Nifluril (Niflumic Acid)

Niflumic Acid is indicated for inflammatory and musculoskeletal conditions where cyclo‑oxygenase inhibition reduces pain and swelling.

• Rheumatoid arthritis: decreases joint inflammation and pain, improving functional ability.
• Osteoarthritis: alleviates chronic joint pain and stiffness associated with cartilage degeneration.
• Dysmenorrhea: reduces menstrual‑related uterine cramping and discomfort.
• Acute musculoskeletal pain: provides short‑term relief of pain from sprains, strains or overuse injuries.

• Niflumic Acid exerts its anti‑inflammatory effect primarily through non‑selective inhibition of cyclooxygenase‑1 and cyclooxygenase‑2 enzymes, which lowers prostaglandin synthesis in inflamed tissues. In addition, the compound blocks certain chloride channels on cell membranes, contributing to reduced neuronal excitability and analgesia. These effects are dose‑dependent and contribute to the clinical efficacy observed in arthritis and dysmenorrhea.

Niflumic Acid may be associated with a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia, abdominal pain or mild diarrhea.
• Headache: mild to moderate intensity, often transient.
• Dizziness or vertigo: sensation of light‑headedness or imbalance.
• Skin rash: mild erythema, pruritus or localized itching.
• Elevated liver enzymes: transient increase in hepatic transaminases without clinical hepatitis.

Serious or Rare Side Effects

• Severe gastrointestinal ulceration or bleeding: perforation, hemorrhage requiring medical intervention.
• Hepatotoxicity: marked elevation of liver enzymes, hepatitis or liver failure in rare cases.
• Renal impairment: acute interstitial nephritis, reduced glomerular filtration or renal failure.
• Blood dyscrasias: agranulocytosis, leukopenia, thrombocytopenia or other hematologic abnormalities.
• Anaphylactic reactions: urticaria, bronchospasm, angioedema or full anaphylaxis.

When prescribing Niflumic Acid, clinicians should consider several precautionary measures to minimize risk.

• Assess renal and hepatic function: evaluate baseline kidney and liver tests before initiating therapy.
• Monitor gastrointestinal risk: avoid use in patients with active ulcers or history of GI bleeding.
• Use lowest effective dose: limit exposure to reduce adverse event likelihood.
• Caution in elderly patients: increased susceptibility to renal and gastrointestinal complications.
• Avoid concomitant NSAIDs or anticoagulants: heightened risk of bleeding and ulceration.
• Check for hypersensitivity: discontinue if rash or anaphylaxis occurs.
• Store at ambient temperature: keep below 25 °C in the original packaging, protected from moisture.

Niflumic Acid can interact with several medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Other NSAIDs or COX‑2 inhibitors: additive gastrointestinal toxicity.
• Corticosteroids: heightened ulceration potential.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: possible reduction in renal function.
• Diuretics: risk of renal impairment and electrolyte imbalance.
• Lithium: NSAIDs may increase lithium serum levels.
• Methotrexate: reduced renal clearance may raise toxicity.