Nispore
Generic Name
Nimesulide
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nispore 50 mg capsule | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory, and antipyretic properties. It is commonly used for short-term treatment of acute pain and primary dysmenorrhea. It is a preferential COX-2 inhibitor.
Uses & Indications
Dosage
Adults
50 mg two to three times daily, or 100 mg twice daily. Maximum daily dose 200 mg. Use for the shortest possible duration.
Elderly
No specific dose adjustment is generally required, but caution is advised due to potential age-related decrease in renal, hepatic, or cardiac function.
Renal_impairment
Contraindicated in severe renal impairment (creatinine clearance <30 mL/min). For moderate impairment, dose reduction may be necessary and should be used with caution.
How to Take
Take orally, preferably after meals, to minimize gastrointestinal side effects. Swallow the capsule whole with water.
Mechanism of Action
Nimesulide selectively inhibits cyclooxygenase-2 (COX-2), an enzyme responsible for the synthesis of prostaglandins involved in inflammation, pain, and fever. This inhibition leads to reduced prostaglandin production, thereby exerting its anti-inflammatory, analgesic, and antipyretic effects. It also has some antioxidant properties.
Pharmacokinetics
Onset
Analgesic effect usually within 30 minutes to 1 hour.
Excretion
Mainly excreted via urine (approximately 65%) and feces (approximately 35%).
Half life
Approximately 2-5 hours.
Absorption
Rapidly and well absorbed from the gastrointestinal tract; peak plasma concentrations reached within 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C9, into its active metabolite 4'-hydroxy nimesulide.
Side Effects
Contraindications
- Hypersensitivity to nimesulide or any excipients, or to other NSAIDs (e.g., aspirin)
- Active peptic ulcer, gastrointestinal bleeding or perforation, history of recurrent ulceration/hemorrhage
- Severe hepatic impairment or history of liver reactions to nimesulide
- Severe renal impairment (creatinine clearance <30 mL/min)
- Severe heart failure
- Third trimester of pregnancy
- Children under 12 years of age
- Concomitant use of other hepatotoxic drugs
Drug Interactions
Lithium
Increased plasma lithium levels.
Methotrexate
Increased methotrexate toxicity.
Other NSAIDs
Increased risk of adverse effects, particularly gastrointestinal.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Diuretics and ACE inhibitors
Reduced antihypertensive effect and increased risk of renal impairment.
Warfarin and other anticoagulants
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Rarely, hypertension, acute renal failure, respiratory depression, and coma may occur. Management involves symptomatic and supportive care. Gastric lavage or activated charcoal may be considered within the first hour of ingestion.
Pregnancy & Lactation
Contraindicated in the third trimester of pregnancy due to risk of premature closure of the ductus arteriosus and fetal renal dysfunction. Not recommended during the first and second trimesters unless essential, and only if the potential benefit outweighs the risk. Not recommended during breastfeeding as nimesulide may pass into breast milk.
Side Effects
Contraindications
- Hypersensitivity to nimesulide or any excipients, or to other NSAIDs (e.g., aspirin)
- Active peptic ulcer, gastrointestinal bleeding or perforation, history of recurrent ulceration/hemorrhage
- Severe hepatic impairment or history of liver reactions to nimesulide
- Severe renal impairment (creatinine clearance <30 mL/min)
- Severe heart failure
- Third trimester of pregnancy
- Children under 12 years of age
- Concomitant use of other hepatotoxic drugs
Drug Interactions
Lithium
Increased plasma lithium levels.
Methotrexate
Increased methotrexate toxicity.
Other NSAIDs
Increased risk of adverse effects, particularly gastrointestinal.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Diuretics and ACE inhibitors
Reduced antihypertensive effect and increased risk of renal impairment.
Warfarin and other anticoagulants
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Rarely, hypertension, acute renal failure, respiratory depression, and coma may occur. Management involves symptomatic and supportive care. Gastric lavage or activated charcoal may be considered within the first hour of ingestion.
Pregnancy & Lactation
Contraindicated in the third trimester of pregnancy due to risk of premature closure of the ductus arteriosus and fetal renal dysfunction. Not recommended during the first and second trimesters unless essential, and only if the potential benefit outweighs the risk. Not recommended during breastfeeding as nimesulide may pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Available in pharmacies across Bangladesh
Approval Status
Approved in Bangladesh (restricted/banned in some countries due to hepatotoxicity concerns)
Patent Status
Off-patent
Clinical Trials
Nimesulide has been extensively studied for its anti-inflammatory and analgesic effects. However, due to concerns regarding hepatotoxicity, ongoing research focuses on its safety profile and risk-benefit assessment.
Lab Monitoring
- Liver function tests (especially transaminases) should be monitored periodically, particularly in patients on long-term therapy or with pre-existing liver conditions.
- Renal function tests (e.g., creatinine, BUN) in patients with impaired renal function or those taking diuretics.
Doctor Notes
- Prescribe Nimesulide for the shortest possible duration and at the lowest effective dose.
- Carefully assess the patient's liver function before initiating treatment and monitor closely during therapy, especially if symptoms of liver injury appear.
- Avoid concomitant use with other hepatotoxic drugs or excessive alcohol.
- Not recommended for use in children under 12 years of age or during the third trimester of pregnancy.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Do not exceed the recommended dose or duration of treatment.
- Report any signs of liver problems (e.g., unusual fatigue, dark urine, yellowing of skin/eyes, abdominal pain) immediately to your doctor.
- Take with food or milk to reduce stomach upset.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Nimesulide may cause dizziness or drowsiness in some individuals. If you experience these effects, avoid driving or operating heavy machinery.
Lifestyle Advice
- Avoid excessive alcohol consumption while taking Nispore.
- Maintain good hydration.
- Inform your doctor about all other medications you are taking.
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