Ledoren (Nimesulide)

Nimesulide acts as an NSAID to manage pain and inflammation across several clinical conditions.

• Mild to moderate pain: provides analgesic relief for acute and chronic pain.
• Osteoarthritis: reduces joint inflammation and improves mobility.
• Rheumatoid arthritis: helps control inflammatory activity and pain.
• Fever: lowers elevated body temperature associated with infections or inflammatory states.

• Nimesulide reversibly inhibits the cyclooxygenase‑2 (COX‑2) enzyme, decreasing the synthesis of prostaglandins that mediate inflammation, pain, and fever. By selectively targeting COX‑2, it reduces inflammatory responses while sparing COX‑1–mediated protective functions in the gastrointestinal tract.

Nimesulide may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia, or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Skin rash or mild itching.
• Elevated liver enzymes without clinical symptoms.

Serious or Rare Side Effects

• Hepatotoxicity: severe liver injury or failure.
• Gastrointestinal ulceration or bleeding.
• Severe skin reactions such as Stevens‑Johnson syndrome.
• Renal impairment or acute kidney injury.
• Anaphylactic reactions.
• Blood dyscrasias including agranulocytosis.

When prescribing Nimesulide, clinicians should consider several safety measures.

• Assess liver function: avoid use in patients with existing hepatic disease.
• Monitor renal function: caution in patients with impaired kidney function.
• Avoid in peptic ulcer disease: risk of gastrointestinal bleeding.
• Do not combine with other NSAIDs or corticosteroids without medical supervision.
• Use cautiously in the elderly: increased susceptibility to adverse effects.
• Store at ambient temperature: keep in the original pack, protect from moisture.

Nimesulide can interact with various medicines, requiring careful management.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Other NSAIDs: heightened gastrointestinal toxicity.
• Corticosteroids: additive ulcer risk.
• Lithium: possible increase in serum lithium levels.
• Methotrexate: reduced clearance leading to toxicity.

Moderate Interactions (Monitor Closely)

• Antihypertensives: may diminish blood pressure control.
• Diuretics: potential reduction in renal perfusion.
• SSRIs: modest increase in bleeding tendency.
• ACE inhibitors: possible renal function impact.
• Oral hypoglycemics: may affect glucose control.