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Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) designed for inhibiting the COX-2 enzyme. It is generally used as an analgesic and antipyretic, which means that it treats acute pain and anxiety, respectively. In addition to its therapeutic properties, however, it is notable for its side effects, including liver damage. Switzerland-based pharmaceutical company Helsinn is responsible for the original manufacturing of nimesulide in 1976, although the patent protection has since been terminated. Today, the nimesulide drug goes by more than 50 brand names across the globe, which include Lomotil, Renova, Nicip, Lamisil, Nimesil, Nimulid and Sulide.
Nimesulide is classified as a NSAID, along with other drugs such as aspirin, ibuprofen and naproxen, because of its analgesic and antipyretic effects. It works by disabling COX-2, an enzyme blamed for causing inflammation and pain. This is why the medication is also known as a COX-2 selective inhibitor.
The recommended dosage, particularly for people 14 years and older, is a 100-milligram tablet twice a day via oral administration. Patients can expect positive results between three and 14 days. Nimesulide is particularly used for specific sources of pain, including osteoarthritis, which is a degenerative joint disease; and dysmenorrhea, a medical condition characterized by pain that women endure during menstrual periods.
It should be noted, however, that nimesulide only treats the symptoms of the aforementioned aliments, but not the ailments themselves. Also, nimesulide is associated with side effects such as abdominal cramps, diarrhea, heartburn, discomfort and vomiting. More serious side effects include edema, which involves swelling as a result of fluid accumulation in certain parts of the body.
The most serious side effect of nimesulide, however, is hepatotoxicity, or liver damage brought about by toxicity. Chemicals that cause this condition are referred to as hepatotoxins. In a 2003 book titled Current Diagnosis & Treatment in Gastroenterology, the authors identified more than 900 drugs that could increase the risk of hepatotoxicity, including nimesulide. As a result, its use and manufacture of the medication has been banned or suspended in several countries, including India, Singapore, the United Kingdom, Denmark and Finland. It is not sold in the United States, where the Food and Drug Administration (FDA) has not evaluated the drug.
Still, nimesulide remains popular in some countries, and there are companies that still manufacture and sell the drug, sometimes illegally depending on the jurisdiction they are under. Moreover, a European Medicines Agency (EMA) committee is arguing for, at the very least, a controlled use and distribution of the medication.
Have any studies been done as to how long someone can take this drug before risking liver damage? Is there a period of time considered "safe" in which people can use it and then stop with a reasonable certainty that liver damage will not occur?
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