Нимулид Суспензия, флакон, 1 шт, 60 мл, 10 мг / мл, для приема внутрь

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Хорошо проникает в кислую среду очага воспаления (40%), синовиальную жидкость (43%). Легко проникает через гистогематические барьеры. Метаболизируется в печени тканевыми монооксигеназами. Основной метаболит – 4-гидроксинимесулид (25%) обладает сходной фармакологической активностью. Период полувыведения нимесулида составляет 1,56-4,95 часа, 4-гидроксинимесулида – 2,89-4,78 часа. 4-гидроксинимесулид выводится почками (65%) и с желчью (35%). У больных с почечной недостаточностью (клиренс креатинина 1,8-4,8 л/ч или 30-80 мл/мин), а также у детей и лиц пожилого возраста фармакокинетический профиль нимесулида существенно не меняется."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Ревматоидный артрит, остеоартроз, артриты различной этиологии, артралгии, миалгии, послеоперационные и посттравматические боли, бурсит, тендинит, альгодисменорея, зубная и головная боль, в том числе при лихорадочном синдроме."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"  Гиперчувствительность, эрозивно-язвенные поражения желудочно-кишечного тракта (в фазе обострения), кровотечения из желудочно-кишечного тракта, полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа или околоносовых пазух и непереносимости ацетилсалициловой кислоты и других нестероидных противовоспалительных препаратов (в том числе в анамнезе), любые нарушения функции печени, почечная недостаточность (клиренс креатинина – менее 30 мл/мин), цереброваскулярное кровотечение, воспалительные заболевания кишечника (болезнь Крона, язвенный колит) в фазе обострения, гемофилия и другие нарушения свертываемости крови, декомпенсированная хроническая сердечная недостаточность, гепатотоксические реакции при использовании нимесулида в анамнезе, алкоголизм, наркомания, прогрессирующие заболевания почек, подтвержденная гиперкалиемия, период после проведения аортокоронарного шунтирования, одновременный прием других гепатотоксических лекарственных средств, беременность, период лактации, детский возраст до 2 лет."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Артериальная гипертензия, сердечная недостаточность, сахарный диабет 2 типа, ишемическая болезнь сердца, цереброваскулярные заболевания, дислипидемия/ гиперлипидемия, заболевания периферических артерий, курение, почечная недостаточность (клиренс креатинина 30-60 мл/мин), анамнестические данные о развитии язвенного поражения желудочно-кишечного тракта, наличие инфекции Helicobacter pylori, пожилой возраст, длительное использование нестероидных противовоспалительных препаратов, алкоголизм, тяжелые соматические заболевания, одновременный прием антикоагулянтов (в том числе варфарин), антиагрегантов (в том числе ацетилсалициловая кислота, клопидогрел), пероральных глюкокортикостероидов, селективных ингибиторов обратного захвата серотонина (в том числе циталопрам, флуоксетин, пароксетин, сертралин)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение препарата может отрицательно влиять на женскую фертильность и не рекомендуется женщинам, планирующим беременность."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nВзрослым: внутрь, по 100 мг (10 мл) 2 раза в сутки. Максимальная суточная доза для взрослых – 200 мг (20 мл). При наличии заболеваний желудочно-кишечного тракта препарат желательно принимать в конце еды или после приема пищи. Детям с 2 лет: внутрь, назначают из расчета разовой дозы 1,5 мг/кг массы тела ребенка 2-3 раза в день, максимальная суточная доза препарата – 5 мг/кг в сутки. Подросткам с массой тела свыше 40 кг – 100 мг (10 мл) не более 2 раз в день.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\n\nЧастота классифицируется по рубрикам, в зависимости от встречаемости случая: очень часто (> 1/10), часто (> 1/100), нечасто (> 1/1000), редко (> 1/10000), очень редко (1/10000). Центральная нервная система: нечасто – головокружение; редко – ощущение страха, нервозность, «кошмарные сновидения»; очень редко – головная боль, сонливость, энцефалопатия (синдром Рейе). Желудочно-кишечный тракт: часто – диарея, тошнота, рвота, повышение «печеночных» трансаминаз; нечасто – запор, метеоризм, гастрит; очень редко - боли в животе, стоматит, дегтеобразный стул, желудочно-кишечное кровотечение, язва и/или перфорация желудка или двенадцатиперстной кишки, гепатит, молниеносный гепатит, желтуха, холестаз. Органы дыхания: нечасто – одышка; очень редко – бронхиальная астма, бронхоспазм. Сердечно-сосудистая система: нечасто – артериальная гипертензия; редко – тахикардия, «приливы». Органы чувств: редко – нечеткость зрения, очень редко – головокружение.  \n\nКожные и слизистые покровы: нечасто – зуд, сыпь, усиление потоотделения; редко: эритема, дерматит; очень редко: крапивница, ангионевротический отек, отечность лица, многоформная экссудативная эритема, в т.ч. синдром Стивенса-Джонсона, токсический эпидермальный некролиз (синдром Лайелла). Почки и мочевыводящая система: нечасто – отеки; редко – дизурия, гематурия, задержка мочи, гиперкалиемия; очень редко – почечная недостаточность, олигурия, интерстициальный нефрит. Органы кроветворения: редко – анемия, эозинофилия; очень редко – тромбоцитопения, панцитопения, геморрагии, пурпура, удлинение времени кровотечения. Аллергические реакции: редко – реакции гиперчувствительности; очень редко – анафилактоидные реакции. Прочие: редко – общая слабость; очень редко – гипотермия.\n\n"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\n\nСимптомы: апатия, сонливость, тошнота, рвота. Симптомы обратимы при оказании поддерживающего ухода за больными. Может возникнуть желудочно-кишечное кровотечение, артериальная гипертензия, острая почечная недостаточность, угнетение дыхания. Лечение: требуется симптоматическое лечение пациента и поддерживающий уход за ним. Специфического антидота нет. В случае, если передозировка произошла в течение последних 4 часов необходимо вызвать рвоту, обеспечить прием активированного угля, (60-100 г на взрослого человека), осмотические слабительные. Форсированный диурез, гемодиализ – неэффективны из-за высокой связи препарата с белками.\n\n"}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nДействие медикаментов, уменьшающих свертываемость крови, усиливается при их одновременном применении с нимесулидом. Нимесулид может снижать действие фуросемида. Нимесулид может увеличивать возможность наступления побочных действий при одновременном приеме метотрексата. Уровень лития в плазме повышается при одновременном приеме препаратов лития и нимесулида. Из-за высокой степени связывания нимесулида с белками плазмы пациенты, которых одновременно лечат гидантоином и сульфаниламидами, должны находиться под наблюдением врача, проходя обследование через короткие промежутки времени. Нимесулид может усиливать действие циклоспорина на почки. Гепатотоксичные лекарственные средства – повышают риск развития гепатотоксического действия. При одновременном применении с глюкокортикостероидами, селективными ингибиторами обратного захвата серотонина увеличивается риск развития кровотечений из желудочно-кишечного тракта.\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nПри назначении препарата пожилым пациентам коррекции режима дозирования не требуется. При длительном применении необходим систематический контроль функции печени и почек не реже 1 раза в две недели. При появлении признаков поражения печени (кожный зуд, желтуха, тошнота, рвота, боль в животе, потемнение мочи, повышение активности \"печеночных\" трансаминаз) следует немедленно прекратить прием препарата и обратиться к врачу. Учитывая сообщения о нарушениях зрения у пациентов, принимавших другие нестероидные противовоспалительные препараты, при появлении любого нарушения зрения лечение должно быть немедленно прекращено и проведено офтальмологическое обследование. Препарат может вызывать задержку жидкости, поэтому у пациентов с высоким артериальным давлением и с заболеваниями сердца нимесулид следует применять с особой осторожностью. Пациентам следует проходить регулярный врачебный контроль, если они наряду с нимесулидом принимают медикаменты, для которых характерно влияние на желудочнокишечный тракт.  \n\nНе следует применять препарат одновременно с другими нестероидными противовоспалительными препаратами. Нимесулид может снижать агрегацию тромбоцитов, однако он не заменяет профилактического действия антиагрегантов (в том числе ацетилсалициловая кислота, клопидогрел, тиклопидин) при сердечно-сосудистых заболеваниях. Применение препарата может отрицательно влиять на женскую фертильность и не рекомендуется женщинам, планирующим беременность. ВЛИЯНИЕ ЛЕКАРСТВЕННОГО ПРЕПАРАТА НА СПОСОБНОСТЬ УПРАВЛЯТЬ ТРАНСПОРТНЫМИ СРЕДСТВАМИ, МЕХАНИЗМАМИ. Необходимо соблюдать осторожность при управлении транспортными средствами и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.\n\n"}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Суспензия."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом, защищенном от света месте при температуре не выше 25°С. Хранить в недоступном для детей месте."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Панацея Биотек Фарма Лтд., Индия."}}]}],"source":null},"description_toggle":false,"short_description":"Нестероидный противовоспалительный препарат (НПВП) из класса сульфонанилидов. Обладает свойствами селективного ингибитора циклооксигеназы-2 (ЦОГ-2) – фермента, участвующего в синтезе простагландинов – медиаторов отека, воспаления и боли; в меньшей степени ингибирует активность ЦОГ-1. Оказывает противовоспалительное, анальгезирующее и жаропонижающее действие. Абсорбция при приеме внутрь – высокая. Прием пищи снижает скорость абсорбции, не оказывая влияния на ее степень. Подвергается энтерогепатической рециркуляции. Время достижения максимальной концентрации активного вещества в плазме крови – 1,5-2,5 ч. Связь с белками плазмы составляет 95%, с эритроцитами 2%, с липопротеинами – 1%, с кислыми альфа 1-гликопротеидами 1 %. Доза препарата не влияет на степень его связывания с белками крови. Максимальная концентрация нимесулида в плазме крови достигает 3,5-6,5 мг/л. Объем распределения – 0,19-0,35 л/кг. Проникает в ткани женских половых органов, где после однократного приема его концентрация составляет около 40% от концентрации в плазме. Хорошо проникает в кислую среду очага воспаления (40%), синовиальную жидкость (43%). Легко проникает через гистогематические барьеры. Метаболизируется в печени тканевыми монооксигеназами. Основной метаболит – 4-гидроксинимесулид (25%) обладает сходной фармакологической активностью. Период полувыведения нимесулида составляет 1,56-4,95 часа, 4-гидроксинимесулида – 2,89-4,78 часа. 4-гидроксинимесулид выводится почками (65%) и с желчью (35%). У больных с почечной недостаточностью (клиренс креатинина 1,8-4,8 л/ч или 30-80 мл/мин), а также у детей и лиц пожилого возраста фармакокинетический профиль нимесулида существенно не меняется.","substance":[{"id":129,"title":"Нимесулид","title_latin":"Nimesulidum","slug":"nimesulid_129"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Нимулид - фото упаковки","image_share":{"isTouch":{"default":null},"isFromTablet":{"default":null}},"diseases":[],"other_packages":[{"id":95282,"title":"Нимулид","subtitle":{"full":"Суспензия, 5 мл, 50/60 мг/мл, для приема внутрь","short":"Суспензия, 5 мл, 50/60 мг/мл","package":"5 мл, 50/60 мг/мл"},"prescription":true,"catalog_section_id":71,"manufacturer":{"id":2586,"title":"Корал 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