Nemine
Generic Name
Nimesulide
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nemine 4 mg tablet | ৳ 0.18 | ৳ 1.80 |
Description
Overview of the medicine
Nemine (Nimesulide) is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, inflammation, and fever. It acts by inhibiting the enzyme cyclooxygenase (COX), which is involved in the synthesis of prostaglandins, inflammatory mediators.
Uses & Indications
Dosage
Adults
100 mg twice daily, after meals.
Elderly
Dosage should be individualized, starting with the lowest effective dose. Caution advised due to increased risk of side effects.
Renal_impairment
Contraindicated in severe renal impairment. In mild to moderate impairment, dosage adjustment may be needed.
How to Take
Take orally, with water, preferably after meals to reduce gastrointestinal upset. Do not chew or crush the tablet.
Mechanism of Action
Nimesulide selectively inhibits cyclooxygenase-2 (COX-2), an enzyme responsible for the synthesis of prostaglandins involved in inflammation, pain, and fever. It has relatively less effect on COX-1, which is involved in gastric protection and platelet aggregation.
Pharmacokinetics
Onset
30-60 minutes
Excretion
Mainly excreted in urine (about 50-60%) and feces (about 30-40%).
Half life
2-5 hours for nimesulide, and 3-6 hours for its main metabolite, 4'-hydroxy-nimesulide.
Absorption
Rapidly and well absorbed from the gastrointestinal tract. Peak plasma concentrations are reached within 1-3 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C9, to 4'-hydroxy-nimesulide (major active metabolite) and other inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to nimesulide or other NSAIDs
- Active gastrointestinal bleeding or peptic ulcer
- Severe hepatic impairment
- Severe renal impairment
- Severe heart failure
- Third trimester of pregnancy
- Children under 12 years
Drug Interactions
Lithium
Increased plasma levels of lithium.
Methotrexate
Increased plasma levels of methotrexate.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Warfarin, other anticoagulants
Increased risk of bleeding.
Diuretics, ACE inhibitors, Angiotensin II receptor antagonists
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered if ingested recently.
Pregnancy & Lactation
Contraindicated in the third trimester of pregnancy due to risk of premature closure of the ductus arteriosus and renal dysfunction in the fetus. Not recommended during breastfeeding due to potential excretion into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
3 years
Availability
Pharmacies, Hospitals
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Generic available (Patent expired)
Clinical Trials
Extensive clinical trials have evaluated Nimesulide's efficacy in pain and inflammation, highlighting its COX-2 selectivity. Post-marketing surveillance led to restrictions in some countries due to hepatotoxicity concerns.
Lab Monitoring
- Liver function tests (especially transaminases) periodically, particularly during long-term treatment.
- Renal function tests (e.g., serum creatinine, BUN) periodically.
Doctor Notes
- Caution in patients with a history of liver disease or gastrointestinal disorders.
- Regular monitoring of liver and renal function is advised, especially for prolonged use.
- Consider the lowest effective dose for the shortest duration.
Patient Guidelines
- Take with food to minimize stomach upset.
- Do not exceed the recommended dose.
- Inform your doctor about any pre-existing medical conditions, especially liver or kidney problems.
- Report any signs of liver injury (e.g., yellow skin/eyes, dark urine) immediately.
- Avoid alcohol while taking this medicine.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness or drowsiness in some individuals. If affected, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain a healthy diet.
- Stay hydrated.
- Avoid excessive alcohol consumption.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.