SANSPAS

Nimesulide 100 mg + dicyclomine HCl 20 mg

Nimesulide is a relative COX-2 selective, non-steroidal anti-inflammatory drug with analgesic and antipyretic properties. This Non Steroidal Anti Inflammatory Drug reduces prostaglandin synthesis by the inhibition of cyclo oxygenase enzyme2 selectively. This is a weaker inhibition .So it produces weaker analgesic property. Its potent anti-inflammatory activity is due to its action on various stages of inflammation. This leads to the inhibition of super oxide anion formation invitro by activated neutrophil, inhibition of histamine release from tissue mast cells and basophiles.

Dicyclomine HCl is an anticholinergic that blocks muscarinic receptors on smooth muscles and prevents the effect of Acetylcholine. Inhibition of Acetylcholine produces relaxation of smooth muscles of gastrointestinal tract and genitourinary tract and reduces the painful spasm and cramp.

Indications

• G.I spasm
• Dysmenorrheal
• Rheumatoid arthritis
• Pain and inflammation
• Fever

Dosage

One tablet twice daily

Contraindications

• Hypersensitivity to dicyclomine and nimesulide
• Narrow angle glaucoma
• Obstructive gastro intestinal tract
• Reflux oesophagitis
• Severe ulcerative colitis
• Active peptic ulcer
• Hepatic impairment

Precautions

• Caution should be exercised in patients with history of chronic inflammation or ulcers, diarrhea, enlargement of the prostrate, hiatal hernia, kidney or liver disease, nerve disease, overactive thyroid, urinary blockage or retention, any allergy, who are taking other medications, elderly, children, during pregnancy and breastfeeding.
• It may cause drowsiness, dizziness, blurred vision or lightheadedness, do not drive a car or operate machinery while taking this medication.
• Avoid alcohol consumption.
• Avoid becoming overheated; otherwise heatstroke may occur.

Side effects

Constipation, Dry mouth, Nausea, Vomiting, Abdominal discomfort, Headache, Dizziness, Confusion, Palpitations, Tachycardia, Increased intraocular pressure, Mydriasis, Urine retention, Urinary hesitancy, Decreased sweating, Diarrhea, Heart burn, Epigastric pain, Pruritis, Skin rash

Drug interactions

• Fenofibrate, salicylic acid, valproic acid and tolbutamide: these drugs displace nimesulide from the plasma binding sites
• Methotrexate and frusemide : these drugs may be displaced from plasma proteins by nimesulide
• Warfarin : exercise caution since efficacy may be increased
• Theophylline: efficacy of sow release theophylline preparations reduced
• Possible antagonism is indicated with donepezil, rivastigmine and galantamine. May cause additional anticholenergic effects and enhance adverse toxic effects if co administered with trospium and tripolidine