Nimesulide is a new non-steroidal anti-inflammatory
analgesic agent given orally or rectally on a twice daily basis in a number of inflammatory and
pain states. Although still at an early stage of clinical assessment, preliminary evidence suggests that
nimesulide 200 to 400mg daily is significantly more effective than placebo in reducing the
pain,
fever and inflammatory symptoms of chronic
rheumatoid arthritis or
osteoarthritis,
respiratory tract infections,
otorhinolaryngological diseases, soft tissue and oral cavity
inflammation, dysmenorrhoea,
phlebitis/
thrombosis,
urogenital disease and
postoperative pain states. In a number of comparative studies,
nimesulide has also been shown to be more effective than
piroxicam (in
osteoarthritis),
paracetamol (
acetaminophen) [in respiratory tract
inflammation],
benzydamine or
naproxen (in
otorhinolaryngological disease),
phenylprenazone (in laryngotracheitis/
bronchitis, respiratory
inflammation and
otorhinolaryngological disease), Serratia
peptidases (in postoperative or dental
pain,
trauma and
phlebitis),
ketoprofen (in postoperative dental
pain) and
mefenamic acid (in dysmenorrhoea). In addition, the efficacy of
nimesulide has been observed to be comparable with that of
aspirin, with or without
vitamin C, and
mefenamic acid (in
respiratory tract infection),
ibuprofen (in soft tissue disease),
naproxen (in respiratory tract
inflammation, dysmenorrhoea and
postoperative pain states),
suprofen and
paracetamol (in
postoperative pain states),
benzydamine (in genitourinary tract
inflammation) and
dipyrone,
paracetamol or
diclofenac (in
fever). The safety profile of
nimesulide has yet to be fully established, although initial evidence suggests the usual adverse effects associated with non-steroidal anti-inflammatory drugs occur, possibly with a lower incidence of gastrointestinal problems than with other members in its therapeutic class.
Nimesulide, therefore, appears to offer a useful alternative to other non-steroidal anti-inflammatory drugs in the treatment of patients with inflammatory conditions and/or
pain and
fever states. However, further definition of its efficacy and tolerability is clearly required, particularly in comparison with established or other new drugs in its therapeutic class.