Nogal
Generic Name
Nimesulide
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nogal 50 mg tablet | ৳ 8.00 | ৳ 80.00 |
| nogal 150 mg tablet | ৳ 22.00 | ৳ 220.00 |
Description
Overview of the medicine
Nogal (Nimesulide) is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. It is often prescribed for conditions like osteoarthritis, dysmenorrhea, and post-operative pain. It has preferential COX-2 inhibitory activity.
Uses & Indications
Dosage
Adults
100 mg twice daily, after meals. Maximum daily dose is 200 mg.
Elderly
No specific dose adjustment is usually required, but caution is advised due to potential for increased sensitivity to side effects.
Renal_impairment
Contraindicated in severe renal impairment (creatinine clearance <30 mL/min). Dose reduction may be necessary in moderate impairment.
How to Take
Take orally with water, preferably after meals to minimize gastrointestinal discomfort. Do not exceed the recommended dose or duration of treatment.
Mechanism of Action
Nimesulide works by inhibiting cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins, inflammatory mediators that cause pain, fever, and inflammation. Its preferential COX-2 inhibition helps reduce side effects associated with COX-1 inhibition, though it is not entirely COX-1 sparing.
Pharmacokinetics
Onset
Within 30-60 minutes for analgesic effects.
Excretion
Mainly excreted in urine (around 50-60%) and feces (around 20-30%).
Half life
Approximately 2-5 hours.
Absorption
Rapidly and well absorbed after oral administration. Peak plasma concentrations are reached within 1-3 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C9, to its main active metabolite, 4'-hydroxy-nimesulide.
Side Effects
Contraindications
- Hypersensitivity to Nimesulide or other NSAIDs
- History of gastrointestinal bleeding or peptic ulcer
- Severe hepatic impairment or active liver disease
- Severe renal impairment (CrCl <30 mL/min)
- Heart failure
- Pregnancy and lactation
- Children under 12 years
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Warfarin
Increased risk of bleeding.
Diuretics
Reduced diuretic and antihypertensive effects.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include lethargy, drowsiness, epigastric pain, nausea, vomiting, and gastrointestinal bleeding. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered within the first few hours.
Pregnancy & Lactation
Nimesulide is contraindicated during pregnancy, especially in the third trimester due to potential adverse effects on the fetus and inhibition of uterine contractions. It is also contraindicated during lactation as it may pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Available in pharmacies nationwide in Bangladesh
Approval Status
Approved for use in Bangladesh (restricted in some other countries due to hepatotoxicity concerns)
Patent Status
Off-patent
Clinical Trials
Numerous clinical trials have evaluated Nimesulide's efficacy and safety in various pain and inflammatory conditions, but concerns regarding hepatotoxicity have led to restrictions in many markets. Ongoing research focuses on its precise COX-2 selectivity and long-term safety profile.
Lab Monitoring
- Liver function tests (ALT, AST, ALP, bilirubin) regularly, especially during prolonged treatment.
- Renal function tests (creatinine, BUN) periodically.
Doctor Notes
- Emphasize the shortest possible duration of treatment and lowest effective dose.
- Monitor liver function tests, especially in patients with pre-existing liver conditions or prolonged use.
- Advise patients on signs of hepatotoxicity and GI bleeding.
- Consider alternatives for long-term pain management.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not crush or chew tablets; swallow whole.
- Report any signs of liver problems (e.g., yellowing of skin/eyes, dark urine, severe abdominal pain) immediately.
- Avoid taking other NSAIDs concurrently without consulting your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Nogal may cause dizziness or drowsiness in some individuals. If you experience these effects, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain adequate hydration.
- Avoid alcohol consumption during treatment.
- Follow a balanced diet.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.