Nimesulide is a relatively COX-2 selective, non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties. Its approved indications are the treatment of acute pain, the symptomatic treatment of osteoarthritis and primary dysmenorrhoea in adolescents and adults above 12 years old.  

Rheumatoid arthritis, osteoarthritis, other degenerative joint disorder, musculoskeletal disorder, low back pain, dysmenorrhoea, gynecological conditions, thrombophlebitis dental pain and in ENT inflammations. In children: Fever and other sign and in RT inflammation.

Adults: 100 mg twice daily.

Children: 5mg/kg/day in 2 or 3 divided doses.

Hypersensitivity, active peptic ulcer disease, hepatic impairment.

Active peptic ulcer, elderly patients with moderate renal impairment, congestive heart failure or cirrhosis.

Reduced dose is necessary

Contraindicated

Use with caution.

Epigastric pain, hurt burn, nausea, diarrhea, vomiting skin rash pruritus dizziness somnolescence headache

Displace methotrexate from its binding sites decrease the plasma level of theophylline oral bioavailability of frusemide may be reduced, displaced by the concomitant use of fenofibrate, salicylic acid, valproic acid.

The mechanism of action of Serratiopeptidase appears to be hydrolysis of histamine, bradykinin and serotonin. Serratiopeptidase also has a proteolytic and fibrinolytic effect. This is achieved by dissolving the complement (specific proteins responsible for inflammation) and increasing the plasmin activity by inhibiting the plasmin inactivators. 

• Resolution of inflammation due to bone and soft tissue injury.
• Reducing inflammation associated with episiotomy and perineal laceration. It reduces breast engorgement in puerperium. Helps to resolve postpartum haematomas and pregnancy related thrombophlebitis. It is also indicated as adjuvant after hysterectomy.
• Hastening absorption of subconjunctival haemorrhage, hyphaemas, and vitreous hemorrhage. In post-operative cases shortens convalescence period. Adjuvant therapy with antibiotics in ocular infections like keratitis, uveitis and endophthalmitis.
• Resolution of inflammatory oedema in acute infections like tonsillitis, pharyngitis, laryngitis and pain following tonsillectomy, also resolves mucus and pus in sinusitis, and otitis media.
• As adjuvant in chronic obstructive pulmonary disease, bronchitis, pulmonary tuberculosis, bronchial asthma, septic abortion, pelvic inflammatory disease and salpingitis                                                                                                                                                                                

Adult: PO- The recommended dose is 5-10 mg 3 times/day 

• Caution should be exercised in patients with history of liver or kidney disease, during pregnancy and breastfeeding
Side Effects : 
Skin rash, diarrhea, loss of appetite, gastrointestinal disturbance and nosebleed. 

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