What to choose Nise, Nimesulide and Dexalgin?

pharmachologic effect

Manufacturer: Dr. Reddis, India
Release form: tablets, granules for suspension, gel for external use

Active ingredient: Nimesulide

Synonyms: Nimulid, Aponil, Nimesil, Nemulex, Nimika, Nimesan, Prolid

The drug has antipyretic, anti-inflammatory and analgesic effects. Nise selectively inhibits the action of the enzyme cyclooxygenase-2, which regulates the synthesis of prostaglandins at the site of inflammation.

The medicine has virtually no effect on another type of enzyme that protects the gastric mucosa and regulates renal blood flow. Therefore, Nise is less likely to have unwanted side effects that are characteristic of other non-steroidal anti-inflammatory drugs (NSAIDs), such as Analgin, Diclofenac, Ketorol.

Pain and its treatment

Pain can accompany both physical injuries and destructive processes caused by diseases. Most often, headaches or toothaches interfere with everyday life; Each time, unpleasant sensations reduce the quality of life, preventing the victim from working effectively or fully resting. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain, inflammation, and fever. Depending on the structure, drugs from this group can either simultaneously work on all effects or focus on relieving a person of either painful sensations or inflammatory processes.

Nise's analogs

Before replacing Nise, you should definitely consult a doctor, since only he will decide on an adequate replacement. A pharmacist at a pharmacy can only offer analogues containing the active ingredient Nimesulide, for example, Nimulid, Nimika, Nemulex.

By agreement with the doctor, Nise tablets can be replaced with other non-steroidal anti-inflammatory drugs, among which there are mono-drugs Ibuprofen, Movalis, Airtal, Indomethacin, and complex ones - Pentalgin, Next, Tempalgin.

The list of analogues with prices is shown in the table

Celebrex

Manufacturer: Pfizer, USA
Release form: capsules

Active ingredient: Celecoxib

Synonyms: Dilaxa, Coxib, Simcoxib

Celebrex is one of the relatively safe analogues of Nise from the NSAID group, due to its selective effect on cyclooxygenase-2.

The Celebrex analogue is used for inflammatory diseases of the musculoskeletal system and the musculoskeletal system.

May be used during pregnancy if the benefit does not outweigh the risk to the fetus.

Arcoxia

Manufacturer: Merck, Netherlands
Release form: film-coated tablets

Active ingredient: Etoricoxib

Synonyms: Bixitor, STREGA, Ethoriax, Atorica

The Arcoxia analogue, as a selective antagonist of cyclooxygenase-2, acts only at the site of inflammation and does not affect other organs in which there is no inflammatory process. Therefore, Arcoxia is safer than other NSAIDs. The medicine is an analogue of Nise in terms of therapeutic effect and is used for the same diseases.

Nizilat

Manufacturer: Dr. Reddis, India
Release form: film-coated tablets

Active ingredient: Amtolmetin guacil

Synonyms: Bixitor, STREGA, Ethoriax, Atorica

The analog Naisilate is a NSAID and has anti-inflammatory, analgesic and antipyretic effects.

The main feature of this analogue is its gastroprotective effect, that is, it protects the cells of the gastric mucosa from the negative effects of increased secretion of hydrochloric acid.

Aertal

Manufacturer: Gedeon Richter, Hungary
Release form: tablets, powder for suspension for internal use, cream for external use

Active ingredient: Aceclofenac

Synonyms: Alental, Aceklagin, Asinak

Aertal is an analogue of Nise in terms of therapeutic effect. It is used for the same diseases as an anti-inflammatory and analgesic.

Dolobene

Manufacturer: Merck, Germany
Release form: gel for external use

Active ingredient: Sodium heparin + Dexpanthenol + Dimethyl sulfoxide

As an analogue of Nise ointment, Dolobene is also used as an anesthetic. But it is advisable to use it for closed injuries, since this analogue also has an anti-edematous effect, and, in addition to pain, it will also relieve swelling and hematoma.

Analogs and substitutes for Nise

In an emergency situation, when a headache or toothache occurs unexpectedly and interferes with planned activities or rest, Nise can be replaced with other non-steroidal anti-inflammatory drugs. Despite the fact that they differ in the strength of action, the speed of its onset and the frequency of unpleasant consequences, a single dose or even a short course is very unlikely to be harmful, and the pain will subside in any case. When choosing, it is worth remembering that any medicine works faster in powder, and gels are mainly used to treat joints and muscles. In this case, less active substance enters the blood, which reduces both unwanted and beneficial effects.

It makes sense to consider non-selective and selective COX inhibitors separately. Sometimes NSAIDs are included in drugs with a complex composition, which have a better effect due to the joint work of substances with different mechanisms of action. Of all the options for dosage forms that can replace Nise, tablets are the most convenient and familiar, but in some cases ointments will be more profitable.

Complete analogues of Nise

Not only Nimesulide shares the active substance with Nise: examples of such drugs include Nimesil and Nimulid. The first drug is another representative of imported drugs; It is sold in the form of granules for preparing a suspension. The finished product has an orange flavor: like powders from other manufacturers, it contains sugar, citric acid and flavoring. Nimesil is prescribed from the age of 12, and the dose in one sachet is the same as the amount of the substance in the Naiza tablet: 100 mg.

Indian Nimulid has more release forms: you can buy both tablets and gel. Of interest are the ready-made suspension 50 mg/5 ml, which is most convenient to give to children after recalculating the dose of nimesulide based on body weight, as well as lozenges. The latter form is convenient because to dissolve the medicine it is enough to put it on the tongue; however, it is taken after meals, like most other NSAIDs. It is better to take Nimulid or Nise for a short time: you can numb the pain with their help for no longer than 10 days.

Non-selective COX inhibitors

By acting on any form of COX, such drugs not only relieve pain and inflammation, but also prevent the enzyme from doing its job of reducing the acidity of gastric juice and producing a protective coating in the stomach. An example is aceclofenac, which is contained in the drug Airtal. The product is available in the form of film-coated tablets, powder for suspension and cream. The tablets should be taken twice a day: one in the morning and one in the evening. Any form of the drug is not prescribed to people under 18 years of age.

To reduce the harmful effects of NSAIDs on the stomach, they are often prescribed in combination with omeprazole and other proton pump inhibitors.

Indomethacin is also known: it is sold not only in tablets, gels and ointments, but is also included in suppositories. This drug has a special area of ​​application: it can be used to reduce the tone of the uterus and prevent premature birth. As an adjuvant, the medicine is prescribed for infectious diseases of the ENT organs, as well as cystitis and prostatitis. Can be used from 14 years of age. Indomethacin tablets are enteric-coated, which allows the drug to pass through the stomach without affecting its mucous membrane.

Diclofenac and ibuprofen

Drugs based on diclofenac and ibuprofen are widely used, but they relatively often cause side effects and require careful attention. Diclofenac is known in the form of enteric-coated tablets, gels and suppositories, and is also included in eye drops. This type of painkiller can be prescribed intramuscularly: in this case, injections can be given for no more than 2 days, after which the patient is transferred to tablets or suppositories. Diclofenac is dosed individually; Since it is difficult to select a dose for children, it is not used until the age of 18. Diclofenac is contained in a drug called Voltaren emulgel: it is useful for pain in the joints and muscles, and has a cooling and soothing effect.

Ibuprofen acts in a similar way: it affects the synthesis of prostaglandins both in the periphery and in the central nervous system. For childhood infections and reactions to vaccinations, it is used as an antipyretic; It is important to understand that any NSAID is not an antibiotic and has no effect on bacteria. In general, suppositories are better suited for children: they can be used by babies whose body weight has reached 6 kg. Ibuprofen can be taken internally from the age of 6, externally - from the age of 14. The same active ingredient contains Nurofen, which is sold in the form of tablets and gels, and also has enhanced formulations: for example, against migraines.

Ketorolac and Ketoprofen

Ketorolac is a mixture of isomers, one of which provides the effect and is used in its pure form to create Dexalgin. This NSAID is superior in strength to most members of the group and is comparable to morphine; It relieves heat and inflammation moderately, better known as an analgesic. Ketorolac is taken orally for no more than 5 days; it is possible to prescribe the medicine in the form of injections: due to its strong effect, it can reduce pain even in cancer. Ketorol and Ketanov contain the same substance: the first of them is additionally available in the form of a gel, the second - only as tablets or solution.

Ketoprofen acts centrally and peripherally. In combination with other drugs, it is used for inflammation of the veins, lymph nodes and blood vessels. The substance is found under different trade names.

• Ketoprofen - inexpensive tablets, gels, suppositories, injections.
• Ketonal - gel, capsules, suppositories, solution for intramuscular and intravenous administration. Extended-release tablets are prescribed once a day.
• Fastum is a gel for external use.

Ketoprofen is sometimes prescribed during pregnancy: only the last trimester is considered an absolute contraindication. It is dosed individually. You can use such medications from the age of 15.

Other options

From the variety of NSAIDs for blocking any COX, several more drugs with other active ingredients can be distinguished. Each of them is capable of relieving pain, the action of each is realized in a similar way. These medications are available in tablets.

• Nizilat
  - tablets with amtolmetin guacin. The drug is distinguished by its protective effect on the lining of the stomach, which smoothes out the side effects of NSAIDs and allows patients to take the medicine for six months. Gastric protection becomes active if the tablets are taken on an empty stomach.

• Nalgesin
  is a drug based on naproxen; Available in dosages of 275 and 550 mg. Not indicated for children under 12 years of age; can be used with caution in pregnant women.

Xefocam falls into a separate group: tablets and lyophilisate with lornoxicam. Unlike other nonspecific COX inhibitors, the substance equally stops the functions of all types of enzyme, and also prevents the release of free oxygen radicals from leukocytes. It should be taken at a dose of 8-16 mg per day, and the analgesic should be taken before meals.

Meloxicam is a selective COX-2 inhibitor

It is possible to more fully replace Nise with drugs from the group of drugs that affect exclusively the second form of the enzyme, which is active only during inflammation. An example of this is Meloxicam; the substance does not negatively affect cartilage tissue and generally has fewer side effects. Take 1-2 tablets internally once a day, externally - also twice a day, rubbing into the skin over the affected area. There is also a solution for intramuscular administration on sale. Meloxicam is prohibited during pregnancy and under 15 years of age.

The analogue is the German drug Movalis. It costs much more and is produced in the form of tablets of the same dosage, ready-made suspension, suppositories and injections. Suppositories of this analgesic are available in two versions: 7.5 and 15 mg. The instructions indicate the possibility of prescribing the medicine from 12 years of age - earlier than is possible for a cheap analogue. Both Movalis and Meloxicam act in the same way, and the difference in their effect can only arise from the quality of the raw materials and the correct choice of dosage form.

Combination drugs with NSAIDs

Medicines with a complex composition can cope with pain faster, but this also carries some risks. Side effects will result from the work of all components; the complex composition can also affect tolerability. Such analgesics are not suitable for daily use: they are needed to quickly relieve acute pain and inflammation.

• Next
  - a combination of ibuprofen and paracetamol. Quickly relieves pain and fever. As an antipyretic tablet you can take for 3 days, against pain - for 5 days. Take the medicine after meals, up to 3 times a day.

• Pentalgin
  contains five active ingredients. Most of it contains paracetamol. The role of NSAID is performed by naproxen, and the antispasmodic drug is drotaverine. Pheniramine fights spasms, calms, relieves swelling, and caffeine dilates blood vessels in the brain. The maximum daily dose of Pentalgin is 4 tablets.

Next can be bought in gel form: Next activegel combines ibuprofen and menthol. Uno express capsules contain only ibuprofen at a dosage of 200 mg. Pentalgin has an extra-gel with ketoprofen available, as well as several tablet formulations, the simplest of which contains only ketoprofen.

Nise or Nimulid – which is better?

Manufacturer: Panacea Biotek, India
Release form: tablets and suspension for oral administration, lozenges, gel for external use

Active ingredient: Nimesulide

Synonyms: Nise, Nimesil, Nemulex, Nimika, Nimesan, Prolid

The Nimulid analogue contains the same active ingredient as Nise. Also produced in India. Its advantage is its convenient form in the form of lozenges. They can be taken quickly and get the effect without wasting time looking for water to wash down the pill.

Features of Dexalgin

The active substance of Dexalgin differs from the composition of Nise: it is a non-selective COX inhibitor called dexketoprofen, which is also the dextrorotatory isomer of ketoprofen. The drug is used for moderate pain: dental, menstrual, muscle and joint pain. Contraindications to its use are similar to those for drugs based on nimesulide, and the effect occurs faster: after 15-30 minutes. You can only be treated with Dexalgin for 3-5 days; drink from half to a whole tablet at a time at regular intervals.

In terms of effect and safety, Dexalgin is superior to many NSAIDs, even if it belongs to a group that is less promising in the opinion of the majority.

Dexalgin can cause all the side effects characteristic of NSAIDs, but this happens less frequently. The drug is more effective than ketoprofen and diclofenac, and in combination with narcotic painkillers it helps to reduce the dose of the latter by half. The advantage over nimesulide is the possibility of intravenous and intramuscular administration: the medicine is sold both in the form of tablets and granules for preparing a solution for oral administration, and in ampoules for injections. In recommended doses and in a short course, any prescribed version of Dexalgin or Nise is well tolerated, which is better not to forget when choosing. It is also important to understand that different NSAIDs should not be taken simultaneously with each other: this increases their adverse reactions and can be dangerous.

Nise or Nimesulide – which is better?

Manufacturer: Atoll, Ozon, Izvarino, AVVA-Rus, Russia
Release form: tablets and suspension for oral administration, lozenges, gel for external use

Active ingredient: Nimesulide

Synonyms: Nise, Nimulid, Nimesil, Nemulex, Nimika, Nimesan, Prolid

The analogue Nimesulide is the non-proprietary international name for Nise and other synonyms. Under the same name, many cheap analogues are produced that have the same therapeutic effect. Reviews from patients indicate that there is no difference between analogues.

Nise or Nimesil

Manufacturer: Berlin Chemie, Germany
Release form: granules for the preparation of suspension for oral administration

Active ingredient: Nimesulide

Synonyms: Nimesulid-Teva, Nise, Nimulid, Aktasulid, Naisulid, Prolid

The analogue Nimesil is a German drug in the form of granules, which, after diluting in water, quickly and effectively relieve any pain - dental, menstrual, traumatic, as well as accompanying various inflammatory diseases. For example, Nimesil will help better with osteochondrosis. The finished suspension has a pleasant taste and smell.

Nimesulide and Nise

Both drugs have a similar composition, features of administration, and due to the same active substance they can cause the same effects: both therapeutic and undesirable. Their dosage forms are similar: you can buy both tablets with the same dosage and gels. Nise differs from Nimesulide in its manufacturer and level of research. Nise is an imported and expensive drug, Nimesulide is its cheaper analogue, the production of which has been mastered by various domestic manufacturers.

For Nimesulide, the instructions may indicate fewer side effects, but both drugs are tolerated almost equally.

Nimesulide in the form of a suspension can be given to children at a dosage of 1.5 mg/kg 2-3 times a day; however, special care should be taken only for patients under 6 years of age. Nise in the usual dosage is contraindicated for children, but it is also available in the form of 50 mg dispersible tablets, which can be prescribed from 3 years of age. Granules for preparing a suspension are also available for sale: they are given to children over 2 years old. In this form, both drugs can act faster, which is especially good for toothache; Unfortunately, if the pain is very severe, medications may not work at all.

Nise or Dexalgin - which is better?

Manufacturer: Berlin Hemi, Germany / Menarin, Italy
Release form: tablets and solution for injection

Active ingredient: Dexketoprofen

Synonyms: Flamadex, Dexonal, Ketodexal

The Dexalgin analogue is used to relieve pain of various origins, as well as for chronic inflammatory diseases of the musculoskeletal system.

During exacerbations, intravenous or intramuscular injections of Dexalgin are usually prescribed.

Nise or Diclofenac

Manufacturer: Dalkhimfarm, Biokhimik, Biosynthesis, MPZ, Russia/Kadila Pharmaceuticals, India
Release form: tablets, injection solution, suppositories, cream and gel for external use.

Active ingredient: Diclofenac

Synonyms: Voltaren, Diclak, Ortofen, Diclovit, Diclogen, Diclonate, Dicloran, Naklofen

Diclofenac is a cheaper alternative to Nise. This is the international nonproprietary name for many domestic and imported substitutes.

The negative point is its negative effect on the gastric mucosa. When prescribing it, the doctor must prescribe a drug that reduces the secretion of gastric juice, for example, Ranitidine or Omez.

Nise or Ibuprofen – which is better?

Manufacturer: Medisorb, Biosintez, Tatkhimfarmpreparaty, Sintez, Russia
Release form: tablets, capsules, suppositories, cream and ointment for external use.

Active ingredient: Ibuprofen

Synonyms: Nurofen, Mig, Ibuprofen-Hemofarm, Ibuprofen Nycomed

The analogue Ibuprofen, as an active substance from the NSAID group, is widely used by various companies in the production of painkillers and anti-inflammatory drugs for the treatment of osteochondrosis, radiculitis, neuralgia, and arthrosis. This analogue of Nise tablets is also often used as an antipyretic for colds.

Ibuprofen ointment, a cheap analogue of Nise gel, also relieves pain well when applied to a damaged joint.

The advantage of Ibuprofen is that it can be used for children from 6 years of age.

Nise or Ketorol - which is better?

Manufacturer: Dr. Reddis, India
Release form: tablets, injection solution, gel for external use

Active ingredient: Ketorolac

Synonyms: Ketanov, Ketalgin, Ketolak, Ketocam

The Ketorol analogue is used for severe and moderate pain of various origins, including in patients with cancer. In terms of the strength of the analgesic effect, Ketorol is comparable to the narcotic drug Morphine.

The medicine is stronger than Nise, but has pronounced side effects: with prolonged use it can cause stomach ulcers and internal bleeding, so it should not be used for more than 5 days.

Contraindications and side effects of nimesulide

Many doctors consider selective COX-2 inhibitors safer, since they are less likely to inhibit cyclooxygenase functions in the digestive system and kidneys. Taking non-selective drugs often causes ulcers in the stomach and intestines and an increase in blood pressure. On the other hand, selective drugs have been studied less and are sometimes withdrawn due to serious side effects.

Nimesulide should not be taken if you are intolerant, especially with aspirin-induced bronchial asthma. Pregnant and lactating women, children under 12 years of age, and persons suffering from drug addiction and alcoholism should not drink it.

Additional obstacles include liver and kidney diseases, heart failure, peptic ulcers, inflammation in the intestines, blood clotting disorders, and hyperkalemia.

During treatment with nimesulide, you should avoid driving due to the effect of the drug on the nervous system.

Drugs have many side effects, even if their likelihood is relatively low. The drugs cause nausea, digestive disorders, and very rarely, ulcers and bleeding from the digestive tract. Substances affect the liver, including hepatitis; edema, urinary retention, renal failure, anemia, eosinophilia, and shortness of breath are also possible. Possible drowsiness, blurred vision, nervousness, tachycardia, hypertension. Nimesulide can affect all organ systems in one way or another, so other reactions are possible.

Nise or Nurofen

Manufacturer: Reckitt Benckiser Healthcare, UK
Release form: tablets, capsules, suppositories, cream and ointment for external use.

Active ingredient: Ibuprofen

Synonyms: Nurofen, Mig, Ibuprofen-Hemofarm, Ibuprofen Nycomed

Nurofen is a well-known brand under which various forms and combinations of analgesics are produced. It is used as an antipyretic and analgesic for colds and other inflammatory diseases, including diseases of the musculoskeletal system and toothache.

This Nise substitute is approved for use in children over 6 years of age and during pregnancy, except the last trimester. In terms of antipyretic effect, Nurofen is stronger and safer than Nise.

Nise or Xefokam

Manufacturer: Takeda, Austria and Germany
Release form: tablets, lyophilisate for the preparation of injection solution

Active ingredient: Lornoxicam

Synonyms: Xefocam Rapid, Zornica, Lornoxicam Canon

The Xefocam analogue, unlike Nise, does not selectively inhibit the enzyme cyclooxygenase. It is used for acute pain syndrome, but more often causes side effects, so it is prescribed for a short time to relieve acute pain.

Nise or Next – which is better?

Manufacturer: OTCPharm, Russia
Release form: tablets

Active ingredient: Ibuprofen + Paracetamol

Synonyms: Ibuklin, Brustan, Nurofen Long

Analog Next is a combination drug of two non-narcotic analgesics that act by different mechanisms. The components complement each other and together have a strong anti-inflammatory, analgesic and antipyretic effect.

The medicine is available without a prescription, unlike Nise, but without a doctor it can be used for no more than 5 days.

It is recommended to avoid alcohol when using Next and other drugs containing Paracetamol due to its strong hepatotoxic effect.

Nise and his substitutes

Nimesulide can be considered a cheap and easy way to find a replacement for Nise: the drugs have the same composition, act in a similar way and differ only in the manufacturing features. If you want to use more expensive analogues, you can stop at Nimesil and Nimulid. Dexalgin is also considered a good analgesic: its effect is similar to the work of nimesulide, but this drug is not selective for cyclooxygenases and, in theory, has more side effects. Tests, however, allow us to expect faster action and greater safety from Dexalgin; its analgesic effect is stronger.

If necessary, you can replace Nise with any other NSAID, regardless of its selectivity. Both the well-known Ibuprofen and Diclofenac, as well as more rare drugs in the home medicine cabinet, can come to the rescue. Combination products can provide the fastest effect, but they cannot be taken for a long time. Most NSAIDs are not suitable for children, and ibuprofen forms are most often prescribed to help young patients.

Nise or Ketoprofen – which is better?

Manufacturer: Vertex, Ellara, Promomed, Sintez, Russia
Release form: tablets, injection solution, suppositories and gel for external use

Active ingredient: Ketoprofen

Synonyms: Ketonal, Flamax, Flexen

Analogue Ketoprofen is a non-steroidal anti-inflammatory drug used for inflammatory diseases of the musculoskeletal and musculoskeletal systems and for various pains.

Ketoprofen is often used externally, and many substitutes for Nise gel contain it, for example, Fastum-gel, Artrum, Spazgel and others.

Application of Nimesulide

Nise and Nimesulide work due to the same substance: nimesulide. The drugs have three beneficial effects at once: they relieve pain, reduce inflammation and become antipyretic. The products are absorbed and distributed throughout the body well; they also penetrate into the cavities of the joints and work in the acidic environment of foci of inflammation.

Food slows down the absorption of nimesulide from tablets, but does not affect its completeness.

The tablets of both drugs contain the same dosage of the active substance, so they are taken according to the same regimen: 1 piece twice a day. The daily dose is only 200 mg or 2 tablets; if the patient has unhealthy kidneys, the maximum dosage for him is halved. To reduce the effect on the gastrointestinal tract, it is recommended to take the medicine after meals. Nimesulide helps with:

• toothache, headache, injuries, menstruation, joint pain;

• rheumatoid and psoriatic arthritis, ankylosing spondylitis;
• osteochondrosis and osteoarthrosis;
• myalgia, inflammation of ligaments and tendons.

In all cases, it is important to use the minimum dosage and complete treatment quickly. For diseases of the musculoskeletal system, nimesulide can be used externally. To do this, apply a 3 cm long column of gel to clean and dry skin without rubbing. They relieve pain in this way for no more than 10 days, and you can use the product up to 4 times a day.

Nise or Nalgesin

Manufacturer: KRKA, Slovenia
Release form: tablets

Active ingredient: Naproxen

Synonyms: Motrin, Apranax, Naprobene

The analogue Nalgesin is used to relieve menstrual and other gynecological pain, with exacerbation of gout and migraine attacks. To reduce temperature during ARVI and other colds. Nalgesin is also used to treat chronic rheumatoid diseases.

The drug is over-the-counter and can be used by children over 9 years of age.

Nise or Meloxicam – which is better?

Manufacturer: Vertex, Ozone, Kanonpharma, Russia
Release form: tablets, injection solution

Active ingredient: Meloxicam

Synonyms: Artrosan, Amelotex, Movasin, Mirlox, Movalis, Melbek

The Meloxicam analogue, like Nise, is a selective COX inhibitor, that is, it selectively reduces the activity of the enzyme that regulates the synthesis of prostaglandins at the site of inflammation.

Meloxicam, like Nise, has fewer side effects and is often prescribed for the treatment of chronic rheumatoid inflammatory diseases.

Mechanism of action of NSAIDs

The action of Nise, Nimesulide, and Dexalgin is based on the same mechanism: a decrease in the activity of an enzyme called cyclooxygenase (COX). There are at least two varieties of it in the body: COX-1 and COX-2; sometimes COX-3 is included in the classification, although some scientists classify this enzyme as the first type. Cyclooxygenase is involved in the development of inflammation, stimulating the production of substances intended for this: prostaglandins. Once the enzyme activity is blocked, inflammation and pain are reduced.

The main part of NSAIDs acts on all types of COX, stopping the performance of its functions with maximum completeness. Such drugs include Dexalgin. Further study of the structure of the target enzyme made it possible to synthesize substances that would affect only COX-2 and have a minimal effect on processes not associated with inflammation. This is exactly how Nise and Nimesulide work. The selectivity classification looks like this:

• non-selective inhibitors, mainly acting on COX-1: dexalgin, aceclofenac, diclofenac, ibuprofen, indomethacin, ketoprofen;
• non-selective, equally affecting both types: Lornoxicam;

• selective for COX-2: nimesulide, meloxicam.

Cyclooxygenases are found in all tissues and have many beneficial functions. It is the blocking of enzymes that leads to the side effects of NSAIDs. The types of adverse events vary depending on the selectivity of the drug.