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► Aulin (nimesulide) - Practical Medicine

Aulin (nimesulide) - granules for oral suspension

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Aulin granules for oral suspension; 100 mg; 30 sachets Medicom International / Angelini 17.71 8.86
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Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:nimesulide

The drug is available on prescription

What is Aulin?

It is a preparation with general action containing a non-steroidal anti-inflammatory drug.

What does Aulin contain and how does it work?

The active substance is Nimesulide , a non-steroidal anti-inflammatory drug (NSAID), the only representative of the sulfoanilide class. It has anti-inflammatory, analgesic and antipyretic effects. Nimesulide counteracts the synthesis of prostaglandins, substances that play a significant role in the development of inflammation. The effect of nimesulide is primarily to inhibit the activity of cyclo-oxygenases, mainly cyclooxygenase-2 (COX-2), and to a small extent cyclooxygenase-1 (COX-1). These enzymes take part in the reactions leading to the formation of prostaglandins from the lipids of cell membranes. In addition, nimesulide comprehensively inhibits the action of other inflammatory mediators. It does not have antimicrobial activity. It is well and quickly absorbed from the gastrointestinal tract. It is characterized by a very rapid analgesic action, which starts as early as 15 minutes after oral administration of the drug. The maximum concentration in the blood is obtained within 2-3 hours after administration. Nimesulide passes through the placenta and into the breast milk of women.

When to use Aulin?

The preparation is indicated in:
· Treatment of acute pain
· In dysmenorrhea.
In each case, an individual doctor will assess the overall risk associated with the use of nimesulide and will decide to use the preparation. Nimesulide should only be used as second-line treatment.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients.
The product is contraindicated if you have ever experienced allergy to Acetylsalicylic acid (colloquially called Aspirin ) or to other nonsteroidal anti-inflammatory drugs (eg Ibuprofen , Ketoprofen ). This sensitization could be manifested in the form of hypersensitivity reactions such as eg asthma attack, bronchospasm, allergic rhinitis, angioneurotic edema or skin reactions, including urticaria, rash, erythema.
The use of the preparation is contraindicated in people:
who have ever experienced symptoms of liver damage after using nimesulide
using parallel preparations with potential hepatic damage
addicted to alcohol, drugs or intoxicants
with active or recurrent gastric and / or duodenal ulcer disease, bleeding or perforation, including NSAIDs
with bleeding from the digestive tract, cerebral vessels, with other bleeding or bleeding diseases
with severe bleeding disorders
with liver problems
with severe kidney problems
with severe heart failure
with fever or flu-like symptoms
and
· In women in the third trimester of pregnancy
· In women who are breast-feeding
· Children under 12 years old.

When should you take extra care with Aulin?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Use of the product at the lowest effective dose over the shortest possible period reduces the risk of side effects.
The use of other non-steroidal anti-inflammatory drugs (including selective COX-2 inhibitors) should be avoided.
If symptoms persist, consult a physician. Do not increase the recommended dose or use other analgesics in parallel.
Increased caution and special medical control is required for elderly people. In elderly patients, the risk of side effects, especially Gastrointestinal bleeding , which can cause death is increased.
The use of non-steroidal anti-inflammatory drugs is associated with the risk of gastrointestinal haemorrhage, ulceration or perforation, which may be the cause of death and may not be preceded by warning signs. These symptoms can occur at any time during treatment, also in people without previous gastrointestinal disorders. These complications are particularly dangerous in the elderly. Always tell your doctor immediately if you have any unusual symptoms on the part of the digestive tract (especially bleeding). If there is bleeding from the gastrointestinal tract, immediate discontinuation of the preparation is necessary.
If you have ever had a stomach and / or duodenal ulcer, tell your doctor who prescribes this medicine. If inflammations or ulcers have occurred in the past, the use of the preparation may contribute to their recurrence.
In the case of people with gastrointestinal disease, after ulceration and / or bleeding, the use of the preparation is possible only under medical supervision with caution. Insufficient ulceration and digestive tract diseases, high doses and advanced age increase the risk of gastrointestinal bleeding. Treatment should be started with the lowest effective dose. Your doctor may prescribe curing agents, such as proton pump inhibitors or misoprostol. Be cautious and consult a doctor immediately if any unusual symptoms occur.
Protective drugs may also be indicated in patients taking medications that increase the risk of gastrointestinal adverse reactions, including peptic ulceration or bleeding (eg corticosteroid s with a general effect, anticoagulants, eg Warfarin , drugs that inhibit platelet aggregation, including even small doses of acetylsalicylic acid [colloquially called aspirin], drugs from the group of selective serotonin reuptake inhibitors). Be careful.
Due to the possibility of exacerbation of the disease, the preparation can be used only under strict medical supervision and with caution in patients with ulcerative colitis or Leśniowski and Crohn's disease.
Particular care should be taken if the product is used in people with hypertension, congestive heart failure, fluid retention, and edema (the use of NSAIDs may cause fluid retention and edema). Patients should remain under medical supervision. Your doctor may recommend monitoring your heart and kidneys.
Prolonged use of NSAIDs at high doses may increase the risk of a heart attack or stroke. Particular caution and close medical supervision is required when using the product in hypertensive patients with congestive heart failure, with ischemic heart disease, peripheral artery disease or cerebrovascular disease, and in patients with risk factors for cardiovascular disease (diabetes, smoking, hyperlipidemia). If you belong to any of the above groups, consult a physician before using the preparation.
The preparation, like other NSAIDs, may cause severe skin reactions, sometimes leading to death, such as Stevens and Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis. These reactions are very rare and usually appear in 1.month of application. In the event of the first symptoms of skin lesions (rash, mucosal lesions) or any symptoms of hypersensitivity, the preparation should be discontinued immediately and a physician should be consulted. If severe skin reactions associated with the use of nimesulide occur, it must not be re-used.
Rarely, the preparation may cause severe liver reactions (also after short-term use). These reactions in very rare cases can lead to death. In the event of first symptoms that may indicate liver damage (such as anorexia, nausea, vomiting, abdominal pain, feeling of tiredness, dark urine) or abnormal liver function tests, the preparation should be immediately discontinued and a doctor should be consulted. The above reactions are transient in most cases, however, after their occurrence, the use of nimesulide should not be resumed in the future.
If during the period of application fever or symptoms similar to flu symptoms occur, the preparation should be discontinued and a doctor should be consulted.
The use of the preparation may be associated with deterioration of renal function. People with impaired renal function and / or heart should exercise caution. If the kidney function worsens, discontinue use and consult a physician.
The product may interfere with platelet function and increase the duration of bleeding. Caution should be exercised in patients with an increased risk of bleeding, including haemorrhagic diathesis. The preparation can not be used instead of acetylsalicylic acid in the prevention of cardiovascular disease.
The preparation, like other NSAIDs, can mask the symptoms of infection. If you suspect an infection, consult your doctor, as appropriate treatment may be necessary. The preparation does not have an antimicrobial effect.
The use of the preparation may cause fertility problems in women and is not recommended in women who are planning to become pregnant.
Additional information about the other ingredients of the preparation:
the preparation contains sucrose; people with hereditary disorders associated with fructose intolerance, Glucose -galactose malabsorption or sucrase-isomaltase deficiency should not use
the sucrose content in the preparation should be taken into account if the preparation is used by people with diabetes
the preparation contains glucose; people with malabsorption of glucose-galactose should not use the preparation.

Does this preparation affect the ability to drive vehicles?
There are no studies on the effect of the preparation on the ability to drive and use machines / machines. The preparation may cause side effects such as balance disorders, drowsiness, dizziness or other disorders of the central nervous system. In the event of their occurrence, do not drive or operate equipment / machines, and do not do other activities that require increased concentration.

Dosage of Aulin

The preparation is in the form of granules for oral suspension. It is intended for oral use. Use the product as directed by your doctor. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Adults and adolescents after the age of 12: 100 mg twice daily. Take after meals.
Use as short as possible, continuously for no more than 15 days.
Elderly patients do not need to modify the dose.
The use of the preparation in children under the age of 12 is contraindicated.
Hepatic impairment is a contraindication to the use of the preparation.
In patients with mild or moderate renal impairment (creatinine clearance 30-80 ml / min) no dose adjustment is required. In patients with severe renal impairment, the use of the preparation is contraindicated.

Can Aulin be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug.If you are pregnant or planning to become pregnant, please inform the doctor prescribing the prescription for this medicine (see the warnings in the section "When should you take extra care with the preparation?").
The use of the preparation is contraindicated in women in the third trimester of pregnancy. Do not use the preparation in the first and second trimester of pregnancy. The use of the preparation in the first and second trimester of pregnancy, and in women planning pregnancy, is allowed only at the express request of the doctor in cases when considering the ratio of expected benefits for the mother to possible risk to the fetus he considers the use of the preparation absolutely necessary (only the shortest effective dose). Only a doctor can assess the benefit / risk ratio in your case.
The use of the preparation in women during breastfeeding is contraindicated.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
It is not recommended to use the preparation with:
· Acetylsalicylic acid or other non-steroidal anti-inflammatory drugs, including selective COX-2 inhibitors (increased risk of side effects, especially ulcers and gastrointestinal bleeding)
· Anticoagulants such as warfarin and other anticoagulants or acetylsalicylic acid (possible increase in their effect and increased risk of bleeding, parallel use is strictly contraindicated in patients with blood coagulation disorders, in other patients, if parallel use of these preparations can not be avoided, strictly monitor blood clotting parameters)
· Drugs that inhibit platelet aggregation, such as, for example, ticlopidine (increased risk of bleeding)
· Corticosteroids or serotonin reuptake inhibitors (increased risk of side effects, especially gastrointestinal bleeding)
· Furosemide (possible reduction in its effectiveness, increased risk of renal dysfunction, special care should be taken if there is a need for parallel stiosowania in patients at risk of heart or kidney failure)
· Diuretics and antihypertensive agents, including angiotensin converting enzyme inhibitors, angiotensin antagonists (possible reduction in their effectiveness, increased risk of renal dysfunction and development of acute renal failure , especially in dehydrated or elderly patients, care should be taken to properly hydrate and control kidney function)
· Lithium (possible increase in lithium concentration and intensification of its toxic effects, if it is necessary to use it in parallel, it is recommended to check the concentration of lithium in the blood)
· Methotrexate (possible increase in methotrexate concentration and intensification of its toxic effects, sometimes severe intoxication, special care should be taken when taking the product and methotrexate in less than 24 hours, in which case renal function monitoring is necessary)
· Cyclosporine and tacrolimus (increased risk of kidney damage, renal function should be monitored, especially in the elderly).
During the period of application, the concentration of other drugs metabolized with the cytochrome P450 2C9 isoenzyme may be increased.

What side effects can occur?

Like all medicines, Aulin can also cause side effects, although they will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
The most common are gastrointestinal side effects, which include: nausea, vomiting, diarrhea and increased liver enzymes. In addition, possible: indigestion, abdominal pain, flatulence, constipation, gastritis, oral mucositis, gastrointestinal bleeding (including tarry stools, bloody vomiting) and ulceration of the gastrointestinal tract, sometimes with bleeding and perforation (including fatal, especially in the elderly), exacerbation of colitis, exacerbation of Leśniowski and Crohn's disease, very rarely hepatitis, jaivice, cholestasis , fulminant hepatitis (including fatal cases).Possible: headache and dizziness, drowsiness, nightmares, anxiety, anxiety, visual disturbances (including blurred vision, blurred), tinnitus, encephalopathy (Reye's syndrome). Possible: increase of heart rate, edema, hypertension, hot flushes, bleeding, hematological disorders, including anemia, eosinophilia, agranulocytosis, leukopenia, thrombocytopenia (if symptoms such as fever, sore throat, flu-like symptoms, superficial mucosal ulceration occur) mouth, fatigue, nosebleeds, bruises, ecchymosis or purpura should immediately consult a doctor, because they may be the first symptoms of hematological disorders). Possible impaired renal function, sodium and water retention, hyperkalemia, painful urination, hematuria, urinary retention, renal failure, interstitial nephritis, malaise, weakness, lowering body temperature. Hypersensitivity reactions (rash, urticaria, pruritus, photosensitivity) and Anaphylactic reactions , including life-threatening anaphylactic shock, angioneurotic edema (swelling of the face, larynx, tongue, throat that may impede breathing), bronchospasm, asthma attack and severe skin reactions: toxic epidermal necrolysis, Stevens and Johnson syndrome, erythema multiforme. Prolonged use of nimesulide in high doses may increase the risk of heart attack or stroke.

Other preparations on the Polish market containing nimesulide

Aulin (tablets)
Minesulin (tablets)
Minesulin (powder for oral suspension)
Nimesil (granules for oral suspension)