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მოქმედების მექანიზმი
ანთების საწინააღმდეგო არასტეროიდული საშუალება, ციკლოოქსიგენაზა-2-ის (ცოგ-2) სელექციური ინჰიბიტორი. პრეპარატს ახასიათებს ანთების საწინააღმდეგო, ტკივილგამაყუჩებელი და სიცხის დამწევი მოქმედება. აღნიშნული მოქმედება განპირობებულია ცოგ-2-ის ინჰიბირების შედეგად პროსტაგლანდინების სინთეზის დათრგუნვით, რომლებიც განაპირობებენ ანთების თანმდევ შეშუპებასა და ტკივილს. გარდა ამისა, პრეპარატი აფერხებს ხრტილოვანი ქსოვილის დამშლელი ფერმენტების (კოლაგენაზა, სტრომელიზინი, ელასტაზა) სინთეზს, რაც ხელს უწყობს ხრტილოვანი ქსოვილის დაზიანების შეფერხებასა და ხრტილოვანი ქსოვილის სინთეზის პროცესების რეგულირებას. შიგნით მიღების შემდეგ ნიმესულიდი კარგად შეიწოვება კუჭ-ნაწლავის ტრაქტიდან. საკვების მიღება ამცირებს აბსორბციის სიჩქარეს, შეწოვის ხარისხის შეუცვლელად. სისხლის პლაზმაში ნიმესულიდის Cmax მიიღწევა მიღებიდან 1.5-2.5 სთ-ის შემდეგ, ხოლო მისი მოქმედება დაახლოებით 6 სთ გრძელდება. პლაზმის ცილებს 99% უკავშირდება. ნიმესულიდი აქტიურად მეტაბოლიზდება ღვიძლში რამდენიმე მეტაბოლიტის წარმოქმნამდე. T1/2 შეადგენს 2-4.5 სთ-ს. მეტაბოლიტების 80% გამოიდევნება შარდის გზით, ხოლო 20% ფეკალურ მასებთან ერთად.

ჩვენებები
სუარონი ინიშნება:
- ოსტეოართრიტის, დაჭიმვისა და ღრძობის დროს განვითარებული ტკივილისა და ანთების სამკურნალოდ;
- სახსრებისა და კუნთების დაავადებების დროს (მათ შორის რევმატოიდული ართრიტი, მაანკილოზებელი სპონდილიტი, ბაქტერიული ართრიტი, ბურსიტი, ტენდინიტი);
- კბილის ტკივილისა და დისმენორეის (მტკივნეული მენსტრუაცია) დროს.

მიღების წესები და დოზები
ნიმესულიდი გამოიყენება მხოლოდ მოზრდილთა ასაკში. ჩვეულებრივ ინიშნება 1 ტაბლეტი 2-ჯერ დღეში, დილას და საღამოს. პაციენტის მდგომარეობისა და მკურნალობის ეფექტურობის გათვალისწინებით შესაძლებელია დოზის გაზრდა - 200 მგ 2-ჯერ დღეში. ტაბლეტები უნდა მიიღონ მთლიანად, ჭამის შემდეგ, საკმარისი რაოდენობის წყალთან ერთად. ასაკოვან პაციენტებში დოზის შერჩევა-შემცირება ხდება ექიმის მიერ პაციენტის მდგომარეობის გათვალისწინებით.

გვერდითი მოვლენები
ჩვეულებრივ სუარონი კარგად გადაიტანება. თუმცა შესაძლებელია განვითარდეს: საჭმლის მომნელებელი სისტემის მხრივ: დისკომფორტი ეპიგასტრიუმში, გულისრევა, დიარეა; ცნს-ის მხრივ: თავბრუსხვევა, თავის ტკივილი, უძილობა; დერმატოლოგიური რეაქციები: გამონაყარი კანზე, ერითემა, ჭინჭრის ციება, ქავილი. იშვიათად შესაძლებელია განვითარდეს შარდვის შემცირება (ოლიგურია), თანმდევი სითხის შეკავებითა და ქსოვილების ადგილობრივი ან დიფუზური შეშუპებით. გასათვალისწინებელია, რომ ნიმესულიდმა, სხვა ანთების საწინააღმდეგო არასტეროიდული საშუალებების მსგავსად, შესაძლოა გამოიწვიოს სტივენს-ჯონსონის, ლაიელის სინდრომი, ასევე ანაფილაქსიური რეაქციები.

უკუჩვენება
- ნიმესულიდისადმი ან პრეპარატის სხვა კომპონენტებისადმი მაღალი მგრძნობელობა;
- აცეტილსალიცილის მჟავას ან სხვა ანთების საწინააღმდეგო არასტეროდული საშუალებებისადმი (ასას) მაღალი მგრძნობელობა;
- კუჭისა და თორმეტგოჯა ნაწლავის წყლულოვანი დაავადება გამწვავების ფაზაში;
- ღვიძლის ან თირკმლების ფუნქციების ზომიერი ან გამოხატული დარღვევები;
- ორსულობა;
- ლაქტაცია (ძუძუთი კვება).

განსაკუთრებული მითითებები
ნიმესულიდი სიფრთხილით ინიშნება პაციენტებში სისხლის შემდედებელი სისტემის დარღვევით და კუჭნაწლავის სისტემის დაავადებებით, ასევე, პაციენტებში რომლებიც იღებენ ანტიკოაგულანტებს ან ანტიაგრეგანტებს (თრომბოციტების აგრეგაციის შემაფერხებელ საშუალებებს). ნიმესულიდი უპირატესად თირკმლების საშუალებით გამოიყოფა, ამიტომ პაციენტებში თირკმლების დარღვეული ფუნქციით, საჭიროა ნიმესულიდის დოზის შემცირება გორგლოვანი ფილტრაციის მაჩვენებლების გათვალისწინებით. პრეპარატმა შესაძლოა ქსოვილებში სითხის შეკავება გამოიწვიოს, ამიტომ პაციენტებში გულის უკმარისობით, ნიმესულიდის დანიშვნა სიფრთხილით უნდა მოხდეს. პაციენტებში, რომელთაც ადრე ასას-ის მიღებისას მხედველობის დარღვევა აღენიშნათ, ნიმესულიდით მკურნალობის ფონზე მხედველობის დარღვევისას, საჭიროა პრეპარატის მოხსნა და ოფთალმოლოგიური კვლევის ჩატარება. სუარონი სიფრთხილით ინიშნება ხანდაზმულ პაციენტებში, განსაკუთრებით მაშინ, როცა გამოხატულია ასაკობრივი სისუსტე. სიფრთხილის დაცვაა საჭირო სუარონისა და ანტიკოაგულანტების, დიურეზული საშუალებების, ანტიჰიპერტენზიული პრეპარატების, ჰიპოგლიკემიური პრეპარატების, დიგოქსინის, ფენიტოინის, ლითიუმის პრეპარატების, სხვა ასას-ის, ციკლოსპორინის, მეტოტრექსატის ერთდროული დანიშვნისას.

ჭარბი დოზირება
დოზის გადაჭარბების შემთხვევაში რეკომენდებულია სიმპტომური თერაპია (კუჭის ამორეცხვა, აქტივირებული ნახშირის მიღება).

შენახვის პირობები და ვადები
პრეპარატის ვარგისიანობის ვადაა 3 წელი, ინახება 10-25oC ტემპერატურაზე, სინათლისაგან დაცულ, მშრალ, ბავშვებისათვის ხელმიუწვდომელ ადგილზე!

აფთიაქში გაცემის წესი
ექიმის რეცეპტის გარეშე!

რეგისტრაციის # და თარიღი
წს N რ - 002327 09.03.2007

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