Эрозивно-язвенные поражения ЖКТ в фазе обострения, Кровотечения из ЖКТ, аспириновая триада, нарушения функции печени, выраженная почечная недостаточность, дерматозы, повреждения эпидермиса, инфекции кожи в области применения (для геля), детский возраст до 2 лет. Повышенная чувствительность к нимесулиду и другим компонентам препарата, ацетилсалициловой ...
1. Нимесулид является нестероидным противовоспалительным средством (НПВС) из класса сульфонанилидов, обладает обезболивающим, противовоспалительным и жаропонижающим действием. Эффект обусловлен селективной блокадой циклооксигеназы-2 , а также ряд других механизмов, таких как: подавление синтеза фактора активизации тромбоцитов, снижение выработки супероксид-аниона стимулированными полиморфноядерными лейкоцитами посредством подавления протеинкиназы С и фосфодиэстеразы IV типа. Предупреждение индуцированной брадикинином и цитокинами гипералгезии посредством ингибирования высвобождения фактора некроза опухолей а. , Нейтрализация гипохлорной кислоты, Предупреждение инактивации ингибиторов а-протеиназы, Ингибирование протеаз (в т. ч. элластазы, коллагеназы), Ингибирование высвобождения гистамина из базофилов и тучных клеток, Замедление деградации хрящевого матрикса посредством ингибирования синтеза металлопротеаз. 2. Ментол оказывает местно-раздражающее, обезболивающее, отвлекающее, противозудное, антисептическое, успокаивающее действие. Эффект в основном обусловлен рефлекторными реакциями, связанными с раздражением чувствительных нервных окончаний: раздражение рецепторов кожи или слизистых оболочек стимулирует образование и высвобождение эндогенных биологически активных веществ (энкефалинов, эндорфинов, пептидов, кининов), участвующих в регуляции болевых ощущений, проницаемости сосудов и др. процессах, обеспечивая обезболивающее, отвлекающее и противозудное действие. Антисептическая активность проявляется неизбирательным поражением микробных клеток. Раздражающий (отвлекающий) эффект способствует понижению болевых ощущений. Местное действие сопровождается сужением сосудов, ощущением холода, переходящим в ощущение легкого жжения и покалывания. Кожно-висцеральные рефлексы (рефлекторная дуга не затрагивает головной мозг) улучшают трофику тканей (соответственно зонам иннервации). Рефлекторно изменяет тонус сосудов как поверхностных, так и глубоко расположенных в тканях и внутренних органах. 3. Капсаицин оказывает воздействие посредством снижения содержания вещества Р, являющегося нейротрансмиттером, осуществляющим проведение реакций боли и зуда от рецепторов периферической нервной системы к центральной. Капсаицин блокирует синтез и передачу вещества Р по нейрону, что ведет к уменьшению интенсивности болевого импульса. 4. Метилсалицилат - производное салициловой кислоты. При местной аппликации быстро проникает в глубокие слои кожи, абсорбируется, гидролизуется и превращается в анион салициловой кислоты. Неселективно ингибирует циклооксигеназу, снижает синтез простагландинов, отвечающих за воспаление, боль, повышение температуры. Нормализует повышенную проницаемость капилляров, улучшает процессы микроциркуляции, уменьшает отек и инфильтрацию воспаленных тканей, вызывает уменьшение болевых ощущений при патологии суставов, мышц и мягких тканей. Оказывает местное раздражающее действие на кожу, что способствует уменьшению болевых ощущений.
Показания к применению
Ревматоидный артрит, суставной синдром при ревматизме и обострении подагры, псориатический артрит, анкилозирующий спондилоартрит, остеохондроз с корешковым синдромом, радикулит, ишиас, люмбаго, остеоартроз, артриты различной этиологии, артралгия, миалгия ревматического и неревматического генеза, воспаление связок, сухожилий, бурситы, постравматическое воспаление мягких тканей и опорно-двигательного аппарата (повреждения и разрывы связок, ушибы), болевой синдром различного генеза (в т, ч, в послеоперационном периоде, при травмах, альгодисменорея, зубная боль, головная боль).
Противопоказания
Эрозивно-язвенные поражения ЖКТ в фазе обострения, Кровотечения из ЖКТ, аспириновая триада, нарушения функции печени, выраженная почечная недостаточность, дерматозы, повреждения эпидермиса, инфекции кожи в области применения (для геля), детский возраст до 2 лет. Повышенная чувствительность к нимесулиду и другим компонентам препарата, ацетилсалициловой кислоте и другим НПВС. С осторожностью следует назначать препарат при артериальной гипертензии, сердечной недостаточности, сахарном диабете тип 2 (инсулиннезависимом).
Применение при беременности и в период грудного вскармливания
Нимесулид не используется у беременных и кормящих женщин. Исследования, подтверждающие его эффективность и безопасность в период беременности и лактации, не проводились. Данных о влиянии на развитие плода нет.
Способ применения и дозы
Перед применением геля следует вымыть и высушить поверхность кожи. Столбик геля длиной примерно 3 см наносят на область максимальной болезненности, растирая равномерным тонким слоем (не втирать) 3-4 раз в сутки. Максимальная доза - 5 мгкг массы теласут. Продолжительность применения препарата - 10 дней.
Побочное действие
Местные реакции: зуд, крапивница, шелушение, транзиторное изменение цвета кожи (не требующее отмены препарата). При появлении каких-либо побочных реакций следует прекратить применение препарата и проконсультироваться с врачом. При нанесении геля на обширные участки кожи или при длительном использовании не исключено развитие системных побочных реакций: изжога, тошнота, рвота, диарея, гастралгия, изъязвление слизистой желудочно-кишечного тракта, повышение активности «печеночных» трансаминаз. головная боль, головокружение. задержка жидкости, гематурия. аллергические реакции (анафилактический шок, кожная сыпь). тромбоцитопения, лейкопения, анемия, агранулоцитоз, удлинение времени кровотечения.
Передозировка
Случаев передозировки при местном применении описано не было. При нанесении более чем 50 г на обширные участки кожи возможно развитие передозировки (системных побочных реакций). Рекомендовано обращение к врачу. Специфических антидотов нет.
Особые указания
Не наносить гель вокруг глаз, на слизистые, на здоровые участки тела, на раневые поверхности. Не использовать при дерматитах. Нельзя касаться руками с гелем чувствительных участков кожи. Следует избегать применения геля с воздухонепроницаемыми повязками. После нанесения геля вымыть руки с мылом. После полного втирания препарата может наблюдаться покраснение, жжение. Эти симптомы обычно проходят через несколько дней после отмены препарата. Следует с осторожностью использовать препарат у пациентов с повышенным риском развития побочных эффектов, связанных с приемом салицилатов. Применение в педиатрии: Показания и рекомендации по применению у детей не известны. Эффект использования у водителей и рабочих связанных с механизмами: Пациенты, принимающие нимесулид внутрь, должны быть предупреждены о его побочном действии - головокружении. Применять с осторожностью во время вождения и работы. Случаев головокружения после местного применения нимесулида описано не было Мутагенность и канцерогенность: В различных исследованиях нимесулид оказался не мутагенным препаратом. Также нет данных о влиянии препарата на хромосомы лимфоцитов in vitro, и взаимодействие с Н-тимидином культивированных человеческих лимфоцитов. Применение в педиатрии: Показания и рекомендации по применению у детей не известны. Эффект использования у водителей и рабочих связанных с механизмами: Пациенты, принимающие нимесулид внутрь, должны быть предупреждены о его побочном действии - головокружении. Применять с осторожностью во время вождения и работы. Случаев головокружения после местного применения нимесулида описано не былоМутагенность и канцерогенность: В различных исследованиях нимесулид оказался не мутагенным препаратом. Также нет данных о влиянии препарата на хромосомы лимфоцитов in vitro, и взаимодействие с Н-тимидином культивированных человеческих лимфоцитов.
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таблетка содержит: Активное вещество: нимесулид 100 мг. Вспомогательные вещества: кальция гидрофосфат 75 мг, целлюлозамикрокристаллическая (тип 114) 40 мг, крахмал кукурузный 54 мг, карбоксиметилкрахмал натрия 35 мг, магния стеарат 3 мг, кремния диоксид коллоидный 2 мг, тальк 1 мг."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"1. Нимесулид является нестероидным противовоспалительным средством (НПВС) из класса сульфонанилидов, обладает обезболивающим, противовоспалительным и жаропонижающим действием. Эффект обусловлен селективной блокадой циклооксигеназы-2 , а также ряд других механизмов, таких как: подавление синтеза фактора активизации тромбоцитов, снижение выработки супероксид-аниона стимулированными полиморфноядерными лейкоцитами посредством подавления протеинкиназы С и фосфодиэстеразы IV типа. Предупреждение индуцированной брадикинином и цитокинами гипералгезии посредством ингибирования высвобождения фактора некроза опухолей а. , Нейтрализация гипохлорной кислоты, Предупреждение инактивации ингибиторов а-протеиназы, Ингибирование протеаз (в т. ч. элластазы, коллагеназы), Ингибирование высвобождения гистамина из базофилов и тучных клеток, Замедление деградации хрящевого матрикса посредством ингибирования синтеза металлопротеаз. 2. Ментол оказывает местно-раздражающее, обезболивающее, отвлекающее, противозудное, антисептическое, успокаивающее действие. Эффект в основном обусловлен рефлекторными реакциями, связанными с раздражением чувствительных нервных окончаний: раздражение рецепторов кожи или слизистых оболочек стимулирует образование и высвобождение эндогенных биологически активных веществ (энкефалинов, эндорфинов, пептидов, кининов), участвующих в регуляции болевых ощущений, проницаемости сосудов и др. процессах, обеспечивая обезболивающее, отвлекающее и противозудное действие. Антисептическая активность проявляется неизбирательным поражением микробных клеток. Раздражающий (отвлекающий) эффект способствует понижению болевых ощущений. Местное действие сопровождается сужением сосудов, ощущением холода, переходящим в ощущение легкого жжения и покалывания. Кожно-висцеральные рефлексы (рефлекторная дуга не затрагивает головной мозг) улучшают трофику тканей (соответственно зонам иннервации). Рефлекторно изменяет тонус сосудов как поверхностных, так и глубоко расположенных в тканях и внутренних органах. 3. Капсаицин оказывает воздействие посредством снижения содержания вещества Р, являющегося нейротрансмиттером, осуществляющим проведение реакций боли и зуда от рецепторов периферической нервной системы к центральной. Капсаицин блокирует синтез и передачу вещества Р по нейрону, что ведет к уменьшению интенсивности болевого импульса. 4. Метилсалицилат - производное салициловой кислоты. При местной аппликации быстро проникает в глубокие слои кожи, абсорбируется, гидролизуется и превращается в анион салициловой кислоты. Неселективно ингибирует циклооксигеназу, снижает синтез простагландинов, отвечающих за воспаление, боль, повышение температуры. Нормализует повышенную проницаемость капилляров, улучшает процессы микроциркуляции, уменьшает отек и инфильтрацию воспаленных тканей, вызывает уменьшение болевых ощущений при патологии суставов, мышц и мягких тканей. Оказывает местное раздражающее действие на кожу, что способствует уменьшению болевых ощущений."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Ревматоидный артрит, суставной синдром при ревматизме и обострении подагры, псориатический артрит, анкилозирующий спондилоартрит, остеохондроз с корешковым синдромом, радикулит, ишиас, люмбаго, остеоартроз, артриты различной этиологии, артралгия, миалгия ревматического и неревматического генеза, воспаление связок, сухожилий, бурситы, постравматическое воспаление мягких тканей и опорно-двигательного аппарата (повреждения и разрывы связок, ушибы), болевой синдром различного генеза (в т, ч, в послеоперационном периоде, при травмах, альгодисменорея, зубная боль, головная боль)."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Эрозивно-язвенные поражения ЖКТ в фазе обострения, Кровотечения из ЖКТ, аспириновая триада, нарушения функции печени, выраженная почечная недостаточность, дерматозы, повреждения эпидермиса, инфекции кожи в области применения (для геля), детский возраст до 2 лет. Повышенная чувствительность к нимесулиду и другим компонентам препарата, ацетилсалициловой кислоте и другим НПВС. С осторожностью следует назначать препарат при артериальной гипертензии, сердечной недостаточности, сахарном диабете тип 2 (инсулиннезависимом)."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Нимесулид не используется у беременных и кормящих женщин. Исследования, подтверждающие его эффективность и безопасность в период беременности и лактации, не проводились. Данных о влиянии на развитие плода нет."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Перед применением геля следует вымыть и высушить поверхность кожи. Столбик геля длиной примерно 3 см наносят на область максимальной болезненности, растирая равномерным тонким слоем (не втирать) 3-4 раз в сутки. Максимальная доза - 5 мгкг массы теласут. Продолжительность применения препарата - 10 дней."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Местные реакции: зуд, крапивница, шелушение, транзиторное изменение цвета кожи (не требующее отмены препарата). При появлении каких-либо побочных реакций следует прекратить применение препарата и проконсультироваться с врачом. При нанесении геля на обширные участки кожи или при длительном использовании не исключено развитие системных побочных реакций: изжога, тошнота, рвота, диарея, гастралгия, изъязвление слизистой желудочно-кишечного тракта, повышение активности «печеночных» трансаминаз. головная боль, головокружение. задержка жидкости, гематурия. аллергические реакции (анафилактический шок, кожная сыпь). тромбоцитопения, лейкопения, анемия, агранулоцитоз, удлинение времени кровотечения."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Случаев передозировки при местном применении описано не было. При нанесении более чем 50 г на обширные участки кожи возможно развитие передозировки (системных побочных реакций). Рекомендовано обращение к врачу. Специфических антидотов нет."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Не наносить гель вокруг глаз, на слизистые, на здоровые участки тела, на раневые поверхности. Не использовать при дерматитах. Нельзя касаться руками с гелем чувствительных участков кожи. Следует избегать применения геля с воздухонепроницаемыми повязками. После нанесения геля вымыть руки с мылом. После полного втирания препарата может наблюдаться покраснение, жжение. Эти симптомы обычно проходят через несколько дней после отмены препарата. Следует с осторожностью использовать препарат у пациентов с повышенным риском развития побочных эффектов, связанных с приемом салицилатов. Применение в педиатрии: Показания и рекомендации по применению у детей не известны. Эффект использования у водителей и рабочих связанных с механизмами: Пациенты, принимающие нимесулид внутрь, должны быть предупреждены о его побочном действии - головокружении. Применять с осторожностью во время вождения и работы. Случаев головокружения после местного применения нимесулида описано не было Мутагенность и канцерогенность: В различных исследованиях нимесулид оказался не мутагенным препаратом. Также нет данных о влиянии препарата на хромосомы лимфоцитов in vitro, и взаимодействие с Н-тимидином культивированных человеческих лимфоцитов. Применение в педиатрии: Показания и рекомендации по применению у детей не известны. Эффект использования у водителей и рабочих связанных с механизмами: Пациенты, принимающие нимесулид внутрь, должны быть предупреждены о его побочном действии - головокружении. Применять с осторожностью во время вождения и работы. Случаев головокружения после местного применения нимесулида описано не былоМутагенность и канцерогенность: В различных исследованиях нимесулид оказался не мутагенным препаратом. Также нет данных о влиянии препарата на хромосомы лимфоцитов in vitro, и взаимодействие с Н-тимидином культивированных человеческих лимфоцитов."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"1. Нимесулид является нестероидным противовоспалительным средством (НПВС) из класса сульфонанилидов, обладает обезболивающим, противовоспалительным и жаропонижающим действием. Эффект обусловлен селективной блокадой циклооксигеназы-2 , а также ряд других механизмов, таких как: подавление синтеза фактора активизации тромбоцитов, снижение выработки супероксид-аниона стимулированными полиморфноядерными лейкоцитами посредством подавления протеинкиназы С и фосфодиэстеразы IV типа. 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Эффект в основном обусловлен рефлекторными реакциями, связанными с раздражением чувствительных нервных окончаний: раздражение рецепторов кожи или слизистых оболочек стимулирует образование и высвобождение эндогенных биологически активных веществ (энкефалинов, эндорфинов, пептидов, кининов), участвующих в регуляции болевых ощущений, проницаемости сосудов и др. процессах, обеспечивая обезболивающее, отвлекающее и противозудное действие. Антисептическая активность проявляется неизбирательным поражением микробных клеток. Раздражающий (отвлекающий) эффект способствует понижению болевых ощущений. Местное действие сопровождается сужением сосудов, ощущением холода, переходящим в ощущение легкого жжения и покалывания. Кожно-висцеральные рефлексы (рефлекторная дуга не затрагивает головной мозг) улучшают трофику тканей (соответственно зонам иннервации). Рефлекторно изменяет тонус сосудов как поверхностных, так и глубоко расположенных в тканях и внутренних органах. 3. 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