Q: My mother is 65 years old and suffers from various age related ailments. Her prime health issue is the severe pain resulting from deterioration of her spine disc near her neck. She has been prescribed Nise (Nimesulide) and this has worked wonderfully for her. Recently her doctor asked her to take Robinax (Methocarbamol) instead of Nise, citing the possibility of liver damage with continual usage of Nise. Robinax has no effect on her pain and it does not work for her at all. Are the liver damage concerns valid? Is there a better replacement for Nise rather than Robinax?

A:Nimesulide (sold under various trade names such as Nise, Nimulid etc) is globally banned due to its toxic effect on liver. Some patients in Finland died due to liver failure. This happened several years ago and no competent doctor should prescribe it. It might interest you to know that nimesulide was discovered in America but not permitted to be used there. The patient can easily take another Non-Steroidal Anti-Inflammatory Drug such as diclofenac (sold under the trade name of Fenaplus, Diclomol etc). If necessary a muscle relaxant such as chlorzoxazone can also be added. Myospaz Forte contains diclofenac + paracetamol + chlorzoxazone and has a dose of 1 tablet thrice daily.