Нимулид Таблетки, 20 шт, 100 мг, для рассасывания

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Легко проникает через гистогематические барьеры."}},{"type":"paragraph","data":{"text":"Метаболизируется в печени тканевыми монооксигеназами. Основной метаболит - 4- гидроксинимесулид (25%), обладает сходной фармакологической активностью, но вследствие уменьшения размера молекул способен быстро диффундировать по гидрофобному каналу ЦОГ-2 к активному центру связывания метальной группы. 4- гидроксинимесулид является водорастворимым соединением, для выведения которого не требуются глутатион и реакции конъюгации II фазы метаболизма (сульфатарование, глюкуронирование и другие)."}},{"type":"paragraph","data":{"text":"Т\u003csub\u003e1/2\u003c/sub\u003e нимесулида - около 1,56-4,95 ч, 4-гидроксинимесулида - 2,89-4,78 ч. 4- гидроксинимесулид выводится почками (65%) и с желчью (35%), подвергается энтерогепатической рециркуляции."}},{"type":"paragraph","data":{"text":"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,"}},{"type":"paragraph","data":{"text":"- суставной синдром при обострении подагры,"}},{"type":"paragraph","data":{"text":"- псориатический артрит,"}},{"type":"paragraph","data":{"text":"- анкилозирующий спондилоартрит,"}},{"type":"paragraph","data":{"text":"- остеохондроз с корешковым синдромом,"}},{"type":"paragraph","data":{"text":"- остеоартроз,"}},{"type":"paragraph","data":{"text":"- миалгия ревматического и неревматаческого генеза,"}},{"type":"paragraph","data":{"text":"- воспаление связок, сухожилий, бурситы, в том числе постравматаческое воспаление мягких тканей,"}},{"type":"paragraph","data":{"text":"болевой синдром различного генеза (в том числе в послеоперационном периоде, при травмах, альгодисменорея, зубная боль, головная боль, артралгия, люмбоишалгия),"}},{"type":"paragraph","data":{"text":"Препарат предназначен для симптоматической терапии, уменьшения боли и воспаления на момент использования, на прогрессирование заболевания не влияет."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Гиперчувствительность к активному веществу или вспомогательным компонентам;"}},{"type":"paragraph","data":{"text":"- полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа или околоносовых пазух и непереносимости ацетилсалициловой кислоты и других НПВП (в т.ч. в анамнезе);"}},{"type":"paragraph","data":{"text":"- эрозивно-язвенные изменения слизистой желудка или двенадцатиперстной кишки, активное желудочно-кишечное кровотечение; цереброваскулярное или иное кровотечение;"}},{"type":"paragraph","data":{"text":"- воспалительные заболевания кишечника (неспецифический язвенный колит, болезнь Крона) в фазе обострения;"}},{"type":"paragraph","data":{"text":"- гемофилия и другие нарушения свертываемости крови;"}},{"type":"paragraph","data":{"text":"-декомпенсированная сердечная недостаточность,"}},{"type":"paragraph","data":{"text":"-печеночная недостаточность или любое активное заболевание печени, выраженная почечная недостаточность (клиренс креатинина менее 30 мл/мин), прогрессирующие заболевания почек, подтвержденная гиперкалиемия;"}},{"type":"paragraph","data":{"text":"-период после проведения аортокоронарного шунтирования;"}},{"type":"paragraph","data":{"text":"-беременность, период грудного вскармливания,"}},{"type":"paragraph","data":{"text":"-детский возраст до 12 лет;"}},{"type":"paragraph","data":{"text":"-анамнестические данные о развитии гепатотоксических реакций при использовании препаратов нимесулида;"}},{"type":"paragraph","data":{"text":"-сопутствующее применение потенциально гепатотоксичных веществ;"}},{"type":"paragraph","data":{"text":"-алкоголизм, наркомания."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Ишемическая болезнь сердца, цереброваскулярные заболевания, застойная сердечная недостаточность, дислипидемия/гиперлипидемия, сахарный диабет, заболевания периферических артерий, курение, клиренс креатинина менее 60 мл/мин."}},{"type":"paragraph","data":{"text":"Анамнестические данные о развитии язвенного поражения ЖКТ, наличие инфекции Helicobacter pylori, пожилой возраст, длительное использование НПВП, частое употребление алкоголя, тяжелые соматические заболевания, сопутствующая терапия следующими препаратами:"}},{"type":"paragraph","data":{"text":"- Антикоагулянты (например, варфарин)"}},{"type":"paragraph","data":{"text":"- антиагреганты (например, ацетилсалициловая кислота, клопидогрель)"}},{"type":"paragraph","data":{"text":"- пероральные глюкокортикостероиды (например, преднизолон)"}},{"type":"paragraph","data":{"text":"- селективные ингибиторы обратного захвата серотонина (например, 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":"Следует использовать минимальную эффективную дозу минимально возможным коротким курсом."}},{"type":"paragraph","data":{"text":"Взрослым и детям старше 12 лет (масса тела более 40 кг): Нимулид обычно назначают внутрь в дозе 100 мг (1 таблетка) 2 раза в сутки в конце или после приема пищи. Таблетку следует положить на язык, где она сразу же начинает растворяться. Проглотить слюну, в которой растворилась таблетка."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота классифицируется по рубрикам, в зависимости от встречаемости случая: очень часто (> 10), часто (<10-<100), нечасто (<100-<1000), редко (<1000-<10000), очень редко (<10000)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЖелудочно-кишечный тракт\u003c/i\u003e: часто - диарея, тошнота, рвота, изжога; нечасто - запор, метеоризм, гастрит; очень редко - боли в животе, стоматит, дегтеобразный стул, желудочно-кишечное кровотечение, язва и/или перфорация желудка или двенадцатиперстной кишки."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЦентральная нервная система\u003c/i\u003e: нечасто - головокружение; редко - ощущение страха, нервозность, кошмарные сновидения; очень редко - головная боль, сонливость, энцефалопатия (синдром Рейе)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОрганы дыхания\u003c/i\u003e: нечасто - одышка; очень редко - бронхиальная астма, бронхоспазм."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСердечно-сосудистая система\u003c/i\u003e: нечасто - артериальная гипертензия; редко - тахикардия, геморрагии, \"приливы\"."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОрганы чувств\u003c/i\u003e: редко - нечеткость зрения, очень редко - головокружение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eКожные и слизистые покровы\u003c/i\u003e: нечасто - зуд, сыпь, усиление потоотделения; редко: эритема, дерматит; очень редко: крапивница, ангионевротический отек, отечность ттиття многоформная экссудативная эритема, в т.ч. синдром Стивенса-Джонсона, токсический эпидермальный некролиз (синдром Лайелла)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПечень и желчевыводяшая система\u003c/i\u003e: часто - повышение \"печеночных\" трансаминаз; очень редко - гепатит, молниеносный гепатит, желтуха, холестаз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПочки и мочевыводяшая система\u003c/i\u003e: нечасто - отеки; редко - дизурия, гематурия, задержка мочи, гиперкалиемия; очень редко - почечная недостаточность, олигурия, интерстициальный нефрит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОрганы кроветворения\u003c/i\u003e: редко - анемия, лейкопения, эозинофилия; очень редко - тромбоцитопения, панцитопения, пурпура, удлинение времени кровотечения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции\u003c/i\u003e: редко - реакции гиперчувствительности; очень редко - анафилактоидные реакции."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбщие реакиии:\u003c/i\u003e редко - общая слабость; очень редко - гипотермия."}},{"type":"paragraph","data":{"text":"В случае появления других, не упомянутых выше, побочных действий или ухудшения Вашего самочувствия обратитесь, пожалуйста, незамедлительно к своему врачу."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e: апатия, сонливость, тошнота, рвота. Они, как правило, обратимы при оказании поддерживающего ухода за больными. Может возникнуть желудочно-кишечное кровотечение, артериальная гипертензия, острая почечная недостаточность, угнетение дыхания."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e: 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."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Действие медикаментов, уменьшающих свертываемость крови, усиливается при их Одновременном применении с нимесулидом."}},{"type":"paragraph","data":{"text":"Нимесулид может снижать действие фуросемида. Уменьшает терапевтический эффект антигипертензивных препаратов. Нимесулид может увеличивать возможность наступления побочных действий при одновременном приеме метотрексата."}},{"type":"paragraph","data":{"text":"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."}},{"type":"paragraph","data":{"text":"Использование с глюкокортикостероидами, ингибиторами обратного захвата серотонина увеличивает риск развития ЖКТ-кровотечений."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Нимулид следует применять с осторожностью пациентам, у которых наблюдалась склонность к кровотечениям, пациентам с заболеваниями верхних отделов желудочно- кишечного тракта или пациентам, получающим лекарственные средства, уменьшающие свертываемость крови, или препараты, подавляющие агрегацию тромбоцитов. Поскольку Нимесулид частично выводится почками, дозировку его для пациентов с нарушениями функции почек следует уменьшать, в зависимости от уровня мочевыделения."}},{"type":"paragraph","data":{"text":"Учитывая сообщения о нарушениях зрения у пациентов, принимавших другие НПВП, лечение должно быть немедленно прекращено, если появляется любое нарушение зрения, и пациента должен обследовать врач-окулист."}},{"type":"paragraph","data":{"text":"Препарат может вызвать задержку жидкости в тканях, поэтому пациентам с высоким артериальным давлением и с нарушениями сердечной деятельности Нимулид следует применять с особой осторожностью. Пациентам следует проходить регулярный врачебный контроль, если они наряду с нимесулидом принимают медикамента, для которых характерно влияние на желудочно-кишечный тракт."}},{"type":"paragraph","data":{"text":"Для снижения риска развития нежелательных явлений со стороны ЖКТ следует использовать минимальную эффективную дозу минимально возможным коротким курсом."}},{"type":"paragraph","data":{"text":"При появлении признаков поражения печени (кожный зуд, пожелтение кожных покровов, тошнота, рвота, боли в животе, потемнение мочи, повышение уровня \"печеночных\" трансаминаз) следует прекратить прием препарата и обратиться к лечащему врачу. Не следует применять препарат одновременно с другими НПВП. Препарат может изменять свойства тромбоцитов, однако не заменяет профилактического действия ацетилсалициловой кислоты при сердечно - сосудистых заболеваниях. После 2-х недель применения препарата необходим контроль показателей функции печени (\"трансаминазы\")."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Пациенты, чья трудовая деятельность требует сосредоточенности (постоянного внимания), должны знать о том, что препарат может вызывать сонливость или головокружение."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки для рассасывания 100 мг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"  Хранить при температуре не выше 25 \u003csup\u003e0\u003c/sup\u003e 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. Не использовать препарат после даты, указанной 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":"Панацея Биотек Лтд, , Индия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Панацея Биотек Лтд"}}]}],"source":null},"description_toggle":false,"short_description":"Нимулид является нестероидным противовоспалительным препаратом (НПВП) из класса сульфонанилидов. Нимесулид относится к новому поколению НПВП, механизм действия которого связан с селективным ингибированием циклооксигеназы-2 (ЦОГ-2)- фермента, участвующего в синтезе простагландинов - медиаторов отека, воспаления и боли и воздействием на ряд других факторов: подавление фактора активации тромбоцитов, фактора некроза опухолей альфа, подавление протеиназ и гистамина. Угнетающее влияние на ЦОГ-1 менее выражено (реже вызывает побочные эффекты, связанные с угнетением синтеза простагландинов в здоровых тканях). Оказывает противовоспалительное, анальгезирующее и выраженное жаропонижающее действие. Абсорбция при приеме внутрь - высокая (прием пищи снижает скорость абсорбции, не влияя на ее степень). Связь с белками плазмы 95%, с эритроцитами - 2%, с липопротеинами - 1%, с кислыми альфа1 -гликопротеидами - 1%. Изменение дозы не влияет на степень связывания. Сmах- 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, но вследствие уменьшения размера молекул способен быстро диффундировать по гидрофобному каналу ЦОГ-2 к активному центру связывания метальной группы. 4- гидроксинимесулид является водорастворимым соединением, для выведения которого не требуются глутатион и реакции конъюгации II фазы метаболизма (сульфатарование, глюкуронирование и другие). Т1/2нимесулида - около 1,56-4,95 ч, 4-гидроксинимесулида - 2,89-4,78 ч. 4- гидроксинимесулид выводится почками (65%) и с желчью (35%), подвергается энтерогепатической рециркуляции. 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":"https://vseapteki.ru/cropping/thumbnails/101/225250/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/225250/share_default/"}},"diseases":[{"id":"853","title":"Другие уточненные изменения зубов и их опорного аппарата (в т.ч. зубная боль)","slug":"853-drugie_utochnennye_izmeneniya_zubov_i_ih_opornogo_apparata_v_tch_zubnaya_bol"},{"id":"1012","title":"Серопозитивный ревматоидный артрит","slug":"1012-seropozitivnyy_revmatoidnyy_artrit"},{"id":"1013","title":"Псориатические и энтеропатические 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