Sulide-100

Introduction

Nimesulide is a selective COX-2 inhibitor NSAID used for its anti-inflammatory, analgesic, and antipyretic effects. By blocking prostaglandin production, it reduces pain, swelling, and fever. In Pakistani medical practice, it is often prescribed for short-term pain management in musculoskeletal conditions, arthritis, and acute inflammatory pain.

How it Works

• Selectively inhibits the COX-2 enzyme, reducing prostaglandin synthesis.

• Provides relief from pain, fever, and inflammation.

• Selectivity may lower risk of stomach irritation compared to non-selective NSAIDs.

Primary Uses

• Osteoarthritis and rheumatoid arthritis.

• Acute musculoskeletal pain (injuries, sprains).

• Post-operative and dental pain.

• Menstrual cramps (dysmenorrhea).

• Migraine and tension headaches.

• Ankylosing spondylitis.

• Fever and flu-related pain (short-term use).

Side Effects

Possible side effects include:

• Stomach pain, nausea, vomiting, diarrhea.

• Dizziness, headache.

• Skin rash or itching.

• Liver enzyme changes (hepatotoxicity risk).

• Rare: severe allergic reaction or gastrointestinal bleeding.

When Not to Use

Do not take if you have:

• Allergy to Nimesulide or other NSAIDs.

• Active stomach or intestinal ulcers.

• Severe heart, kidney, or liver disease.

• History of gastrointestinal bleeding.

• Pregnancy (especially 3rd trimester) or breastfeeding.

• Age under 12 years.

• History of asthma triggered by NSAIDs.

• Bleeding disorders or are on anticoagulants.

Precautions & Warnings

• Use cautiously in elderly patients and those with kidney or liver impairment.

• Monitor liver function if used beyond short-term.

• May increase cardiovascular risk (heart attack or stroke).

• Avoid alcohol to reduce risk of bleeding and liver damage.

• Not suitable for children/adolescents under 18 due to hepatotoxicity risk.

Drug Interactions

• Anticoagulants (e.g., warfarin): increases bleeding risk.

• Lithium: may increase blood levels → toxicity risk.

• Methotrexate: increased toxicity.

• Diuretics, ACE inhibitors, ARBs: may worsen kidney function.

• Corticosteroids: increased risk of GI bleeding.

• Other NSAIDs: higher risk of stomach side effects.

Food Interactions

• Avoid alcohol → increases bleeding and liver toxicity.

• Avoid excessive grapefruit juice → may raise drug levels.

• High-fat meals → delay absorption.

• Dairy/antacids → may reduce absorption (separate intake by a few hours).

• Limit caffeine → may worsen nervousness or insomnia.

• Spicy foods → may increase gastric irritation.

How to Use

• Take with or after meals to reduce stomach irritation.

• Swallow whole with water; do not crush or chew.

• Follow doctor’s prescribed dosage (usually once or twice daily).

• Short-term use only.

Overdose

• Symptoms: nausea, vomiting, stomach pain, dizziness, liver damage (severe cases).

• Immediate medical attention is required.

Missed Dose

• Take as soon as you remember.

• If near next dose, skip missed dose.

• Do not double dose.

Storage & Disposal

• Store below 25°C, in a cool, dry place.

• Keep away from children and direct sunlight.

• Do not use if packaging is damaged.

• Dispose of unused/expired tablets safely via pharmacist guidelines.

Doctor Review

Reviewed by: Dr. Hina Qureshi, MBBS, FCPS (Rheumatology)

“Nimesulide is sometimes prescribed in Pakistan for short-term relief of arthritis pain, menstrual cramps, and musculoskeletal injuries. However, because of its potential liver side effects, it should be used cautiously, in the lowest effective dose and shortest possible duration, always under a doctor’s supervision.”

Quick Tips

• Take with food to reduce stomach upset.

• Do not exceed prescribed dose or duration.

• Avoid alcohol while taking this medicine.

• Report unusual fatigue, jaundice, or persistent stomach pain immediately.

• Not recommended for children or long-term use.

Disclaimer:
This profile is for educational and informational purposes only. It is not a prescription. Always consult a licensed physician in Pakistan before starting or adjusting any NSAID treatment.