"Aertal": instructions for use. Cheap analogue of "Aertal". Anti-inflammatory drugs for joints (NSAIDs): review of Aertal or Nimesil, which is better

Osteoarthritis, rheumatoid arthritis and other diseases of the joints and spine that occur with pain and inflammation.

Peculiarities: all the drugs in this group act on a similar principle and cause three main effects: analgesic, anti-inflammatory and antipyretic.

These effects are expressed to varying degrees in different drugs, so some drugs are better suited for long-term treatment of joint diseases, while others are mainly used as painkillers and antipyretics.

Most common side effects: allergic reactions, nausea, abdominal pain, erosions and ulcers of the gastrointestinal mucosa.

Main contraindications: individual intolerance, exacerbation of gastric and duodenal ulcers.

Important information for the patient:

Drugs that have a pronounced analgesic effect and a significant number of side effects (diclofenac, ketorolac, nimesulide and others) can only be used as prescribed by a doctor.

Among nonsteroidal anti-inflammatory drugs, there is a group of so-called “selective” drugs that are less likely to have side effects from the gastrointestinal tract.

Even over-the-counter pain relief medications cannot be used long-term. If they are required frequently, several times a week, it is necessary to be examined by a doctor and treated according to the recommendations of a rheumatologist or neurologist.

In some cases, long-term use of drugs from this group requires additional use of proton pump inhibitors that protect the stomach.

Remember, self-medication is life-threatening; consult a doctor for advice on the use of any medications.

UDC 616.72-002

E. A. Zamyatina, G. G. Bagirova

APPLICATION OF MELOXICAM (MOVALIS)

AND ACECLOFENAC (AERTALA) IN ELDERLY PEOPLE WITH OSTEOARTHROSIS

Annotation. The paper presents data from a clinical study of elderly people with osteoarthritis (mean age 64.4 ± 7.8) who took meloxicam (Movalis) or aceclofenac (Aertal). Meloxicam (Movalis) was prescribed at a dose of 7.5 mg twice daily for 10 days, and aceclofenac (Aertal) at a dose of 100 mg twice daily for the same period of time. The patients underwent standard arthrological and paraclinical examinations. X-ray and ultrasound examination of the affected joints was performed. The condition of all patients was assessed using the VAS and WOMAC scales, and the arthrosis severity index was determined. After treatment, all patients noted a decrease in pain and swelling in the affected joints. All studied indicators in both groups significantly decreased almost equally. A comparison of these two drugs showed similar effectiveness in reducing pain and inflammation in the joint, they were well tolerated by patients and the presence of isolated cases of adverse effects.

Key words: osteoarthritis, treatment, meloxicam, aceclofenac.

Abstract. The research includes data of the clinical examination of elderly people with osteoarthritis (fp average 64.4 ± 7.8) taking Meloxicam (movalis) and Aceclofenac (Airtal). Meloxicam (movalis) has been prescribed 7.5 mg 2 times a day for

10 days, Aceclofenac (Airtal) - 100 mg 2 times a day for the same period of time. Patients underwent standard arthrological and paraclinical examinations. Roentgenological and ultrasonic examinations of the affected joints were also carried out. The state of the patients has been evaluated according to VAS and WOMAC scales, defining the index of arthrosis. After the given treatment the patients have noticed the reduction of pain and edema of the affected joints. All the indicators under study have reduced equally in both groups. The comparison of these two medicines shows effectiveness in treatment of pain and edema of the affected joints, good tolerance and single cases of unfavorable effects.

Key words: osteoarthritis, treatment, Meloxicam, Aceclofenac.

Diseases of the musculoskeletal system are among the most common among elderly and senile people. Among them, the most common is osteoarthritis (OA). The disease occurs in 60-70% of patients over 65 years of age, and more often in women. Weight-bearing joints such as the knees and hips are mainly affected. The resulting pain brings physical suffering, limits the ability to move and self-care, impairs the quality of life, often leading to disability in elderly patients. Treatment of these diseases is associated with significant economic costs. Therefore, pain relief as quickly as possible is the main goal of treatment. In this case, it is necessary to select an individual treatment regimen for each patient, taking into account the severity of the disease, the prevalence of joint damage, concomitant diseases and age.

Most often, drugs from the group of nonsteroidal anti-inflammatory drugs (NSAIDs) are used in the treatment of pain. Their use as part of complex therapy for OA makes it possible to achieve rapid symptomatic improvement and provide the patient with a comfortable wait for the onset of action of “chondroprotectors” and non-drug treatment methods. However, the use of drugs from this group may be accompanied by a number of adverse drug reactions. Therefore, when choosing them, the following are taken into account: the speed of development and severity of the effect, good tolerability with long-term use. In elderly people, the choice of drug is complicated by the presence of concomitant diseases and the need for their therapy. It is also often overlooked that NSAIDs, having little effect on blood pressure (BP) in patients with initially normal values, significantly increase mean blood pressure in patients with arterial hypertension. This requires the use of drugs with the least spectrum of side effects, such as NSAIDs with higher selectivity.

Material and methods

The study included 60 women aged 60 to 79 years, divided into two groups: Group I - 30 women, average age 63.4 ± 6.8 years, who took movalis for 10 days; Group II - 30 women, average age 65.4 ± 7.7 years, who took Airtal for 10 days. All patients had a history of arterial hypertension.

The patients came to the clinic for pain in the knee and hip joints. Patients complained of pain when moving, especially when going down stairs, and swelling of the joints. The patients underwent standard arthrological and paraclinical examinations. All underwent X-ray examination. The X-ray stage was assessed according to the classification of L. Kellgren and L. Lowrens. To clarify the nature of the process, the subjects underwent an ultrasound examination of the affected joints.

Meloxicam (Movalis) was prescribed at a dose of 7.5 mg twice daily for 10 days. Aceclofenac (Aertal) - at a dose of 100 mg twice a day, also for 10 days. The condition of patients before and after treatment was assessed using the VAS and WOMAC scales, and the arthrosis severity index was determined.

Statistical data processing was carried out on a computer using the Statistica 6.0 program (StatSoft, USA). Quantitative data are presented as follows: means plus or minus standard deviation (SD).

Research results

An examination of the joints revealed an increase in their volume in all patients, local pain along the inner surface of the knee joint in 80% of patients, and in 100% of cases, limitation of active and passive movements in the affected joint. According to the X-ray examination, X-ray stage I was observed in 14 (23.4%) patients, II - in 25 (41.6%), III - in 21 (35%). Ultrasound examination revealed the presence of synovitis in 83% of cases, mainly in the suprapatelar bursa and inversions of the knee joint, and in 78% - in the m. Ileopsoas in the hip-

renny joints. In 100% of patients, tendinitis was detected, predominantly of the gracilis muscle and the medial head of the gastrocnemius muscle, of which tenosynovitis of these muscles was detected in 15% of cases. In 8% of cases, ligamentitis of the patellar ligament and lateral ligaments was detected. Baker's cysts were detected in 20%.

Before the start of treatment, the condition of all patients was assessed using the VAS and WOMAC scales, and the arthrosis severity index was determined (Tables 1, 2).

Table 1

Dynamics of clinical parameters in elderly patients with OA treated with movalis (n = 30; M ± SD)

Pain according to VAS, mm 7.5 ± 1 4.5 ± 1.2< 0,0001

Total WOMAC index, cm 151.8 ± 44.2 126.5 ± 39.5< 0,0001

Arthrosis severity index, points 15.1 ± 3.8 10.9 ± 3.3< 0,0001

table 2

Dynamics of clinical parameters in elderly patients with OA treated with Airtal (n = 30; M ± SD)

Indicator Before treatment After treatment P

Pain according to VAS, mm 7.4 ± 1.2 5 ± 1.2< 0,0001

Total WOMAC index, cm 149 ± 39.6 125.9 ± 38.3< 0,0001

Arthrosis severity index, points 15 ± 3.6 11.3 ± 3.4< 0,0001

It follows from the tables that before treatment, the indicators in both groups did not differ significantly. After treatment, all patients noted a decrease in pain and swelling in the affected joints. All indicators in both groups decreased significantly and also had similar values. No adverse reactions that could lead to drug withdrawal were recorded. According to the patients, the drugs were well tolerated. Only two patients from group I and one patient from

Group II showed a slight increase in blood pressure during antihypertensive therapy.

Comparison of these indicators after treatment between the group taking meloxicam (Movalis) and the group taking aceclofenac (Aertal) did not show significant differences (Table 3).

Table 3

Comparative characteristics of clinical parameters between movalis and airtal after treatment in elderly patients with OA (n = 30; M ± SD)

Indicator Movalis Airtal P

Pain according to VAS, mm 4.5 ± 1.2 5 ± 1.2 > 0.05

Total WOMAC index, cm 126.5 ± 39.5 125.9 ± 38.3 > 0.05

Arthrosis severity index, points 10.9 ± 3.3 11.3 ± 3.4 > 0.05

Discussion

It is now known that the administration of NSAIDs is indicated for all patients with rheumatic diseases. However, the purpose of these pre-

parats is associated with a risk of developing undesirable effects, especially in elderly people due to the presence of concomitant pathology. In this case, it is necessary to consider the possibility of drug interactions. Therefore, when choosing a drug, it is necessary to minimize these risks, but at the same time reduce pain and stop inflammation in the joint. In this work, we compared two drugs with different mechanisms of action on inflammation.

Meloxicam is an NSAID belonging to the oxicam class, which has analgesic, anti-inflammatory and antipyretic effects. It is a selective COX-2 inhibitor. It binds to the top of the COX-2 channel and has a balanced COX-2 selectivity profile. As a result, the synthesis of prostaglandins is reduced in the inflammation site to a much greater extent than in the gastric mucosa and kidneys. In addition to influencing the synthesis of prostaglandins, meloxicam inhibits lipid peroxidation, reduces the formation of free oxygen radicals, platelet activating factor, tumor necrosis factor-a, proteinases and other inflammatory mediators. Meloxicam does not interact with other drugs, including cytostatics, diuretics, cardiac glycosides, adrenergic blockers, which is of great importance in the management of patients with concomitant diseases. Numerous studies on the chondroprotective effect of meloxicam have shown that it increases the synthesis of proteoglycans in the explant of osteoarthritis cartilage, and also inhibits chondrocyte apoptosis. Additionally, meloxicam does not express anti-inflammatory cytokines. This allows us to consider it as an NSAID with a chondroprotective effect. However, the cost of the drug is quite high (as of 2011 - about 500 rubles for 20 tablets).

Thus, meloxicam’s good anti-inflammatory, analgesic and chondroprotective effects, as well as good tolerability, allow it to be widely used in patients with OA.

Aceclofenac (Aertal) is a non-selective NSAID. It inhibits both COX isoforms. Coefficient COX-2/COX-1, i.e. the average inhibitory concentration for aceclofenac is 0.26 µM, while for celecoxib this coefficient is 0.70 µM, i.e. it may be considered more selective for COX-2. The selectivity of aceclofenac was confirmed by the work of B. Hinz and co-authors, who determined the severity of blockade of COX-2 and COX-1 in human neutrophils under the influence of aceclofenac 100 mg and diclofenac 75 mg. It turned out that after taking both drugs, the activity of COX-2 was suppressed by more than 97%, while COX-1 was suppressed by 46 and 82%, respectively. In addition to blocking COX-2, aceclofenac affects the synthesis of cytokines such as interleukin-1 (IL-1) and tumor necrosis factor a (TNF a). In addition, it suppresses the process of IL-1-associated activation of metalloproteinases, which is one of the reasons for the positive effect of aceclofenac on the synthesis of proteoglycans in articular cartilage. Aceclofenac promotes the expression of proteoglycans and hyaluronic acid in both preclinical and late stages of OA. It stimulates the synthesis of glycosaminoglycans in cartilage in OA patients with diclofenac and naproxen, who do not have such properties. This property is one of the main advantages of aceclofenac and determines the purpose

the appropriateness of its use in patients with OA. L. Blot et al studied the effect of aceclofenac, meloxicam and diclofenac (control) on the metabolism of newly synthesized proteoglycan and hyaluronate molecules in explants of human cartilage affected by OA. The results of the study showed that aceclofenac and meloxicam in a concentration corresponding to their content in the synovial fluid can have a positive effect on the overall metabolism of proteoglycans and hyaluronate in cartilage tissue in OA, while diclofenac did not have a similar effect on the metabolism of cartilage. This suggests that aceclofenac and meloxicam should not worsen the biomechanical characteristics of the joint and may be able to slow down the destruction of joints in osteoarthritis. Another advantage of the drug is its moderate cost, which is important for elderly patients (as of 2011 - about 300 rubles for 20 tablets).

In our study, a comparison of these two drugs showed similar effectiveness in reducing pain and inflammation in the joint, they were well tolerated by patients and had a minimal number of adverse effects.

Thus, the use of meloxicam (Movalis) and aceclofenac (Aertal) in elderly patients with OA leads to a significant, persistent reduction in pain and inflammation in the joint with good tolerability of the drug, and therefore the choice of drug will often be determined by its cost.

Bibliography

1. Nasonov, E. L. Modern trends in pharmacotherapy of osteoarthritis / E. L. Nasonov // Consilium medicus. - 2001. - No. 3. - R. 408-415.

2. Badokin, V.V. Non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis / V.V. Badokin // Modern rheumatology. - 2009. - No. 1. - P. 73.

3. Tsvetkova, E. S. Movalis in the treatment of osteoarthritis / E. S. Tsvetkova // Scientific and practical rheumatology. - 2005. - No. 2. - P. 29.

4. Alekseeva, L. I. Risk factors for osteoarthritis / L. I. Alekseeva // Scientific and practical rheumatology. - 2000. - No. 2. - P. 36.

5. Benevolevskaya, L. I. Factors contributing to the development of osteoarthritis / L. I. Benevolevskaya, N. V. Podchalimova, M. M. Brzhezovsky, etc. // Therapeutic archive. - 1987. - No. 4. - P. 35.

6. Nasonov, E. L. Pain syndrome in pathology of the musculoskeletal system / E. L. Nasonov // Doctor. - 2002. - No. 4. - P. 15.

7. Nasonova, V. A. Meloxicam (movalis) - a selective COX-2 inhibitor

in clinical practice / V. A. Nasonova // Scientific and practical rheumatology. -2000. - No. 4. - P. 16.

8. Eliseev, M. S. Use of meloxicam (amelotex) in patients with gonarthrosis / M. S. Eliseev, S. A. Vladimirov // Modern rheumatology. - 2011. - No. 2. -S. 31.

9. Mazurov, V. I. Use of meloxicam (movalis) in patients with rheumatic diseases with concomitant coronary heart disease / V. I. Mazurov // Clinical Medicine. - 2004. - No. 12. - P. 54.

10. Alekseeva, L. I. Modern approaches to the treatment of osteoarthritis / L. I. Alekseeva // Russian Medical Journal. - 2003. - No. 11 (4). - P. 5.

11. Karateev, A. E. Use of non-steroidal anti-inflammatory drugs / A. E. Karateev, N. N. Yakhno, L. B. Lazebnik, etc. // Clinical recommendations. - M.: IMA-PRESS, 2009. - P. 168.

12. Karateev, A. E. Nonsteroidal anti-inflammatory drugs in modern clinical practice: the pros are more than the cons / A. E. Karateev // Modern Rheumatology. - 2008. - No. 1. - P. 70.

13. Vertkin, A. L. Deforming osteoarthritis: strategy for managing patients with somatic pathology / A. L. Vertkin, A. V. Naumov // Russian Medical Journal. - 2007. - T. 15, No. 4. - P. 319-324.

14. Vertkin, A. L. Osteoarthrosis in the practice of a general practitioner / A. L. Vertkin, L. I. Alekseeva, A. V. Naumov, etc. // Russian Medical Journal. - 2008. -T. 16, No. 7. - pp. 478-480.

15. Nasonov, E. L. The use of non-steroidal anti-inflammatory drugs in medicine at the beginning of the 21st century / E. L. Nasonov // Russian Medical Journal. - 2003. - No. 11. - R. 375-378.

16. Emery, P. Considerations for nonsteroidal anti-inflammatory drug therapy: benefits / P. Emery // Scand J. Rheumatol. - 1996. - No. 25 (Suppl. 105). - R. 5-12.

17. Rainsford, K. Anti-inflammatory drugs in the 21st century / K. Rainsford // Subcell Biochem. - 2007. - No. 42. - R. 3-27.

18. Egorov, I. V. Features of the treatment of articular syndrome in elderly people with arterial hypertension / I. V. Egorov, V. V. Tsurko // Modern rheumatology. - 2008. - No. 4. - P. 52.

19. Zyryanov, S. K. Safety of pharmacotherapy for pain: current state of the problem / S. K. Zyryanov, O. N. Nelga, Yu. B. Belousov // Difficult patient. -2007. - No. 3. - P. 54.

20. Karateev, A. E. Criteria for choosing a non-steroidal anti-inflammatory drug / A. E. Karateev, V. G. Barskova // Handbook of a polyclinic doctor. -2007. - No. 5. - P. 44.

21. Chichasova, N.V. Meloxicam in the treatment of chronic diseases of the musculoskeletal system / N.V. Chichasova // Attending physician. - 2011. - No. 4. - P. 26.

22. Khitrov, N. A. Treatment of pain syndrome in osteoarthritis / N. A. Khitrov // Modern rheumatology. - 2009. - No. 2. - P. 48.

23. Yocum, D. Safety and efficacy of meloxicam in the treatment of osteoarthritis: a 12-week, double-blind, multiple doses, placebo controlled trial. The Meloxicam Osteoarthritis Investigators / D. Yocum, R. Fleischmann, P. Dalgin et al. //Arch. Int. Med. -2000. - V. 160. - P. 2947-2954.

24. Badokin, V.V. Use of meloxicam for rheumatic diseases / V.V. Badokin // Pharmateka. - 2005. - No. 13. - P. 1-8.

25. Ding, C. Do NSAIDs affect the progression of osteoarthritis? / C. Ding // Inflammation. - 2002. - No. 26. - R. 139-142.

26. Saraf, S. Aceclofenac: A potent Non-Steroidal Anti-Inflammatory Drug / S. Saraf // Latest Reviews. - 2006. - No. 4 (3).

27. Tsurko, V.V. Aceclofenac (Aertal): experimental data and results of clinical studies in articular syndrome / V.V. Tsurko // Clinical pharmacology and therapy. - 2009. - No. 1. - P. 62-65.

28. Lidburg, P. COX-2/COX-1 selectivity of aceclofenac in comparison with celecox-ib and rofecoxib in the human whole blood assay / P. Lidburg, I. Vojnovic, T. Warner // Osteoarthritis and cartilage. - 2000. - No. 8 (Suppl. B), TH0 53.

29. Hinz, B. Aceclofenac reserves cyclooxygenase 1 as a resalt of limited but sustained biotransformation to diclofenac / B. Hinz, T. Rau, D. Augel et al. // Clinical Pharmacology & Therapeutics. - 2003. - No. 74. - R. 222-235.

30. Nasonova, V. A. Aceclofenac (Aertal) in rheumatological practice / V. A. Nasonova // Therapeutic archive. - 2005. - T. 77, No. 5. - R. 87-90.

31. Nasonova, V. A. Symptomatic treatment of pain in rheumatic diseases: the place of aceclofenac / V. A. Nasonova, A. E. Karateev // Modern rheumatology. - 2009. - No. 3. - P. 58.

32. Blot, L. Effects of diclofenac, aceclofenac and meloxicam on the metabolism of proteoglycans and hyaluronan in osteoarthritic human articular cartilage / L. Blot, A. Marcelis, J.-P. Devogelaer, D.-H. Manicourt // Br. J. Pharmacol. - 2000. - No. 131. -R. 1413-1421.

Zamyatina Ekaterina Aleksandrovna graduate student, Orenburg State Medical Academy

E-mail: zamyatina.katerina@yandex. ru

Bagirova Henrietta Georgievna Doctor of Medical Sciences, Professor, Head of the Department of Polyclinic Therapy, Orenburg State Medical Academy

Email: [email protected]

Zamyatina Ekaterina Alexandrovna Postgraduate student, Orenburg State Medical Academy

Bagirova Genrietta Georgievna Doctor of medical sciences, professor, head of sub-department of polyclinic therapy, Orenburg State Medical Academy

UDC 616.72-002 Zamyatina, E. A.

The use of meloxicam (Movalis) and aceclofenac (Aertal) in elderly people with osteoarthritis / E. A. Zamyatina, G. G. Bagirova // News of higher educational institutions. Volga region. Medical Sciences. - 2012. - No. 1 (21). - P. 40-46.

ADVICE To make objects on the screen larger, press Ctrl + Plus at the same time, and to make objects smaller, press Ctrl + Minus

Nonsteroidal anti-inflammatory drugs are a whole group of drugs that have a similar mechanism of action. Such medications can have analgesic, antipyretic and anti-inflammatory effects. Their use allows you to cope with pain, fever and inflammatory processes. Such drugs may be based on various active components with slightly different properties. And today we are considering what to prefer, which is better: Aceclofenac or Airtal or Nise?

Aertal is better or Aceclofenac?

Such medications can be purchased at a pharmacy without a prescription, and quite often pharmacists call them similar and completely interchangeable, but is this true?

In fact, Aceclofenac and Airtal are characterized by a similar composition; they are based on the same active component - aceclofenac. But this does not give grounds to call them 100% analogues. If only because they come in completely different forms. Thus, Airtal can be purchased in the form of tablets, powder for preparing a suspension for internal consumption, and also in the form of a cream.
Aceclofenac is available only in the form of tablets, each of which is a source of 100 mg of the active substance.

In principle, both of these drugs can be used to correct various conditions that are characterized by inflammation, pain and fever. But most often they are used in the treatment of inflammatory and degenerative diseases of the joints, as well as the spine, in the treatment of soft tissue diseases and in many pathologies that are accompanied by pain in the lower back. Indications for the use of Aceclofenac in tablets and Aertal in the form of tablets and suspensions are, in principle, the same. But, as we have already found out, Airtal is also available in the form of a cream, which is indicated for patients with a number of ailments and injuries of the musculoskeletal system to eliminate pain, as well as inflammatory processes.

If we compare Aceclofenac and Aertal tablets, their difference lies only in the manufacturer and price. Thus, Aceclofenac is produced by domestic pharmaceutical companies. The cost of ten tablets is approximately fifty-five rubles. But Aertal is produced in Spain, and it costs an order of magnitude more – about three hundred to four hundred rubles.

Thus, if you choose between Aceclofenac and Airtal tablets, then there is no fundamental difference between them. They contain the same amount of active substance and act on the body in exactly the same way. True, some doctors advise, if there is an appropriate financial opportunity, to give preference to Aertal, citing the fact that medicines are produced abroad under more careful control and are subject to more checks than here.

Of course, if there is a need to use a suspension or cream, then there is nothing to choose from. Aceclofenac simply does not have such dosage forms.

Nise is better or Aertal?

Nise, like Airtal, is a representative of non-steroidal anti-inflammatory drugs. But this medicine contains a completely different active component, represented by nimesulide.

This substance has, in principle, the same effect on the body as aceclofenac (the main component of Aertal) - it eliminates pain, reduces temperature, and relieves inflammation.

Nise, like Airtal, is most often used to treat pathologies of the musculoskeletal system. But in some cases, both drugs can be used if necessary to eliminate pain of various origins (after operations and injuries, toothache and headache, algomenorrhea, etc.).

Airtal, as we have already found out, can be purchased in the form of tablets, powder for preparing a suspension and cream.

Nise is sold in the form of tablets, granules for making a suspension and gel.

As for the optimal dosage, to achieve the desired positive effect, Nise needs to be taken one hundred milligrams at a time, twice a day. In some situations, the daily dosage may increase to four hundred milligrams. The classic dosage of Aertal is the same - one hundred milligrams at a time, twice a day.

Contraindications to the use of such drugs are also approximately similar. None of them can be used during pregnancy and childbearing, as well as in children under eighteen years of age. Both medications are contraindicated for bleeding, ulcers and erosions in the gastrointestinal tract, serious problems in the functioning of the kidneys, liver and heart.

The average cost of twenty Aertal tablets is three hundred to four hundred rubles, and twenty Nise tablets is one hundred and ninety rubles. Aertal is produced in Spain, and Nise is produced in India.

Thus, both medications cope quite effectively with negative symptoms, eliminate pain and inflammation, and also reduce temperature. At the same time, doctors say that Airtal is considered safer, its use is much less likely to provoke gastropathy. Nise (nimesulide) is much more likely to cause the development of disorders in the digestive tract. In addition, it is considered more hepatotoxic (more harmful to the liver).

Thus, when choosing between Nise and Aertal, it is better to give preference to the more expensive latter medicine. But if the product is intended for one-time use, then there is no point in paying more. And Nise copes wonderfully with the assigned tasks.

In the fight against pain, many drugs of various pharmacological groups are used. Each of them is unique, but the most widely used group is non-steroidal anti-inflammatory drugs, which have a number of significant advantages over steroids and narcotic analgesics in cases of typical pain syndrome.

Among NSAIDs you can find many representatives. This group includes “Aertal” and “Nimesil”, which have many similarities and differences that you should be aware of when making a choice.

The active ingredient of the drug is aceclofenac, belonging to the group of non-steroidal anti-inflammatory drugs. The drug is available in three main forms. The most common form of cream is for external use, which in some cases allows to accelerate the effect of the medicine. For oral administration, the drug is available in two forms: tablets with different concentrations of the active substance, as well as powder for preparing a suspension. This makes it easier to take the drug for different age groups.

The effectiveness of the drug is ensured due to non-selective inhibition of enzymes COX-1 And TsOG-2, leading to inhibition of the synthesis of inflammatory mediators. This mechanism of action provides an analgesic and anti-inflammatory effect on the periphery of the body. Due to its high permeability, the drug is used topically, eliminating pain and inflammation in the area of ​​application.

The drug is actively absorbed into the systemic circulation and is almost completely metabolized in the liver, which almost completely eliminates its effect on the gastrointestinal tract.

Airtal metabolites are excreted by the intestines and kidneys, so chronic renal failure is a serious contraindication for the use of the drug.

"Aertal" cannot be used in cases where there is a history of allergic reactions to the drug, as well as products containing diclofenac. In case of documented exacerbation of bronchial asthma while taking NSAIDs, Airtal is also contraindicated.

Aertal has strict age restrictions. It is prohibited for the treatment of persons under 18 years of age. In addition, the drug should not be used by pregnant and nursing mothers. Its effect on the fetus has not been reliably studied, but even the high risk to the life of the mother does not allow the use of Airtal.

The active substance of the drug "Nimesil" is nimesulide. It also belongs to the group of non-steroidal anti-inflammatory drugs. "Nimesil" has a single release form - powder for preparing a suspension. In the classic version, the drug has a yellow color and an orange smell. Its taste is more often described as tasteless.

Nimesil has more selective mechanism of action, blocking only COX-2. This reduces the negative impact on the gastric mucosa when taken orally. The drug has anti-inflammatory, analgesic and antipyretic effects. This significantly expands the scope of the drug, allowing it to be used to eliminate fever that is not accompanied by pain.

The most common side effects are dyspeptic disorders: diarrhea, nausea and vomiting. This can make it much more difficult to use the drug regularly. Due to its potential hepatotoxicity, the drug cannot be used in combination with other drugs in this group, as well as paracetamol.

Persons with a history of gastrointestinal diseases, such as:

• Crohn's disease.
• Nonspecific ulcerative colitis.
• Peptic ulcer of the stomach and duodenum.
• Perforation of the ulcer.
• Bleeding from the gastrointestinal tract.

In addition, cardiovascular diseases should be taken into account. The period after coronary artery bypass surgery, cerebrovascular and other hemorrhages, as well as heart failure requires special attention. Liver and kidney failure are also contraindications to the use of the drug.

"Nimesil" should not be used in the treatment of children under 12 years of age, as well as pregnant and nursing mothers.

What are the similarities and differences?

Both drugs belong to the same pharmacological group and have the same mechanisms of action. Airtal has a greater variety of release forms and can be used both internally and topically. This provides a great advantage in the treatment of inflammatory joint diseases, since the effect occurs much faster when applied externally.

The use of Aertal in children's practice is not allowed, but Nimesil is approved for use from 12 years of age. None of the drugs are suitable for the treatment of pregnant and nursing mothers.

In terms of the number of side effects, Nimesil is significantly inferior, since it is hepatotoxic and has a negative effect on the cardiovascular system. Nimesil also has a much larger list of contraindications.

What to choose

"Nimesil", like "Aertal", is used for various diseases of the muscular-articular system. First of all, these are dislocations, sprains, bruises and damage to the ligamentous apparatus. This list of injuries is most common among athletes.

Aertal and nimesil are used for pain in joints and muscles of unspecified origin, as well as for pain in the back and along the nerves. In case of repeated pain attacks, to continue treatment with these drugs, you must consult your doctor regarding the duration of treatment.

Contrary to popular belief, Nimesil cannot be used as an antipyretic during bacterial and viral infections.

To summarize, it should be said that airtal is more beneficial for use in everyday life. This is facilitated by a convenient form of release - cream, as well as a minimum of side effects and contraindications.

Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Airtal in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Aertal in the presence of existing structural analogues. Use for the treatment of lumbago, rheumatoid arthritis and arthrosis in adults, children, as well as during pregnancy and lactation.

Airtal is a non-steroidal anti-inflammatory drug (NSAID). It has anti-inflammatory, analgesic and antipyretic effects. Inhibits the synthesis of prostaglandins and, thus, affects the pathogenesis of inflammation, pain and fever.

In rheumatic diseases, the anti-inflammatory and analgesic effect of aceclofenac helps to significantly reduce the severity of pain, morning stiffness, and swelling of the joints, which improves the patient's functional condition.

Aceclofenac + excipients.

Quickly and completely absorbed after oral administration. Binding to plasma albumin is 99%. Penetrates into the synovial fluid, where its concentration reaches 57% of the plasma concentration level. Metabolized to a small extent. Its main metabolite found in plasma is 4′-hydroxyaceclofenac. It is excreted by the kidneys mainly in the form of hydroxy derivatives (about 2/3 of the administered dose).

Relief of inflammation and pain syndrome with:

• lumbago;
• toothache;
• humeroscapular periarthritis;
• rheumatic lesions of soft tissues.

• rheumatoid arthritis;
• osteoarthritis (arthrosis);
• ankylosing spondylitis.

Film-coated tablets 100 mg.

Powder for the preparation of suspension for oral administration 100 mg.

Cream for external use (sometimes mistakenly called ointment).

Other forms, be it injections in ampoules or in solution, do not exist at the time the drug was described in the reference book.

Instructions for use and dosage regimen

Adults are prescribed 100 mg orally (1 tablet) 2 times a day in the morning and evening.

The tablets should be swallowed whole with sufficient liquid.

• nausea, vomiting;
• diarrhea;
• pain in the epigastric region;
• intestinal colic;
• dyspepsia;
• flatulence;
• anorexia;
• constipation;
• erosive and ulcerative lesions;
• bleeding and perforation of the gastrointestinal tract (hematemesis, melena);
• stomatitis (including aphthous);
• fulminant hepatitis;
• headache;
• dizziness;
• sleep disorders (insomnia or drowsiness);
• excitation;
• sensitivity disorders;
• disorientation;
• impaired memory, vision, hearing, taste;
• noise in ears;
• convulsions;
• irritability;
• tremor;
• depression;
• anxiety;
• skin rash;
• hives;
• bronchospasm;
• eczema;
• erythroderma;
• vasculitis;
• pneumonitis;
• Stevens-Johnson syndrome;
• Lyell's syndrome;
• anaphylactic shock;
• peripheral edema;
• interstitial nephritis;
• hematuria, proteinuria;
• leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia, aplastic anemia;
• tachycardia;
• arterial hypertension;
• congestive heart failure;

• erosive and ulcerative lesions of the gastrointestinal tract in the acute phase;
• gastrointestinal bleeding or suspicion of it;
• history of bronchospasm, urticaria, rhinitis after taking acetylsalicylic acid or other NSAIDs (complete or incomplete acetylsalicylic acid intolerance syndrome - rhinosinusitis, urticaria, polyps of the nasal mucosa, bronchial asthma);
• period after coronary artery bypass surgery;
• severe liver failure or active liver disease;
• disorders of hematopoiesis and coagulation;
• severe renal failure, progressive kidney disease;
• confirmed hyperkalemia;
• pregnancy;
• lactation period (breastfeeding);
• children and adolescents up to 18 years of age;
• hypersensitivity to aceclofenac or other components of the drug.

Use during pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and breastfeeding.

There are no clinical data on the use of the drug Airtal during pregnancy. Regular use of non-steroidal anti-inflammatory drugs (NSAIDs) in the 3rd trimester of pregnancy can lead to decreased tone and weaker uterine contractions. The use of NSAIDs can lead to premature closure of the ductus bollus in the fetus and, possibly, to prolonged pulmonary hypertension in the newborn, a delay in the onset of labor and an increase in the duration of labor.

Epidemiological studies in humans have not provided data indicating embryotoxicity of NSAIDs. However, in experimental studies on rabbits with the administration of aceclofenac (10 mg/kg per day), morphological changes in the fetus were observed in some cases. There is no data on the presence of a teratogenic effect in rats.

There are no data on the excretion of aceclofenac into breast milk in humans. In experimental studies, when radioactive 14C-aceclofenac was administered to lactating rats, no noticeable transfer of radioactivity into milk was observed.

During treatment with the drug, systematic monitoring of peripheral blood patterns, liver and kidney function, and stool examination for the presence of blood should be carried out.

Because of the important role of prostaglandins in maintaining renal blood flow, special caution should be exercised when prescribing to patients with heart or renal failure, the elderly, those taking diuretics, and patients with reduced blood volume (for example, after major surgery). If aceclofenac is prescribed in such cases, it is recommended to monitor renal function.

In patients with liver failure, the kinetics and metabolism differ from those in patients with normal liver function.

To reduce the risk of developing adverse events from the gastrointestinal tract, the minimum effective dose should be used for the shortest possible short course.

Patients taking the drug must refrain from drinking alcohol.

Impact on the ability to drive vehicles and operate machinery

Patients suffering from dizziness and other central nervous system disorders while taking Aertal should refrain from activities that require increased concentration and speed of psychomotor reactions (driving vehicles and working with dangerous mechanisms).

When used simultaneously with the drug Airtal, it is possible to increase the plasma concentrations of digoxin, phenytoin, and lithium.

When used simultaneously with the drug Airtal, the effectiveness of diuretics and antihypertensive drugs may be reduced.

The simultaneous use of potassium-sparing diuretics and the drug Airtal can lead to the development of hyperglycemia and hyperkalemia.

When taking the drug Airtal and glucocorticosteroids (GCS) or other NSAIDs simultaneously, the risk of developing side effects from the digestive system increases.

When taking the drug Airtal and selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline) simultaneously, it increases the risk of bleeding from the gastrointestinal tract.

Concomitant use of the drug Airtal may increase the nephrotoxic effect of cyclosporine.

During the simultaneous use of Aertal and hypoglycemic drugs, the development of both hypo- and hyperglycemia is possible (control of blood glucose levels is necessary).

Taking the drug Airtal within 24 hours before or after using methotrexate may lead to an increase in the concentration of methotrexate in plasma and to an increase in its toxic effect.

When used simultaneously with acetylsalicylic acid, a decrease in the concentration of aceclofenac in the blood plasma is possible.

With the simultaneous use of antiplatelet agents and anticoagulants, the risk of bleeding increases (regular monitoring of blood coagulation parameters is necessary).

Analogues of the drug Aertal

Structural analogues of the active substance:

Analogs in terms of therapeutic effect (drugs for the treatment of rheumatoid arthritis):

Which is better: Nimesil or Aertal?

Non-steroidal anti-inflammatory drugs are represented by a fairly wide group of names. Among them there are many drugs with the same active ingredients, as well as many drugs that have similar effects, for example, Airtal and Nimesil, which have proven their effectiveness. Which is better: Nimesil or Aertal?

Comparison of drugs

Both drugs are intended to relieve inflammation and relieve pain in various diseases.

Aertal

The drug is intended to relieve inflammation and alleviate the condition in patients with rheumatic diseases. Aceclofenac, the main active ingredient of Aertal, affects the peripheral nervous system. In this case, pain is relieved and joint stiffness is reduced due to the body being in one position for a long time.

The active substance helps well with osteochondrosis, arthritis, rheumatism and other disorders. Patients are often prescribed the drug in two forms: for external and internal use. In this case, the therapy is complex and most effective.

Nimesil

This drug, like the previous one, has a targeted effect on relieving inflammatory processes of various kinds. Taking Nimesil is prescribed to relieve pain and alleviate general condition.

Nimesil is used for the following pain:

Comparison of drugs

A comparison of Nimesil or Aertal according to some parameters is presented in the table below:

Features for comparison

Medicine

Aertal

Nimesil

Release form of the drug for oral administration

Tablets, powder mixtures for suspension preparation

Granulated powder for suspension preparation

Maximum blood concentration

From 1.5 to 3 hours

1 tablet twice a day

1 sachet twice a day

Use during pregnancy

Cream (tube) – from 300

Tablets 100 mg (20 pcs.) – from 350

From 700 for 30 pcs. sachet

Form of the drug for external use

Age limit

Taking the drug after meals

Taking the drug before meals

Both medications have a significant list of contraindications and can provoke the development of side effects.

Contraindications and side effects

Both non-steroidal anti-inflammatory drugs have many contraindications.

• intolerance to the ingredients of the drug;
• ulcer of the duodenum or stomach;
• with severe damage to the liver or kidneys;
• serious cardiac diseases.

Taking Airtal and Nimesil can provoke the development of side effects associated with disruption of the gastrointestinal tract, headaches and dizziness. If the dose is exceeded, the occurrence of adverse reactions becomes more likely.

Important! If it is necessary to combine the use of Aertal or Nimesil with other medications, then this possibility should be discussed with the attending physician.

Analogs

If a patient is prescribed to take Nimesil and Airtal, then in some cases they can be replaced with analogues with the same or another active ingredient.

Airtal has the following analogues with the same active ingredient:

Analogs of Aertal of a similar focus, but with a different composition:

If the question arises whether it is possible to drink Nimesil together with Aertal, then the answer is that they have an identical effect. Which drug is better is determined individually depending on the person’s condition and the characteristics of the body.

Found a mistake? Select it and press Ctrl + Enter

IMPORTANT. The information on the site is provided for informational purposes only. Do not self-medicate. At the first sign of disease, consult a doctor.

Cheap analogues of Aertal tablets, as well as cream, ointment and powder

Joint diseases are a pathology that forces patients to use anti-inflammatory painkillers. The article talks about the effective drug Airtal and the features in choosing its inexpensive analogues, taking into account information about the drug and reviews from doctors and patients.

Who is prescribed Aertal and why?

Airtal is a remedy for the treatment of joint diseases, containing aceclofenac. Refers to non-steroidal anti-inflammatory drugs for systemic and local use. Suppresses the synthesis of prostaglandins, providing an anti-inflammatory effect and reducing pain.

Penetrates well into the joint fluid and provides a long-lasting effect. The drug is available in Hungary in the form of tablets and powder for the preparation of a suspension with a single dose of 100 mg of aceclofenac and in the form of a 1.5% cream.

Airtal in the form of oral forms is used to treat pathologies of the musculoskeletal system and certain conditions accompanied by pain, including:

• rheumatism, including extra-articular changes;
• osteoarthritis;
• rheumatoid arthritis;
• Bekhterev's disease;
• toothache;
• primary dysmenorrhea;
• lumbodynia.

Airtal is taken 1 tablet or packet 1-2 times a day after or during meals. The powder is dissolved in warm water and drunk. The maximum daily dose is 200 mg.

Airtal is contraindicated for:

• hypersensitivity to aceclofenac, components of the drug or acetylsalicylic acid;
• after gastrointestinal bleeding or perforation due to taking NSAIDs;
• peptic ulcer of the stomach or duodenum;
• bleeding or hemostasis disorders;
• severe cardiac, severe renal and liver failure;
• with angina pectoris and after myocardial infarction or coronary artery bypass grafting.

The medicine is not used during breastfeeding, in the third trimester of pregnancy and in children under 18 years of age.

Side effects of Airtal are most often associated with undesirable effects on the digestive system.

Acute erosions and ulcers, perforation of the wall of the digestive tract, and bleeding, sometimes severe, were observed. Nausea with vomiting, loose stools, flatulence, abdominal pain, exacerbation of gastritis, and other dyspeptic manifestations are noted. Allergic reactions, neurological disorders, and anemia occur.

When treated with aceclofenac, the risk of myocardial infarction and stroke may increase. The cream is used topically in adults in the treatment of pain after injuries to the musculoskeletal system, in the complex therapy of lumbago, torticollis and periarthrosis. The product is applied to clean skin up to 3 times a day.

The cream should not be used if there have been intolerance reactions to its components.

Features of drug-drug interactions require caution in case of hypertension - aceclofenac reduces the effectiveness of some antihypertensive drugs. It is not used in combination with other NSAIDs, methotrexate, cardiac glycosides, lithium compounds, anticoagulants, fluoroquinolones.

Interactions relate more to oral forms of aceclofenac; when treated with cream, the restrictions are minimal.

The cost of Aertal is rubles for 20 tablets, a larger package is more profitable - 60 tablets for 800 rubles. 20 packets of 100 mg each will cost around $100. The price of 60 grams of cream is 330 rubles. Many analog products are cheaper. Let's look at them.

How to replace Aertal?

Pharmacies sell domestic preparations of aceclofenac in the form of tablets and there is a large assortment of all forms of anti-inflammatory drugs with other active substances with similar effectiveness.

Complete analogues of Aertal are represented by three tableted generic drugs produced in Russia. In terms of composition, properties and features of use, they are identical to the Hungarian generic (the original product is Niplonac).

Their cost is much more affordable:

• Aceclofenac (ZAO Berezovsky Federal Plant) up to 100 rubles for 20 tablets;
• Alental (JSC “VERTEX”) 250 rubles for 20 tablets;
• Aceclofenac (“Synthesis”) – packs of 20 and 60 tablets for 220 and 550 rubles.

Some NSAIDs with other active ingredients can replace Airtal in cases where drugs with aceclofenac are unavailable.

When choosing a replacement anti-inflammatory drug, you need to understand that in different clinical situations, not all drugs will have the same effect. The severity of the analgesic and anti-inflammatory effect differs with different duration and nature of the pathological process.

Therefore, replacement of prescription drugs, which include tablets and Airtal powder, with drugs with a different composition should be carried out by a doctor. On your own or with the help of a pharmacist, you can choose a drug of aceclofenac that is suitable for the price and choose a replacement cream.

Tablets and capsules

Aceclofenac can be completely replaced only by using other prescription NSAIDs. Over-the-counter products - Ibuprofen, Naproxen and Aspirin - will not provide the desired effect. Meloxicam, diclofenac, celecoxib and ketoprofen will have a similar effect for chronic joint damage.

For acute pain, the optimal replacement would be Ketorolac.

Meloxicam is an optimal remedy for patients with joint damage; it has chondroprotective properties. Available in tablets of 7.5 and 15 milligrams, taken once a day. The drug can be used in remission of stomach ulcers.

Imported substitutes - medicines Meloxicam-Teva, Meloxicam Stada cost 10 tablets of 15 mg or 20 tablets of 7.5 mg, the same dosage of the Russian drug from different manufacturers costs from 75 to 130 rubles.

Diclofenac is the most famous and very popular drug used for joint diseases due to its low cost. Several years ago it was considered the standard of anti-inflammatory therapy, but now its use is limited due to side effects.

It has a pronounced side effect on the stomach, can cause thrombosis and lead to the development of heart attacks and strokes. Reduces the effectiveness of antihypertensive drugs when used together.

Used in the form of tablets of 50 and 75 mg and capsules of 100 mg. The maximum daily dose is 150 milligrams. Imported products Dicloberl and Diklak 75 mg No. 10 – 70 rub. Russian-made diclofenac costs from 48 rubles. (100 mg 20 pcs.)

Ketoprofen - capsules and tablets of 50, 100 and 150 mg. A non-selective drug with a good analgesic effect for chronic inflammation. 25 capsules of foreign Ketonal, 50 mg each, cost 100 rubles. Domestic Ketoprofen is 1.5-2 times cheaper.

Celecoxib is a selective anti-inflammatory drug, available in the form of capsules with a dosage of 100 and 200 mg. Does not exhibit gastrotoxicity and can be used for stomach problems.

It affects the processes of excitation in the heart, therefore it is used to a limited extent in cardiac pathology. Cheap analogues include imported Dilax in rubles for 10 capsules and domestic Rouxib-Routek at the same price.

Ketorolac is a drug with a predominant analgesic effect, the most effective of those listed for acute conditions - injury, toothache, after surgery. The maximum effect occurs in the first 3-5 days after injury or the onset of pain.

Not used for chronic pain (except for oncology). Tablets contain 10 mg of ketorolac, taken up to 4 times a day.

The most famous imported product is Romanian Ketanov, the price of 10 tablets is 60 rubles. Domestic Ketorolac costs about 20 rubles.

Creams, ointments and gels

The choice is made among anti-inflammatory drugs based on ketoprofen, nimesulide and diclofenac with a similar analgesic effect:

• Fastum gel - contains 2.5% ketoprofen, 30 grams of gel cost 240 rubles, 100g - 550 rubles;
• Ketonal - 5% cream with ketoprofen, price 30g - 300 rubles. There is a 2.5% gel, 50g costs 300 rubles;
• Bystrumgel is a Russian medicine with the same substance in a concentration of 2.5%, the cost of 30 grams is 190 rubles;
• Nise - 1% nimesulide gel, 20 g cost 175 rubles;
• Diclak gel containing 5% diclofenac, price 50 g - 270 rubles;
• domestic Diclofenac in the form of 1% gel and ointment, an inexpensive product with a price of 30 rubles per 30 grams, 5% gel costs 2-2.5 times more.

The most effective products are those containing 5% ketoprofen and diclofenac.

Powders in bags

When choosing a replacement for Airtal in powder form, the products are compared with other components. The most popular NSAIDs in powders are the Italian drug Nimesil, containing 100 mg nimesulide. Its cost is 680 rubles for 30 packages.

Nimesulide has many restrictions on its use due to hepatotoxicity; in addition to the standard contraindications for NSAIDs, it cannot be used for liver disease, alcoholism, colds and flu, and if the patient’s body temperature increases, the medicine should be discontinued. In a number of countries that continue to use it, joint diseases have been excluded from the indications.

In neighboring countries, the drugs Dexalgin-sachet (dexketoprofen) and Catafast (diclofenac potassium) are on sale, the effectiveness and safety of which are higher than that of nimesulide.

Patient reviews of analogues

Mostly, patient opinions about aceclofenac drugs are positive and relate to the use of Aertal itself. The majority note a good effect and tolerability and plan to use this medicine in the future. Mentions of adverse reactions refer to effects on the stomach. There are fewer opinions from doctors, and they are also positive.

Thus, doctor Marina from the city of Cherepovets writes that she sees the good effect of the drug not only on patients who are satisfied with the treatment, but also experienced an exacerbation of chronic inflammation during the treatment. However, she notes that the effect is noticeable after taking one, maximum two doses of the medicine.

Pharmacists have the same opinion about Aertal cream, watching as customers come again for this medicine and thank them for their advice.

And a resident of Kaluga, who bought the drugs aceclofenac Aertal and Alental to treat his mother and periodically took them himself for pain, writes that the drugs were recommended by a rheumatologist for pain in the shoulder joint.

1 Description of the drug Teraflex, a list of Russian analogues that are cheaper, and their prices

2 5 analogues of Ibuklin for pain and inflammation

Leave feedback

What will help with migraines: analogues of Sumamigraine

What can replace Hyposart to eliminate cardiac muscle disorders?

Quinax eye drops: characteristics and Russian analogues

Cheap Russian analogues of Duphalac

Characteristics of the drug De-Nol and its domestic analogues

Effective medicines for flu and colds

The drug Milgamma in ampoules: characteristics and analogues of Russian production

Comparison of analogues of Vesicare tablets

Actovegin: characteristics of the drug and a list of cheap analogues

The best for the nose: analogues of Polydex spray

List of analog drugs cheaper than Isofra

Cheap analogues of Mydocalm in injections and tablets

All information is presented for informational purposes; before starting treatment, consult a specialist.

Inexpensive analogues of Nise gel and tablets

Pain and inflammation cause a lot of unpleasant sensations, and when intense, they cause agony. In order to eliminate symptoms and treat inflammatory processes, drugs of the synthetic group are used, which include Nise, as well as its analogues.

About the drug

A drug that has an analgesic and anti-inflammatory effect in many pathological processes.

The effect of using a medicine is based on the body's reaction to its composition. The active substance is nimesulide.

Available in the form of regular and dispersible tablets, also in the form of medicinal powder for the preparation of suspension and gel for external use.

Regardless of the form of release, indications for use are pain and inflammation in diseases:

• arthritis of psoriatic or rheumatoid type;
• sciatica or radiculitis;
• joint disorders due to rheumatism or gout;
• spondyloarthritis or osteochondrosis;
• lumbago or arthritis;
• myalgia or arthralgia;
• feverish condition;
• inflammation of soft tissues after injuries;
• bursitis or tendon damage;

Nise tablets and suspension are used to relieve pain, dental pain, menstrual pain and headaches. Nise gel is recommended for traumatic injuries and after operations performed on muscles, bones or joints.

The instructions for use of the drug warn about the undesirable use of the drug in tablets and suspensions for pathologies:

• erosions or ulcers on the mucous membranes of the gastrointestinal tract;
• liver/kidney dysfunction;
• aspirin triad.

Gel Nise is not prescribed if the skin is affected by infection or dermatoses.

Absolute contraindications for any form of release of the analogue are considered to be the period of pregnancy/lactation and sensitivity to the existing composition.

The drug has many side effects, but they most often occur with an overdose or the presence of contraindications. In case of an adverse reaction, the patient experiences symptoms:

• disorders of the stomach and intestines;
• migraine;
• allergies (including anaphylactic shock);
• circulatory disorders.

The average price for Nise gel and tablets is 200 rubles, suspension powder is 300 rubles.

Similar medicines

If necessary (due to the high price, contraindications, side effects, etc.), Nise can be replaced with analogues. Depending on the indications, as well as the reason for searching for a substitute, the doctor may prescribe analogs that are cheaper or more expensive than the original. It should be borne in mind that some analogues of this group are sold in pharmacy chains only with a prescription.

Nimesulide and Ibuprofen are substitutes that cost much less than the original.

Nimesulide

Direct analogue of Nise gel and tablets. The medicine is used for therapy for inflammatory diseases of the musculoskeletal system and other body systems. Also, tablets and gel for external application are used as a strong pain reliever for various forms of pain.

The active substance has a name identical to the name of the drug - Nimesulide. Tablets contain 100 mg. the main component and additional substances necessary to enhance the effect of the composition.

List of direct indications:

• osteoarthritis;
• dysmenorrhea;
• migraine;
• toothache;
• injuries to muscles, joints or bones;
• pathologies of the musculoskeletal system.

An analogue of Nise tablets is contraindicated in case of damage to the gastrointestinal mucosa, heart failure, and a substitute in the form of a gel is contraindicated in case of open wounds and infectious processes on the skin.

• children's age (up to 12 years);
• intolerance to the components of the composition;
• blood pathologies;
• kidney/liver diseases;
• alcohol addiction;
• allergy to one or more substances from the composition of the drug.

A cheap analogue of Nise can cause side symptoms:

• pain in the epigastric region, feeling of nausea, severe heartburn, change in stool;
• constant dizziness or drowsiness;
• erythema, rash or urticaria;
• slower removal of fluid from the body, swelling;
• thrombocytopenic purpura.

The price of the drug Nimesulide is from 80 rubles.

Ibuprofen

Another cheap analogue of Nise gel and other forms of release is Ibuprofen. The drug has a wide range of effects and is recommended for providing analgesic, antipyretic, and anti-inflammatory effects.

• tablets (extended, regular and for resorption);
• extended-release capsules;
• suspension;
• caviar gel

The active component of the analogue is ibuprofen.

Instructions for use include the following indications:

• signs of a viral disease (ARVI/flu);
• arthritis (psoriatic), osteoarthritis and spondylosis;
• migraine, myalgia and neuralgia;
• spinal artery syndrome, Barré-Lieu or nephrotic;
• bursitis, tendinitis and hematomas;
• hypotension, ankylosing spondylitis, fever;
• injury to soft tissue or bones.

An inexpensive analogue is also used for therapy for sprains of ligament tissue, arthritis (rheumatoid), articular syndrome or radiculitis.

The list of contraindications to the use of medications is extensive. The main contraindications for Ibuprofen include:

• the presence of ulcers or erosions on the walls of the stomach or intestines (except for the use of gel);
• sensitivity to the existing composition;
• pathologies of the optic nerve and deviations regarding the function of color visual perception;
• Asperin asthma;
• hypertension, amblyopia or scotoma;
• impairment of the full functioning of the kidneys/liver;
• heart failure;
• hemophilia, edema, leukopenia;
• third trimester pregnancy.

The Russian drug causes side effects that affect the nervous, digestive, circulatory and urinary systems. An allergic reaction is also possible.

The cost of medicines is from 70 rubles, depending on the form prescribed by the specialist.

Nimesil

An anti-inflammatory drug with an analgesic effect, Nimesil, is included in the list of drugs that are analogues of Nise.

The drug is produced only in the form of a powder for dissolution and preparation of a suspension. The active component is nimesulide.

• infectious inflammation;
• inflammatory and degenerative processes affecting the musculoskeletal system;
• gynecological, urological and vascular inflammatory pathologies;
• post-traumatic complications;
• dental diseases;
• migraine.

Nimesil has earned positive reviews for eliminating pain during menstruation and as an antipyretic.

• inflammatory processes in the gastrointestinal tract;
• installation of a shunt in the aorta;
• fever;
• intolerance to any constituent substances.

The body’s negative reaction to the Nise analogue is expressed in the following symptoms: heart rhythm disturbances, headaches, intestinal dysfunction and allergies.

The price for Nimesil is from 500 rubles.

Nimulid

A good analgesic and pain reliever is Nimulid, developed on the basis of nimesulide as an active ingredient. Among the drugs that replace Nise, Nimulid is considered one of the most effective; in addition, the drug has several release forms. Lingual, regular tablets and suspension. Also, the drug in the form of an ointment can replace Nise gel.

• arthritis of rheumatoid or psoriatic nature;
• bursitis, musculoskeletal injuries;
• osteochondrosis or spondyloarthritis;
• articular gouty syndrome;
• myalgia.

• erosive - ulcerative damage to the mucous membrane of the walls of the stomach or intestines;
• diseases developing in the liver or kidneys;
• tendency to allergies, including intolerance to the composition;
• pregnancy/lactation.

Side symptoms often include headaches and severe weakness. When treated with ointments, a local allergic reaction is possible.

The analogue is cheaper than Nise - from 170 rubles.

Aertal

The non-steroidal drug Airtal is a substitute for Nise in three main forms (tablets, gel and suspension). However, unlike Nise, Aertal contains the main component - aceclofenac, which eliminates pain and prevents the process of inflammation.

• periarthritis in the shoulder and shoulder blade area;
• lumbago;
• rheumatism progressing in soft tissues;
• osteoarthritis;
• dental pain;
• rheumatoid arthritis;
• ankylosing spondylitis.

The cream can be used to relieve swelling of tissues and eliminate pain of a limited nature (for example, due to injuries).

• damage to the walls of the gastrointestinal tract;
• hives;
• bronchospasm;
• medicinal rhinitis;
• liver dysfunction;
• circulatory pathologies;
• hyperkalemia;
• a woman carrying a fetus;
• breastfeeding;
• childhood.

Before starting treatment with Airtal, you should pay attention to signs of side effects associated with dysfunction of the stomach/intestines and nervous system. An allergic reaction is possible.

The price for Aertal is from 270 rubles.

Aceclofenac

The drug Aceclofenac with analgesic, antipyretic and anti-inflammatory effects belongs to the group of analogues of the drug Nise.

There is only one release form - tablets, which contain a medicinal substance - aceclofenac.

Indications for symptomatic therapy:

• spondylitis;
• arthritis;
• periarthritis;
• osteoarthritis;
• inflammation of soft tissues (rheumatoid).

• age of patients under 18 years;
• gastrointestinal pathologies associated with the presence of ulcers or erosions;
• aortic bypass;
• heart failure;
• lactation/pregnancy;
• allergy to the medicinal composition of the drug.

Side effects manifest themselves in the digestive tract, circulatory and nervous systems, as well as in the form of allergies.

The cost of the Nise analogue is from 230 rubles.

Conclusion

Taking into account all the features of treatment with drugs of this group, experts are of the opinion that Nise’s analogues have more disadvantages than the original. However, it is impossible to determine what is best for the patient in each specific case. Sometimes cheaper analogues are more effective than the original drug with a high cost. The effect of drugs on the body often does not depend on price, so the choice of drugs should be trusted only to the attending physician.