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Nimesulide/Paracetamol

Why it's used

Nimesulide/Paracetamol is used to relieve mild to moderate pain such as headache, toothache, cold, flu, joint pain, or periods pain. It is a prescription medicine. This medicine works by reducing the activity of certain chemicals in the body to provide pain-relieving effects. Nimesulide+Paracetamol is also used to reduce fever. This medicine reduces fever by increasing the loss of heat from the body.
Nonsteroidal Anti-inflammatory Drugs
Nimesulide+Paracetamol is a prescription medicine that belongs to a class of medicines called Nonsteroidal Anti-inflammatory Drugs. Nonsteroidal anti-inflammatory drugs, also called as NSAIDs, help reduce fever, decrease pain, and prevent clotting of blood. NSAIDs also reduce inflammation in the body when used in higher doses.

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How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Nimesulide/Paracetamol. If you have any questions related to this medicine, ask your doctor or pharmacist. Use this medicine as recommended by your doctor.
Nimesulide/Paracetamol is used with or without food.

Typical Dosage

This medicine is typically used for a period of 3 days for fever, and 10-15 days for pain.
This medicine should be used on an as-needed basis.

Talk to Your Doctor

Talk to your doctor if your condition persists or worsens or if you develop new symptoms. Tell your doctor if feel faint, vomit blood, have bloody or black stools, stomach pain, loss of hearing, pain or fever persists or gets worse, loss of appetite, nausea, vomiting, stomach pain, persistent tiredness, dark urine, fever, flu-like symptoms, feeling achy, feeling unwell, and chills. If you have any kidney disease, Dose adjustment of nimesulide is not required in patients with mild to moderate kidney dysfunction. In the case of paracetamol, precaution should be taken in a patient with severe kidney problems. If you have issues with the health of your liver, Nimesulide is not required in patients with severe liver dysfunction. In the case of paracetamol, precaution should be taken in a patient with severe liver problems.

Use in Children

The safety and effectiveness of using Nimesulide/Paracetamol in children has not been established. The use of Nimesulide+Paracetamol is not intended for children less than 12 years. However, patients of 12-18 years can take Nimesulide+Paracetamol tablets/granules, and there is no need for dose adjustment in such patients.

Limit Alcohol

Limit the consumption of alcohol with Nimesulide+Paracetamol.
Wash your hands thoroughly after handling or coming in contact with Nimesulide+Paracetamol.

Storage

You should store Nimesulide/Paracetamol at 25°C (77°F) for paracetamol, away from moisture for paracetamol, and Protect from light for paracetamol. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Nimesulide/Paracetamol for conditions for which it was not prescribed. Do not give Nimesulide/Paracetamol to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Nimesulide+Paracetamol

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Nimesulide+Paracetamol depends on the following factors:
  • patient's age
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by your doctor
  • any other medicines in use
  • herbal supplements consumed

Nimesulide+Paracetamol Dosage

Missed Dose

Take the missed dose as soon as you remember. Do not take a second dose to make up for the dose that you may have missed.

Overdose

What to do if you overdose on Nimesulide+Paracetamol?
If you have taken more than the recommended dose of Nimesulide+Paracetamol, get medical advice immediately. If the overdose has happened within the last 1 hour, the toxic effect can be reduced by taking activated charcoal. N-acetylcysteine may be used as an antidote up to 24 hours after ingestion of Nimesulide+Paracetamol. It is best to use N-acetylcysteine within 8 hours of overdose. Oral methionine may be also be used as an alternative if the patient is in a remote area without access to a hospital or medical care.
Symptoms of an overdose of Nimesulide+Paracetamol
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • abdominal pain
  • abnormalities of glucose metabolism
  • alters brain function or structure (encephalopathy)
  • bleeding
  • blood in the urine
  • eating disorder
  • fatal
  • increased and decreased heartbeat
  • inflammation of the pancreas
  • kidney injury caused by damage to the kidney tubule cells
  • liver failure
  • low sugar level
  • pale color of the skin
  • presence of an excessive amount of acids in the body
  • protein in the urine
  • swelling in the brain
  • vomiting
If you think you have overdosed on Nimesulide/Paracetamol, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Nimesulide+Paracetamol

Before you use Nimesulide+Paracetamol, tell your doctor of your medical and health history including the following:
  • alcohol addiction
  • allergic to Nimesulide+Paracetamol
  • drug abuse
  • fever or flu
  • heart failure
  • increased liver enzymes
  • kidney disorders
  • liver problems
  • long-term inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • severe blood clotting disorders
  • stomach or intestinal ulcers or bleeding
  • stroke
  • sugars intolerance
  • underweight
Excessive alcohol consumption may increase the risk of liver damage. The use of nimesulide may cause stomach or intestinal bleeding or ulceration/perforation in patients with gastrointestinal disorders. Patient with kidney problems may experience worsening of the functioning of the kidney when using Nimesulide+Paracetamol. The use of nimesulide may interfere with platelet functioning patients with a blood disorder (bleeding diathesis). Nimesulide+Paracetamol may cause serious allergic reactions such as skin rashes, itching, breathing problems, swelling of the lips, tongue, throat or face, red, peeling or blistering skin or hives in patients who are allergic to Nimesulide+Paracetamol.
Before you use Nimesulide+Paracetamol, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Discuss with your doctor if you are allergic to acetylsalicylic acid, or other non-steroidal anti-inflammatory drugs.
The use of Nimesulide/Paracetamol may change blood cell levels. Paracetamol may cause a decrease in the level of thrombocytes, leukocytes, granulocytes, neutrophils, red/white, or platelets count.

Use when Pregnant

Nimesulide+Paracetamol is not safe for use in women who are pregnant. If you are pregnant or planning to become pregnant, you should discuss the impact on the fetus with your doctor before you start using this medicine. Nimesulide+Paracetamol should not be used during the last 3 months of pregnancy. Nimesulide+Paracetamol belongs to the NSAID class of medicines. NSAIDs should not be taken after 29 weeks of pregnancy as these medicines may cause serious harm to the unborn baby.

If Breastfeeding

Nimesulide/Paracetamol is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding, or stop using this medicine during this period. The use of Nimesulide+Paracetamol should not be in women who are breastfeeding their infants.

If trying to Conceive

Consult with your doctor on the use of Nimesulide+Paracetamol, if you are trying to conceive. Nimesulide should not be used during pregnancy because it may decrease the ability of the women to conceive.

Alcohol

Limit drinking alcohol with Nimesulide+Paracetamol. Consumption of alcohol may cause liver damage.

Seizures

Nimesulide+Paracetamol may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.

Increase in Risk

This medicine may cause stomach bleeding. Regular use of tobacco or alcohol may increase the risk. Discuss with your doctor if you smoke and drink alcohol regularly.

Side-effects in Older Patients

Older patients may have a higher incidence of side-effects when using Nimesulide/Paracetamol. Elderly patients may see an increased risk of stomach and intestinal bleeding, rupture in the wall of the stomach and intestine, and abnormality in the functioning of the kidney, heart, or liver.

Long-term Use

Long term usage of paracetamol may cause headache or worsen the condition of patients suffering from headache.

What precautions should be taken during Pregnancy and Nursing, and administering Nimesulide+Paracetamol to Children or the Older Adults?

Pregnant Women

Contraindication
Warning: Nimesulide+Paracetamol should not be used during the last 3 months of pregnancy.

Breastfeeding

Contraindication
Warning: The use of Nimesulide+Paracetamol should not be in women who are breastfeeding their infants.

Younger Adults Population

Contraindicated or Not Recommended
Warning: Nnimesulide should not be used in children less than 12 years respectively.

Older Adults Population

Precaution
Warning: Elderly patients are more likely to side effects of non-steroidal anti-inflammatory drugs such as stomach and intestinal bleeding, rupture in the wall of the stomach/intestine tract, or abnormality in the functioning of kidney, heart, and liver function.

Nimesulide+Paracetamol Side-effects

The following severe side-effects may also occur when using Nimesulide/Paracetamol:
  • allergic reactions
    Symptoms: skin rashes, itching, breathing problems, swelling of the lips, swelling of the tongue, swelling of the throat, swelling of the face, red, peeling or blistering skin, hives, hoarseness, life-threatening drug-induced skin reaction, red scaly rash with bumps under the skin (acute generalized exanthematous pustulosis)
    If these symptoms occur, discontinue the Nimesulide+Paracetamol and consult with your doctor.
  • Symptoms: abnormal material in the blood, abnormally low levels of thrombocytes, low level of neutrophils, deficiency of red cells, white cells, and platelets, decrease in the number of leukocyte lack of granulocytes
  • liver and kidney damage | abnormal functioning of the kidney, heart, liver | (when used possibly fatal)
  • rupturing or bleeding of the stomach and intestinal |
Your doctor has prescribed this medicine because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious cases of side-effects. This page does not contain a complete list of all possible side-effects.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Nimesulide+Paracetamol by Severity and Frequency

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:
  • gastrointestinal haemorrhage and perforation
  • impaired renal, cardiac and hepatic function

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If these symptoms occur, discontinue the Nimesulide+Paracetamol and consult with your doctor.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Liver Damage

Patients taking nimesulide, paracetamol at a high dose/long-term, drinking excess alcohol, or taking other medicines containing paracetamol are at an increased risk. Headache, severe liver damage or reactions may occur in these patients which can be possibly fatal. These patients may experience nausea, abdominal pain, vomiting, fatigue, dark urine or abnormal liver parameter tests. Paracetamol or nimesulide should be stopped on the occurrence of these reactions. Also, precaution along with consultation of doctor should be considered in such patients. Patients should not use more than one analgesics at the same time.

Stomach and Intestinal Disorder

Patients with a history of stomach/intestinal diseases and taking nimesulide are at an increased risk. These patients may experience bleeding, ulcer, or rupture in the wall of the stomach and intestinal tract. Nimesulide should be stopped on the occurrence of these symptoms. Also, precaution should be taken in patients with a history of stomach ulcer, bleeding, irritation/swelling in the stomach and intestinal tract (Crohn's disease/ulcerative colitis).

Skin Allergy

Patients taking paracetamol are at an increased risk. These patients may experience severe skin reaction like skin reddening, blisters and rashes. Patients should consult the doctor and medicine should be stopped on the occurrence of these symptoms.

Abnormalities in the Functioning of Kidney and Heart

Patients taking nimesulide or paracetamol are at an increased risk. These patients may experience worsening of the functioning of the kidney and heart. Discontinue of nimesulide or precaution while taking paracetamol should be considered in such cases.

Elderly Patients

Elderly Patients taking non-steroidal anti-inflammatory drugs are at increased risk. These patients are more likely to side effects of non-non-steroidal anti-inflammatory drugs such as stomach and intestinal bleeding, rupture in the wall of the stomach/intestine, and abnormality in the functioning of the kidney, heart, and liver. Clinical monitoring should be considered in these patients.

Bleeding Problem

Patients taking nimesulide are at greater risk. Patients with unusual susceptibility to bleed (bleeding diathesis) may experience interference in the functioning of platelets. Nimesulide should be taken with care in patients with bleeding diathesis.

Fever/ Flu-like Symptoms

Patients taking nimesulide are at an increased risk. These patients may experience fever or flu-like symptoms. Such patients should not take this medicine.

Interactions with Nimesulide+Paracetamol

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Nimesulide/Paracetamol. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Domperidone

Nimesulide/Paracetamol interacts with domperidone, which is used to treat nausea and vomiting. When paracetamol is used with domperidone, it may increase the absorption of paracetamol.

Metoclopramide

There may be an interaction of Nimesulide+Paracetamol with metoclopramide, which is used to treat heartburn. When paracetamol is used with metoclopramide, it may increase the absorption of paracetamol.

Blood Thinner

Nimesulide/Paracetamol may interact with blood thinner (anti-coagulants, salicylates, and aspirin), which are used to prevent blood clot. When paracetamol or nimesulide is used with blood thinners or anticoagulants, it may increase the occurrence of bleeding. Also, effects of coumarins or warfarin may be prolonged by using paracetamol daily.

Imatinib

Your doctor's guidelines may need to be followed while taking this medicine along with Imatinib, which is used to treat cancer. Patients should not take paracetamol with imatinib on a regular basis.

Cholestyramine

Special instructions need to be followed while taking this medicine along with cholestyramine, which used to treat itching. When cholestyramine is taken within one hour after taking paracetamol, it may decrease the absorption of paracetamol.

Medicines Containing Paracetamol

Nimesulide/Paracetamol may interact with medicines containing paracetamol (migraine preparations, Cough/cold remedies, and a combination of paracetamol and ibuprofen). When paracetamol is used with medicines containing paracetamol such as cough/cold remedies, migraine preparations, and combinations of paracetamol and ibuprofen. Patients should not take these medicines together.

Interactions of Nimesulide+Paracetamol by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Nimesulide+Paracetamol be not used?

Allergy to Nimesulide+Paracetamol

This medicine should not be used by patients who are allergic to it. These patients may have the following symptoms if they use this medicine:

Allergy to Aspirin

This medicine should not be used by patients who are allergic to aspirin or other non-steroidal anti-inflammatory drugs. It may increase the risk of a severe allergic reaction. These patients may have the following symptoms if they use this medicine:

Severe Heart Failure

Nimesulide should not be used in patients with heart failure.

Fever or Flu

Nimesulide should not be used in patients who are suffering from fever or flu.

Severe Condition of Abnormal Bleeding Disorders

Nimesulide should not be used in patients who have a problem with bleeding such as stroke, stomach or bowel bleeding.

Stomach Ulcer

Nimesulide should not be used in patients with stomach ulcer.

Alcoholism and drug addiction

Patients who are alcoholic or who have drug addiction should not use nimesulide.

Pregnancy And Breastfeeding

Nimesulide should not be used in the third trimester of pregnancy and the women who are breastfeeding their infants.

Severe Kidney or Liver Problems

Nimesulide should not be used in patients with severe kidney or liver problems.

Children Under 12 Years

Nimesulide should not be used in Children under 12 years.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Nimesulide+Paracetamol is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Nimesulide/Paracetamol .

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