Nimesulide analogues are cheaper. Pros and cons of Movalis

International name

Nimesulide (Nimesulide)

Group affiliation

NSAIDs

Dosage form

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

pharmachologic effect

NSAIDs, has anti-inflammatory, analgesic, antipyretic and antiplatelet effects. Unlike other NSAIDs, it selectively suppresses COX-2, inhibits the synthesis of Pg in the focus 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 various etiologies, tendinitis, bursitis; spicy pain syndrome: algomenorrhea, 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, 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 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 blood clotting disorders, decompensated CHF, liver failure or any active liver disease, hepatotoxic reactions when using nimesulide in history, alcoholism, drug addiction, severe chronic renal failure (CC less than 30 ml / min), progressive kidney disease, confirmed hyperkalemia, the period after coronary artery bypass grafting, 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 messages.

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.

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

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

From the side 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 12, hepatitis, incl. fulminant, jaundice, cholestasis.

On the part of the hematopoietic organs: rarely - anemia, eosinophilia; very rarely - thrombocytopenia, pancytopenia, purpura, hemorrhages, prolongation of bleeding time.

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

From the senses: rarely - blurred vision.

From the side of the CCC: infrequently - a decrease in blood pressure; rarely - tachycardia, "flushing" of blood to the skin of the face and upper half torso.

Others: infrequently - hyperkalemia; rarely - general weakness; very rarely - hypothermia.

Application and dosage

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

In patients with CKD daily dose- 100 mg.

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

special instructions

Should be checked every 2 weeks functional tests liver.

If signs of liver damage appear (skin 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 the reports of visual impairment in patients taking other NSAIDs, if any visual impairment occurs, treatment should be immediately discontinued and an ophthalmological examination should be performed.

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

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

Do not use the drug simultaneously with other NSAIDs.

Nimesulide can reduce platelet aggregation, but it does not replace preventive action antiplatelet agents (including ACS, clopidogrel, ticlopidine) in 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 an increased concentration of attention and speed of psychomotor reactions.

Interaction

Hepatotoxic drugs - an increased risk of developing a hepatotoxic effect.

Enhances the effect of anticoagulants.

Can reduce diuretic action furosemide. Displaces furosemide, fenofibrate, salicylic acid and tolbutamide due to plasma protein binding.

May increase the toxicity of methotrexate.

Increases the concentration of Li + in plasma.

May enhance the nephrotoxic effect of cyclosporine.

At simultaneous application with GCS, selective serotonin reuptake inhibitors, the risk of bleeding from the gastrointestinal tract increases.

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Do you use Nimesulide as an analogue or vice versa?

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 form of tablets is produced in blisters No. 10 pieces. In total, there are thirty tablets in one package.
2. in the form of a suspension for oral intake one vial 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 Powderto prepare medicine. It has a white color, when dissolved it forms a white syrup with a pleasant lemon smell. One sachet contains two grams of powder.

The active ingredient of the drug is nimesulide. In one tablet of the active substance - 100 mg, in one gram of powder - 50 mg, in 1 ml of suspension 10 mg, in 1 g - 100 mg of the active element.

Auxiliary components are:

• Tablets - lactose monohydrate, sodium croscarmellose, 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.

The indications include:

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

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

Nimesulide instruction

Nimesulide in the form of a suspension is not prescribed for children under 2 years of age. Tablets are contraindicated in children under 12 years of age. After 2 years of age, the suspension is used on the recommendation of a doctor to relieve pain, 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 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 is calculated depending on the weight of the patient. For example, for a child weighing twenty kilograms per day, 30 mg of suspension, 20 * 1.5, is needed, so we get the required number.

How to use - adult doses

1. Nimesulide in the form of a powder for the preparation of a suspension. The entire contents of one sachet is dissolved in one hundred milliliters warm water. Normal daily dosage for adults, two sachets per day taken after the last meal. The daily dose should not exceed two hundred milligrams per day. This form the drug does not require a reduction in dosage for the elderly. But for people suffering from renal insufficiency, the daily dose should be one hundred milligrams of the drug. The duration of taking the powder is 15 days.
2. In the form of tablets.Nimesulide tabletsare used only for oral administration to patients over twelve years of age. It is best to take the funds immediately after a meal, drinking plenty 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 agent is completely absorbed. Lubricate the affected area at least 3 times a day on clean skin.

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

Contraindications for use

To pathological conditions for which the drug should not be used include:

• erosive and ulcerative disease digestive tract;
• Intragastric bleeding;
• Diseases of the heart muscle;
• Postponed shunting;
• Pregnancy period;
• Breast-feeding;
• Allergic reaction to one of the components of the remedy;
• Age limit up to twelve years.

Side effects

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

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

The price of Nimesulide

Nimesulide price in tablets per 12 tablets per different regions Russia is from 80 - 90 rubles.

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

Nimesulide's analogs

The most popular today are:

• Amtolmetin;

All the above medicines are produced in different dosage forms, which is an undoubted advantage when choosing a similar remedy. The appointment of funds is done only by a doctor.

Nimesil or Nimesulide - what is the difference?

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

The drugs have, differing, although they have one active ingredient. For example, Nimesulide in syrup is prescribed for the treatment of children from the age of two, at the same time when Nimesil is allowed to be used only when they reach 12 years of age. There are also some differences in contraindications, Nimesulide is not forbidden to be taken with diabetes, but for taking Nimesil it is strict contraindication. And, of course, the price category. Nimesil is much more expensive.

Ketorolac or Nimesulide - which is better?

These funds belong to the same drug group. Used to suppress inflammation and pain. But if you answer the question of what is more effective than Ketorolac or Nimesulide, then even doctors cannot give an exact answer. All 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 cycloogenases, due to which its analgesic effects on the body do not decrease. In addition, Nimesulide has a strong anti-inflammatory property, unlike Ketorolac, which does not positive impact to the development of inflammatory processes.

Nimesulide or Diclofenac - what's the difference?

Diclofenac is a non-steroidal drug used to relieve symptoms of various pathological processes in the body. Diclofenac has analgesic properties, has a slight antipyretic and anti-inflammatory effect. If you follow the instructions for use, then 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 analgesic, so 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 sea. When out of the blue, I had a bad toothache. And to such an extent that I could not chew and even turn my head. But it’s good that there was a pharmacy nearby, they advised me to buy this remedy. According to the pharmacist, it anesthetizes well. After taking the pill, an hour later, everything went away for me, at least I could, eat, and turn my head. And the pain of this did not happen to me, which is very good. The same remedy was advised 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 these pharmacodynamic properties this group drugs finds wide application in practical medicine. Let's take a look at the features of the use of 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 medicines. In its group, the drug belongs to selective inhibitors of the cyclooxygenase-2 enzyme, which effectively suppresses the production of prostaglandins in the focus of inflammation.

Another distinctive feature in 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 oppression of education and other mediators involved in inflammatory reactions organism.

Pharmacokinetic features

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

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

Almost all patients before admission 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

Indications for the appointment of the drug "Nimesulide" is not so much. Among them, it is worth noting acute pain syndrome, primary osteoarthritis with pain syndrome, as well as primary emerging dysmenorrhea. AT pediatric practice the use of the drug is also effective. This is evidenced by the reviews left about taking Nimesulide. For children under 12 years of age, it is not recommended to purchase it - this should be remembered.

Contraindications to prescribing the drug

Like all non-steroidal anti-inflammatory drugs, "Nimesulide" is contraindicated in the presence of a gastric ulcer or duodenal ulcer in the acute stage, a decrease in the detoxification function of the liver, and the simultaneous administration of the drug with hepatotoxic drugs. The drug is contraindicated for use in patients with a significant decrease 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 due to high probability development of adverse reactions. Do not prescribe "Nimesulide" for the treatment of influenza and influenza-like conditions, hyperthermia.

Side effects

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

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

On the part of the gastrointestinal tract, bleeding, perforation of ulcers is quite rare. Occur much more frequently pain in the epigastric region, nausea, vomiting, diarrhea or constipation.

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

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

The use 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", the 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 be feared when taking a drug such as "Nimesulide"? Instructions for use, patient reviews inform about some warnings. An important point in the appointment of the drug "Nimesulide" is the use of a minimum therapeutic dose medicinal product. If the drug is not effective at the minimum dosage, the drug should be discontinued.

In the event of the development of a hepatotoxic effect of the drug (which is monitored by biochemical indicators blood) taking 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, analgesics. You should also refrain from drinking alcohol.

"Nimesulide" should be prescribed with a high degree of caution to patients with hepatic or renal insufficiency in order to avoid the risk of progression of the latter.

Particular attention should be paid to the administration of 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 ability of the drug to disrupt the functions of cytochrome P450 is known. In view of oppression functional activity of this enzyme, the dose of drugs metabolized by this cytochrome should be revised downwards.

"Nimesulide": analogues, reviews

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

Conclusion

"Nimesulide" is a powerful anti-inflammatory agent for the treatment inflammatory diseases, predominantly of the musculoskeletal system. In view of high risk development of side effects, it is necessary to consult with your doctor about taking the drug "Nimesulide". Reviews of doctors prescribing this drug, and patients taking it, are positive, as it contributes to a rapid reduction in 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 remedy for them in terms of efficiency and price, on the other hand, without consulting a specialist, it is rather difficult to navigate through numerous analogues of the same drug.

For the treatment of joint diseases, Nimesil is often prescribed, this drug belongs to the group nonsteroidal drugs and effectively reduces inflammation. However, the tool has high cost. Is it possible to pick up 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 drug, you should find out its basic properties. Nimesil contains the only active ingredient- substance nimesulide. This remedy 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 focus of inflammation in the body and not disrupt the functioning of the gastrointestinal tract.

In addition to nimesulide, the drug contains auxiliary components. They help to give the drug a certain 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 means 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 drug 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 diseases of the joints.
• Dental pain.
• Deforming osteoarthritis - to eliminate symptoms.
• Painful menses.

It should be noted that Nimesil is used exclusively as symptomatic remedy. Do not use the product for a long time, because the drug eliminates acute manifestations inflammation. The medicine does not work on the cause of the pain.

Analogues of the drug have similar indications for use. All NSAIDs have a similar mechanism of action. An analogue should be chosen, focusing not on 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 with respect to the above indications.

Contraindications

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

Powder Nimesil and analogues should not be used in the presence of such conditions:

1. Allergic reaction to aspirin, other NSAIDs, as well as auxiliary components of the drug.
2. Toxic liver disease caused by drugs or alcohol.
3. Simultaneous administration of drugs that pathologically affect the liver and hepatobiliary tract.
4. Acute period of inflammatory and peptic ulcer digestive system.
5. Coronary artery bypass grafting - early postoperative period.
6. Acute respiratory infections with low fever - nimesulide suppresses immune reactions inflammation and lowers the temperature, prevents recovery.
7. Bronchial asthma and other diseases associated with allergy to NSAIDs.
8. Violations of hematopoiesis and the process of blood coagulation.
9. Liver failure.
10. Pregnancy and lactation period.
11. Childhood.
12. kidney disease 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 their occurrence may depend on the manufacturing technique of the drug. This means that the original Nimesil is less likely to cause adverse reactions than its cheaper counterparts. This should be taken into account when choosing a tool.

Possible side effects of Nimesulide Powder:

1. Violation of hematopoietic processes - any hematopoietic sprouts can suffer. When treating with Nimesil analogs, it should be monitored general analysis blood.
2. Various forms 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 the use of any NSAID.
4. Dysregulation of blood pressure, feeling hot, increased heart rate.
5. Nausea and vomiting, unstable chair- may be associated with the intake of any medication inside.
6. Exacerbations 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. Violation of the kidneys - a decrease in the amount of urine, the appearance of blood in it, nephritis.

These adverse reactions may be the reason for replacing the funds with analogues. Sometimes severity side effects forces to abandon the use of any drugs containing nimesulide.

Analogues

If the doctor has prescribed you the drug Nimesil, and you are not satisfied with its price or the features of the action of the remedy, you should discuss with the 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 It doesn't hurt to consider alternatives for the price.
2. The composition of the drug - auxiliary components can cause unwanted side reactions, disrupt work internal organs, be a trigger for allergies.
3. Evidence-based efficacy and safety of each drug clinical research This information is easiest to get from an experienced doctor. Specialists regularly get acquainted with the results of international research.
4. Features of the action of the active substance, if preparations that do not contain nimesulide act as an alternative. In this case, a doctor's consultation is required.

Considering the listed criteria for choosing a remedy, 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 drugs with nimesulide in the composition is Nise. This remedy is produced in India and has similar features of action as 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 Nise. Auxiliary components of the product differ from those of Nimesil. Part drugs Nise includes:

• calcium hydrophosphate.
• Cellulose.
• Starch.
• magnesium stearate.
• Silica.
• Sucrose.

These substances should be considered in the presence of intolerance to any drugs by the patient.

According to international clinical trials, safety and efficacy ratios funds Nise 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 a symptomatic therapy for such conditions:

• Rheumatoid arthritis.
• Gouty attack of arthritis.
• Psoriasis with articular syndrome.
• Bechterew's disease.
• 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 trials.

Nimulid

Another Indian pharmaceutical company produces another analogue of Nimesil. They are the drug Nimulid.

The tool is sold in Russian pharmacies at a price of 120 to 300 rubles. The cost is comparable to Nise, but much lower than the price of Nimesil. Consider this criterion when choosing.

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

Pay attention to the presence of such auxiliary components:

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

These components can cause unwanted side reactions.

According to the results of international studies, the safety and efficacy index is significantly inferior to both Nimesil and Nise. 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 the use of Nise. There are also no special side effects or contraindications.

Nemulex

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

The powder is better absorbed and starts its action faster. Nemulex is produced in Russia and has more than low price, however, its cost is still quite high. For 30 doses of powder in a pharmacy, they will ask about 600 rubles. However, there is a package with 10 bags of funds at a price of about 200 rubles.

The Russian drug manufacturer does not share the results of clinical trials. This allows you to think about the low efficacy and safety of the drug.

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.

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

Nimesulide

Numerous manufacturers from different countries a medicine with the trade name Nimesulide is produced. This tool is completely different composition auxiliary components and has a price of 40 to 1500 rubles for various dosage forms.

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

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

Products with other active ingredients

The presence of side effects in nimesulide suggests the replacement of the drug with analogues according to the mechanism of action with another active ingredient. Because the group nonsteroidal drugs is numerous in number various means, there are ample opportunities for choosing the right drug.

A feature of nimesulide is its toxic effect on the liver. In addition, the drug has a rather negative effect on the condition of the gastric mucosa. Deprived of these features are tools such as:

• Meloxicam.
• Celebrex.
• Etoricoxib.

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

If the patient has individual intolerance drugs based on nimesulide, but they are well tolerated by other NSAIDs, you can consider the use of such drugs:

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

The listed funds are less selective than Nimesil and its analogues. They often cause adverse reactions from the stomach and intestines. Inhibitors should be used concomitantly proton pump that protect the lining of the digestive tract.

Treatment with non-steroidal anti-inflammatory drugs (or NSAIDs) last years gaining popularity among both the adult contingent of the population and children. In this regard, pharmaceutical companies are striving to create new drugs and improve old ones. Meloxicam is one of the most effective means NSAID groups, and the list of diseases for which it can be prescribed, steps over more than a dozen. Despite its effectiveness, analogues of the drug are isolated, which can be cheaper, but not inferior in efficiency.

Meloxicam, or its popular trade name Movalis, is most often used in the presence of pain associated with injuries, inflammation in the joints, spine. The drug reduces the manifestation of pain, relieves inflammation and swelling, which makes it popular in the treatment of osteochondrosis, arthritis, arthrosis, and injuries. Apply the remedy even when specific diagnoses: with 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. AT modern medicine two types of NSAIDs are used - COX-1 and the more modern COX-2, to which Meloxicam belongs.

The advantage is that the drug has fewer side effects. It is for this purpose that the standard scheme for administering Movalis has been developed, when it is better to inject in the first days of the disease, which allows you to maximize the effect on the focus of inflammation and pain, after which a course of the drug is prescribed in tablets. This makes it possible to reduce the risk of acute ulcer or erosion of the mucosa in the stomach, which provoke bleeding.

Meloxicam also causes less nausea, vomiting, pain in the abdomen. The use of injections and tablets allows you to increase the course of treatment with Meloxicam, while its analogue Diclofenac is allowed to take an order of magnitude less.

It can be noted that most doctors and pharmacy chains 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. At the same time, the course of treatment is designed for 3 injections and a course of tablets, that is, you need to buy two packs of Movalis. There are also limitations in use. Do not prescribe Movalis to pregnant women, during lactation and children under 12 years of age.

You can replace Movalis with two options - this is to find substitutes-analogues of Movalis with the same active substance or choose an analogue from the NSAID group, where there is a different composition.

Analogues with the active substance meloxicam

Meloxicam, as an active substance, is part of such drugs:

• amelotex;
• meloxicam;
• artrozan.

Most cheap analogue Movalis means - Meloxicam itself, which is produced by several enterprises. The release form is tablets of 7.5 and 15 mg, as well as ampoules for injection. To replace Movalis with Meloxicam, it is necessary to inform the 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 produced in the form of a gel and rectal suppositories.

Before using drugs, the composition of which consists of meloxicam (Amelotex, Movalis), you need to familiarize yourself with the list of contraindications. It is forbidden to prescribe a medicine in the presence of hypersensitivity to the active substance, with 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 for kidney failure, bleeding in the digestive tract, with liver failure, hyperkalemia. When prescribed in the elderly and with poor liver and kidney function, you need to pass additional examinations and strictly follow your doctor's instructions.

Meloxicam's analogs

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

Diclofenac

Consider an old proven remedy - Diclofenac. For the first time, Diclofenac began to be used back in the 60s of the last century, and with its advent, medicine was able to move away from the appointment narcotic analgesics. The drug is actively used to treat pathologies of a rheumatoid nature, in traumatology, and the treatment of women's diseases.

Diclofenac, as an analogue of Movalis, has a number of disadvantages. because of strong impact on the organs of 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 so quickly when pinched sciatic nerve, Do not lie trigeminal nerve. Another plus is a large number of ointments and gels local impact in trauma and inflammation. Also, the drug is available at a price. Diclofenac has analogues in which it is included, its synonyms are Dicloberl, Voltaren, Diclak, Ortofen.

Nimesulide

For the treatment of 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 tool belongs to the group of NSAIDs (sulfonanilides), and the action is associated with COX-2. Nise well anesthetizes, relieves puffiness 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 plus 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 the age of 12 years and with serious diseases of the gastrointestinal tract, liver, kidneys. Many NSAIDs have properties to influence blood pressure and reduce effectiveness antihypertensive drugs Nise is no exception.

Contraindications and side effects allows the use of drugs, the composition of which contains Nimesulide, only after consulting a doctor. Analogues of Nimesulide are Nise, Nimesil, Nimid.

ibuprofen

Ibuprofen is a rare drug that is prescribed for young children. Unlike other NSAIDs, Ibuprofen is less dangerous and at the same time better relieves inflammation. Ibuprofen is more commonly used to treat high temperature, reducing the inflammatory process. Of the minuses - less pain relief for injuries and diseases of the joints.

Ibuprofen indications:

1. Diseases associated with inflammation in musculoskeletal system: arthritis, arthrosis, spondyloarthritis. Assign with Bechterew's disease, epicondylitis, periarthritis.
2. The presence of pain due to injuries, pinched nerves, headaches, pain during menstruation.
3. An increase in body temperature due to influenza, acute respiratory infections, acute respiratory viral infections, with infections.

It can be concluded that Ibuprofen and its synonyms are used not only for the treatment of joints and 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 drug 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 funds for "ambulance", instructors recommend carrying it in a car in case of an accident. The drug is rarely prescribed for the treatment chronic pathologies joints and spine. Ketorolac is more used to relieve pain from injuries, after surgery and in case of acute pain. The analogue of Ketorolac is Ketanov.

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

2016-10-25

Anti-inflammatory drugs for osteochondrosis are the basic main therapy for degenerative-dystrophic diseases of the spine. The popularity of 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 for osteochondrosis is prescribed not only by doctors. Almost every patient knows that in case of back pain, first of all, you need to take this drug. However, he has side effect on the gastrointestinal tract, so we warn you against self-administration of the drug.

During the development of these drugs, scientists expected that they could 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 using selective analogues (nise, nimesil) are somewhat lengthened.

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

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

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

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

Due to the presence of the above side effects when using non-steroidal anti-inflammatory drugs after 10 days of their use, you need to take a break. These drugs are contraindicated in gastric ulcer.

It should be understood that the treatment of osteochondrosis with NSAIDs is symptomatic, therefore, the treatment of the disease allows only for a while to eliminate the pain syndrome.

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

Steroid anti-inflammatory drugs

Steroid anti-inflammatory drugs for osteochondrosis are prescribed when a person has a strong pain syndrome in the back, which is not 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 Decreased secretion of adrenal hormones.

The effect of addiction also occurs when using prednisolone, hydrocortisone. For similar reasons, it is not recommended to use dexamethasone for a long time in osteochondrosis. 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 time of action in comparison with dimexide.
3. Diprospan has a strong analgesic effect.
4. Dimexide penetrates well through the skin, therefore it is used for electrophoresis in degenerative-dystrophic diseases of the spine.
5. Cancellation of steroids is carried out gradually by daily dose reduction.

At home, the use of diprospan and movalis is impossible, so only a doctor can prescribe such medicines.

Although diclofenac and ketorolac are the most popular means with osteochondrosis, we do not recommend using them on their own. Unfortunately, their side effects too serious. It is enough to “earn” an ulcer once in order to forever abandon the use of the most effective means from degenerative-dystrophic diseases of the spine.

pharmachologic effect

NSAIDs, in the structure of which there is a sulfonilide group. Nimesulide is believed to be 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, due to inhibition of predominantly 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 myeloperoxidase enzyme is important.

Pharmacokinetics

After oral administration, nimesulide is well absorbed from the gastrointestinal tract, Cmax in blood plasma is reached after 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 at a concentration of 40% of the plasma concentration.

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

T 1/2 from plasma is 2-3 hours.

Excreted from the body mainly in the urine, about 98% of the dose is excreted within 24 hours. With prolonged therapy, nimesulide accumulation 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.

Dosing regimen

Inside adults 100-200 mg 2 times / day, children - 1.5 mg / kg 2-3 times / 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 (CC less than 30 ml / min), pregnancy, lactation; hypersensitivity to nimesulide and other NSAIDs (including acetylsalicylic acid).

Use during pregnancy and lactation

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 an overdose of the drug (within 4 hours after taking it or after taking high dose) it is recommended to wash the stomach, take activated charcoal (adults - 60-100 mg) and / or an osmotic laxative. Regular monitoring of liver and kidney function is necessary. There are no data on the possibility of removing nimesulide by hemodialysis. Formed diuresis, hemodialysis are ineffective due to the high connection of the drug with proteins.

drug interaction

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

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

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

Application for violations of liver function

Contraindicated in moderate and severe liver failure.

Application for violations of kidney function

Contraindicated in renal failure (CC 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 violations of the activity of the heart, visual impairment.

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

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

Influence on the ability to drive vehicles and control mechanisms

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