Нимесулид-Тева Таблетки, пачка, 30 шт, 100 мг, для приема внутрь, для тела, для взрослых

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Статистически значимых различий между этими параметрами после однократного приема и назначением на протяжении 7 дней в дозе 100 мг 2 раза в день не обнаружено."}},{"type":"paragraph","data":{"text":"Объем распределения - 0,19-0,35 л/кг. Легко проникает через гистогематические барьеры (в тканях женских половых органов после однократного приема нимесулида концентрация составляет около 40% от концентрации в плазме крови), в т.ч. в кислую среду очага воспаления и синовиальную жидкость (40% и 43% соответственно от концентрации в плазме крови)."}},{"type":"paragraph","data":{"text":"Метаболизируется в печени с участием монооксигеназ, в т.ч. системы цитохрома Р450 (CYP) 2С9. Основной метаболит - водорастворимый 4-гидроксинимесулид (25%), обладает сходной с нимесулидом фармакологической активностью."}},{"type":"paragraph","data":{"text":"Нимесулид выводится в основном с мочой (приблизительно 50% принятой дозы). Период полувыведения (Т\u003csub\u003e1/2\u003c/sub\u003e) нимесулида - 3-6 часов, 4-гидроксинимесулида - 3-5 часов. 4-гидроксинимесулид выводится почками (65%) и с желчью (35%), подвергается энтерогепатической рециркуляции."}},{"type":"paragraph","data":{"text":"Всего 1-3% нимесулида выводится в неизмененном виде. Приблизительно 29% дозы выводится в виде метаболита с калом."}},{"type":"paragraph","data":{"text":"Фармакокинетический профиль нимесулида у пожилых людей после однократного и повторного приема препарата не меняется."}},{"type":"paragraph","data":{"text":"У пациентов с легким и умеренным нарушением функции почек - клиренс креатинина (КК) 30-80 мл/мин, С\u003csub\u003emах\u003c/sub\u003e нимесулида и его основного метаболита в плазме крови не превышают таковые у здоровых добровольцев. Повторный прием нимесулида не сопровождается его кумуляцией."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"- Острый болевой синдром: альгодисменорея, послеоперационные и посттравматические боли, артралгия, миалгия, зубная и головная боль, тендинит, бурсит."}},{"type":"paragraph","data":{"text":"- Симптоматическое лечение остеоартрита, сопровождающегося болевым синдромом (препарат предназначен для симптоматической терапии, уменьшения боли и воспаления на момент использования, на прогрессирование заболевания не влияет; нимесулид следует назначать только в качестве терапии второй линии)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Известная гиперчувствительность к нимесулиду или любому из входящих в его состав вспомогательных веществ."}},{"type":"paragraph","data":{"text":"- Реакции гиперчувствительности в анамнезе в ответ на прием НПВП (например, бронхоспазм, ринит, крапивница, полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа или околоносовых пазух и непереносимости ацетилсалициловой кислоты и других НПВП)."}},{"type":"paragraph","data":{"text":"- Желудочно-кишечное кровотечение или перфорация стенок кишечника в анамнезе, связанные с предшествующим лечением НПВП, эрозивно-язвенные поражения слизистой оболочки желудка и двенадцатиперстной кишки (два или более подтвержденных эпизодов изъязвления и/или кровотечения), воспалительные заболевания кишечника (болезнь Крона, язвенный колит) в фазе обострения."}},{"type":"paragraph","data":{"text":"- Цереброваскулярное кровотечение, нарушения свертываемости крови, сопровождавшиеся кровотечением в анамнезе, гемофилия."}},{"type":"paragraph","data":{"text":"- Декомпенсированная сердечная недостаточность."}},{"type":"paragraph","data":{"text":"- Печеночная недостаточность или любое заболевание печени в стадии обострения, гепатотоксические реакции при использовании нимесулида в анамнезе, сопутствующее применение других потенциально гепатотоксичных веществ."}},{"type":"paragraph","data":{"text":"- Выраженная почечная недостаточность (КК менее 30 мл/мин), прогрессирующие заболевания почек, подтвержденная гиперкалиемия."}},{"type":"paragraph","data":{"text":"- Послеоперационный период после проведения аортокоронарного шунтирования."}},{"type":"paragraph","data":{"text":"- Сопутствующие простудные заболевания с высокой температурой."}},{"type":"paragraph","data":{"text":"- Врожденная непереносимостью лактозы, нарушение всасывания глюкозы- галактозы, недостаточность лактазы."}},{"type":"paragraph","data":{"text":"- Детский возраст до 12 лет."}},{"type":"paragraph","data":{"text":"- Третий триместр беременности и период грудного вскармливания."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- Тяжелые соматические заболевания: ишемическая болезнь сердца, цереброваскулярные заболевания, дислипидемия/гиперлипидемия, сахарный диабет, облитерирующие заболевания периферических артерий, легкая и умеренно выраженная почечная недостаточность (КК 30-80 мл/мин), анамнестические данные о развитии язвенного поражения желудочно-кишечного тракта, наличие инфекции Helicobacter pylori."}},{"type":"paragraph","data":{"text":"- Курение, пожилой возраст, длительное использование НПВП, алкоголизм, одновременный прием антикоагулянтов (в т.ч. варфарина), антиагрегантов (в т.ч. ацетилсалициловой кислоты, клопидогрела), пероральных глюкокортикостероидов, селективных ингибиторов обратного захвата серотонина (в т.ч. циталопрама, флуоксетина, пароксетина и сертралина)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение препарата Нимесулид-Тева противопоказано в третьем триместре беременности."}},{"type":"paragraph","data":{"text":"Как и другие НПВП, препарат Нимесулид-Тева не рекомендуется применять у женщин, пытающихся забеременеть."}},{"type":"paragraph","data":{"text":"Ингибирование синтеза простагландинов может оказывать негативное влияние на беременность и/или развитие эмбриона/плода. Результаты эпидемиологических исследований указывают на повышенный риск самопроизвольного прерывания беременности (выкидыши на ранних сроках) и развития пороков сердца, а также развития гастрошизиса (порока развития, представляющего собой незаращение передней брюшной стенки в околопупочной области, при котором происходит выпадение наружу органов брюшной полости) на фоне применения НПВП в первом триместре беременности. Риск тератогенности и эмбриотоксичности возрастает с увеличением дозы и продолжительности лечения."}},{"type":"paragraph","data":{"text":"Если препарат Нимесулид-Тева принимает женщина, которая пытается забеременеть, или в течение первого и второго триместра беременности, доза и длительность лечения должны быть минимально возможными."}},{"type":"paragraph","data":{"text":"В течение третьего триместра беременности все ингибиторы синтеза простагландинов могут воздействовать на:"}},{"type":"paragraph","data":{"text":"\u003ci\u003eплод\u003c/i\u003e:"}},{"type":"paragraph","data":{"text":"- сердечно-легочная токсичность (с преждевременным закрытием боталлова артериального протока с развитием легочной гипертензии);"}},{"type":"paragraph","data":{"text":"- нарушение функции почек, которое может прогрессировать вплоть до развития почечной недостаточности;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eмать и новорожденного:\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"- удлинение времени кровотечения (даже при назначении низких доз);"}},{"type":"paragraph","data":{"text":"- снижение сокращений матки (задержка и удлинение родов)."}},{"type":"paragraph","data":{"text":"Нет данных о выделении нимесулида с грудным молоком, препарат Нимесулид-Тева противопоказан в период грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Следует назначать минимальную эффективную дозу с возможно минимально коротким курсом лечения. Максимальная продолжительность лечения нимесулидом составляет 15 дней."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВзрослые\u003c/i\u003e: 100 мг нимесулида 2 раза в день после еды. У пациентов с почечной недостаточностью максимальная суточная доза - 100 мг."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПожилые лица\u003c/i\u003e: снижать суточную дозу нет необходимости."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДети (младше 12 лет)\u003c/i\u003e: препарат Нимесулид-Тева противопоказан."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПодростки (от 12 до 18 лет)\u003c/i\u003e: коррекции дозы не требуется."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушенная функция почек\u003c/i\u003e: коррекции дозы у пациентов с легким и умеренным нарушением функции почек (КК 30-80 мл/мин) обычно не требуется. Препарат Нимесулид-Тева противопоказан в случае тяжелого нарушения функции почек (КК <30 мл/мин)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушение функции печени\u003c/i\u003e: применение препарата Нимесулид-Тева противопоказано.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Данные клинико-эпидемиологических исследований свидетельствуют о том, что длительное применение любых НПВП (особенно в высоких дозах) потенциально может сопровождаться увеличением риска возникновения тромбоза артерий (в т.ч. проявляющегося инфарктом миокарда или ишемическим инсультом)."}},{"type":"paragraph","data":{"text":"На фоне применения НПВП возможно развитие отечного синдрома, артериальной гипертензии, усугубление течения сердечной недостаточности. Очень редко сообщалось о возникновении серьезных кожных реакций, включая синдром Стивенса-Джонсона и токсический эпидермальный некролиз."}},{"type":"paragraph","data":{"text":"Чаще всего наблюдаются различные желудочно-кишечные расстройства (особенно у предрасположенных и пожилых лиц): пептические язвы, перфорация стенки желудочно- кишечного тракта, развитие потенциально тяжелых желудочно-кишечных кровотечений, тошнота, рвота, кровавая рвота, метеоризм, боли в животе, диарея, запор, мелена, стоматит, язвенный колит, реже наблюдаются проявления гастрита."}},{"type":"paragraph","data":{"text":"Нижеприведенные нежелательные явления на фоне приема нимесулида были выявлены в ходе контролируемых клинических исследований (помечены знаком \"*\"), а также маркетинговых наблюдений с представленной частотой, классифицируемой согласно рекомендациям Всемирной организации здравоохранения: очень часто (не менее 10%); часто (1-10%); нечасто (0.1-1%); редко (0.01-0.1%); очень редко (менее 0.01%, включая отдельные случаи)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции:\u003c/i\u003e редко - гиперчувствительность*; очень редко - анафилаксия. Нарушения водно-электролитного баланса: редко - гиперкалиемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения психики\u003c/i\u003e: редко - тревожность, страх*, нервозность*, \"кошмарные\" сновидения*."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны нервной системы и органов чувств\u003c/i\u003e: нечасто - головокружение*; редко - расплывчатость зрения*; очень редко - нарушения зрения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны сердечно-сосудистой системы\u003c/i\u003e: нечасто - артериальная гипертензия*; редко - тахикардия*, лабильность артериального давления*, \"приливы\" крови к лицу*."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны органов дыхания\u003c/i\u003e: нечасто - диспноэ*; очень редко - бронхоспазм."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны пищеварительной системы\u003c/i\u003e: часто - диарея*, тошнота*, рвота*; нечасто - запор*, метеоризм*, гастрит*; очень редко - боль в животе, диспепсия, стоматит, мелена, желудочно-кишечное кровотечение, язва и перфорация двенадцатиперстной кишки и/или желудка."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны печени и желчевыводящих путей\u003c/i\u003e: часто - повышение активности \"печеночных\" ферментов*; очень редко - гепатит, в т.ч. молниеносного течения, желтуха, холестаз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны кожи и подкожных тканей\u003c/i\u003e: нечасто - зуд*, сыпь*, усиленное потоотделение*; редко - эритема*, дерматит*; очень редко - крапивница, ангионевротический отек, отек лица, мультиформная эритема, синдром Стивенса- Джонсона, токсический эпидермальный некролиз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны почек и мочевыводящих путей\u003c/i\u003e: редко - дизурия*, гематурия*, задержка мочеиспускания*; очень редко - почечная недостаточность, олигурия, интерстициальный нефрит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСистемные нарушения\u003c/i\u003e: нечасто - отечный синдром*; редко - недомогание*, астения*; очень редко - гипотермия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны крови\u003c/i\u003e: редко - анемия*, эозинофилия*; очень редко - тромбоцитопения, панцитопения, пурпура."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e: апатия, сонливость, тошнота, рвота, желудочно-кишечные кровотечения, повышение артериального давления, острая почечная недостаточность, угнетение дыхания."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e: симптоматическая и поддерживающая терапия. Специфического антидота нет. В первые 4 часа после передозировки - следует вызвать рвоту, целесообразен прием активированного угля (1 г/кг массы тела). Проведение форсированного диуреза и гемодиализа неэффективно."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eФармакодинамические взаимодействи\u003c/i\u003eя. Сочетание препарата Нимесулид-Тева с другими НПВП, включая ацетилсалициловую кислоту, в противовоспалительных дозах (≥1г однократно или ≥3г за сутки) не рекомендуется."}},{"type":"paragraph","data":{"text":"НПВП усиливают антикоагулянтный эффект варфарина. Пациенты, получающие варфарин и антиагреганты (включая клопидогрел и ацетилсалициловую кислоту) на фоне приема нимесулида, имеют повышенный риск развития кровотечений."}},{"type":"paragraph","data":{"text":"Ингибиторы синтеза простагландинов (НПВП, в т.ч. нимесулид) могут повышать нефротоксичность циклоспорина."}},{"type":"paragraph","data":{"text":"При одновременном применении с глюкокортикостероидами и селективными ингибиторами обратного захвата серотонина увеличивается риск развития кровотечений из желудочно-кишечного тракта."}},{"type":"paragraph","data":{"text":"НПВП могут снижать эффективность диуретиков и других антигипертензивных препаратов. У пациентов с начальными нарушениями функции почек (например, у обезвоженных пациентов или пациентов пожилого возраста с нарушенной функцией почек) сопутствующее назначение ингибиторов ангиотензинпревращающего фермента (АПФ) или антагонистов ангиотензина II с ингибиторами ЦОГ может привести к усилению проявлений почечной недостаточности (обычно обратимой). Эту комбинацию следует назначать с осторожностью, особенно пациентам пожилого возраста. Пациенты должны получать необходимое количество жидкости, также стоит рассмотреть вопрос о необходимости мониторинга функции почек."}},{"type":"paragraph","data":{"text":"У здоровых людей нимесулид кратковременно уменьшает выраженность натрийуретического действия фуросемида (в меньшей степени - калийуретического)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eФармакокинетические взаимодействия\u003c/i\u003e. Сопутствующее назначение нимесулида и фуросемида приводит к снижению (примерно на 20%) AUC, не оказывая влияния на его почечный клиренс."}},{"type":"paragraph","data":{"text":"НПВП снижают клиренс лития, приводя к увеличению его концентрации в плазме крови и токсичности."}},{"type":"paragraph","data":{"text":"Нимесулид ингибирует CYP2C9. Плазматические концентрации препаратов, которые являются субстратами этого фермента, могут повышаться при сопутствующем применении препарата Нимесулид-Тева."}},{"type":"paragraph","data":{"text":"Осторожность требуется при назначении нимесулида менее чем за 24 часа до или после лечения метотрексатом (концентрация метотрексата в плазме крови может увеличиться, что приведет к росту его токсичности)."}},{"type":"paragraph","data":{"text":"Исследования in vitro показали возможность вытеснения нимесулидом из связи с белками плазмы крови фуросемида, фенофибрата, толбутамида, салициловой и вальпроевой кислот (клинического значения данный факт не имеет)."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Каждые 2 недели следует контролировать функциональное состояние печени. При появлении признаков поражения печени (кожный зуд, желтуха, тошнота, рвота, боль в животе, потемнение мочи, повышение активности \"печеночных\" трансаминаз) следует немедленно прекратить лечение."}},{"type":"paragraph","data":{"text":"Учитывая возможность нарушения зрения у пациентов, принимавших НПВП, при появлении подобных симптомов лечение должно быть немедленно прекращено и проведено офтальмологическое обследование."}},{"type":"paragraph","data":{"text":"Препарат может вызывать задержку жидкости, в связи с чем у пациентов с высоким уровнем артериального давления или признаками застойной сердечной недостаточности нимесулид следует применять с особой осторожностью."}},{"type":"paragraph","data":{"text":"Пациентам следует находиться под регулярным врачебным контролем, если они наряду с нимесулидом принимают препараты, для которых также характерно ульцерогенное влияние на желудочно-кишечный тракт. Не следует применять препарат одновременно с другими НПВП (включая селективные ингибиторы ЦОГ-2) и ненаркотическими анальгетиками."}},{"type":"paragraph","data":{"text":"Нимесулид снижает агрегацию тромбоцитов, вместе с тем он не способен заменить профилактический прием антиагрегантов (ацетилсалициловая кислота, клопидогрел, тиклопидин) при сердечно-сосудистых заболеваниях."}},{"type":"paragraph","data":{"text":"Применение препарата может отрицательно влиять на женскую фертильность (не рекомендуется женщинам, планирующим беременность)."}},{"type":"paragraph","data":{"text":"Риск возникновения нежелательных явлений может быть снижен за счет применения наименьшей эффективной дозы препарата Нимесулид-Тева на протяжении максимально короткого периода."}},{"type":"paragraph","data":{"text":"Пациентам, у которых на фоне приема препарата Нимесулид-Тева развиваются симптомы, характерные для повреждения печени (например, анорексия, тошнота, рвота, боль в правом подреберье, повышенная утомляемость, потемнение мочи), или отмечается повышение активности \"печеночных\" трансаминаз, назначение нимесулида следует прекратить. Этим пациентам также не следует повторно назначать нимесулид."}},{"type":"paragraph","data":{"text":"Пациентам, у которых развились признаки сопутствующего простудного заболевания (например, появилось повышение температуры тела), назначение нимесулида следует прекратить."}},{"type":"paragraph","data":{"text":"При применении НПВП возможно развитие случаев кровотечения, изъязвлений и перфорации стенок желудка или кишечника. Риск их развития выше при назначении высоких доз НПВП, при приеме их пациентами с язвой желудка и двенадцатиперстной кишки в анамнезе, а также пожилыми лицами. При необходимости проведения терапии в этих случаях следует рассмотреть вопрос о необходимости сопутствующего применения мизопростола или ингибиторов протонного насоса."}},{"type":"paragraph","data":{"text":"Следует предупредить пациентов (особенно с отягощенным анамнезом, а также лиц пожилого возраста) о необходимости сообщать врачу о любых необычных абдоминальных симптомах (особенно возникающих на ранних этапах лечения)."}},{"type":"paragraph","data":{"text":"Описаны случаи задержки жидкости и развития отечного синдрома на фоне приема НПВП, в связи с чем пациенты с артериальной гипертензией и/или застойной сердечной недостаточностью, ишемической болезнью сердца, заболеваниями периферических артерий и/или цереброваскулярными заболеваниями требуют особо тщательного наблюдения. Такие же меры предосторожности следует предпринимать при назначении нимесулида пациентам с повышенным риском развития сердечно-сосудистых заболеваний (например, гиперлипидемия, сахарный диабет и курение)."}},{"type":"paragraph","data":{"text":"У пациентов с нарушением функции почек требуется соблюдать осторожность при назначении препарата Нимесулид-Тева (возможно дальнейшее ухудшение их функции), при снижении клиренса креатинина лечение следует прекратить."}},{"type":"paragraph","data":{"text":"Нимесулид следует с осторожностью применять у пациентов с геморрагическим диатезом, поскольку он может снижать агрегацию тромбоцитов."}},{"type":"paragraph","data":{"text":"Риск развития серьезных кожных реакций (эксфолиативный дерматит, синдром Стивенса- Джонсона и токсический эпидермальный некролиз) на фоне приема НПВП выше в начале лечения (большинство из этих реакций появляется в течение первого месяца лечения). Лечение препаратом Нимесулид-Тева следует отменять при появлении первых признаков сыпи, повреждениях слизистой или других проявлениях гиперчувствительности."}},{"type":"paragraph","data":{"text":"Препарат Нимесулид-Тева содержит лактозы моногидрат. Пациенты с врожденной непереносимостью лактозы, нарушением всасывания глюкозы-галактозы или недостаточностью лактазы не должны принимать этот препарат."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Влияние препарата Нимесулид-Тева на скорость психомоторных реакций специально не изучалось. Тем не менее, пациентам, у которых после приема препарата Нимесулид-Тева наблюдается головокружение или сонливость, необходимо соблюдать осторожность при управлении транспортными средствами и занятиях другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки 100 мг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить при температуре не выше 25 °С в сухом, защищенном от света месте. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не применять по истечении срока годности, указанного на упаковке."}}]},{"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":"Блюфарма Индустрия Фармацеутика С.А., Sao Martinho do Bispo, 3045-016 Coimbra, Portugal, Португалия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Тева Фармацевтические Предприятия Лтд"}}]}],"source":null},"description_toggle":false,"short_description":"Нимесулид относится к числу нестероидных противовоспалительных препаратов (НПВП), оказывает противовоспалительное, анальгезируюгцее, жаропонижающее и антиагрегантное действия. В отличие от индометацина, в большей степени подавляет циклооксигеназу 2 (ЦОГ-2), нежели ЦОГ-1 (потенциально реже вызывает побочные эффекты, связанные с угнетением синтеза простагландинов в здоровых тканях, тормозя их синтез преимущественно в очаге воспаления). Нимесулид хорошо всасывается при приеме внутрь (прием пищи снижает скорость абсорбции, не влияя на ее степень). После однократного приема 100 мг нимесулида максимальная концентрация (Сmах) в плазме крови у взрослых достигает 3-4 мг/л и наблюдается через 2-3 часа. Связь с белками плазмы крови - 95%, с эритроцитами - 2%, с липопротеинами - 1%, с кислыми альфа1-гликопротеидами - 1%. Увеличение дозы не влияет на степень связывания. Площадь под кривой \"концентрация-время\" (AUC) составляет 20-35 мг ч/л. Статистически значимых различий между этими параметрами после однократного приема и назначением на протяжении 7 дней в дозе 100 мг 2 раза в день не обнаружено. Объем распределения - 0,19-0,35 л/кг. Легко проникает через гистогематические барьеры (в тканях женских половых органов после однократного приема нимесулида концентрация составляет около 40% от концентрации в плазме крови), в т.ч. в кислую среду очага воспаления и синовиальную жидкость (40% и 43% соответственно от концентрации в плазме крови). Метаболизируется в печени с участием монооксигеназ, в т.ч. системы цитохрома Р450 (CYP) 2С9. Основной метаболит - водорастворимый 4-гидроксинимесулид (25%), обладает сходной с нимесулидом фармакологической активностью. Нимесулид выводится в основном с мочой (приблизительно 50% принятой дозы). Период полувыведения (Т1/2) нимесулида - 3-6 часов, 4-гидроксинимесулида - 3-5 часов. 4-гидроксинимесулид выводится почками (65%) и с желчью (35%), подвергается энтерогепатической рециркуляции. Всего 1-3% нимесулида выводится в неизмененном виде. Приблизительно 29% дозы выводится в виде метаболита с калом. Фармакокинетический профиль нимесулида у пожилых людей после однократного и повторного приема препарата не меняется. У пациентов с легким и умеренным нарушением функции почек - клиренс креатинина (КК) 30-80 мл/мин, Сmахнимесулида и его основного метаболита в плазме крови не превышают таковые у здоровых добровольцев. 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