Physicians usually consider the age and health of the patient along with any medications the patient is taking before determining a nimesulide dose. The possible harmful effects of nimesulide might require dosage adjustments in patients who take certain prescription medications or in individuals with with heart or kidney impairment. Many countries have deemed the medication unsafe for human consumption and restricted its availability to veterinary use.
Pharmaceutical companies classify nimesulide as a cyclooxygenase-2 (COX-2) inhibitor. COX-2 and other COX enzymes produce the hormone prostaglandin, which is responsible for inflammatory reactions. While nimesulide acts similar to other non-steroidal anti-inflammatory drugs (NSAIDS), it also inhibits histamine release. The chemical composition of nimesulide differs from other NSAIDS as a sulfonamide chain replaces the usual carbonate component.
The medication generally acts as an analgesic, anti-inflammatory, and fever-reducing agent, and its uses include treatment of acute pain and pain associated with dysmenorrhea or osteoarthritis. The typical adult nimesulide dose is 100 milligrams taken twice a day. Children over the age of 12 generally receive a nimesulide dose of 5 milligrams for every kilogram of body weight divided into two or three doses per day. Studies indicate an increased risk of developing possible life threatening side effects with prolonged use, and researchers suggests patients not take the medication for longer than two weeks.
Federal drug regulating agencies called the safety of nimesulide into question as studies and patient reporting suggested a higher risk of liver toxicity while using the medication compared to other NSAIDS. Over 100 countries discontinued using the medication in human patients because of these findings, and nimesulide is not available in Canada, the United Kingdom, or the United States. Though some countries allow nimesulide use, warning labels advise that patients having heart, kidney, or liver disease should not use the medication.
Common nimesulide side effects include diarrhea, vomiting, dizziness, and headache. Some patients develop a red, itchy skin rash. Individuals who are allergic to sulfur containing medications may have a severe reaction to the drug. More serious adverse reactions include the possibility of gastrointestinal bleeding and altered clotting ability, resulting from a decrease in platelet adhesion. This risk increases in elderly patients because of the aging process and because of the various other medications that some of these patients require.
Physicians may alter the nimesulide dose for elderly patients, and the medication is not recommended for patients experiencing gastric disorders. Nimesulide dose might also be affected by combining the NSAID with other medications. Medications that interact with nimesulide include cyclosporine, digitalis, and lithium. Also on the list of interacting medications are methotrexate and phenytoin. All of these formulations compete with nimesulide for the enzymes necessary for metabolism, which may decrease or increase the blood levels of nimesulide or the other medication.