Nimesulide: Chemical Formula, Mechanism of Action, Indications, Dosage, Side Effects, Precautions and contraindications

It is of synthetic origin and is an anti-inflammatory drug, nonsteroidal and fast-acting.

Nimesulide is not a classic NSAID, it has a weak action against the synthesis of cox-2 inhibitor prostaglandins, but it has a potent anti-inflammatory activity.

It behaves as a competitive inhibitor of histamine release in vivo and in vitro. Therefore it possesses antihistamine and anti-allergic properties.

Nimesulide was first marketed in Italy in 1985 and has since been launched in approximately 50 countries worldwide.

A variety of companies market the medication. Several adverse reactions were reported with Nimesulide during the second half of 1998 and the first months of 1999.

Currently, its use is prohibited in many countries and restricted to infants.

Chemical formula



N-(4-Nitro-2-fenoxifenil) metanosulfonamida

Mechanism of action

It belongs to the pharmacological group that inhibits cyclooxygenase depending on the mechanism of action and is also classified in the pharmacological group Analgesics and Anti-inflammatory Agents.

Nimesulide improves the patient’s condition by blocking the production of prostaglandins and thus relieves pain and inflammation.


It is used to treat acute pain associated with osteoarthritis, dysmenorrhea, rheumatoid arthritis, rheumatism, thrombophlebitis, and other conditions.

It is also used to treat mild to moderate pain caused by sprains and strains of joints and muscles.


The usual dose is 100 mg twice a day, but in children, you should administer 5 mg per kg of body weight in 2 or 3 divided doses.

Precautions and contraindications

Nimesulide should be used with caution in patients with a history of bleeding, upper gastrointestinal diseases, and subjects undergoing anticoagulant therapy or medications that inhibit platelet aggregation.

Patients should be under direct medical supervision while taking substances with limited gastric tolerance at the same time.

Because the drug is mainly eliminated through the kidneys, renal insufficiency patients should have a lower dose depending on the glomerular filtration rate.

The product should not be administered in patients with severe renal insufficiency.

It can cause water retention. Therefore, it should not be administered to patients with reduced cardiac function.

Patients whose activity requires alertness should take the product with care if they feel drowsiness or dizziness during therapy, as it could affect their performance and job security.

Cases of visual disturbances have been reported when other non-steroidal anti-inflammatory drugs are used.

If problems appear in the eyes, treatment should be interrupted and an eye examination performed.

The medicine should not be administered if you are allergic to Nimesulide, hypertensive, or if you have gastric ulceration.

Side effects

The severe or irreversible adverse effects that the patient may present when using Nimesulide give rise to other complications that include Stevens-Johnson syndrome and Lyell syndrome.

Through action on COX-2, colon cancer can occur. The use of Nimesulide can cause hepatotoxic risks; it can even cause liver damage.

This can happen not only in children but also in adults. Nimesulide produces life-threatening effects that include anaphylaxis.

One study reveals that using five days of Nimesulide by a woman of 70 years causes jaundice and, according to laboratory tests, hypoglycemia, hypoalbuminemia, and even coagulopathy.

According to some studies, Nimesulide should not be used as the primary mode of therapy as an antipyretic, particularly for children.

The signs and symptoms that occur after the acute overdose of Nimesulide include, among other diseases, hypotension and hypothermia.

Symptomatic adverse reactions produced by Nimesulide are more or less tolerable, and if they become severe, they can be treated symptomatically, as they are:

  • Headache
  • Drowsiness
  • Abdominal discomfort
  • Heartburn
  • Abdominal cramps
  • Sickness
  • Vertigos
  • Diarrhea
  • Thrombocytopenia
  • Eczema
  • Acne
  • itch
  • Clotting disorders
  • Blood in the urine
  • Decreased urination renal failure

Adverse reactions

Before using Nimesulide, the doctor should be informed about the current list of medications that the patient is taking to avoid this type of reaction, for example, vitamins, supplements, if you have allergies, pre-existing diseases, and current health conditions, such as They are pregnancy or some upcoming surgery.

Some health conditions can make the body more susceptible to the side effects of the medication.

The effects of the drug nimesulide can change if given together with other components.

This can increase your risk of side effects or cause your medication not to work correctly and decrease the percentage of absorption in each patient.

Nimesulide can interact, without causing any adverse effects, with the following medications and products:

• Cyclosporine

• Digitalis glycosides

• Lithium

• Methotrexate

• Phenytoin