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Overview

Welcome to Dwaey, specifically on HYLO-FRESH page.
This medicine contains an important and useful components, as it consists of
Euphrasia officinalis, Sodium hyaluronateis available in the market in concentration

Name

Nimesulide

Precaution

Before initiating **Nimesulide**, it is important to consult with a healthcare provider, particularly for individuals with the following conditions: - **Liver Disease**: **Nimesulide** is primarily metabolized by the liver, and its use in patients with pre-existing **liver dysfunction** or those with **liver disease** (such as cirrhosis or hepatitis) is contraindicated due to the risk of **hepatotoxicity** (liver damage). Liver function should be monitored regularly during treatment. - **Gastrointestinal (GI) Conditions**: Like other NSAIDs, **Nimesulide** can increase the risk of **gastric ulcers**, **GI bleeding**, or **perforation**, especially in individuals with a history of **GI problems** such as ulcers, gastritis, or inflammatory bowel disease. Careful monitoring is recommended for these individuals. - **Renal Impairment**: Individuals with **kidney disease** or **renal insufficiency** may be at higher risk for **renal damage** while taking **Nimesulide**, and should be closely monitored, especially with prolonged use. - **Cardiovascular Disease**: **Nimesulide** can cause fluid retention and increase blood pressure, which may exacerbate heart failure or lead to the development of **hypertension**. Use with caution in patients with **cardiovascular disease**. - **Pregnancy and Breastfeeding**: **Nimesulide** should not be used during pregnancy, especially during the **third trimester**, as it may cause **premature closure of the ductus arteriosus** in the fetus. It is also not recommended during breastfeeding, as it may pass into breast milk. - **Allergic Reactions**: Patients who have had an allergic reaction to **Nimesulide** or other **NSAIDs** (such as **aspirin** or **ibuprofen**) should not take this medication. Symptoms of an allergic reaction include swelling, hives, or difficulty breathing.

Indication

**Nimesulide** is used for the following conditions: - **Pain Relief**: It is commonly prescribed for the relief of **acute pain** (e.g., post-operative pain, musculoskeletal pain, or dental pain). - **Osteoarthritis**: **Nimesulide** is used to reduce inflammation, pain, and stiffness in patients with **osteoarthritis**. - **Rheumatoid Arthritis**: It helps alleviate inflammation and pain in **rheumatoid arthritis**, a chronic autoimmune disease affecting joints. - **Dysmenorrhea**: **Nimesulide** is effective in treating **painful menstrual periods** (dysmenorrhea) by reducing menstrual cramps. - **Fever Reduction**: It is also used to reduce fever associated with various conditions, such as **viral infections** or **common cold**. However, due to safety concerns, **Nimesulide** is not recommended for long-term use, and its use is restricted in several countries due to concerns about **liver toxicity**.

Contra indication

**Nimesulide** is contraindicated in the following situations: - **Liver Disease**: It should not be used in individuals with **severe liver impairment**, or those with a history of **liver toxicity** (e.g., jaundice or hepatitis) related to **Nimesulide** or other **NSAIDs**. - **Gastrointestinal Conditions**: Patients with a history of **gastric ulcers**, **GI bleeding**, or perforations should avoid **Nimesulide**, as it can worsen these conditions. - **Renal Impairment**: Severe **renal impairment** (e.g., **chronic kidney disease** or **renal failure**) is a contraindication to **Nimesulide**, as it can further damage kidney function. - **Pregnancy (Third Trimester)**: **Nimesulide** is contraindicated during the **third trimester of pregnancy** due to the risk of fetal complications such as premature closure of the ductus arteriosus and fetal kidney damage. - **Breastfeeding**: It is contraindicated in breastfeeding mothers, as **Nimesulide** is excreted in breast milk and could affect the infant. - **Hypersensitivity**: Individuals with **hypersensitivity** or allergic reactions to **Nimesulide**, **NSAIDs**, or **sulfonamides** should avoid using this drug.

Side Effect

Common and serious side effects of **Nimesulide** include: - **Common Side Effects**: - **Headache**. - **Nausea** or **vomiting**. - **Dizziness** or **drowsiness**. - **Stomach upset**, including **abdominal pain** or **gastritis**. - **Rash** or **itching**. - **Serious Side Effects**: - **Liver Toxicity**: **Nimesulide** has been associated with severe **liver damage**, including **hepatitis** and **jaundice**, which can be life-threatening in some cases. Liver function should be monitored during treatment. - **Gastrointestinal Bleeding**: Like other NSAIDs, **Nimesulide** can increase the risk of **gastric ulcers**, **bleeding**, and **perforation**, which may lead to serious complications such as anemia or shock. - **Renal Damage**: Long-term use of **Nimesulide** can cause **renal impairment**, which can be severe in individuals with pre-existing kidney disease. - **Allergic Reactions**: Severe allergic reactions, including **anaphylaxis** (difficulty breathing, swelling of the face, lips, or throat), can occur, requiring immediate medical attention.

Pregnancy Category ID

0

Mode of Action

**Nimesulide** is a **NSAID (non-steroidal anti-inflammatory drug)** that works by inhibiting the **cyclooxygenase (COX)** enzymes, specifically **COX-2**. These enzymes play a key role in the production of **prostaglandins**, chemicals in the body that mediate **inflammation**, **pain**, and **fever**. By inhibiting **COX-2**, **Nimesulide** reduces the synthesis of these **pro-inflammatory prostaglandins**, which helps alleviate symptoms of pain and inflammation. Unlike traditional NSAIDs, **Nimesulide** is selective for **COX-2**, theoretically reducing the gastrointestinal side effects seen with **COX-1 inhibitors** (like **ibuprofen**). However, it still carries the risk of cardiovascular, renal, and liver issues, particularly with prolonged use.

Interaction

**Nimesulide** may interact with other medications, including: - **Anticoagulants**: Combining **Nimesulide** with **blood thinners** like **warfarin** increases the risk of bleeding. Regular monitoring of **INR** is recommended for patients on **warfarin**. - **Other NSAIDs**: Using **Nimesulide** in combination with other **NSAIDs** (such as **ibuprofen**, **aspirin**) increases the risk of gastrointestinal toxicity, including **ulcers**, **bleeding**, and **perforation**. - **Diuretics**: **Nimesulide** can reduce the effectiveness of **diuretics** (water pills) and increase the risk of **kidney damage**, especially in individuals with pre-existing kidney issues. - **Antihypertensives**: It can reduce the effectiveness of certain **blood pressure medications** like **ACE inhibitors**, **ARBs**, and **beta-blockers**. Blood pressure should be monitored regularly. - **Lithium**: **Nimesulide** may increase the levels of **lithium** in the blood, leading to potential **lithium toxicity**. Regular monitoring of lithium levels is advised. - **Methotrexate**: Combining **Nimesulide** with **methotrexate** may increase the risk of **methotrexate toxicity**, especially in high doses.

Pregnancy Category Note

Information not available

Adult Dose

- **Pain relief** (e.g., acute pain, dental pain, musculoskeletal pain): The typical dose for adults is **100 mg** twice a day, preferably after meals to minimize gastrointestinal irritation. - **Osteoarthritis and Rheumatoid Arthritis**: The usual dose is **100 mg** twice daily, with a maximum daily dose of **200 mg**. - **Dysmenorrhea** (painful menstrual periods): The typical dose is **100 mg** twice daily during the menstrual period.

Child Dose

**Nimesulide** is not typically recommended for children under 12 years of age, as its safety and efficacy in pediatric populations are not well established. In some countries, it is contraindicated in children due to concerns about liver toxicity.

Renal Dose

In patients with **renal impairment**, **Nimesulide** should be used with caution, and dose adjustments may be necessary. For individuals with **severe renal dysfunction** (creatinine clearance <30 mL/min), **Nimesulide** is generally contraindicated due to the risk of further kidney damage. Regular monitoring of renal function is recommended for those with mild to moderate renal impairment.

Administration

Information not available