annotation. Nise's analogs in the presence of available structural analogs. Use for the treatment of pain and inflammation in joints and muscles in adults, children, as well as during pregnancy and lactation.

Nise- non-steroidal anti-inflammatory drug. 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.

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 of 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 prostanoid receptors of the EP type, which is expressed in analgesic and anti-inflammatory effects.

It has a slight effect on COX-1, practically does not interfere with 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 exposure to 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 decomposition 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. joint pain at rest and during movement, reduces morning stiffness and swelling of the joints. Promotes increased range of motion.

Pharmacokinetics

After oral administration, Nise is well absorbed from the gastrointestinal tract. Food intake reduces the rate of absorption without affecting its extent. 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 inflammation focus (40%), synovial fluid (43%). Easily penetrates the histo-hematological barriers. The metabolite is excreted by the kidneys (65%) and in the 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 genesis;
• inflammation of ligaments, tendons, bursitis;
• post-traumatic inflammation of soft tissues and musculoskeletal system (injuries and ruptures of ligaments, bruises);
• pain syndrome of various origins (including in the postoperative period, with injuries, algodismenorrhea, toothache, headache);
• fever of various origins (including with infectious and inflammatory diseases).

Forms of issue

Tablets 100 mg.

Dispersible tablets 50 mg (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

Pills

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 area, it can be taken at the end or after a meal.

Dispersible tablet should be taken at the end of 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 suspension, for children over the age of 12, 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. For adolescents weighing more than 40 kg, the drug is prescribed 100 mg 2 times a day.

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

Before applying the gel, wash and dry the surface of the skin. With a uniform thin layer, without rubbing, a strip of gel approximately 3 cm long is applied to the area of ​​maximum 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). The duration of the drug use is 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;
• lengthening 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 failure (CC
  

  Nise is a non-narcotic

  anesthetic and

  antipyretic drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs). Nise is used as a symptomatic drug as part of complex therapy for various conditions and diseases accompanied by fever, pain and inflammation. The main areas of application of Nise are the therapy of osteoarthritis and

  osteoarthritis

  And also relief of pain syndrome of various etiology and localization (for example, trauma, toothache, menstrual pain, diseases of the ear, throat, nose, etc.) and a decrease in body temperature during infections.

  Names, varieties and forms of release

  Nise is currently available in the following dosage forms:

  • Oral tablets;
  • Dispersible tablets (soluble in a small amount of water) for oral administration;
  • Suspension for oral administration;
  • Gel for external use.

  These dosage forms are conditionally considered varieties of the drug Nise. Of course, it is correct to attribute the listed variants of the drug to different dosage forms, but the term "varieties" is also quite suitable for everyday use, provided that all participants in the discussion mean the same thing by it.

  Tablets for oral administration are referred to simply as tablets or "Nise 100", and various terms are often used to refer to a suspension, such as syrup, solution and others, which are combined to mean a liquid dosage form intended for oral administration. Also, the suspension is called "Nise for Children", since it is this form of the drug that is approved for use in children from 2 years of age. Dispersible tablets are sometimes referred to as dissolving tablets because they are intended to be taken orally after first being dissolved in a small amount of water. These tablets differ from the usual ones in the lower dosage of the active substance, as well as the minimal risk of irritation of the gastric mucosa.

  Gel for external use is often mistakenly referred to as ointment. However, since Nise is not available in this dosage form, when people say "Nise ointment", they mean exactly the gel.

  Nise - composition

  As an active substance, all Nise dosage forms contain

  nimesulide in the following different dosages:

  • Oral tablets - 100 mg of nimesulide per tablet;
  • Dispersible tablets - 50 mg of nimesulide per tablet;
  • Suspension - 50 mg of nimesulide per 5 ml of solution;
  • Gel - 1% (10 mg of nimesulide in 1 g).

  Excipients of all Nise dosage forms are shown in the table.
  

  Auxiliary components of Nise tablets	Auxiliary components of dispersible tablets Nise	Auxiliary components of the suspension Nise	Auxiliary components of Nise gel
  Microcrystalline cellulose		Sucrose	Methyl salicylate
  Corn starch		Sorbitol	Diaethyl phthalate
  Magnesium stearate		Methylparaben	Propylene glycol
  Talc		Propylparaben	Sodium benzoate
  Colloidal silicon anhydrate	Pineapple flavor	Pineapple flavor	Diethylene glycol monoethyl ether
  Sodium glycogen glycollate	Sodium carboxymethyl starch	Quinoline yellow dye	Polyoxyl 40 from Castor Oil
  Calcium hydrogen phosphate	Calcium phosphate	Xanthan gum	Carbomer 940
  	Silica	Polysorbate 80	Disodium edetat
  	Aspartame	Lemon acid	Water
  		Glycerol	Butylhydroxytoluene
  		Water	Capsaicin
  			Menthol
  			Trometamol

  Therapeutic action

  Nise is a drug from the group of non-steroidal

  anti-inflammatory drugs(NSAIDs) and has three main therapeutic effects:

  • Pain relieving effect (analgesic);
  • Antipyretic effect (reduces body temperature);
  • Anti-inflammatory action.

  All three therapeutic effects are due to the ability of the active substance Nise to block work cyclooxygenase- an enzyme that synthesizes prostaglandins and leukotrienes. Prostaglandins and leukotrienes are substances that activate and maintain the inflammatory process, causing tissue damage, swelling, pain and redness. In turn, inflammation provokes cell death and the formation of a large amount of toxic substances that enter the systemic circulation and provoke an increase in body temperature.

  Nise, blocking the work of cyclooxygenase, prevents the formation of leukotrienes and prostaglandins, which, in turn, stops the active course of the inflammatory process. Since the inflammatory process is minimized, the associated pain, fever, edema and redness are relieved. The functioning of the affected organ is also facilitated.

  Since Nise has a nonspecific effect, it is capable of exerting a therapeutic effect in the inflammatory process, regardless of the location and nature of the cause that caused it. That is why Nise is able to stop pain during menstruation, joint diseases, injuries, neuralgia, headache and toothache, etc. Also, the drug perfectly reduces body temperature in case of a viral or bacterial infection, and also reduces the severity of any inflammatory process, regardless of what exactly it is caused by (for example, infection, autoimmune disease, trauma, etc.).

  In terms of the severity of the anti-inflammatory effect, Nise is superior to Indomethacin, Diclofenac, Ibuprofen and Piroxicam. The analgesic effect of Nise is the same with Ibuprofen, but less pronounced compared with Indomethacin. The antipyretic effect of Nise is more powerful than that of Indomethacin, Ibuprofen, Aspirin and Paracetamol.

  Since Nise can exert its effects locally and systemically, it is used in various dosage forms, depending on the localization of the inflammatory process and pain. For example, with the localization of pain and inflammation in the internal organs and on the mucous membranes, it is necessary to take Nise inside so that the drug can reach all the affected cells and tissues with the blood flow. And with the localization of pain in muscles or skin, you can not take Nise inside, but apply it externally, directly to the affected area, so that the active substances penetrate to the focus of inflammation through the skin structures. Often, to enhance the therapeutic effect, the drug is simultaneously taken orally and applied externally, especially for chronic diseases of the joints.

  In addition to antipyretic, anti-inflammatory and analgesic effects, Nise has a number of other, less significant and not so pronounced effects. So, the drug reduces the ability of platelets to stick together (aggregation) and the formation of blood clots by suppressing the factor of platelet activity.

  Nise - indications for use

  Consider the indications for the use of forms for oral and external use in children and adults.

  Nise tablets, dispersible tablets and suspension

  All dosage forms of Nise for oral administration are indicated for use in adults with the following diseases or conditions:

  • Rheumatoid arthritis;
  • The defeat of the joints with rheumatism;
  • Periods of exacerbation of gout;
  • Psoriatic arthritis;
  • Ankylosing spondylitis;
  • Osteochondrosis;
  • Radiculitis;
  • Sciatica;
  • Lumbago;
  • Osteoarthritis;
  • Arthritis of any cause;
  • Joint pain (arthralgia);
  • Muscle pain (myalgia);
  • Inflammation of ligaments and tendons (tendinitis, tendovaginitis, etc.);
  • Bursitis;
  • Traumatic inflammation of the soft tissues of the musculoskeletal system (for example, after bruises, ruptures and sprains, etc.);
  • Pains of various genesis and localization (menstrual, dental, joint, headache, pain after surgery, with gynecological and ENT diseases, etc.);
  • An increase in body temperature of any genesis.

  Suspension Nise is indicated for use in children with the following diseases or conditions:

  • Elevated body temperature in any disease, including after vaccination;
  • Inflammatory process of ENT organs and respiratory tract in viral or bacterial infections;
  • Relief of pain after surgery, trauma, soft tissue injuries, etc.

  It should be remembered that in children and adults, Nise is a symptomatic remedy that does not cure the disease, but is only able to stop pain, relieve fever and reduce inflammation, thereby alleviating and improving the general condition of a person. Therefore, it should always be used in combination with other drugs, the effects of which are aimed at curing pathology or reaching the stage of remission.

  Nise gel (ointment)

  The gel is applied externally in adults and children over 7 years of age with the following diseases or conditions:

  • Inflammatory or degenerative diseases of bones, joints, ligaments, muscles and tendons, such as gout, rheumatism, arthritis, osteoarthritis, osteochondrosis, sciatica, lumbago, bursitis, tendinitis, sciatica, etc .;
  • Muscle pain of any origin;
  • Traumatic inflammation of the organs of the musculoskeletal system (for example, bruises, lacerations or sprains of muscles, ligaments, etc.).

  The gel, like the oral forms, is intended exclusively for symptomatic therapy, that is, relieving pain, fever and reducing inflammation. The gel will not heal a tear in the ligaments, but will only ease the symptoms of the condition. Therefore, in combination with Nise gel, it is necessary to use drugs or manipulations, the action of which is aimed at curing the disease.

  Instructions for use

  Let's consider the rules for the use of different dosage forms of Nise separately in order to avoid confusion.

  Nise tablets - instructions for use

  The tablets should be taken immediately after meals. The tablet is swallowed whole, without biting, chewing or crushing in other ways, but with a small amount of water (100-200 ml). It is not recommended to use Nise tablets before meals, as this can provoke irritation or discomfort from the stomach.

  Nise tablets can be given to children from 12 years old.

  Nise is given to children who have reached 12 years of age in the same dosages as adults. Elderly people over the age of 65 should also take Nise in unreduced standard dosages. In renal failure with creatinine clearance, determined by Reberg's test, at least 30 ml / min, it is also not necessary to reduce the dosage of the drug. If creatinine clearance is below 30 ml / min, then Nise cannot be used in any dosages.

  To relieve pain, relieve fever or reduce the severity of inflammation, it is recommended to take Nise 1 tablet (100 mg) twice a day. It is advisable to take the tablets at regular intervals, for example every 12 hours. If necessary, you can increase the number of tablets to 4 tablets per day, which can be taken at least 6 hours apart. The maximum permissible daily dosage of Nise is 400 mg, exceeding which can provoke an overdose.

  The duration of taking Nise is determined by the speed of cure and a decrease in the severity of painful symptoms. That is, in each specific case, the duration of the course of therapy is determined individually and can range from several days to several weeks.

  Instructions for use of dispersible tablets Nise

  Dispersible tablets must be taken either with or immediately after a meal. It is not recommended to take the drug in this form before meals, since there is a high risk of side effects from the digestive tract.

  Before taking one tablet, dissolve in a teaspoon of water. If you need to take two tablets at once, then it is optimal to dissolve both of them in a tablespoon of water. In general, to calculate the required amount of water, you can use the following ratio - one tablet per 5 ml of water (1 teaspoon).

  Dissolved tablets are taken without additional water or any other drinks. If a person has a desire to wash off the sensation and taste of tablets from the oral mucosa, then you can take a long sip of clean water.

  Dispersible tablets can be given to children from the age of three.

  To relieve pain, fever and inflammation in various diseases, adults and adolescents over 12 years old should take Nise 100 mg (2 dispersible tablets) twice a day. If necessary, you can increase the frequency of taking the pills up to 4 times a day, observing at least 6-hour intervals between them. The maximum allowable daily dosage of Nise for adults and children over 12 years old is 400 mg.

  In elderly people over 65 years of age and with renal failure with a creatinine clearance of at least 30 ml / min, Nise is used in usual dosages, which do not need to be reduced. In renal failure with creatinine clearance below 30 ml / min, Nise cannot be used in principle.

  For children aged 3 to 12 years, the daily dosage of Nise is calculated individually by body weight, based on the ratio of 3 to 5 mg per 1 kg of body weight. For example, a child weighing 20 kg should take Nise at a dosage of 3 * 20 = 60 mg and 5 * 20 = 120 mg, that is, 60 - 120 mg per day. The daily dosage calculated in this way is divided into 2 - 3 equal parts for taking 2 - 3 times a day at approximately equal intervals. The maximum allowable daily dosage of Nise is 5 mg per 1 kg of the child's body weight. If the child's weight is more than 40 kg, but he is under 12 years old, then he is given Nise in an adult dosage of 100 mg twice a day.

  The duration of the use of Nise is determined individually, depending on the rate of disappearance of symptoms.

  Instructions for the use of Nise suspension

  Before use, the vial with the suspension is shaken so that its contents become homogeneous, after which the required amount is poured into a measuring cup or syringe and drunk. If necessary, you can drink the suspension with a little water.

  Nise in the form of a suspension can be used for children from two months old in the following dosages:

  • Children aged 2 months - 2 years - the dosage of the suspension is calculated individually by body weight, based on the ratio of 1.5 mg per 1 kg of weight. That is, a child weighing 10 kg needs 1.5 * 10 = 15 mg of Nise per day. The calculated daily amount of the drug is divided into 2 - 3 equal parts and given to the child 2 - 3 times a day. In our example, 15 mg / 3 = 5 mg, that is, the child needs to be given a 5 mg Nise suspension (which corresponds to 0.5 ml or 13 drops) three times a day;
  • Children aged 2 - 5 years - take 2.5 ml of suspension 2 - 3 times a day;
  • Children 5 - 12 years old - take 5 ml of suspension 2 - 3 times a day;
  • Children over 12 years old - take the drug in an adult dosage in any dosage form, that is, 100 mg 2 times a day, which corresponds to 10 ml of suspension, 1 regular tablet or 2 dispersible tablets.

  The suspension can be used not only for children, but also for adults who, for whatever reason, cannot or do not want to take pills. In all cases, for a person of any age, there are no restrictions on the use of the Nise suspension, it is only necessary to correctly dose the drug. The only category of people for whom it is undesirable to take Nise in the form of a suspension due to the presence of sucrose in it is diabetes mellitus.

  The duration of taking the Nise suspension is different and depends on the rate of normalization of the person's condition and the disappearance of symptoms. In acute conditions, it is recommended to use Nise for no more than 5 to 10 days.

  Gel (ointment) Nise - instructions for use

  The gel is applied to previously washed and dried areas of the skin in the area of ​​direct projection of pain and inflammation. If

  not open, then the skin is washed with warm water and soap and dried well with a soft towel. If there is an open wound on the skin, symptoms

  dermatitis

  or any damage, then Nise gel cannot be applied.

  For a single application, approximately 3 cm of gel is squeezed out of the tube and, without rubbing, evenly distribute it over the affected surface. Then leave for 1 - 2 minutes so that the composition is absorbed into the skin. After that, you can apply a regular gauze bandage to the damaged area or leave it uncovered. Airtight dressings should not be applied over the gel.

  The gel is applied to the skin 3-4 times a day. It is not recommended to apply the gel more than 4 times a day, as this can provoke the development of side effects. The maximum allowable amount of gel that can be used during the day is 30 g, which corresponds to 1.5 tubes of 20 g.

  The duration of the use of the gel is determined individually, depending on the rate of disappearance of unpleasant symptoms. It is not recommended to use Nise gel for more than 10 days in a row without consulting a doctor.

  When rubbing the gel into the surface of the skin, a burn may appear, which goes away on its own within a few days. If irritation appears in the area of ​​application of the gel, then the use of Nise should be discontinued.

  Capsaicin, which is part of the gel, can provoke a burning sensation and redness of the skin in the area of ​​application. In rare cases, the burning sensation does not disappear, but turns into an increased sensitivity of this area of ​​the skin. These effects are normal skin reactions to the gel and do not require discontinuation of the drug.

  When using the gel, it is necessary to avoid contact with the eyes, as well as on the mucous membranes of the nose, mouth and other organs. After using the drug, close the tube tightly and wash your hands with soap and water.

  special instructions

  Nise in the form of tablets, dispersible tablets and suspensions should be used with caution in people suffering from

  eye diseases

  Kidney and liver. If creatinine clearance against the background of renal failure is less than 30 ml / min, then Nise cannot be used. In other cases, with renal failure, the drug is approved for use, but with caution and under the close supervision of a physician. During the entire period of therapy, if it lasts more than a week, the functioning of the liver should be monitored and

  If there is a deterioration in the condition or function of the kidneys or liver, then Nise should be canceled and any drugs containing nimesulide should not be used in the future.

  Also, Nise should be used with caution for people suffering from cardiovascular diseases, dehydration, asthenia, metabolic disorders and diseases of the digestive tract.

  Since Nise is able to reduce blood clotting, it must be used with caution by people prone to bleeding, taking anticoagulants and suffering from hemorrhagic diathesis. In the presence of these conditions, during the entire course of Nise's use, blood coagulation parameters (platelet count, fibrinogen, APTT, PTI, INR, TB, etc.) should be monitored.

  In order to reduce the risk of side effects, it is necessary to use Nise in the minimum effective dosage. If within 2 - 3 days against the background of the use of Nise, the person's condition does not improve, then you should stop taking the drug and consult a doctor.

  If, while taking Nise tablets or suspension, a person develops nausea, anorexia, vomiting, abdominal pain, darkening of urine, yellowing of the skin, increased activity of AST and ALAT, as well as fatigue, then you should immediately stop using the drug and consult a doctor, since the data symptoms indicate the development of liver damage. In the future, a person who has similar symptoms should not use Nise and any other drugs containing nimesulide.

  Influence on the ability to control mechanisms

  Gel Nise does not interfere with the ability to control mechanisms. Nise tablets and suspension are capable of provoking

  dizziness

  drowsiness

  Therefore, while taking these dosage forms of the drug, one should refrain from any activities that require a high speed of reactions and concentration of attention.

  Overdose

  The gel usually does not cause an overdose. However, when applying more than 50 g of gel at a time, such is possible. When using tablets and suspensions, an overdose is also possible, and it manifests itself with the following symptoms:

  • Apathy;
  • Drowsiness;
  • Nausea;
  • Vomit;
  • Increased pressure;
  • Violation of the kidneys (edema, urinary retention, increased concentration of urea, creatinine in the blood, etc.);
  • Seizures;
  • Irritation of the digestive tract;
  • Gastrointestinal bleeding;
  • Respiratory depression;
  • Liver failure.

  Treatment of an overdose consists in washing the stomach, taking sorbents (activated carbon, Polysorb, Polyphepan, Enterosgel, etc.) and laxatives, followed by maintaining the normal functioning of organs and systems.

  Interaction with other medicinal products

  Nise reduces the effect of Furosemide and enhances the effects of anticoagulants,

  Cyclosporine

  and lithium compounds. The risk of developing side effects increases when Nise is used simultaneously with

  Methotrexate glucocorticosteroids

  and reuptake inhibitors

  serotonin

  Nise for children

  Nise is approved for use in children only as directed by a doctor, since, although in rare cases, it can cause severe side effects. Depending on the age of the child, it is recommended to use different forms of the drug:

  • Children under 3 years old - only Nise suspension can be given;
  • Children 3 - 12 years old - dispersible tablets or Nise suspension can be given;
  • Children over 12 years old - Nise can be given in any form.

  The dosage of the drug for children is also determined by age:

  • Children aged 2 months - 2 years - the dosage of the suspension is calculated individually by body weight, based on the ratio of 1.5 mg per 1 kg of weight. The calculated daily amount of the drug is divided into 2 - 3 equal parts and given to the child 2 - 3 times a day;
  • Children aged 2 - 5 years - take 2.5 ml of suspension 2 - 3 times a day. The dosage of dispersible tablets is calculated individually according to the ratio of 3-5 mg per 1 kg of body weight;
  • Children 5 - 12 years old - take 5 ml of suspension or 1 dispersible tablet 2 - 3 times a day;
  • Children over 12 years old - take the drug in an adult dosage in any dosage form, that is, 100 mg (10 ml of suspension, 1 regular tablet or 2 dispersible tablets) 2 times a day.

  Pregnancy and breastfeeding

  Nise can have a negative effect on fertility,

  pregnancy

  planning pregnancy

  Also, the use of Nise is contraindicated in

  breastfeeding

  Since it is not known whether the drug is excreted in

  Nise for pain, including toothache

  For pains of various localization, Nise should be taken in the form of tablets or suspension, a maximum of every 6 hours, that is, 4 times a day. Adults and children over 12 years old are advised to take 100 mg at a time, children 5 - 12 years old - 50 mg each, and 2 - 5 years old - 25 mg each. Nise relieves pain well, but if the effect of the drug is not enough, then you should not take it often and a lot (for example, 2 - 3 tablets every 1 - 2 hours), but replace with another one that has a stronger analgesic effect, for example,

  Ketorol

  Ketonal

  Nise from temperature

  Nise knocks down beautifully

  temperature

  Keeping it within the normal range for a fairly long period of time. However, since the drug can cause severe side effects, Nise should not be used, especially in children, as a first-line drug to lower body temperature. It is recommended to use Nise as a last-line remedy when Paracetamol and

  Ibuprofen

  turned out to be ineffective and after taking them, the body temperature did not return to normal.

  Alcohol compatibility

  Since both alcohol and Nise have a toxic effect on the liver, their combined use is not desirable. When drinking alcoholic beverages while taking Nise, the risk of liver damage and the development of toxic

  hepatitis A

  
  

  Side effects of Nise

  Regular and dispersible tablets, as well as Nise suspension, can provoke the following side effects from various organs and systems:

  1. Allergic reactions:

  • Skin rash;
  • Bronchospasm;
  • Anaphylactic shock.

  2. Central nervous system:

  • Dizziness;
  • Feeling of fear;
  • Nervousness;
  • Nightmares;
  • Headache;
  • Drowsiness;
  • Reye's syndrome.

  3. Leather:

  • Rash;
  • Sweating;
  • Erythema;
  • Dermatitis;
  • Hives;
  • Quincke's edema;
  • Puffiness;
  • Exudative erythema multiforme;
  • Lyell's syndrome;
  • Stevens-Johnson Syndrome.

  4. Urinary system:

  • Swelling;
  • Pain when urinating;
  • Blood in the urine
  • Retention of urine;
  • An increase in the concentration of potassium in the blood;
  • Renal failure;
  • Decreased amount of urine;
  • Interstitial nephritis.

  5. Digestive tract:

  • Diarrhea;
  • Constipation;
  • Nausea;
  • Vomit;
  • Flatulence;
  • Gastritis;
  • Abdominal pain;
  • Stomatitis;
  • Tar stools;
  • Bleeding from the organs of the gastrointestinal tract;
  • Stomach or intestinal ulcer.

  6. Liver and biliary tract:

  • Hepatitis;
  • Jaundice;
  • Cholestasis.

  7. Blood system:

  • Anemia;
  • Eosinophilia (an increase in the number of eosinophils);
  • Pancytopenia (decrease in the number of platelets, erythrocytes and blood leukocytes);
  • Purpura;

  8. Respiratory systems:

  • Dyspnea;
  • Exacerbation of bronchial asthma;
  • Bronchospasm.

  9. The cardiovascular system:

  • Hypertension;
  • Palpitations;
  • Hemorrhage;
  • Tides.

  Other:

  • Blurred vision;
  • General weakness;
  • Decrease in body temperature below normal.

  Gel Nise, as a rule, has only local adverse reactions such as itching, hives and flaking of the skin. However, when the gel is applied to large areas of the skin, due to the ingestion of the drug into the bloodstream, the following systemic side effects may develop:

  • Heartburn;
  • Nausea;
  • Vomit;
  • Diarrhea;
  • Stomach pain;
  • Ulceration of the lining of the stomach or intestines;
  • Increased activity of AsAT and ALT;
  • Headache;
  • Dizziness;
  • Swelling;
  • Blood in the urine
  • Anaphylactic shock;
  • Skin rash;
  • Thrombocytopenia (decreased platelet count);
  • Leukopenia (decrease in the number of blood leukocytes);
  • Anemia;
  • Prolongation of bleeding time.

  Contraindications for use

  Gel Nise is contraindicated for use in the following conditions or diseases:

  • Dermatoses;
  • Damage to the skin;
  • Infectious and inflammatory in the area of ​​application of the gel;
  • Pregnancy and the period of breastfeeding.

  Suspension, tablets and dispersible tablets are contraindicated for use if a person has the following diseases or conditions:

  • Hypersensitivity to the components of the drug;
  • Bronchial asthma, combined with nasal polyps and intolerance to Aspirin or other drugs of the NSAID group;
  • Stage of exacerbation of erosive and ulcerative lesions of the digestive tract;
  • Gastrointestinal or bleeding from any other location;
  • Exacerbation of inflammatory bowel disease;
  • Hemophilia;
  • Blood clotting disorders;
  • Heart failure in the stage of decompensation;
  • Liver failure or liver disease in the acute stage;
  • Liver damage in the past, which arose while taking drugs containing nimesulide;
  • Alcoholism;
  • Addiction;
  • Renal failure with creatinine clearance less than 30 ml / min;
  • Hyperkalemia (increased levels of potassium in the blood);
  • The first 2 - 3 months after coronary artery bypass grafting;
  • Pregnancy and the period of breastfeeding;
  • Age under 12 years for tablets, 3 years for dispersible tablets and 2 years for suspension.

  Nise (tablets, gel): therapeutic effect, indications and contraindications - video

  Nise - analogues

  Currently, Nise has synonyms and analogs on the pharmaceutical market. Synonyms are drugs that, as an active substance, like Nise, contain nimesulide. Nise's analogs are drugs from the NSAID group, which have the most similar therapeutic effect.

  Synonyms for Nise tablets and suspensions

  • Actasulide tablets;
  • Ameolin tablets;
  • Aponil tablets;
  • Aulin granules and tablets;
  • Coxtral tablets;
  • Nemulex granules;
  • Nimesan tablets;
  • Nimesil granules and tablets;
  • Nimesulide granules and tablets;
  • Nimica dispersible tablets;
  • Nimulide suspension, tablets and lozenges;
  • Prolid dispersible tablets.

  Gel Nise has only two synonyms- these are gels Nimulid and Sulaidin.

  Analogs of Nise tablets and suspensions are the following drugs:

  • Algezir Ultra tablets;
  • Arketal Rompharm solution for injection;
  • Brustan tablets;
  • Fastcaps capsules;
  • Vimovo tablets;
  • Dexalgin solution and tablets;
  • Diclofenac tablets and solution;
  • Ibuklin tablets;
  • Ibuprofen tablets and suspension;
  • Ibufen suspension;
  • Indomethacin tablets;
  • Ketonal capsules, solution, tablets, rectal suppositories;
  • Ketonal Duo capsules;
  • Ketoprofen tablets and solution;
  • Ketorol tablets and solution;
  • Meloxicam tablets and solution;
  • MIG 400 tablets;
  • Nalgezin tablets;
  • Naproxen tablets;
  • Next tablets;
  • Nurofen tablets, suspension, solution and gel;
  • OKI granules and rectal suppositories;
  • Rakstan-Sanovel tablets;
  • Solpaflex tablets;
  • Sirdalud tablets;
  • Sustilac tablets;
  • Flamax capsules and solution;
  • Flexen capsules, solution and rectal suppositories;
  • Flamadex solution.

  Analogs of Nise gel are the following medications:

  • Bioran gel;
  • Butadion ointment;
  • Fastgel gel;
  • Voltaren Emulgel gel;
  • Diclac gel;
  • Diclobene gel;
  • Diklovit gel;
  • Diclogen gel;
  • Diclonat P gel;
  • Dicloran gel;
  • Diclofenac gel and ointment;
  • Diclofenacol cream;
  • Long gel and cream;
  • Dorosan aerosol;
  • Ibalgin cream;
  • Ibuprofen ointment and gel;
  • Indobene gel;
  • Indomethacin gel and ointment;
  • Ketonal gel and cream;
  • Ketoprofen gel;
  • Nurofen gel;
  • Ortofen ointment and gel;
  • Ortofer ointment;
  • Piroxicam gel;
  • Fastum gel;
  • Finalgel gel;
  • Flexen gel.

  Nise (gel, tablets, suspension) - reviews

  More than 90% of reviews of Nise tablets are positive, due to the high efficacy of the drug. In the reviews, people note that the drug reliably relieves pain of various localization (in the muscles, dental, menstrual, traumatic,

  radiculitis neuralgia

  and others) for 8 - 12 hours, which allows them to take the drug before bedtime and in the morning, and sleep normally the whole night, and during the day to work productively or do household chores.

  Also, most of the positive reviews about Nise tablets and suspensions used to lower body temperature. However, these reviews, in addition to the positive characteristics of the effect of the drug, contain a warning against the constant use of Nise in children. This caution is due to the fact that the drug can cause a sharp and persistent drop in temperature below normal and liver damage, and therefore it is not used in the first place in the heat. In general, pediatricians recommend first giving Paracetamol to lower the temperature, if it does not work - Ibuprofen, and only if the latter is ineffective - Nise.

  Many parents, fearing the possible negative effect of Nise, prefer to call an ambulance and give their child an injection with the so-called lytic mixture (Analgin + Paracetamol or Aspirin). However, this lytic mixture is much more dangerous for children than Nise, therefore, at a stable temperature, you should not be afraid of this drug, but give it only if both Paracetamol and Ibuprofen are ineffective.

Nise (tablets, gel, suspension) - instructions for use, analogs, reviews, price

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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Nise is a non-narcotic anesthetic and antipyretic drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs). Nise is used as a symptomatic drug as part of complex therapy for various conditions and diseases accompanied by fever, pain and inflammation. The main areas of application of Nise are the treatment of osteoarthritis and osteoarthritis, as well as the relief of pain syndrome of various etiology and localization (for example, trauma, toothache, menstrual pain, ear, throat, nose diseases, etc.) and a decrease in body temperature in infections.

Names, varieties and forms of release

Nise is currently available in the following dosage forms:

• Oral tablets;
• Dispersible tablets (soluble in a small amount of water) for oral administration;
• Suspension for oral administration;
• Gel for external use.

These dosage forms are conditionally considered varieties of the drug Nise. Of course, it is correct to attribute the listed variants of the drug to different dosage forms, but the term "varieties" is also quite suitable for everyday use, provided that all participants in the discussion mean the same thing by it.

Tablets for oral administration are referred to simply as tablets or "Nise 100", and various terms are often used to refer to a suspension, such as syrup, solution, and others, which are combined to refer to a liquid oral dosage form. Also, the suspension is called "Nise for children", since it is this form of the drug that is approved for use in children from 2 years of age. Dispersible tablets are sometimes referred to as dissolving tablets because they are intended to be taken orally after first being dissolved in a small amount of water. These tablets differ from the usual ones in the lower dosage of the active substance, as well as the minimal risk of irritation of the gastric mucosa.

Gel for external use is often mistakenly referred to as ointment. However, since Nise is not available in this dosage form, when people say "Nise ointment", they mean exactly the gel.

Nise - composition

As an active substance, all Nise dosage forms contain nimesulide in the following different dosages:

• Oral tablets - 100 mg of nimesulide per tablet;
• Dispersible tablets - 50 mg of nimesulide per tablet;
• Suspension - 50 mg of nimesulide per 5 ml of solution;
• Gel - 1% (10 mg of nimesulide in 1 g).

Excipients of all Nise dosage forms are shown in the table.

Auxiliary components of Nise tablets	Auxiliary components of dispersible tablets Nise	Auxiliary components of the suspension Nise	Auxiliary components of Nise gel
Microcrystalline cellulose		Sucrose	Methyl salicylate
Corn starch		Sorbitol	Diaethyl phthalate
Magnesium stearate		Methylparaben	Propylene glycol
Talc		Propylparaben	Sodium benzoate
Colloidal silicon anhydrate	Pineapple flavor	Pineapple flavor	Diethylene glycol monoethyl ether
Sodium glycogen glycollate	Sodium carboxymethyl starch	Quinoline yellow dye	Polyoxyl 40 from Castor Oil
Calcium hydrogen phosphate	Calcium phosphate	Xanthan gum	Carbomer 940
	Silica	Polysorbate 80	Disodium edetat
	Aspartame	Lemon acid	Water
		Glycerol	Butylhydroxytoluene
		Water	Capsaicin
			Menthol
			Trometamol

Therapeutic action

Nise is a drug from the group of non-steroidal anti-inflammatory drugs(NSAIDs) and has three main therapeutic effects:

• Pain relieving effect (analgesic);
• Antipyretic effect (reduces body temperature);
• Anti-inflammatory action.

All three therapeutic effects are due to the ability of the active substance Nise to block work cyclooxygenase - an enzyme that synthesizes prostaglandins and leukotrienes. Prostaglandins and leukotrienes are substances that activate and maintain the inflammatory process, causing tissue damage, swelling, pain and redness. In turn, inflammation provokes cell death and the formation of a large amount of toxic substances that enter the systemic circulation and provoke an increase in body temperature.

Nise, blocking the work of cyclooxygenase, prevents the formation of leukotrienes and prostaglandins, which, in turn, stops the active course of the inflammatory process. Since the inflammatory process is minimized, the associated pain, fever, edema and redness are relieved. The functioning of the affected organ is also facilitated.

Since Nise has a nonspecific effect, it is capable of exerting a therapeutic effect in the inflammatory process, regardless of the location and nature of the cause that caused it. That is why Nise is able to stop pain during menstruation, joint diseases, injuries, neuralgia, headache and toothache, etc. Also, the drug perfectly reduces body temperature in case of a viral or bacterial infection, and also reduces the severity of any inflammatory process, regardless of what exactly it is caused by (for example, infection, autoimmune disease, trauma, etc.).

In terms of the severity of the anti-inflammatory effect, Nise is superior to Indomethacin, Diclofenac, Ibuprofen and Piroxicam. The analgesic effect of Nise is the same with Ibuprofen, but less pronounced compared with Indomethacin. The antipyretic effect of Nise is more powerful than that of Indomethacin, Ibuprofen, Aspirin and Paracetamol.

Since Nise can exert its effects locally and systemically, it is used in various dosage forms, depending on the localization of the inflammatory process and pain. For example, with the localization of pain and inflammation in the internal organs and on the mucous membranes, it is necessary to take Nise inside so that the drug can reach all the affected cells and tissues with the blood flow. And with the localization of pain in muscles or skin, you can not take Nise inside, but apply it externally, directly to the affected area, so that the active substances penetrate to the focus of inflammation through the skin structures. Often, to enhance the therapeutic effect, the drug is simultaneously taken orally and applied externally, especially for chronic diseases of the joints.

In addition to antipyretic, anti-inflammatory and analgesic effects, Nise has a number of other, less significant and not so pronounced effects. So, the drug reduces the ability of platelets to stick together (aggregation) and the formation of blood clots by suppressing the factor of platelet activity.

Nise - indications for use

Consider the indications for the use of forms for oral and external use in children and adults.

Nise tablets, dispersible tablets and suspension

All dosage forms of Nise for oral administration are indicated for use in adults with the following diseases or conditions:

• Rheumatoid arthritis;
• The defeat of the joints with rheumatism;
• Periods of exacerbation of gout;
• Psoriatic arthritis;
• Ankylosing spondylitis;
• Osteochondrosis;
• Radiculitis;
• Sciatica;
• Lumbago;
• Osteoarthritis;
• Arthritis of any cause;
• Joint pain (arthralgia);
• Muscle pain (myalgia);
• Inflammation of ligaments and tendons (tendinitis, tendovaginitis, etc.);
• Bursitis;
• Traumatic inflammation of the soft tissues of the musculoskeletal system (for example, after bruises, ruptures and sprains, etc.);
• Pains of various genesis and localization (menstrual, dental, joint, headache, pain after surgery, with gynecological and ENT diseases, etc.);
• An increase in body temperature of any genesis.

Suspension Nise is indicated for use in children with the following diseases or conditions:

• Elevated body temperature in any disease, including after vaccination;
• Inflammatory process of ENT organs and respiratory tract in viral or bacterial infections;
• Relief of pain after surgery, trauma, soft tissue injuries, etc.

It should be remembered that in children and adults, Nise is a symptomatic remedy that does not cure the disease, but is only able to stop pain, relieve fever and reduce inflammation, thereby alleviating and improving the general condition of a person. Therefore, it should always be used in combination with other drugs, the effects of which are aimed at curing pathology or reaching the stage of remission.

Nise gel (ointment)

The gel is applied externally in adults and children over 7 years of age with the following diseases or conditions:

• Inflammatory or degenerative diseases of bones, joints, ligaments, muscles and tendons, such as gout, rheumatism, arthritis, osteoarthritis, osteochondrosis, sciatica, lumbago, bursitis, tendinitis, sciatica, etc .;
• Muscle pain of any origin;
• Traumatic inflammation of the organs of the musculoskeletal system (for example, bruises, lacerations or sprains of muscles, ligaments, etc.).

The gel, like the oral forms, is intended exclusively for symptomatic therapy, that is, relieving pain, fever and reducing inflammation. The gel will not heal a tear in the ligaments, but will only ease the symptoms of the condition. Therefore, in combination with Nise gel, it is necessary to use drugs or manipulations, the action of which is aimed at curing the disease.

Instructions for use

Let's consider the rules for the use of different dosage forms of Nise separately in order to avoid confusion.

Nise tablets - instructions for use

The tablets should be taken immediately after meals. The tablet is swallowed whole, without biting, chewing or crushing in other ways, but with a small amount of water (100-200 ml). It is not recommended to use Nise tablets before meals, as this can provoke irritation or discomfort from the stomach.

Nise tablets can be given to children from 12 years old.

Nise is given to children who have reached 12 years of age in the same dosages as adults. Elderly people over the age of 65 should also take Nise in unreduced standard dosages. In renal failure with creatinine clearance, determined by Reberg's test, at least 30 ml / min, it is also not necessary to reduce the dosage of the drug. If creatinine clearance is below 30 ml / min, then Nise cannot be used in any dosages.

To relieve pain, relieve fever or reduce the severity of inflammation, it is recommended to take Nise 1 tablet (100 mg) twice a day. It is advisable to take the tablets at regular intervals, for example every 12 hours. If necessary, you can increase the number of tablets to 4 tablets per day, which can be taken at least 6 hours apart. The maximum permissible daily dosage of Nise is 400 mg, exceeding which can provoke an overdose.

The duration of taking Nise is determined by the speed of cure and a decrease in the severity of painful symptoms. That is, in each specific case, the duration of the course of therapy is determined individually and can range from several days to several weeks.

Instructions for use of dispersible tablets Nise

Dispersible tablets must be taken either with or immediately after a meal. It is not recommended to take the drug in this form before meals, since there is a high risk of side effects from the digestive tract.

Before taking one tablet, dissolve in a teaspoon of water. If you need to take two tablets at once, then it is optimal to dissolve both of them in a tablespoon of water. In general, to calculate the required amount of water, you can use the following ratio - one tablet per 5 ml of water (1 teaspoon).

Dissolved tablets are taken without additional water or any other drinks. If a person has a desire to wash off the sensation and taste of tablets from the oral mucosa, then you can take a long sip of clean water.

Dispersible tablets can be given to children from the age of three.

To relieve pain, fever and inflammation in various diseases, adults and adolescents over 12 years old should take Nise 100 mg (2 dispersible tablets) twice a day. If necessary, you can increase the frequency of taking the pills up to 4 times a day, observing at least 6-hour intervals between them. The maximum allowable daily dosage of Nise for adults and children over 12 years old is 400 mg.

In elderly people over 65 years of age and with renal failure with a creatinine clearance of at least 30 ml / min, Nise is used in usual dosages, which do not need to be reduced. In renal failure with creatinine clearance below 30 ml / min, Nise cannot be used in principle.

For children aged 3 to 12 years, the daily dosage of Nise is calculated individually by body weight, based on the ratio of 3 to 5 mg per 1 kg of body weight. For example, a child weighing 20 kg should take Nise at a dosage of 3 * 20 = 60 mg and 5 * 20 = 120 mg, that is, 60 - 120 mg per day. The daily dosage calculated in this way is divided into 2 - 3 equal parts for taking 2 - 3 times a day at approximately equal intervals. The maximum allowable daily dosage of Nise is 5 mg per 1 kg of the child's body weight. If the child's weight is more than 40 kg, but he is under 12 years old, then he is given Nise in an adult dosage of 100 mg twice a day.

The duration of the use of Nise is determined individually, depending on the rate of disappearance of symptoms.

Instructions for the use of Nise suspension

The suspension is recommended to be taken before meals, however, if any discomfort in the stomach area occurs, it is necessary to switch to taking the drug immediately after completing the meal.

Before use, the vial with the suspension is shaken so that its contents become homogeneous, after which the required amount is poured into a measuring cup or syringe and drunk. If necessary, you can drink the suspension with a little water.
Nise in the form of a suspension can be used for children from two months old in the following dosages:

• Children aged 2 months - 2 years - the dosage of the suspension is calculated individually by body weight, based on the ratio of 1.5 mg per 1 kg of weight. That is, a child weighing 10 kg needs 1.5 * 10 = 15 mg of Nise per day. The calculated daily amount of the drug is divided into 2 - 3 equal parts and given to the child 2 - 3 times a day. In our example, 15 mg / 3 = 5 mg, that is, the child needs to be given a 5 mg Nise suspension (which corresponds to 0.5 ml or 13 drops) three times a day;
• Children aged 2 - 5 years - take 2.5 ml of suspension 2 - 3 times a day;
• Children 5 - 12 years old - take 5 ml of suspension 2 - 3 times a day;
• Children over 12 years old - take the drug in an adult dosage in any dosage form, that is, 100 mg 2 times a day, which corresponds to 10 ml of suspension, 1 regular tablet or 2 dispersible tablets.

The suspension can be used not only for children, but also for adults who, for whatever reason, cannot or do not want to take pills. In all cases, for a person of any age, there are no restrictions on the use of the Nise suspension, it is only necessary to correctly dose the drug. The only category of people for whom it is undesirable to take Nise in the form of a suspension due to the presence of sucrose in it is diabetes mellitus.

The duration of taking the Nise suspension is different and depends on the rate of normalization of the person's condition and the disappearance of symptoms. In acute conditions, it is recommended to use Nise for no more than 5 to 10 days.

Gel (ointment) Nise - instructions for use

The gel is applied to previously washed and dried areas of the skin in the area of ​​direct projection of pain and inflammation. If the wound is not open, then the skin is washed with warm water and soap and dried well with a soft towel. If there is an open wound on the skin, symptoms of dermatitis or any damage, then Nise gel cannot be applied.

For a single application, approximately 3 cm of gel is squeezed out of the tube and, without rubbing, evenly distribute it over the affected surface. Then leave for 1 - 2 minutes so that the composition is absorbed into the skin. After that, you can apply a regular gauze bandage to the damaged area or leave it uncovered. Airtight dressings should not be applied over the gel.

The gel is applied to the skin 3-4 times a day. It is not recommended to apply the gel more than 4 times a day, as this can provoke the development of side effects. The maximum allowable amount of gel that can be used during the day is 30 g, which corresponds to 1.5 tubes of 20 g.

The duration of the use of the gel is determined individually, depending on the rate of disappearance of unpleasant symptoms. It is not recommended to use Nise gel for more than 10 days in a row without consulting a doctor.

When rubbing the gel into the surface of the skin, a burn may appear, which goes away on its own within a few days. If irritation appears in the area of ​​application of the gel, then the use of Nise should be discontinued.

Capsaicin, which is part of the gel, can provoke a burning sensation and redness of the skin in the area of ​​application. In rare cases, the burning sensation does not disappear, but turns into an increased sensitivity of this area of ​​the skin. These effects are normal skin reactions to the gel and do not require discontinuation of the drug.

When using the gel, it is necessary to avoid contact with the eyes, as well as on the mucous membranes of the nose, mouth and other organs. After using the drug, close the tube tightly and wash your hands with soap and water.

special instructions

Nise in the form of tablets, dispersible tablets and suspensions should be used with caution in people suffering from diseases of the eye, kidneys and liver. If creatinine clearance against the background of renal failure is less than 30 ml / min, then Nise cannot be used. In other cases, with renal failure, the drug is approved for use, but with caution and under the close supervision of a physician. During the entire period of therapy, if it lasts more than a week, the functioning of the liver and kidneys should be monitored. If there is a deterioration in the condition or function of the kidneys or liver, then Nise should be canceled and any drugs containing nimesulide should not be used in the future.

Also, Nise should be used with caution for people suffering from cardiovascular diseases, dehydration, asthenia, metabolic disorders and diseases of the digestive tract.

Since Nise is able to reduce blood clotting, it must be used with caution by people prone to bleeding, taking anticoagulants and suffering from hemorrhagic diathesis. In the presence of these conditions, during the entire course of Nise's use, blood coagulation parameters (platelet count, fibrinogen, APTT, PTI, INR, TB, etc.) should be monitored.

In order to reduce the risk of side effects, it is necessary to use Nise in the minimum effective dosage. If within 2 - 3 days against the background of the use of Nise, the person's condition does not improve, then you should stop taking the drug and consult a doctor.

If, while taking Nise tablets or suspension, a person develops nausea, anorexia, vomiting, abdominal pain, darkening of urine, yellowing of the skin, increased activity of AST and ALAT, as well as fatigue, then you should immediately stop using the drug and consult a doctor, since the data symptoms indicate the development of liver damage. In the future, a person who has similar symptoms should not use Nise and any other drugs containing nimesulide.

Influence on the ability to control mechanisms

Gel Nise does not interfere with the ability to control mechanisms. Nise tablets and suspension can provoke dizziness and drowsiness, therefore, while taking these dosage forms of the drug, one should refrain from any activities that require a high speed of reactions and concentration of attention.

Overdose

The gel usually does not cause an overdose. However, when applying more than 50 g of gel at a time, such is possible. When using tablets and suspensions, an overdose is also possible, and it manifests itself with the following symptoms:

• Apathy;
• Drowsiness;
• Nausea;
• Increased pressure;
• Violation of the kidneys (edema, urinary retention, increased concentration of urea, creatinine in the blood, etc.);
• Irritation of the digestive tract;
• Gastrointestinal bleeding;
• Respiratory depression;

Treatment of an overdose consists in washing the stomach, taking sorbents (activated carbon, Polysorb, Polyphepan, Enterosgel, etc.) and laxatives, followed by maintaining the normal functioning of organs and systems.

Interaction with other medicinal products

Nise reduces the effect of Furosemide and enhances the effects of anticoagulants, Cyclosporin and lithium compounds. The risk of side effects increases when Nise is used simultaneously with methotrexate, glucocorticosteroids and serotonin reuptake inhibitors.

Nise for children

Nise is approved for use in children only as directed by a doctor, since, although in rare cases, it can cause severe side effects. Depending on the age of the child, it is recommended to use different forms of the drug:

• Children under 3 years old - only Nise suspension can be given;
• Children 3 - 12 years old - dispersible tablets or Nise suspension can be given;
• Children over 12 years old - Nise can be given in any form.

The dosage of the drug for children is also determined by age:

• Children aged 2 months - 2 years - the dosage of the suspension is calculated individually by body weight, based on the ratio of 1.5 mg per 1 kg of weight. The calculated daily amount of the drug is divided into 2 - 3 equal parts and given to the child 2 - 3 times a day;
• Children aged 2 - 5 years - take 2.5 ml of suspension 2 - 3 times a day. The dosage of dispersible tablets is calculated individually according to the ratio of 3-5 mg per 1 kg of body weight;
• Children 5 - 12 years old - take 5 ml of suspension or 1 dispersible tablet 2 - 3 times a day;
• Children over 12 years old - take the drug in an adult dosage in any dosage form, that is, 100 mg (10 ml of suspension, 1 regular tablet or 2 dispersible tablets) 2 times a day.

Pregnancy and breastfeeding

Nise can have a negative effect on fertility, pregnancy and fetal development, therefore, the drug is not recommended for use during the entire period of gestation, as well as at the stage of pregnancy planning. Also, the use of Nise during breastfeeding is contraindicated, since it is not known whether the drug is excreted in milk.

Nise for pain, including toothache

For pains of various localization, Nise should be taken in the form of tablets or suspension, a maximum of every 6 hours, that is, 4 times a day. Adults and children over 12 years old are advised to take 100 mg at a time, children 5 - 12 years old - 50 mg each, and 2 - 5 years old - 25 mg each. Nise relieves pain well, but if the effect of the drug is not enough, then you should not take it often and a lot (for example, 2 - 3 tablets every 1 - 2 hours), but replace with another one that has a stronger analgesic effect, for example, Ketorol or Ketonal.

Nise from temperature

Nise perfectly knocks down the temperature, keeping it within the normal range for a fairly long period of time. However, since the drug can cause severe side effects, Nise should not be used, especially in children, as a first-line drug to lower body temperature. It is recommended to use Nise as a last-line remedy, when Paracetamol and Ibuprofen were ineffective and after taking them, the body temperature did not return to normal.

Alcohol compatibility

Since both alcohol and Nise have a toxic effect on the liver, their combined use is not desirable. When drinking alcoholic beverages while taking Nise, the risk of liver damage and the development of toxic hepatitis increases significantly.

Side effects of Nise

Regular and dispersible tablets, as well as Nise suspension, can provoke the following side effects from various organs and systems:
1. Allergic reactions:

• Skin rash ;
• Bronchospasm;

2. Central nervous system:

• Dizziness;
• Feeling of fear;
• Nightmares;
• Drowsiness;
• Reye's syndrome.

3. Leather:

• Rash;
• Dermatitis;
• Hives;
• Puffiness;
• Exudative erythema multiforme;
• Lyell's syndrome;
• Stevens-Johnson Syndrome.

4. Urinary system:

• Swelling;
• Retention of urine;
• An increase in the concentration of potassium in the blood;
• Renal failure;
• Decreased amount of urine;
• Interstitial nephritis.

5. Digestive tract:

• Nausea;
• Vomit;
• Abdominal pain;
• Tar stools;
• Bleeding from the organs of the gastrointestinal tract;
• Stomach or intestinal ulcer.

6. Liver and biliary tract:

• Increased activity of AsAT and ALT;
• Hepatitis;

Registration number:

P No. 12824/03 - 040411

Trade name of the drug: Nise ®

International non-proprietary name of the drug: nimesulide.

Dosage form:

pills

Composition

Each tablet contains:
Active substance: nimesulide 100 mg.
Excipients: calcium hydrogen phosphate 75 mg, cellulose
microcrystalline (type 114) 40 mg, corn starch 54 mg, sodium carboxymethyl starch 35 mg, magnesium stearate 3 mg, colloidal silicon dioxide 2 mg, talc 1 mg.

Description

Round biconvex tablets with a smooth surface, white with a yellowish sheen.

Pharmacotherapeutic group:

non-steroidal anti-inflammatory drug (NSAID).

ATX code: M01AX17.

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 (less often it causes side effects associated with inhibition of prostaglandin synthesis in healthy tissues). It has anti-inflammatory, analgesic and pronounced antipyretic effects.

Pharmacokinetics

Oral absorption is high (food intake reduces the rate of absorption without affecting its degree). Time to reach maximum concentration (T max) - 1.5-2.5 hours. Communication with plasma proteins - 95%, with erythrocytes - 2%, with lipoproteins - 1%, with acid alpha-glycoproteins - 1%. Dose variation does not affect the degree of binding. The maximum concentration (C max) is 3.5-6.5 mg / l. The volume of distribution is 0.19-0.35 l / kg. 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 inflammation focus (40%), synovial fluid (43%). Easily penetrates histohematogenous barriers.

It is 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 into the hydrophobic channel of COX-2 to the active binding site of the methyl group. 4-hydroxynimesulide is a water-soluble compound that does not require glutathione and phase II metabolic conjugation reactions (sulfation, glucuronidation, etc.) 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 failure (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

Rheumatoid arthritis;
- articular syndrome with exacerbation of gout;
- psoriatic arthritis;
- ankylosing spondylitis;
- osteochondrosis with radicular syndrome;
- osteoarthritis;
- myalgia of rheumatic and non-rheumatic genesis;
- inflammation of ligaments, tendons, bursitis, including post-traumatic inflammation
soft tissues;
- pain syndrome of various origins (including in the postoperative period, with
injuries, algodismenorrhea, toothache, headache, arthralgia, lumboishalgia).

The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use, does not affect the progression of the disease.

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 a history); erosive and ulcerative changes in the mucous membrane of the stomach and duodenum (duodenum), active gastrointestinal bleeding, cerebrovascular or other bleeding; inflammatory bowel diseases (Crohn's disease, ulcerative colitis) in the acute phase; hemophilia and other blood clotting 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 period; children under 12 years of age (for this dosage form, see the section "Special instructions").

Carefully

Ischemic heart disease, cerebrovascular disease, congestive heart failure, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, creatinine clearance less than 60 ml / min. Anamnestic data on the development of ulcerative lesions of the gastrointestinal tract, the presence of infection Helicobacter pylori, old age, long-term use of NSAIDs, frequent alcohol consumption, severe physical illness, concomitant therapy with anticoagulants (for example, warfarin), antiplatelet agents (for example, acetylsalicylic acid, clopidogrel), oral glucocorticosteroids (for example, prednisolone), selective serotonin inhibitors (for example, seizure inhibitors) citalopram, fluoxetine, paroxetine, sertraline).

Method of administration and dosage

The minimum effective dose should be used in the smallest possible short course. The tablets are taken with sufficient water, preferably after meals. Adults and children over 12 years of age 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 daily dose reduction of up to 100 mg.

Side effect

The frequency of side effects is classified depending on 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 (Reis syndrome).

From the side of the skin: infrequently - itching, rash, increased sweating; rarely: erythema, dermatitis; very rare: urticaria, angioedema, facial swelling, exudative erythema multiforme, 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 liver and biliary system: often - an increase in "hepatic" transaminases; very rarely - hepatitis, fulminant hepatitis, jaundice, cholestasis. From the side of the hematopoietic organs: rarely - anemia, eosinophilia; very rarely - thrombocytopenia, pancytopenia, purpura, prolonged bleeding time From the respiratory system: infrequently - shortness of breath; very rarely - exacerbation of bronchial asthma, bronchospasm. From the senses: rarely - blurred vision.

On the part of the cardiovascular system: infrequently - arterial hypertension; rarely, tachycardia, hemorrhages, "hot flashes". Others: rarely - general weakness; very rarely - hypothermia.

Overdose

Symptoms: apathy, drowsiness, nausea, vomiting. Gastrointestinal bleeding, increased blood pressure, acute renal failure, respiratory depression may occur.

Treatment: requires symptomatic treatment of the patient and supportive care. There is no specific antidote. If an overdose has occurred within the last 4 hours, it is necessary to induce vomiting, ensure the intake of activated carbon (60-100 g per adult), osmotic laxatives. Forced diuresis, hemodialysis are ineffective due to the high connection of the drug with proteins.

Interaction with other medicinal products

The effect of drugs that reduce blood clotting is enhanced when they are used simultaneously with nimesulide.

Nimesulide can 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 and nimesulide preparations.

Nimesulide may increase the effect of cyclosporine on the kidneys.

Use with glucocorticosteroids, serotonin reuptake inhibitors, increases the risk of gastrointestinal bleeding.

special instructions

Since Nise is partially excreted by the kidneys, its dose for patients with impaired renal function should be reduced, depending on the creatinine clearance parameters. Given the 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 tissues, therefore, patients with high blood pressure and cardiac dysfunctions should use Nise® 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 (itching, yellowing of the skin, nausea, vomiting, abdominal pain, dark urine, increased levels of "liver" transaminases), stop taking the drug and consult your doctor. The drug should not be used concomitantly with other NSAIDs.

The drug can change the properties of platelets, but does not replace the prophylactic effect 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 monitor the biochemical parameters of liver function.

This dosage form is contraindicated for children under 12 years old, but if it is necessary to use nimesulide in children over 7 years old, dispersible tablets 50 mg 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 of attention and speed of psychomotor reactions.

Release form

Tablets 100 mg. 1, 2 or 10 PVC / aluminum blisters of 10 tablets together with instructions for use are packed in a cardboard box.

Storage conditions

List B.
In a dry, dark place at a temperature not exceeding 25 ° C.
Keep out of the reach of children!

Shelf life

3 years.
Do not use after the expiration date printed on the package.

Conditions of dispensing from pharmacies

On prescription.

Manufacturer

Dr. Reddy's Laboratories Ltd., 7-1-27, Amirpet, Hyderabad - 500016, Andhra Pradesh, India

Production site address

Dr. Reddy of Laboratories Ltd.

1. Sites 42, 45 and 46, Bachupalli Village, Qutbullapur Mandal, Ranga Reddy District, Andhra Pradesh, India

2. Khol village, Nalagarh Road, Buddy Consumer claims should be sent to the following address: Representative office of Dr. Reddy s Laboratories Ltd: 115035, Moscow, Ovchinnikovskaya nab., 20, building 1 Solan district, Himachal Pradesh , India