Indian manufacturer Dr. Reddy’s Laboratories Ltd. produces 1% Nise gel in plastic tubes of 20 g and 50 g. The secondary packaging of the drug is a cardboard box with an enclosed annotation. In the Anatomical Therapeutic Chemical (ATX) Classification System (ATC), Nize Gel is assigned the code M02AA. The average package price of 20 g is 150 rubles, and 50 g – 250 rubles.
For long-term therapy of any pathologies, it is better to purchase a large package of Nise gel. This will save money and time spent visiting the pharmacy.
Nise gel is characterized by a jelly-like consistency, light yellow color and the absence of foreign particles. The product has a pleasant floral scent due to the flavor added by the manufacturer (Narcissus-938). In addition to the active ingredient nimesulide, the product for external use contains the following auxiliary components:
- potassium dihydrogen phosphate;
- distilled water;
- propylene glycol;
Auxiliary ingredients provide easy absorption of the active substance into the skin and its delivery to bone, joint and cartilage tissues affected by inflammation. Store the medicine at room temperature, in a place protected from direct sunlight.
A unique combination of active and auxiliary ingredients Nise gel allows you to use it as a tool for complex treatment. Doctors include the drug in therapeutic pathogenetic schemes to prevent further destructive and degenerative destruction of articular and cartilage tissues. And the anti-inflammatory effect of an external agent provides a quick reduction in symptoms: pain, stiffness of movements, severe swelling.
The synthesis of Nise gel, the main action of which is aimed at suppressing the activity of cyclooxygenase, avoided the occurrence of pronounced side effects from oral administration of LDPE. This drug is completely safe for patients with high blood pressure and prone to ulceration of the mucous membranes of the gastrointestinal tract.
Pain is a protective reaction of the body to the effects of internal and external negative factors. Two mechanisms are involved in its launch:
- local. After the development of the inflammatory process, a nerve impulse is transmitted to the central nervous system;
- central. The brain is aware of the pain and produces a response to the occurrence of an incoming signal.
Pain, as a satellite of almost all diseases of the musculoskeletal system, is initiated by various substances that excite nociceptors (tissue, plasma, tachykinins). The course application of Nise gel allows you to prevent the development of events in such a negative scenario, to reduce the severity of uncomfortable sensations due to the relief of the inflammatory process.
The active ingredient in the Nise gel belongs to the sulfonanilide class. The main pharmacological action of nimesulide is the blocking of the enzyme, as a direct participant in the synthesis of prostaglandins from polyunsaturated fatty acids. These biologically active substances transmit nerve impulses from one cell to another and initiate the spread of pain. The increased production of prostaglandins becomes the cause of the appearance of such pathological conditions:
- the formation of inflammatory foci;
- the formation of edema of various localization and severity;
- the occurrence of pain.
The active substance Nise gel prevents the production of prostaglandin E2 not only in inflammatory foci, but also in the nociceptor system, which makes innervation in the spinal cord impossible.
One of the main mechanisms of action of the active ingredient in Nise gel is to reduce the concentration of rapidly converting prostaglandin H2. It is precisely on it that prostaglandinisomerase acts, forming in the course of a complex biochemical reaction a mediator of pain, swelling and inflammation – prostaglandin E2.
A gradual decrease in the content of prostaglandins in tissues leads to a decrease in the activity of prostanoid receptors. This condition is characterized by an analgesic and anti-inflammatory effect. An important point in all the mechanisms of action of the Nize gel is the absence of any effect on the formation of prostaglandins from arachidonic acid. This explains the insignificant list of contraindications and side effects of this external drug.
Nise gel also exhibits pronounced decongestant activity immediately after application of its skin due to its ability to trigger the following mechanisms of exposure:
- suppression of red blood cell aggregation by reducing the synthesis of endoperoxides and thromboxane A2;
- inhibition of activation of circulating proenzyme by increasing the content of inhibitor-1;
- prevention of the release of biologically active substances of histamine, which provokes tissue swelling and allergic reactions;
- promotes the formation of lymphocytes produced by the immune system to destroy foreign proteins.
One of the undoubted advantages of Nise gel is the rapid relief of interleukin-6 and urokinase, the main culprits of degenerative changes in cartilage. Nimesulide is involved in the synthesis of elastase and collagenase, which ensure the optimal functioning of the human musculoskeletal system.
Even “neglected” joint problems can be cured at home! Just remember to smear it once a day.
The active substance Nise gel exhibits powerful antioxidant activity. Nimesulide prevents the destruction of cells by free radicals, prevents tissue damage by the toxic decomposition products of molecular oxygen.
The active and auxiliary ingredients of the Nise gel penetrate into the systemic circulation in small quantities. For example, no traces of the product of nimesulide metabolism are detected at all provided that the patient complies with the recommended single dosages and the duration of the course of treatment. Anesthetic effect occurs in about 15-30 minutes. With a single use of an external agent in the bloodstream after 24 hours, the maximum therapeutic concentration is created. It is about 300 times lower than that determined by oral administration of Nise in tablet form or Nimesulide in granules.
During clinical trials, the duration of the analgesic effect in patients was established – from 30 minutes to six hours. A decrease in the severity of pain has a positive effect on a person’s ability in everyday life during the usual daily manipulations (movement, dressing, toilet, light, hard work) – in 60% of patients after applying 1 g of the drug and in 66% after distribution of 2 g on the skin the drug.
Indications for use
Nise gel is included in the therapeutic regimens of patients who are diagnosed with various diseases of the musculoskeletal system. An external drug is used to prevent further destruction of bones, cartilage and joints. The drug is used to relieve the inflammatory process and reduce the severity of pain with exacerbation of chronic diseases of the spinal column. In the treatment of injuries and severe bruises, the use of Nise gel is also practiced to eliminate swelling of soft tissues located near injuries.
The drug can be used at home to treat extensive hematomas (bruises). The active ingredient of the drug helps to quickly regenerate damaged small blood vessels, restore microcirculation and reduce the severity of swelling.
Nise gel is used as a pathagenetic and symptomatic treatment for the following pathologies:
Neuropathologists recommend that patients rub the drug into the area of inflammation when a nerve is pinched in the spinal column, intervertebral hernias, and neuralgia. Nise gel quickly relieves pain and swelling with sprains, including the ankle.
Instructions for use
Nise gel is well absorbed by the skin due to its delicate texture. To improve absorption and prevent the development of bacterial infection, the drug should be applied only to clean skin. It should not have any damage, not even microtrauma (cracks, wounds, scratches). The maximum diffusion of the main ingredients is ensured by the presence of auxiliary components in the gel base.
With the simultaneous use of gel and Nise tablets, daily and single dosages can vary significantly. When conducting complex treatment, the amount of the drug for oral administration is reduced by 2-3 times.
It is necessary to apply the drug only to those parts of the body where pain is felt. The gel cannot be rubbed – it should only be distributed with a thin layer on the surface of the skin. The annotation states that to ensure an analgesic and anti-inflammatory effect, it is enough to squeeze a column of funds no more than 3 cm long from the tube. When diagnosing damage in large areas of the body, the amount of gel can be increased.
The maximum concentration of nimesulide in the tissues affected by inflammation is achieved by applying the gel 2-3 times a day. The duration of the therapeutic course does not exceed 4 weeks. Longer use will cause the accumulation of the drug ingredients in the tissues, which leads to the development of an allergic reaction like hives. After applying the drug to the skin, you should wash your hands, as if nimesulide gets into your eyes and mucous membranes, you get a burning sensation.
After 3-4 weeks of treatment, neurologists or surgeons evaluate the effectiveness of the Nize gel. If therapy does not bring results, or they are minimal, the doctor replaces the drug with another drug.
Contraindications and side effects
External preparations with nimesulide in any concentration are not prescribed for patients with relapses of gastrointestinal pathologies of any etiology. The ability of the active substance to prolong and increase bleeding excludes from the list of indications for the use of nimesulide people with ulcers of the stomach and duodenum, impaired integrity of the mucous membranes of the digestive system. The following pathological conditions include contraindications to Nise Gel:
- acute and chronic renal failure;
- hyperthermia during viral or bacterial respiratory and intestinal infections;
- drug addict.
The drug is not included in the therapeutic schemes of women during gestation and during lactation. Nise gel is not intended for the treatment of children under 12 years old. Relative contraindications include arterial hypotension, non-insulin-dependent diabetes mellitus, acute and chronic heart failure. In the presence of such diseases, the use of an external agent is allowed only under constant monitoring of the blood composition using laboratory tests.
Side effects after applying the Nize gel to the skin usually occur in patients with intolerance to the active ingredient. Sometimes skin rashes are provoked not by nimesulide, but by auxiliary components that the manufacturer used as a gel base. Systemic symptoms develop in very rare cases due to insignificant penetration of chemicals into the bloodstream. What side effects may occur after absorption of the drug into inflammatory foci is described in detail in this table:
|number||Local symptoms||General clinical manifestations|
|1.||Skin redness||Dyspeptic disorders: nausea, bouts of vomiting, excessive gas formation, diarrhea|
|2.||Puffiness development||Ulceration of the mucous membranes of the gastrointestinal tract|
|3.||The formation of small rashes||Headaches and dizziness|
|5.||Lengthening the duration of bleeding with skin damage||Epigastric pain|
|6.||Formation of large blisters filled with liquid contents||Bronchospasm|
|8.||—||The appearance of fresh blood or blood clots in the urine|
Side effects of Nise gel often arise when medical advice is neglected, when the patient applies an excessive amount of an external agent in the hope of a speedy recovery. In any case, if you feel worse, you must stop using the drug and consult a doctor to replace it.
Before using Nise Gel, you need to test. A small amount should be applied to the wrist or bend of the elbow. If after 30-40 minutes redness and rashes do not appear on the skin, then treatment can be started.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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