Pharmacodynamic parameters. Nitrobenzene derivative nimesulide is an active pharmaceutical ingredient of nimide. Nimesulide inhibits the CO-mediated process of conversion of arachidonic acid to the precursor of prostaglandins, prostacyclin and thromboxane a2. Nimesulide exhibits both analgesic and antipyretic and anti-inflammatory effects mediated by the action of Tsog-2, but has little effect on platelet function or loss of gastric cytoprotection associated with Tsog-1 activity.
The therapeutic effect of nimesulide is the result of a complex of its effects aimed at inhibiting a number of key mediators of the inflammatory process, such as prostaglandins, free radicals, proteolytic enzymes and histamine, tumor necrosis factor α, and platelet activating factor.
Topical use of the preparation leads to relief or a decrease in the intensity of pain (arthralgia, among other things) during movement and at rest, weakens the state of morning stiffness and swelling in the joints, and helps to expand the range of motion in the joints.
At an early stage of the inflammatory process, nimesulide is not inferior in anti-inflammatory effect to piroxicam and indomethacin in equimolar concentrations.
Pharmacokinetic parameters. Topical application of nimesulide ensures its gradual percutaneous penetration into the underlying tissues and synovial fluid. Almost no entry into the systemic circulation occurs, therefore, no significant systemic action is noted.
Topical therapy for diseases of the musculoskeletal system (tendosynovitis, post-traumatic tendonitis, periarthritis, osteoarthritis, muscle strain, heavy physical activity on the joints), which are manifested by stiffness of movement, pain and inflammation.
Adults externally 3-4 times a day. before the procedure, rinse and dry the painful skin area, then spread a thin layer of gel on it, rubbing a little, a strip of gel (3 cm). the duration of treatment is ≤4 weeks, depends on the individual on the effectiveness of therapy.
Hypersensitivity to the active substance of the preparation or its other constituents; skin infectious diseases; dermatitis; violation of the integrity of the skin; allergic reactions (urticaria, bronchospasm, rhinitis) to inhibitors of prostaglandin synthesis in history.
Mild to moderate local skin irritation (allergic reactions, limited hyperemia, itching, rash, peeling).
Vasomotor rhinitis, Quincke's edema, dyspnea, bronchospasm (in sensitive individuals, rarely).
It is required to monitor the condition of elderly patients with congestive heart failure, disorders of hepatic or renal functions, as well as patients with severe pathology of the coagulation system, hemorrhage or ulcers of the upper digestive tract.
Combined use with other topical agents is not recommended.
Do not apply to damaged skin areas or under occlusive dressings.
Avoid contact with mucous membranes and eye contact.
Use for a minimum period of time at the minimum dose necessary to control symptoms.
In the absence of positive dynamics, a doctor's consultation is necessary.
Do not use in case of hypersensitivity to NSAIDs. When this condition occurs, therapy is discontinued.
Due to the likelihood of photosensitization when using the product, it is necessary to refrain from visits to the solarium and UV irradiation.
Not prescribed during pregnancy and lactation.
There is no effect on the reaction rate when driving vehicles or other mechanisms.
There are no data on the effectiveness and safety of use in childhood.
Not detected (in case of external use).
Nevertheless, it is necessary to take into account the likelihood of nimesulide entering the systemic circulation. At the same time, due to the displacement of some preparations from the connection with blood plasma proteins, their effect and toxicity may increase. Thus, caution is required when combined with other NSAIDs, methotrexate, cyclosporine, digoxin, antihypertensive, diuretic, anticoagulant preparations, phenytoin, lithium preparations, oral hypoglycemic preparations.
With the combined topical use of several NSAIDs, local irritation (desquamation, hyperemia, urticaria) may occur.
The anti-inflammatory effect is enhanced when combined with GCS, aminoquinolones and gold preparations.
When the gel is used over a large area of the skin or if the specified dose is exceeded, there is a possibility of developing systemic side effects characteristic of NSAIDs (such as cephalalgia, dizziness, dyspepsia, epigastralgia).
The dose is reduced or the preparation is stopped. Treatment is symptomatic.
At a temperature of ≤25 ° C in the original packaging. do not freeze.
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