Dosages & Reactions

Interactions:

Acenocoumarol

Adverse Effect: an increased risk of bleeding
Clinical Management: In patients receiving oral anticoagulation the prothrombin time (PT) or international normalized ratio (INR) should be closely monitored with the addition and withdrawal of treatment with nonsteroidal antiinflammatory drugs (NSAIDs) including fenoprofen. Coagulation parameters should also be reassessed periodically during concurrent therapy. Adjustments of the acenocoumarol dose may be necessary in order to maintain the desired level of anticoagulation
Amiloride

Adverse Effect: reduced diuretic effectiveness hyperkalemia or possible nephrotoxicity
Clinical Management: When administering Nimesulide and Amiloride concurrently monitor the patient for decreased effectiveness of the diuretic and hyperkalemia. Monitor blood pressure weight changes urine output potassium levels and creatinine levels.
Amlodipine

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Ardeparin

Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed
Clinical Management: Patients receiving Ardeparin and Nimesulide should be monitored closely for bleeding which may be serious. Gastrointestinal bleeding is a particular concern with this combination as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to Ardeparin . Nimesulide should be discontinued several days prior to surgery.
Atenolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Atenolol Comb.

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Benazepril

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Betaxolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Bisoprolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Bumetanide

Adverse Effect: decreased diuretic and antihypertensive efficacy
Clinical Management: When administering Bumetanide and Nimesulide concurrently monitor blood pressure and weight. Also follow the patient for decreased urine output and increased edema.
Captopril

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Captopril Comb.

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Carvedilol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Celiprolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Chlorpropamide

Adverse Effect: a possible increased risk of hypoglycemia
Clinical Management: When Nimesulide is coadministered with Chlorpropamide patients should be monitored more closely for hypoglycemia. Dose of Chlorpropamide may need to be reduced when Nimesulide is added to therapy.
Chlorthalidone

Adverse Effect: Decreased diuretic and antihypertensive efficacy
Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently monitor blood pressure and weight. Also follow the patient for decreases in urine output and increased edema.
Clopamide

Adverse Effect: Decreased diuretic and antihypertensive efficacy
Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently monitor blood pressure and weight. Also follow the patient for decreases in urine output and increased edema.
Dalteparin

Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed
Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding which may be serious. Gastrointestinal bleeding is a particular concern with this combination as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Diltiazem

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Enalapril

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Enalapril Comb.

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Enoxaparin

Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed
Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding which may be serious. Gastrointestinal bleeding is a particular concern with this combination as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Esmolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Felodipine

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Flunarizine

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Frusemide

Adverse Effect: decreased diuretic and antihypertensive efficacy
Clinical Management: When administering Frusemide and Nimesulide concurrently monitor blood pressure and weight. Also follow the patient for decreased urine output and increased edema.
Glibenclamide

Adverse Effect: A possible increased risk of hypoglycemia
Clinical Management: When Nimesulide is coadministered with Glibenclamide patients should be monitored more closely for hypoglycemia. Dose of Glibenclamide may need to be reduced when Nimesulide is added to therapy.
Gliclazide

Adverse Effect: a possible increased risk of hypoglycemia
Clinical Management: When nonsteroidal antiinflammatory agents (NSAIDs) are coadministered with a sulfonylurea drug patients should be monitored more closely for hypoglycemia. Doses of the sulfonylurea may need to be reduced when NSAIDs are added to therapy.
Glimepiride

Adverse Effect: a possible increased risk of hypoglycemia
Clinical Management: When nonsteroidal antiinflammatory agents (NSAIDs) are coadministered with a sulfonylurea drug patients should be monitored more closely for hypoglycemia. Doses of the sulfonylurea may need to be reduced when NSAIDs are added to therapy.
Glipizide

Adverse Effect: a possible increased risk of hypoglycemia
Clinical Management: When Nimesulide is coadministered with Glipizide patients should be monitored more closely for hypoglycemia. Doses of Glipizide may need to be reduced when Nimesulide is added to therapy.
Indapamide

Adverse Effect: Decreased diuretic and antihypertensive efficacy
Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently monitor blood pressure and weight. Also follow the patient for decreases in urine output and increased edema.
Ketorolac

Adverse Effect: enhanced gastrointestinal adverse effects (peptic ulcers gastrointestinal bleeding and/or perforation)
Clinical Management: Concomitant use of ketorolac and other nonsteroidal antiinflammatory agents is contraindicated.
LMWH sod.salt

Adverse Effect: Increased risk of bleeding and hematoma when neuraxial anesthesia is employed
Clinical Management: Patients receiving LMWH sod.salt and Nimesulide concurrently should be monitored closely for bleeding which may be serious. Gastrointestinal bleeding is a particular concern with this combination as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Labetalol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Lacidipine

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Levobunolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Lisinopril

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Lithium

Adverse Effect: Lithium toxicity (weakness tremor excessive thirst confusion)
Clinical Management: Serum lithium levels should be monitored within the first few days if a nonsteroidal antiinflammatory drug is added or discontinued from therapy and periodically thereafter. Patients should be followed for any symptoms of toxicity; a decrease in the lithium dose is often required with concomitant therapy.
Methotrexate

Adverse Effect: methotrexate toxicity (leukopenia thrombocytopenia anemia nephrotoxicity mucosal ulcerations)
Clinical Management: In general do not administer NSAIDS within 10 days of high-dose methotrexate (ie doses used in cancer therapy).
Metoprolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Metoprolol Comb.

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Nadroparin

Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed
Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding which may be serious. Gastrointestinal bleeding is a particular concern with this combination as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Nifedipine

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Nimodipine

Adverse Effect: an increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent Nimesulide and Nimodipine should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Nitrendipine

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Ofloxacin

Adverse Effect: an increased risk of seizures
Clinical Management: Ofloxacin should be used cautiously in patients receiving other medications which may lower the seizure threshold including nonsteroidal antiinflammatory drugs (NSAIDs). Alternative therapy should be considered especially in patients who are predisposed to seizure activity.
Oxprenolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Perindopril

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Phenindione

Adverse Effect: An increased risk of bleeding
Clinical Management: In patients receiving Phenindione the prothrombin time (PT) or international normalized ratio (INR) should be closely monitored with the addition and withdrawal of treatment with nonsteroidal antiinflammatory drugs (NSAIDs) including nimesulide. Coagulation parameters should also be reassessed periodically during concurrent therapy. Adjustments of the phenindione dose may be necessary in order to maintain the desired level of anticoagulation. Clinicians and patients should be aware of the increased potential for bleeding especially from the gastrointestinal tract during concomitant therapy.
Pindolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Propranolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Propranolol Comb.

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ramipril

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Ramipril Comb.

Adverse Effect: Decreased antihypertensive and natriuretic effects
Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Reviparin

Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed
Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding which may be serious. Gastrointestinal bleeding is a particular concern with this combination as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Sotalol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Spironolactone

Adverse Effect: reduced diuretic effectiveness hyperkalemia or possible nephrotoxicity
Clinical Management: When administering Nimesulide and Spironolactone concurrently monitor the patient for decreased effectiveness of the diuretic and hyperkalemia. Monitor blood pressure weight changes urine output potassium levels and creatinine levels.
Timolol

Adverse Effect: Decreased antihypertensive effect
Clinical Management: If concurrent therapy is required monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Tinzaparin

Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed
Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding which may be serious. Gastrointestinal bleeding is a particular concern with this combination as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Tolbutamide

Adverse Effect: a possible increased risk of hypoglycemia
Clinical Management: When nonsteroidal antiinflammatory agents (NSAIDs) are coadministered with a sulfonylurea drug patients should be monitored more closely for hypoglycemia. Doses of the sulfonylurea may need to be reduced when NSAIDs are added to therapy.
Verapamil

Adverse Effect: An increased risk of gastrointestinal hemorrhage
Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage such as weakness nausea and blood in the stool.
Warfarin

Adverse Effect: An increased risk of bleeding
Clinical Management: Although there is no evidence that nimesulide at therapeutic doses would alter the anticoagulant effect of warfarin caution should be exercised when these two drugs are used concurrently. Other NSAIDs have been shown to increase the hypoprothrombinemic response to warfarin. Monitor prothrombin times (PT) or international normalized ratios (INR) and watch patients for signs of bleeding especially from the gastrointestinal tract.
Xipamide

Adverse Effect: Decreased diuretic and antihypertensive efficacy
Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently monitor blood pressure and weight. Also follow the patient for decreases in urine output and increased edema.

Naloxone Hydrochloride

Naproxen

Neomycin Sulfate

Neostigmine Bromide

Niacin(nicotinic acid)

Nifedipine

Nitrofurantoin

Nitroprusside Sodium

Norepinephrine Bitartrate

Nortriptyline Hydrochloride

Nystatin

Nitrofurazone