Nise tablets and blood pressure
This medicine is intended to eliminate the following unpleasant symptoms:
- headache or muscle pain;
- elevated temperature;
- arthritis and rheumatism;
- diseases of the spine;
- inflammation of various etiologies.
It is also used as an antioxidant and to prevent bronchospasm in asthma, platelet aggregation, and destruction of cartilage tissue.
Should I take Nise for blood pressure? The answer to this question is positive, but only if it is low, since the drug increases blood pressure and has a slight effect on vascular tone. In addition, “Nise” retains water in the tissues, which negatively affects the body with high blood pressure. “Nise” interacts well with tablets whose action is aimed at lowering blood pressure.
Used to quickly eliminate headaches, reduces fever well, relieves inflammation and body aches
Considering these properties of the medicine, even people who are neither hypertensive nor hypotensive should consult a doctor and carefully monitor the condition of the body when taking this product. This should also be done by hypertensive patients, who may sometimes be prescribed this drug in small doses.
Indications and contraindications for Nise therapy
The instructions for the drug indicate that the medication helps with acute attacks of pain and primary dysmenorrhea. Nise is prescribed as a medicine for secondary therapy; the risk of adverse reactions is preliminarily assessed for each patient. The list of diseases for which the medication is effective is presented:
- rheumatoid, psoriatic arthritis;
- articular syndrome that occurs during an exacerbation of gout;
- ankylosing spondylitis;
- osteochondrosis, osteoarthrosis;
- muscle pain;
- pain syndrome that occurs after injuries, surgical interventions, etc.
The drug is contraindicated:
- in case of individual intolerance to nimesulide or other ingredients of their component composition;
- the appearance of nettle fever, allergy symptoms due to previous use of Aspirin or other NSAIDs;
- treatment with other drugs with toxic effects on the liver;
- alcohol or drug addiction;
- bleeding from the gastrointestinal tract, damage to the gastric mucosa when taking NSAIDs;
- problems with the rate of blood clotting;
- dysfunction of the kidneys, heart, liver;
- clinical signs of influenza, ARVI.
The medicine is not used during lactation and in the last trimester of gestation. The drug is contraindicated in patients under twelve years of age and is not used when planning pregnancy due to its effect on fertility.
Composition and release form of the product
Nimesulide is the main substance in the medicine, which increases blood pressure, relieves spasms, and lowers temperature. It is supplemented with: calcium hydrogen phosphate, microcrystalline cellulose, sodium carboxymethyl starch, magnesium stearate, silicon dioxide, talc.
"Nise" can be found at the pharmacy in the following forms:
- tablets of 10 pieces in a blister, each tablet contains 100 mg of active substance;
- lozenges, each containing 50 mg of active substance;
- gel containing nimesulide 1%, used for external use;
- suspension (50 mg of nimesulide in every 5 ml of solution).
“Which form should I choose?” – your doctor will give you the answer to this question, depending on your diagnosis, age and other individual characteristics.
Acts quickly and effectively
Instructions for use NISE
To reduce the risk of side effects, it is necessary to use the drug in the minimum effective dose with the shortest duration of treatment. If the patient's condition does not improve, treatment should be stopped.
Use in patients with liver dysfunction
Nimesulide is metabolized in the liver to form the active metabolite 4-hydroxy-nimesulide. In patients with severe or severe liver dysfunction, the metabolism of nimesulide is impaired, clearance decreases and the concentration of nimesulide in the blood increases, which can lead to drug accumulation. There are also reports of liver dysfunction occurring while taking nimesulide, ranging from moderate to severe, including death. Thus, nimesulide is not recommended for use in patients with liver pathology. If patients taking nimesulide develop symptoms suggestive of liver damage (eg, anorexia, nausea, vomiting, abdominal pain, fatigue, dark urine) or abnormal results of liver function tests, the drug should be discontinued. Such patients are not recommended to be prescribed nimesulide in the future.
During treatment with nimesulide, it is recommended to avoid the simultaneous use of hepatotoxic drugs, analgesics, other NSAIDs and alcohol consumption.
Use in patients with gastrointestinal dysfunction
Gastrointestinal bleeding or ulcer/perforation may develop at any time while using the drug, with or without warning symptoms, with or without a history of gastrointestinal complications. If gastrointestinal bleeding or ulcers occur, the drug should be discontinued.
Nise should be prescribed with caution to patients with gastrointestinal disorders, ulcerative colitis or a history of Crohn's disease.
Use in patients with renal impairment
The drug should be prescribed with caution to patients with renal or heart failure, as its use may lead to deterioration of renal function. If renal function deteriorates, the drug should be discontinued. Patients with severe renal impairment should avoid taking nimesulide. Nimesulide should also be used with caution in patients with severe metabolic disorders, dehydration and asthenia, as these patients may be more sensitive to the renal effects of nimesulide.
Use in patients with impaired hemostasis
Since nimesulide can impair platelet function, it should be used with caution in patients with hemorrhagic diathesis, under constant monitoring.
Use in Elderly Patients
Elderly patients most often develop side effects when taking the drug, including gastrointestinal bleeding, perforation, dysfunction of the heart, kidneys and liver. Therefore, regular clinical monitoring of the patient’s condition is recommended.
Impact on the ability to drive vehicles and operate machinery
Due to the fact that, when taken orally, nimesulide can cause dizziness and drowsiness in some patients, they should refrain from engaging in potentially hazardous activities that require increased concentration.
Indications for use
Depending on the disease, you need to select a form of release of the product that will provide an optimal effect on the problem. For example, tablets are recommended for use for inflammation of joints, ligaments, arthrosis, fever, infectious diseases and to relieve pain from injuries.
Gel is the most suitable option for gout, pinched nerves and problems with the skeletal system. “Nise” can also take hypotensive drugs in order to slightly increase blood pressure, but this should only be done under the supervision of a medical professional.
Pharmacological effect of the drug on blood pressure
According to the pharmacotherapeutic group, “Nise” belongs to non-steroidal anti-inflammatory drugs. It is easily absorbed by the body and metabolized by the liver and kidneys.
Remember that Nise increases blood pressure, so it should not be prescribed to hypertensive patients and people with heart failure. Those who are undergoing long-term treatment with this drug should regularly check the condition of their kidneys and liver. The main reason for this is possible fluid retention in the tissues, which leads to increased blood pressure.
Adverse reactions and overdose
Clinical studies have shown that use of the drug in high dosages may increase the risk of developing diseases caused by arterial thrombosis. During therapeutic manipulations, patients experienced swelling, increased blood pressure, and heart failure.
Common adverse reactions to Nise include:
- bleeding from the gastrointestinal tract;
- peptic ulcers, gastric perforation;
- attacks of vomiting with nausea;
- active gas formation, diarrhea;
- dyspeptic disorders;
- pain in the abdominal area;
- tarry stools, ulcerative stomatitis.
The development of gastritis was observed less frequently in patients.
Accidentally exceeding the prescribed amount of Nise can cause drowsiness, apathy, discomfort in the epigastric region, vomiting with nausea. These phenomena are reversible and can be treated with symptomatic treatment.
Sometimes there is an increase in blood pressure, respiratory depression, bleeding from the gastrointestinal tract, and coma. An overdose of NSAIDs threatens the development of allergic reactions, including angioedema and anaphylaxis.
The pathological condition is treated with maintenance therapy using activated carbon (1 tablet per 10 kg of body weight) or an osmotic laxative. At the same time, renal and hepatic functionality is monitored.
Contraindications to taking pills
Like any other medicine, Nise may not always be beneficial. To prevent this from happening, read the instructions carefully before use. It should not be used by patients who have kidney or liver problems, stomach bleeding, bronchial asthma, or children under 12 years of age. In severe heart failure, the use of tablets is also contraindicated. If you are allergic to any of the components of the drug, do not take it. When taking anti-diabetic pills or diuretics, also consult your doctor, as Nise enhances their effect.
An overdose increases the side effects, so if symptoms appear, gastric lavage is recommended
"Nise" has some side effects that may occur to varying degrees or not occur at all. These include:
- attacks of nausea, vomiting;
- problems with urination;
- shortness of breath, especially in people with bronchial asthma;
- hypertension;
- general weakness.
If these negative signs appear, it is better to stop taking the drug and consult a doctor.
Pregnancy is also a contraindication to using the drug "Nise" for blood pressure or cramps. Despite the fact that these problems often bother pregnant women, this medicine will not work in this case. “Nise” can negatively affect the life and health of the unborn child. This applies not only to tablets and suspension, but also to gel.
Nise®
Glucocorticosteroids
: Increase the risk of gastrointestinal ulcers or bleeding.
Antiplatelet agents and selective serotonin reuptake inhibitors
: Increase the risk of gastrointestinal bleeding.
Anticoagulants
: NSAIDs may enhance the effect of anticoagulants such as warfarin. Due to the increased risk of bleeding, this combination is not recommended and is contraindicated in patients with severe coagulation disorders. If combination therapy cannot be avoided, careful monitoring of blood clotting parameters is necessary.
Diuretics:
NSAIDs may reduce the effect of diuretics. In healthy volunteers, nimesulide temporarily reduces the excretion of sodium under the influence of furosemide, to a lesser extent the excretion of potassium, and reduces the diuretic effect itself. Co-administration of nimesulide and furosemide leads to a decrease (by approximately 20%) in the area under the concentration-time curve (AUC) and a decrease in the cumulative excretion of furosemide without changing the renal clearance of furosemide. Co-administration of furosemide and nimesulide requires caution in patients with impaired renal or cardiac function.
ACE inhibitors and angiotensin II receptor antagonists:
NSAIDs may reduce the effect of antihypertensive drugs. In patients with mild to moderate renal failure (creatinine clearance 30-80 ml/min), when co-administered with ACE inhibitors, angiotensin II receptor antagonists or substances that suppress the cyclooxygenase system (NSAIDs, antiplatelet agents), further deterioration of renal function and the occurrence of acute renal failure, which is usually reversible. These interactions should be considered in patients taking Nise® in combination with ACE inhibitors or angiotensin II receptor antagonists. Therefore, coadministration of these drugs should be used with caution, especially in elderly patients. Patients should be kept adequately hydrated and renal function should be closely monitored after initiating concomitant therapy.
There is evidence that NSAIDs reduce lithium
, which leads to an increase in the concentration of lithium in the blood plasma and its toxicity. When prescribing nimesulide to patients receiving lithium therapy, plasma lithium concentrations should be regularly monitored.
Clinically significant interactions with glibenclamide, theophylline, digoxin, cimetidine and antacids (for example, a combination of aluminum and magnesium hydroxides)
was not observed.
Nimesulide inhibits the activity of the CYP2C9 isoenzyme. When taking drugs metabolized with the participation of this isoenzyme with nimesulide, the concentration of these drugs in plasma may increase.
When used simultaneously with
antiepileptic drugs (valproic acid), antifungal drugs (ketoconazole), antituberculosis drugs (isoniazid), amiodarone, methotrexate, methyldopa, amoxicillin in combination with clavulanic acid, an
additive hepatotoxic effect is possible.
Due to the high degree of binding of nimesulide to plasma proteins, patients concomitantly taking sulfonamides
should be under the supervision of a doctor, undergoing examinations at short intervals.
When nimesulide is prescribed less than 24 hours before or after taking methotrexate
Caution is required, since in such cases the plasma concentration of methotrexate and, accordingly, the toxic effects of this drug may increase.
Due to their effect on renal prostaglandins, inhibitors of prostaglandin synthetase, such as nimesulide, may increase the nephrotoxicity of cyclosporines
.
In vitro studies
showed that nimesulide is displaced from the binding sites by tolbutamide and salicylic acid. Although these interactions were determined in blood plasma, these effects were not observed during clinical use of the drug.
