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Are all pain killers except nimulid safe?

Answered by: Chandra M. Gulhati
Editor,
MIMS,
New Delhi

Q. If you say nimulid is not safe, do you mean that all the other pain killers are safe because all analgesics have hepato/renal toxicity?

A.  We do not comment on brands but are always willing to respond on medicines. Nimulid is a brand name; its ingredient is Nimesulide. No drug is safe; all have side effects. The issue is the comparative safety of medicines based on their use. For example another NSAID pain-killer, diclofenac sodium, is indicated for musculo-skeletal disorders. For this indication its safety profile is acceptable. Nimesulide is an American drug but not approved for use in the United States. It is also not approved in over 160 countries of the world including Britain, Australia, Canada etc. In those countries where it is legally permitted, its indications have been drastically curtailed last year. It is now only approved for use only in acute pain, osteoarthritis and painful menstruation. It is not permitted for use in fever. Its use in patients below 12 years has been banned. Other pain-killers do not suffer from these adverse reports and regulatory orders. For example there is no country, where diclofenac has been banned or placed under severe restrictions. The ultimate aim is to give relief to patients with as little adverse effects as possible. Why use a potentially toxic drug when safer alternatives are available?

A.  We do not comment on brands but are always willing to respond on medicines. Nimulid is a brand name; its ingredient is Nimesulide. No drug is safe; all have side effects. The issue is the comparative safety of medicines based on their use. For example another NSAID pain-killer, diclofenac sodium, is indicated for musculo-skeletal disorders. For this indication its safety profile is acceptable. Nimesulide is an American drug but not approved for use in the United States. It is also not approved in over 160 countries of the world including Britain, Australia, Canada etc. In those countries where it is legally permitted, its indications have been drastically curtailed last year. It is now only approved for use only in acute pain, osteoarthritis and painful menstruation. It is not permitted for use in fever. Its use in patients below 12 years has been banned. Other pain-killers do not suffer from these adverse reports and regulatory orders. For example there is no country, where diclofenac has been banned or placed under severe restrictions. The ultimate aim is to give relief to patients with as little adverse effects as possible. Why use a potentially toxic drug when safer alternatives are available?

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