Nimesulide analogues are cheaper. Pros and cons of Movalis

International name

Nimesulide

Group affiliation

NSAIDs

Dosage form

Tablets, dispersible tablets, oral suspension, granules for oral suspension, lozenges, granules for oral solution

pharmachologic effect

NSAIDs have anti-inflammatory, analgesic, antipyretic and antiplatelet effects. Unlike other NSAIDs, it selectively suppresses COX-2 and inhibits Pg synthesis at the site of inflammation; has a less pronounced inhibitory effect on COX-1 (less likely to cause side effects associated with inhibition of Pg synthesis in healthy tissues).

Indications

Rheumatoid arthritis, osteoarthritis, arthritis of various etiologies, tendinitis, bursitis; spicy pain syndrome: algodismenorrhea, postoperative and post-traumatic pain, arthralgia, myalgia, dental and headache.

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

Contraindications

Hypersensitivity, complete or incomplete combination bronchial asthma, recurrent polyposis of the nose or paranasal sinuses and intolerance to ASA and other NSAIDs (including a history), erosive and ulcerative lesions of the mucous membrane of the stomach and duodenum, active gastrointestinal bleeding, cerebrovascular or other bleeding, inflammatory bowel disease (Crohn's disease, ulcerative colitis) in the acute phase, hemophilia and other bleeding disorders, decompensated CHF, liver failure or any active liver disease, history of hepatotoxic reactions when using nimesulide, alcoholism, drug addiction, severe chronic renal failure (creatinine clearance less than 30 ml/min), progressive kidney disease, confirmed hyperkalemia, period after coronary artery bypass surgery, simultaneous use of other hepatotoxic drugs, pregnancy, lactation, childhood up to 12 years old.

Side effects

Frequency: often - more than 1/100 and less than 1/10, infrequently - more than 1/1000 and less than 1/100, rarely - more than 1/10000 and less than 1/1000, very rarely - less than 1/10000, including individual reports.

Allergic reactions: rarely – hypersensitivity reactions; very rarely - anaphylactoid reactions.

From the side of the central nervous system: infrequently – dizziness; rarely – fear, nervousness, “nightmare” dreams; very rarely - headache, drowsiness, Reye's syndrome.

From the skin: infrequently - itching, rash, increased sweating; rarely – erythema, dermatitis; very rarely - urticaria, angioedema, swelling of the face, multiform exudative erythema, incl. Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).

From the outside genitourinary system: infrequently - swelling; rarely – dysuria, hematuria, urinary retention; very rarely - renal failure, oliguria, interstitial nephritis.

From the outside digestive system: often – diarrhea, nausea, vomiting, increased activity of “liver” transaminases; infrequently – constipation, flatulence, gastritis; very rarely - abdominal pain, stomatitis, tarry stools, bleeding from the gastrointestinal tract, ulcer and/or perforation of the stomach or duodenum, hepatitis, incl. fulminant, jaundice, cholestasis.

From the hematopoietic organs: rarely – anemia, eosinophilia; very rarely - thrombocytopenia, pancytopenia, purpura, hemorrhage, prolongation of bleeding time.

From the outside respiratory system: infrequently - shortness of breath; very rarely - exacerbation of previous bronchial asthma, bronchospasm.

From the senses: rarely – blurred visual perception.

From the cardiovascular system: infrequently – decrease in blood pressure; rarely – tachycardia, “flushes” of blood to the skin of the face and upper half torso.

Other: infrequently – hyperkalemia; rarely - general weakness; very rarely - hypothermia.

Application and dosage

Orally, after meals, 50-100 mg 2 times a day.

In patients with chronic renal failure daily dose– 100 mg.

The minimum effective dose should be used for the shortest possible short course.

special instructions

Should be monitored every 2 weeks functional tests liver.

If signs of liver damage appear (itching, jaundice, nausea, vomiting, abdominal pain, dark urine, increased activity of liver transaminases), you should immediately stop taking the drug and consult a doctor.

Given reports of visual impairment in patients taking other NSAIDs, if any visual impairment occurs, treatment should be stopped immediately and an ophthalmological examination performed.

The drug can cause fluid retention, so nimesulide should be used with extreme caution in patients with high blood pressure and heart disease.

Patients should undergo regular medical supervision if, along with nimesulide, they take medications that are characterized by an effect on the gastrointestinal tract.

The drug should not be used simultaneously with other NSAIDs.

Nimesulide may reduce platelet aggregation, but it does not replace preventive action antiplatelet agents (including ACS, clopidogrel, ticlopidine) for cardiovascular diseases.

The use of the drug may adversely affect female fertility and is not recommended for women planning pregnancy.

Care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Interaction

Hepatotoxic drugs – increased risk of developing hepatotoxic effects.

Strengthens the effect of anticoagulants.

May reduce diuretic effect furosemide Displaces furosemide, fenofibrate, salicylic acid and tolbutamide from association with plasma proteins.

May increase the toxicity of methotrexate.

Increases the concentration of Li+ in plasma.

May enhance the nephrotoxic effect of cyclosporine.

At simultaneous use with GCS, selective serotonin reuptake inhibitors, the risk of developing gastrointestinal bleeding increases.

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Do you use Nimesulide as an analogue or vice versa its analogues?

The drug Nimesulide belongs to the clinical and pharmacological group of non-steroidal anti-inflammatory drugs. They are used to reduce inflammation and pain of various etiologies.

The drug Nimesulide is available in the following dosage forms:

1. The tablet form is produced in blisters No. 10 pieces. There are thirty tablets in one package.
2. In the form of a suspension for oral administration one bottle contains 60 ml of medicine.
3. Nimesulide gel has a light transparent structure yellow color. One tube contains 30 grams of the drug.
4. Nimesulide powderfor preparing medicine. It is white in color and when dissolved it forms a white syrup with a pleasant lemon smell. One sachet contains two grams of powder.

The active component of the product is nimesulide. One tablet of the active substance contains 100 mg, one gram of powder contains 50 mg, 1 ml of suspension contains 10 mg, and 1 g contains 100 mg of the active element.

Auxiliary components are:

• Tablets - lactose monohydrate, croscarmellose sodium, sodium lauryl sulfate, magnesium stearate, calcium hydrogen phosphate dihydrate;
• Nimesulide ointment – carbomer, ethanol, macrogol 400, propylene glycol.

Nimesulide indications for use

Nimesulide is used to suppress the severity of pain and inflammation in certain pathological conditions of the patient.

Indications include:

1. Myalgia (muscle pain) regardless of etiology.
2. , which is accompanied by pain of varying intensity.
3. The development of an inflammatory process in the body that affects the ligamentous structures of the joint tissue.
4. Formation of post-traumatic inflammation.
5. Pain in teeth, varying intensity.
6. Migraine attacks.
7. Severe pain in the postoperative period.

Sometimes the drug is used as an antipyretic for severe infectious fever.

Nimesulide instructions

Nimesulide in the form of a suspension is not prescribed to children under 2 years of age. Tablets are contraindicated for children under 12 years of age. After 2 years of age, the suspension is used on the recommendation of a doctor to relieve pain and reduce body temperature in acute conditions.

Dosing of the drug for children under twelve years of age

The normal dosage of the drug is 1.5-3 mg of the drug per kilogram of the baby’s weight. One dosage should not be more than 5 mg per kilogram of the child’s weight. That is, the dosage of the drug will be calculated depending on the patient’s weight. For example, for a child weighing twenty kilograms per day, 30 mg of suspension is needed, 20 * 1.5, thus we get the required number.

How to use - dosage for adults

1. Nimesulide in powder form for the preparation of a suspension. The entire contents of one sachet are dissolved in one hundred milliliters warm water. Normal daily dosage for adults, two sachets per day are taken after the last meal. The daily dose should not exceed two hundred milligrams per day. This form The drug does not require a dosage reduction for older people. But for people suffering from kidney failure, the daily dose should be one hundred milligrams of the drug. The duration of taking the powder is 15 days.
2. In tablet form.Nimesulide tabletsare used only for oral administration to patients over twelve years of age. It is best to take the product immediately after a meal, with a large volume of water, without chewing.

1. Ointment (gel). The drug is applied with light massaging movements to the site of localization of the inflammatory process and pain, continue to rub until the product is completely absorbed. Apply to the affected area at least 3 times a day on clean skin.

Important! The use of a bandage or compress using gel is not provided for in the instructions.

Contraindications for use

TO pathological conditions people in whom the drug should not be used include:

• Erosive and ulcerative disease digestive tract;
• Intragastric bleeding;
• Diseases of the heart muscle;
• Previous bypass surgery;
• Pregnancy period;
• Breast-feeding;
• Allergic reaction to one of the components of the product;
• Age restrictions up to twelve years.

Side effects

1. Itching, rash, erythema.
2. Hypertension.
3. Nausea, heartburn, diarrhea.
4. Anemia.
5. Swelling.
6. Fluid retention in the body.
7. Hematuria.
8. Dysuria.

If even one of the above negative reactions of the body to taking the drug occurs, you should immediately visit a specialized doctor.

Price for Nimesulide

Nimesulide price in tablets for 12 tablets per different regions Russia ranges from 80 – 90 rubles.

The cost of the drug in the form of an ointment for local application is about 200 rub. for one tube.

Nimesulide's analogs

The most popular today are:

• Amtolmetin;

All of the medications listed are available in different dosage forms, which is a definite advantage when choosing similar product. The prescription of the drug is made only by the doctor.

Nimesil or Nimesulide - what is the difference?

The first thing to notice is that different shapes release. It is produced only in powder form, but Nimesulide can be purchased in three medicinal forms.

The drugs differ, although they have the same active ingredient. For example, Nimesulide in syrup is prescribed for the treatment of children starting from the age of two, at the same time when Nimesil is allowed to be used only upon reaching 12 years of age. There are also some differences in contraindications; Nimesulide is not prohibited from being taken when diabetes mellitus, but for taking Nimesil it’s strict contraindication. And, of course, the price category. Nimesil is many times more expensive.

Ketorolac or Nimesulide - which is better?

These drugs belong to the same drug group. Used to suppress inflammation and pain. But if you answer the question of what is more effective: Ketorolac or Nimesulide, then even doctors cannot give an accurate answer. This is because all people different organisms, and it is simply impossible to predict the effect of a particular drug.

Ketorolac eliminates the increased concentration in the blood of elements that are responsible for the production of prostaglandins, these are components causing pain. But Nimesulide stops the action of type 2 cyclogenases, due to which its analgesic effect on the body is not reduced. In addition, Nimesulide has a strong anti-inflammatory property, unlike Ketorolac, which does not have positive influence on the development of inflammatory processes.

Nimesulide or Diclofenac - what is the difference?

Diclofenac is a non-steroidal drug used to relieve symptoms of various pathological processes in organism. Diclofenac has analgesic properties and has a slight antipyretic and anti-inflammatory effect. If you follow the instructions for use, the drug can be used as a prophylaxis for postoperative and traumatic pain.

Unlike Nimesulide, Diclofenac is released in an infectious form, which makes it more versatile. Diclofenac is good for bruises and sprains varying degrees gravity. The drug is a fairly powerful pain reliever, which is why it is often used for oncological diseases when a powerful analgesic effect is required. Nimesulide has a less pronounced analgesic property.

Nimesulide reviews

Valentina, 44 years old

“I bought Nimesulide for the first time when I was on vacation at the seaside. When, out of the blue, I got a severe toothache. And to such an extent that I could not chew or even turn my head. But it’s good that there was a pharmacy nearby and they advised me to buy this product. According to the pharmacist, it relieves pain well. After taking the pill, an hour later everything went away for me, at least I could eat and turn my head. And pain like this never happened to me, which is very good. I recommended this same remedy to my mother; she drank it to relieve pain in her legs.”

They are a special class medicines, which have three significant effects: anti-inflammatory, antipyretic and analgesic. Due to such pharmacodynamic features this group finds drugs wide application V practical medicine. Let's look at the features of using the drug "Nimesulide", patient reviews of this drug, as well as possible adverse effects and dosing features.

Pharmacodynamic features

"Nimesulide" is a representative of the group of non-steroidal anti-inflammatory drugs medicines. In its group, the drug belongs to selective inhibitors of the enzyme cyclooxygenase-2, which effectively suppresses the production of prostaglandins at the site of inflammation.

Another distinctive feature The mechanism of action of the drug "Nimesulide" is its ability to inhibit the release of an enzyme called myeloperoxidase, which significantly inhibits the production free radicals, without affecting the processes of chemo- and thigmotaxis, as well as phagocytosis. In addition, “Nimesulide” contributes to the suppression of education and other mediators involved in inflammatory reactions body.

Pharmacokinetic features

The main route of administration of this drug is oral, which is due to the high bioavailability of the drug and the rate at which it reaches maximum concentration in the blood plasma of patients. Thus, the highest concentration is achieved 120-180 minutes after administration, and the degree of binding of the drug to blood plasma proteins approaches 98% of the initially administered amount of Nimesulide (reviews from patients and doctors confirm this).

The main organ in which drug metabolism occurs is the liver. In this case, during the process of biotransformation, an active metabolite called hydroxynimesulide is formed. The main route of excretion of the drug is its excretion in the urine (about 65% of the drug is eliminated), about 35% of the drug is excreted in feces.

Almost all patients are interested in any additional information about the drug "Nimesulide". Instructions for use, analogues, indications and contraindications, side effects- the most frequently asked questions.

Indications for use

There are not many indications for prescribing Nimesulide. Among them, it is worth noting acute pain syndrome, primary osteoarthritis with pain syndrome, as well as primary dysmenorrhea. IN pediatric practice The use of the drug is also effective. This is evidenced by the reviews left about taking Nimesulide. It is not recommended to purchase it for children under 12 years of age - this should be kept in mind.

Contraindications to the use of the drug

Like all non-steroidal anti-inflammatory drugs, Nimesulide is contraindicated in the presence of a gastric or duodenal ulcer in the acute stage, a decrease in the detoxification function of the liver, or the simultaneous administration of the drug with hepatotoxic drugs. The drug is contraindicated for use in persons with a significant decrease in excretory function kidneys less than 30 ml/min), hematological disorders and problems of the blood coagulation system, in patients with impaired function of cardio-vascular system.

Nimesulide is contraindicated in patients with surgical pathology, pregnant and breastfeeding women, as well as children under 12 years of age due to high probability development of adverse reactions. You should not prescribe Nimesulide for the treatment of influenza and influenza-like conditions, hyperthermia.

Side effects

This drug is characterized not only by high anti-inflammatory activity, but also by a high incidence of adverse reactions. They usually occur during the first week of therapy with Nimesulide. Reviews regarding the occurrence of side effects leave much to be desired.

On the skin and skin side effects are associated with allergic manifestations and reactions to the drug, which manifest themselves in the form of skin itching and rashes, dermatitis, redness, urticaria. Side effects such as Stevens-Johnson syndrome occur much less frequently.

From the gastrointestinal tract, bleeding and perforation of ulcerative defects are quite rare. Much more likely to occur painful sensations in the epigastric region, nausea, vomiting, diarrhea or constipation.

From the central side nervous system apathy, excessive drowsiness, constant headaches and unreasonable dizziness, vestibular disorders may occur.

On the part of the hematopoietic and cardiovascular systems, the development of eosinophilia, thrombocytopenia and pancytopenia, anemic syndrome, tachycardia, increased blood pressure, and the development of hyperkalemia is possible.

Application of "Nimesulide" and reviews

The use of "Nimesulide" has firmly taken its place in clinical practice rheumatological diseases of the musculoskeletal system. Despite significant limitations in the indications for the drug "Nimesulide", reviews about it are positive due to its high effectiveness in the treatment of rheumatic diseases. This is due to the specificity of the effect on cyclooxygenase-2 and the high degree of selectivity for this enzyme.

special instructions

What should you be wary of when taking a drug such as Nimesulide? Instructions for use and patient reviews inform you of some warnings. An important point in the prescription of the drug "Nimesulide" is the use of minimal therapeutic dose medicine. If the drug is not effective at the minimum dosage, the drug should be discontinued.

In case of development of hepatotoxic effect of the drug (which is monitored by biochemical parameters blood), the drug should also be stopped immediately. This group of patients (who develop cellular liver damage) is further prohibited from prescribing Nimesulide. It should be noted that even in the absence of side effects from the liver, the drug should not be combined with hepatotoxic drugs, other non-steroidal anti-inflammatory drugs, and analgesics. You should also refrain from drinking alcohol.

"Nimesulide" should be prescribed with great caution to patients with liver or kidney failure to avoid the risk of progression of the latter.

Particular attention should be paid to prescribing the drug to patients with flu-like symptoms. This is due to the fact that Nimesulide has an antipyretic effect and is able to mask the manifestations of a bacterial infection.

Drug interactions

Because of high ability drug cause intestinal bleeding Nimesulide should not be combined with anticoagulants such as Warfarin, as there is a high risk of side effects.

The drug is known to disrupt the functions of cytochrome P450. Due to oppression functional activity given enzyme, the dose of drugs metabolized by this cytochrome should be revised downward.

"Nimesulide": analogues, reviews

The main analogues (according to active substance) are “Nimid”, “Nimesil”, “Remesulid”, “Toro-sanovel”. The drug is available in tablet form, 100 mg sachets or 10 mg (per 1 g of gel). Therapeutic activity analogues of the drug are good, so patients also leave positive reviews about them. Patients leaving reviews about Nimesulide buy tablets less than the drug in sachet form.

Conclusion

"Nimesulide" is a powerful anti-inflammatory drug for the treatment inflammatory diseases, mainly the musculoskeletal system. In view of high risk If side effects develop, you must consult with your doctor regarding taking Nimesulide. Reviews from doctors prescribing this drug and patients taking it are positive, as it helps to quickly reduce the symptoms of the disease.

The variety of non-steroidal anti-inflammatory drugs on the pharmaceutical market has pros and cons. On the one hand, patients can choose the most suitable drug for them based on the combination of effectiveness and price, on the other hand, without consulting a specialist, it is quite difficult to navigate the numerous analogues of the same drug.

For the treatment of joint diseases, the drug Nimesil is often prescribed; this drug belongs to the group non-steroidal drugs and effectively relieves inflammation. However, the product has high cost. Is it possible to find an analogue of Nimesil in Russia so that it is cheaper than the original? Let's try to figure it out.

Nimesil

To talk about analogues of a medicine, you should know its basic properties. Nimesil contains the only active ingredient– substance nimesulide. This drug belongs to selective non-steroidal anti-inflammatory drugs (NSAIDs).

The selectivity of nimesulide is a property of a substance that allows it to selectively act on the source of inflammation in the body and not disrupt the functioning of the gastrointestinal tract.

In addition to nimesulide, the medicine contains auxiliary components. They help give the product a specific dosage form and improve the absorption of the main substance. Auxiliary components include:

• Ketomacrogol.
• Sucrose.
• Flavors.
• Maltodextrin.
• Lemon acid.

This Nimesil formula is approved by the manufacturer - pharmaceutical company, which produces the drug in Italy. Foreign production The product explains its high cost - about 600–800 rubles for 30 doses of powder.

Indications

What are Nimesil and its analogues used for? The mechanism of action of the drug is associated with stopping inflammation by blocking a special enzyme - cyclooxygenase. This property of the medicine determines a number of indications for the use of Nimesil:

• Pain syndrome in osteochondrosis.
• Pain in the lower back and other areas of the spine of unknown etiology.
• Injuries of the musculoskeletal system.
• Inflammatory joint diseases.
• Dental pain.
• Deforming osteoarthritis – to eliminate symptoms.
• Painful menstruation.

It is worth noting that Nimesil is used exclusively as symptomatic remedy. The product should not be used for a long time, since the drug eliminates acute manifestations inflammation. The medicine does not affect the cause of the pain.

Analogues of the drug have similar indications for use. All NSAIDs have a similar mechanism of action. You should choose an analogue based not on the indications, but on its effectiveness, the number of side effects and price characteristics.

Nimesil is an original product containing the substance nimesulide, its manufacturer guarantees healing effect regarding the listed indications.

Contraindications

Before using Nimesil and its analogues, you should familiarize yourself with the list of contraindications. The best option– preliminary consultation with a doctor who, after a full examination, will rule out the presence of undesirable conditions in the patient.

Nimesil powder and analogues should not be used in the presence of the following conditions:

1. Allergic reaction to aspirin, other NSAIDs, as well as auxiliary components of the drug.
2. Toxic liver diseases caused by drugs or alcohol.
3. Simultaneous use of drugs that have a pathological effect on the liver and hepatobiliary tract.
4. Acute period of inflammatory and peptic ulcers digestive system.
5. Coronary artery bypass grafting – early postoperative period.
6. Acute respiratory infections with low fever – nimesulide suppresses immune reactions inflammation and reduces temperature, preventing recovery.
7. Bronchial asthma and other diseases associated with allergies to NSAIDs.
8. Disorders of hematopoiesis and blood clotting.
9. Liver failure.
10. Pregnancy and lactation period.
11. Childhood.
12. Kidney diseases with severe violation organ functions.

These contraindications can be safely transferred to any analogue of Nimesil, since they relate to the active substance - nimesulide.

Side effects

Side effects of the drug and its analogues occur infrequently. The number and frequency of occurrence may depend on the manufacturing technique of the drug. This means that the original Nimesil is less likely to cause unwanted reactions than its cheap counterparts. This should be taken into account when choosing a product.

Possible side effects of Nimesulide powder:

1. Disruption of hematopoietic processes - any germs of hematopoiesis may suffer. When treating with Nimesil analogues, you should monitor general analysis blood.
2. Various shapes allergic reaction– from mild urticaria to bronchospasm and anaphylactic shock.
3. Headache, nervousness, drowsiness during the day and insomnia at night, dizziness are likely effects from using any NSAID.
4. Dysregulation of blood pressure, feeling of heat, increased heart rate.
5. Nausea and vomiting, unstable chair– may be associated with taking any medication orally.
6. Exacerbation of inflammatory diseases of the digestive tract with the formation of ulcers and bleeding from them.
7. Toxic effect on the liver - hepatitis, jaundice, increased enzymes in biochemical analysis blood.
8. Impaired kidney function - a decrease in the amount of urine, the appearance of blood in it, nephritis.

These adverse reactions may be the reason for replacing the product with analogues. Sometimes expressiveness side effects forces you to stop using any drugs containing nimesulide.

Analogs

If your doctor has prescribed you the drug Nimesil, but you are not satisfied with its price or the way the drug works, you should discuss with a specialist the possibility of using analogues.

When choosing similar drug, consider several criteria:

1. The cost of the original medicine and its analogues - you should not save the minimum amount and take risks by using generics (analogues). However, when big difference In terms of price, it wouldn't hurt to consider alternatives.
2. Composition of the drug - auxiliary components can cause unwanted side reactions and interfere with the functioning of the internal organs, be a trigger for allergies.
3. Efficacy and safety of each drug based on data clinical trials– this information is most easily obtained from experienced doctor. Experts regularly familiarize themselves with the results of international research.
4. Features of the action of the active substance, if drugs that do not contain nimesulide are used as an alternative. In this case, consultation with a doctor is required.

Taking into account the listed criteria for choosing a drug, we will try to analyze both drugs containing nimesulide and other NSAIDs that have a similar mechanism of action and indications for use.

Nise

One of the most popular medications containing nimesulide is Nise. This product is produced in India and has action features similar to Nimesil.

The price of the drug is much less than that of its competitor - about 150-300 rubles. This is an important argument in favor of choosing the drug Nise. The auxiliary components of the product differ from those of Nimesil. Part medicines Nise includes:

• Calcium hydrogen phosphate.
• Cellulose.
• Starch.
• Magnesium stearate.
• Silica.
• Sucrose.

These substances should be taken into account if the patient is intolerant to any medications.

According to international clinical trials, safety and effectiveness factors Nise means differ by several hundredths of a point from the corresponding criteria for Nimesil.

The instructions for use of Nise recommend the use of the drug as symptomatic treatment for the following conditions:

• Rheumatoid arthritis.
• Gouty arthritis attack.
• Psoriasis with articular syndrome.
• Ankylosing spondylitis.
• Myalgia.

These conditions are not included in the indications for taking Nimesil. In turn, the manufacturer of the drug Nise took into account the listed conditions when conducting clinical studies.

Nimulid

Another Indian pharmaceutical company produces another analogue of Nimesil. It is the drug Nimulid.

The product is sold in Russian pharmacies at prices ranging from 120 to 300 rubles. The cost is comparable to the drug Nise, but much lower than the price of Nimesil. Take this criterion into account when choosing.

Auxiliary components depend on the form of the medicine; a feature of Nimulid is the presence of lozenges. This form is best used on the road and when it is impossible to take a pill.

Pay attention to the presence of the following auxiliary components:

• Lactose.
• Croscarmellose sodium.
• Polysorbate.
• Docusate sodium.
• Povidone.
• Mannitol.
• Flavors.

The listed components can cause unwanted side reactions.

According to the results of international studies, the safety and effectiveness indicator is significantly inferior to both Nimesil and Nise. The last drug is in the same price category, which makes its use a more desirable alternative to the use of Nimulid.

Indications for use are completely identical to the listed conditions for using Nise. There are also no special side effects or contraindications.

Nemulex

The drugs listed above are available in tablet form, and the original Nimesil is produced in powder form. If you need to choose an analogue of such a dosage form, you should consider the drug Nemulex.

The powder is better absorbed and begins to act faster. Nemulex is produced in Russia and has more low price, however, its cost is still quite high. For 30 doses of powder, the pharmacy will ask about 600 rubles. However, there is a package with 10 sachets of the product at a price of about 200 rubles.

The Russian drug manufacturer does not share the results of clinical studies. This allows us to think about the low effectiveness and safety of the drug.

The auxiliary components of the product repeat the composition of the original Italian drug, but additionally contain silicon dioxide.

Indications, contraindications and side effects are identical to those listed.

If the features of use and the price of medicines are similar, choose original drug. The manufacturer of this product took care of conducting clinical trials and shares the results in the public domain.

Nimesulide

Numerous manufacturers from different countries A medicine is produced under the trade name Nimesulide. This product has absolutely different composition auxiliary components and has a price from 40 to 1500 rubles for various dosage forms.

Choosing a drug with this name is much more difficult than studying the peculiarities of the action of original drugs.

The cheapest is Nimesulide from a Russian pharmaceutical company North Star. Choose this drug if it is impossible to use more expensive analogues.

Products with other active ingredients

The presence of side effects with nimesulide suggests replacing the drug with analogues according to the mechanism of action with a different active component. Since the group non-steroidal drugs is numerous in number various means, there are ample opportunities for choosing the appropriate drug.

A special feature of nimesulide is its toxic effect to the liver. In addition, the drug has a rather negative effect on the condition of the gastric mucosa. Such means as:

• Meloxicam.
• Celebrex.
• Etoricoxib.

The listed drugs have a fairly high cost, but are highly selective drugs.

If the patient experiences individual intolerance drugs based on nimesulide, but they are well tolerated by other NSAIDs, you can consider using the following medications:

• Diclofenac.
• Ibuprofen.
• Ketorolac.
• Ketorol.
• Ketoprofen.

The listed agents are less selective than Nimesil and its analogues. They often cause side effects from the stomach and intestines. Inhibitors should be used simultaneously proton pump, which protect the mucous membrane of the digestive tract.

Treatment with drugs from the non-steroidal anti-inflammatory drugs (or NSAIDs) group last years is gaining popularity among both adults and children. In this regard, pharmaceutical companies strive to create new medicines and improve old ones. Meloxicam is one of the most effective remedies NSAID groups, and the list of diseases for which it can be prescribed exceeds more than a dozen. Despite its effectiveness, there are analogues of the drug that may cost less, but are not inferior in effectiveness.

Meloxicam, or its popular trade name Movalis, is most often used in the presence of pain associated with injuries, inflammation in the joints and spine. The drug reduces pain, relieves inflammation and swelling, which makes it popular in the treatment of osteochondrosis, arthritis, arthrosis, and injuries. Use the product even when specific diagnoses: for epicondylitis, ankylosing spondylitis and others.

Pros and cons of Movalis

If we consider the mechanism of action, then active substance Meloxicam is involved in the process of selective inhibition of prostaglandins, which, in turn, cause inflammation and, as a result, other symptoms. IN modern medicine Two types of NSAID drugs are used - COX-1 and the more modern COX-2, which includes Meloxicam.

One of the advantages is that the drug has fewer side effects. It is for this purpose that a standard regimen for administering Movalis has been developed, when it is better to give injections in the first days of the disease, which allows maximum impact on the source of inflammation and pain, after which a course of the drug in tablets is prescribed. This makes it possible to reduce the risk of acute ulcer or erosion of the mucous membrane in the stomach, which provokes bleeding.

Meloxicam also causes less nausea, vomiting, and abdominal pain. Use via injections and tablets allows you to increase the course of treatment with Meloxicam, while its analogue Diclofenac is allowed to be taken an order of magnitude less.

It can be noted that most doctors and pharmacy chains They recommend the trade name Movalis, which is better absorbed and produced by well-known pharmaceutical companies. In addition to the advantages of treatment with Movalis, there are also negative sides. First of all, it's the price.

In different regions of our country, prices may vary, but it will be difficult to find a drug cheaper than 400 rubles. In this case, the course of treatment is designed for 3 injections and a course of tablets, that is, you need to buy two packages of Movalis. There are also limitations in application. Movalis should not be prescribed to pregnant women, during lactation and children under 12 years of age.

You can replace Movalis with two options - find substitute analogues of Movalis with the same active substance or select an analogue from the NSAID group, which has a different composition.

Analogues with the active substance meloxicam

Meloxicam, as an active substance, is included in the following drugs:

• amelotex;
• meloxicam;
• arthrozan.

Most cheap analogue Movalis products are Meloxicam itself, which is produced by several companies. The release form is tablets of 7.5 and 15 mg, as well as ampoules for injection. To replace Movalis with Meloxicam, you must inform your doctor, who will prescribe the duration of the drug and dosage.

A common remedy is Amelotex, which is several times cheaper than Movalis and its composition contains meloxicam. In addition to tablets and ampoules, the drug is available in the form of a gel and rectal suppositories.

Before using drugs containing meloxicam (Amelotex, Movalis), you need to familiarize yourself with the list of contraindications. It is prohibited to prescribe the medicine if there is hypersensitivity to the active substance, if peptic ulcer stomach and duodenum during the period of exacerbation.

Since the drugs have a powerful effect and cause a number of side effects, it is forbidden to use Meloxicam when renal failure, bleeding in the gastrointestinal tract, liver failure, hyperkalemia. When prescribed in old age and with weak liver and kidney function, you need to undergo additional examinations and strictly follow the doctor's recommendations.

Meloxicam analogs

In general, the NSAID group contains an extensive list of drugs with similar indications. If we take analogues of the active substance, then its synonymous drugs are Ibuprofen, Nimesulide, Diclofenac. These drugs are used to treat diseases of the musculoskeletal system, prescribed for arthrosis, spondylitis, osteoporosis, epicondylitis, rheumatism and other pathologies with severe pain.

Diclofenac

Let's consider an old proven remedy - Diclofenac. Diclofenac was first used back in the 60s of the last century, and with its advent, medicine was able to move away from prescribing narcotic analgesics. The drug is actively used for the treatment of rheumatoid pathologies, in traumatology, and in the treatment of women's diseases.

Diclofenac, as an analogue of Movalis, has a number of disadvantages. Because of strong impact on the gastrointestinal tract, kidneys and liver, the course of its use is limited to injections up to 5 days, a course of tablets - up to 2 weeks. Due to the effect on the mucous membrane of the stomach and intestines, tablets are rarely prescribed.

There are a number of advantages that Diclofenac has. Diclofenac in injections has a powerful analgesic effect, that is, Movalis will not be able to relieve pain from pinching so quickly sciatic nerve, Do not lie trigeminal nerve. Another plus is a large number of ointments and gels for local impact for injuries and inflammations. The drug is also affordable. Diclofenac has analogs that contain it; its synonyms are Diclofenac, Voltaren, Diclak, Ortofen.

Nimesulide

To treat many inflammations and injuries, an analogue of Movalis, Nimesulide, is often used. In practice, its analogue is also called Nise, although the composition of the drug is Nimesulide. The drug belongs to the group of NSAIDs (sulfonanilides), and the action is associated with COX-2. Nise relieves pain well, relieves swelling and is available in several forms, which makes it possible to prescribe it for many pathologies.

The cost of the drug is slightly cheaper than Movalis, but its advantage is that it can be used immediately in the form of tablets or powder, without resorting to injections. Ointments containing Nimesulide are effective; granules and injections are used. The drug is contraindicated in children under 12 years of age and with serious diseases of the gastrointestinal tract, liver, and kidneys. Many NSAIDs have properties that affect blood pressure and reduce effectiveness antihypertensive drugs– Nise is no exception.

Contraindications and side effects allow the use of drugs containing Nimesulide only after consulting a doctor. Analogs of Nimesulide are Nise, Nimesil, Nimid.

Ibuprofen

Ibuprofen is a rare drug prescribed for young children. Unlike other NSAIDs, Ibuprofen is less dangerous and at the same time relieves inflammation better. Ibuprofen is more often used for treatment high temperature, reducing the inflammatory process. The downside is less pain relief for injuries and joint diseases.

Indications for Ibuprofen:

1. Diseases associated with inflammation in musculoskeletal system: arthritis, arthrosis, spondyloarthritis. Prescribed for ankylosing spondylitis, epicondylitis, periarthritis.
2. The presence of pain due to injuries, pinched nerves, headaches, pain during menstruation.
3. Increased body temperature due to influenza, acute respiratory infections, ARVI, and infections.

It can be concluded that Ibuprofen and its synonyms are used not only for the treatment of joints and the spine, but also as symptomatic therapy in children and adults with infections and viruses. The drug also has affordable price. Its analogues are Nurofen, Dolgit, Ibufen.

The product is used in the form of tablets, ointments, powder and injections.

Ketorolac

Ketorolac is considered the most powerful drugs from the NSAID group, is included in the list of emergency medicines; instructors recommend carrying it in a car in case of an accident. The drug is rarely prescribed for treatment chronic pathologies joints and spine. Ketorolac is more used to relieve pain in injuries, after operations and in cases of acute pain. An analogue of Ketorolac is Ketanov.

Whatever drug you choose, do not forget that all medications have their side effects. To choose a drug that is right for you, you should consult a doctor, because only a specialist knows what will help best.

2016-10-25

Anti-inflammatory drugs for osteochondrosis are the basic therapy for degenerative-dystrophic diseases of the spine. The popularity of the drugs is due to three mechanisms of action: anti-inflammatory, analgesic and pathogenetic.

When using anti-inflammatory drugs, most of the pathogenetic links of the disease are eliminated. Diclofenac is prescribed not only by doctors for osteochondrosis. Almost every patient knows that for back pain, the first thing you need to do is take this drug. However, he has side effect on the gastrointestinal tract, therefore we warn you against taking the drug on your own.

During the development of these drugs, scientists hoped that they would be able to cure osteochondrosis. In practice, it turned out that diclofenac, ibuprofen, ketorolac, ketonal, movalis and other representatives of non-selective anti-inflammatory drugs (NSAIDs) can be used for no more than 10 days. The terms of use of selective analogues (nise, nimesil) are somewhat extended.

Long-term use of NSAIDs is limited by side effects, among which the most pronounced is their negative effect on the gastrointestinal tract. We will talk about indications and contraindications for the use of NSAIDs for osteochondrosis below.

Non-steroidal anti-inflammatory drugs for the spine

The most popular non-steroidal anti-inflammatory drugs for diseases of the spine are diclofenac, ibuprofen, ketorolac. Wide use These NSAIDs are due more to the habit of doctors than to their therapeutic effect.

Ketonal for osteochondrosis is prescribed for severe pain without pronounced inflammatory changes. If swelling predominates, dimexide should be administered simultaneously with medications using electrophoresis.

The drugs described above are non-selective, therefore they are not without side effects characteristic of all NSAIDs:

• interfere with mucus secretion gastrointestinal tract what causes colitis and ulcers;
• processed in the liver, therefore they can increase organ damage against the background of hepatitis of various etiologies;
• excreted by the kidneys, therefore not recommended for renal failure;
• despite the antiallergic effect that occurs when using anti-inflammatory drugs, their individual components a person may experience allergies.

Due to the presence of the above-described side effects, when using non-steroidal anti-inflammatory drugs, after 10 days of using them, you need to take a break. These medications are contraindicated for gastric ulcers.

It should be understood that treatment of osteochondrosis with NSAIDs is symptomatic, so therapy for the disease can only temporarily eliminate pain.

Doctors' choice between diclofenac and ketorolac is explained by the fact that the latter medicine has a more pronounced analgesic effect. The prescription of diclofenac is due to the good anti-inflammatory effect of the drug.

Steroidal anti-inflammatory drugs

Steroid anti-inflammatory drugs for osteochondrosis are prescribed when a person has severe back pain that cannot be relieved by non-steroidal drugs.

The most common representatives of the group are diprospan, dimexide, movalis. Steroids have a strong analgesic and anti-inflammatory mechanism of action, but they have a significant limitation - when long-term use the release of hormones from the adrenal cortex decreases.

An addictive effect also occurs when using prednisolone and hydrocortisone. For similar reasons, long-term use of dexamethasone for osteochondrosis is not recommended. The use of steroids for diseases of the spine is carried out according to certain rules:

1. Introduced steroid drugs immediately in an effective therapeutic dose.
2. Movalis has an extended duration of action compared to dimexide.
3. Diprospan has a strong analgesic effect.
4. Dimexide penetrates well through the skin, therefore it is used for electrophoresis in degenerative diseases of the spine.
5. Steroid withdrawal is carried out gradually by reducing doses daily.

It is impossible to use diprospan and movalis at home, so only a doctor can prescribe such medications.

Despite the fact that diclofenac and ketorolac are the most popular means for osteochondrosis, we do not recommend using them independently. Unfortunately, they side effects too serious. It is enough to “earn” an ulcer once to forever abandon the use of the most effective means from degenerative-dystrophic diseases of the spine.

pharmachologic effect

NSAIDs, which have a sulfonylide group in their structure. It is believed that nimesulide is a selective COX-2 inhibitor. It has a pronounced anti-inflammatory, as well as analgesic and, to a lesser extent, antipyretic effect. The mechanism of action is associated with inhibition of prostaglandin synthesis. Suppresses the synthesis of prostaglandins in the area of ​​inflammation to a greater extent than in the gastric mucosa or kidneys, which is due to inhibition primarily of COX-2.

In addition, in the mechanism of the anti-inflammatory action of nimesulide, its ability to suppress the formation of free oxygen radicals (without affecting hemostasis and phagocytosis) and inhibit the release of the enzyme myeloperoxidase is important.

Pharmacokinetics

After oral administration, nimesulide is well absorbed from the gastrointestinal tract, Cmax in blood plasma is reached within 1-2 hours.

Protein binding is 99%. After oral administration of a single dose of 100 mg, nimesulide is present in the tissues of the female genital organs in a concentration of 40% of the concentration in plasma.

Metabolized in the liver, the main metabolite hydroxynimesulide has pharmacological activity.

T1/2 from plasma is 2-3 hours.

It is excreted from the body mainly through urine, about 98% of the dose is excreted within 24 hours. With prolonged therapy, accumulation of nimesulide is not observed.

Indications

Osteoarthritis, extra-articular rheumatic diseases, pain and inflammation after surgical intervention, pain and fever in acute inflammatory processes in the upper respiratory tract, pain associated with dysmenorrhea.

Dosage regimen

Orally for adults, 100-200 mg 2 times a day, for children - 1.5 mg/kg 2-3 times a day.

Maximum dose for children - 5 mg/kg/day in 2-3 doses.

Side effect

From the digestive system: heartburn, nausea, stomach pain; in some cases - tarry stools, melena (associated with bleeding and erosive and ulcerative lesions Gastrointestinal tract).

From the side of the central nervous system: rarely - headaches, dizziness, drowsiness.

Allergic reactions: skin rash, erythema, urticaria.

Others: rarely - oliguria, fluid retention in the body, local or systemic edema; in some cases - thrombocytopenic purpura.

Contraindications for use

Peptic ulcer of the stomach and duodenum in the acute phase, acute bleeding from the gastrointestinal tract, moderate and severe liver failure, renal failure (creatinine clearance less than 30 ml/min), pregnancy, lactation; increased sensitivity to nimesulide and other NSAIDs (including acetylsalicylic acid).

Use during pregnancy and breastfeeding

Nimesulide is contraindicated for use during pregnancy and lactation.

There are no direct indications of the embryotoxic and tocolytic effects of nimesulide.

Use in children

Overdose

Symptoms: nausea, vomiting, drowsiness, apathy, gastrointestinal bleeding, increased blood pressure, acute renal failure, respiratory depression;

Treatment: Symptomatic and supportive treatment is recommended. There is no specific antidote for Nimesulide. Patients admitted to the hospital with symptoms of drug overdose (within 4 hours after taking it or after taking high dose) it is recommended to lavage the stomach, take activated charcoal (adults - 60-100 mg) and/or an osmotic laxative. Regular monitoring of liver and kidney function is necessary. There is no data on the possibility of removing nimesulide using hemodialysis. Formed diuresis and hemodialysis are ineffective due to the high binding of the drug to proteins.

Drug interactions

Possible manifestations drug interactions at simultaneous administration nimesulide orally with digoxin, phenytoin, lithium preparations, diuretics, antihypertensive drugs, other NSAIDs, anticoagulants, cyclosporine, methotrexate, oral hypoglycemic agents.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

Store the drug in a dry place, protected from light, at a temperature not exceeding 25°C. Keep out of the reach of children. Shelf life - 4 years. Do not use after expiration date.

Use for liver dysfunction

Contraindicated in moderate and severe liver failure.

Use for renal impairment

Contraindicated in renal failure (creatinine clearance less than 30 ml/min).

Use in elderly patients

special instructions

Caution should be used orally in patients with impaired renal function, with arterial hypertension, with cardiac dysfunction, visual impairment.

When used externally, a doctor's monitoring of the condition of elderly patients with impaired renal function, liver function, and congestive heart failure is required.

When used in pediatrics, dosage forms intended for children should be used. In children under 6 years of age, when using nimesulide externally, medical supervision is required.

Impact on the ability to drive vehicles and operate machinery

Due to the fact that nimesulide, when taken orally, can cause dizziness and drowsiness, it should be used with caution in patients engaged in potentially hazardous activities that require increased concentration and rapid psychomotor reactions.