Clinical Studies

Adverse Effects


Packaging Information




Nimesulide And Paracetamol Combination.

Nimesulide is a newer nonsteroidal anti-inflammatory drug (NSAID) with selective cyclo-oxygenase-2 (COX-2) enzyme inhibiting property. It has potent analgesic, anti pyretic and anti-inflammatory activity on oral and rectal administration. By respecting the activity of cyclooxygenase-1 (COX-1), nimesulide possesses a much lower risk for gastroduodenal lesions in comparison to other classical NSAIDs. Unlike nimesulide, paracetamol, another effective analgesic and antipyretic agent without anti-inflammatory activity, is a non-selective COX inhibitor. There have been many combinations of analgesic and anti-inflammatory preparations available in the market, particularly that of paracetamol and ibuprofen. In line with this, is there any justification for a combination of nimesulide and paracetamol? Thus far available informations suggest that such a combination of nimesulide and paracetamol would be irrational. Nimesulide has better pharmacological profile as compared to paracetamol in terms of its analgesic and anti-inflammatory activity as enumerated below:
  • Nimesulide is a multi-action drug. Beside being a potent and specific inhibitor of COX-2, the inducible form of the enzyme involved in inflammatory and painful conditions (COX-2/COX-1 = 0.1), it inhibits the production and release of oxygen free radicals and hypochlorous acid in neutrophils, without affecting their function. It does not alter the constitutive COX enzyme (COX-1) which is essential for physiological functions of the body. On the other hand, paracetamol is a nonselective COX-inhibitor devoid of anti-inflammatory activity (COX-2/COX-1 = 7.4) which inhibits central COX, responsible for antipyretic and analgesic action. Lower ratio of COX-2/COX-1 is considered as safe for NSAIDs.

  • Nimesulide has an antipyretic effect that is much greater than that of paracetamol, both after oral (>200 fold) and rectal (>50 fold) administration. It's antipyretic action is longer lasting than that of paracetamol and about 3 times higher after oral administration as compared to the rectal dosing. The antipyretic effect of nimesulide given orally appears at a lower dose than that for its anti-inflammatory and analgesic action.

  • Compared with other NSAIDs and paracetamol, nimesulide shows significantly faster reduction in fever and other signs and symptoms (dysphagia, oedema and pharyngeal pain) of respiratory tract inflammation. The greater antipyretic effect of nimesulide may be partially related to its high plasma concentration after oral administration.

  • When antipyretics are needed, the traditional agents, aspirin or paracetamol are prescribed. These drugs have good antipyretic activity but their non-selective inhibition of COX enzyme leads to various side effects which are not observed with nimesulide. These evidences support the fact that nimesulide is relatively a better analgesic, antipyretic and anti-inflammatory agent.