Fenofibrate, salicylic acid valproic acid, and tolbutamide displace nimusulide from the plasma binding sites.

Nimesulide displaces methotrexate and frusemide from plasma proteins.

Nimesulide should be used ith caution along with warfarin since efficacy may be increased. Nimesulide may decrease efficacy of slow release theophylline prepns.

Concurrent use of levodopa with racemethionine may derease the therapeutic effects of levodopa.

Pain and inflammation

FIXED DOSE COMBINATIONS APPROVED BY DCG(I)

Nausea, diarrhoea, vomiting, dizziness,rash somnolence, headache

Nimesulide is contraindicated in active peptic ulcer and moderateto evere hepatic impairment . Nimesulide shuld be avoided in pregnant and lactating women

. Precautions-

To be used with caution in pts with renal impairment, heart failure, or cirrhosis, volume or salt depleted pts. elderely pts. salt depleted pts.

To be avoided in pregnant and lactaing women,metabolic acidosis, severe hepatic function impairment. Use racemethionine with caution.

Pain and inflammation

Dosage-

Adult- 1 tab bid Child - 5mg/kg/day nimesulide divided in 2 to 3 daily doses

Pharmacology-

Nimesulide is a weak inhibitor o postagalndin synthesis.It apears to act at different stages of inflammatory reaction and the mechanism by which it exerts it action are many. It leads to inhibition of superoxide anion generation in vitro activated neutrophils,inhibitiion of histamine release from tissue mast cells and basophilis. It cause inhibion of platelet activating factor synthesis of metoproteinase thus preventing breakdown of osteoarthiritic human cartilage.

Pharmacokinetics-

After oral admin nimesulide is rapidly and alomost completely absorbed. It is highly bound to plasma proteins and is extensively metabolised in liver. The major metabolite is pharmacologically actve. The pharmacokinetis of raceethinine is not well known.

Nimesulide should be avoided in pregnant and lactating women.