Nimesulide substitutes

Discussion in 'Dental Archive' started by Anonymous, Sep 17, 2006.

  1. Anonymous

    Anonymous Guest

    Nimesulide is legal in my country.

    My wife has a tooth problem & the doctor has
    prescribed a capusle containing Nimesulide-100mg
    & Serratiopeptidase-15mg to be taken just
    once a day for 6 days.

    She has taken one dose till now. Just now, I found out
    that nimesulide is banned in many countries because of
    liver & kidney problems.

    I went back & talked to the doctor, but she said that
    there were controversies regarding Nimesulide but it
    isn't more dangerous than any other NSAIDs.

    However, I am still scared because my wife has taken
    ibuprofen, paracetamol, diflocenac etc in the last month.

    Is there any other safer tablet I can substitute for
    Nimesulide - my wife doesn't seem to have much fever.
    I think the doctor has given it mainly for reducing
    inflammation & pain. My wife has swollen cheeks from
    dental surgery few weeks back - she isn't visiting the
    dentist any more - this is from a regular physician.

    What do people recommend as a substitute & what
    dosage? I am travelling & in unfamiliar territory & hence
    do not have a choice of changing too many doctors
    now.

    Is diflocenac a good safe substitute for reducing dental
    inflamation - what should be equivalent dosage?

    Is there a diff between diflocenac sodium or diflocenac
    pottasium?

    Also what is Serratiopeptidase?
     
    Anonymous, Sep 17, 2006
    #1
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  2. Anonymous

    George Guest

    Dear Anonymous,

    Nimesulide is legal in my home country also. I used it several times
    (myself included) and I believe it's one of the most effective
    painkillers. It should be safe for short courses, but of course all
    medication has side effects. If you want to play it completely safe,
    you cannot get anything safer than paracetamol, on the other hand it
    sucks for dental pain because it doesn't have any anti-inflammatory
    effect. I would stay away from diclofenac as it can be really heavy on
    the stomach. Ibuprofen at 400-60 mg is quite effectivfe for dental
    pain. Serropeptidase is an enzyme sometimes prescribed for arthritis
    sufferers. I haven't really heard of it being used as a common
    painkiller, but it does have anti-inflammatory action.

    Regards,
    George
     
    George, Sep 17, 2006
    #2
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  3. Anonymous

    Anonymous Guest

    Steven Bornfeld wrote:
    Inflammation & pain more than 2 weeks
    after wistom tooth surgery.
    There is slight swellin of cheek remaining
    & pain in the throat & ear, because of some
    fluid apparently.
     
    Anonymous, Sep 17, 2006
    #3
  4. Anonymous

    Anonymous Guest

    George wrote:

    Are you a doctor, George?
    How many doys is short course & how much dosage per day.
    Will try that, because she has taken ibuprofen many times before.
    As per some reports, I read, Nimesulide carries slightly more
    risk than ibuprofen.
     
    Anonymous, Sep 17, 2006
    #4
  5. Anonymous

    George Guest

    Anonymous wrote:
    I'm a dentist.
    Short course is hard to define absolutely. It's generally any course of
    medication intended to treat an acute problem (eg pain after wisdom
    tooth removal) rather than a chronic problem (eg arthritis, when the
    patient is on painkillers for life). 100-200mg 2-3 times per day is a
    good theurapeutic dose.
    Since I moved countries and nimesulide doesn't exist in the UK, I've
    been relying on ibuprofen and it's an ok drug. But in the end all
    NSAIDs will affect the kidneys to some extent.

    Take care,
    George
     
    George, Sep 18, 2006
    #5
  6. Anonymous

    Anonymous Guest

    George wrote:
    She has taken some pain killers in the last 3 months (mostly
    Ibuprofen, Diclofenac & Paracetamol). Not very heavy dosages,
    but pain killers every few days, because of variety of unrelated
    problems - a sprain, then a headache, a sprain again & then this
    tooth. That's why I am a little worried.

    Anyway, she had a surgery for one lower wisdom tooth almost
    2.5 weeks back - the dentists say she healed well, but the pain
    which started on day 5 never fully went away. After 2 weeks,
    she developed more problems
    - Mouth developed something which seemed like an oral thrush
    - She had a lot of pain while swallowing & ear ache.
    Pain mostly only in the night & a lot.

    Finally, I went to a General Physician instead of the dental surgeon.
    The GP said, the clot has formed, but there is still fluid & there is
    inflammation. The GP gave her Nimesulide (100 mg only once
    in the night), Betadine Gargle(Povidone Iodine 1%) thrice a day
    & some probiotics.

    Almost immediatelly, the improvement was radical.
    I am assuming, it's the Betadine which is the biggest factor,
    because she had some probiotics, though much cheaper ones even
    before she went to the Doc & she has also had the NSAID's before.

    How can the Gargle give so much improvement almost immediatelly?
     
    Anonymous, Sep 18, 2006
    #6
  7. Anonymous

    George Guest

    Anonymous wrote:
    Beats me. It's probably the antibiotics rather than the mouthwash that
    did the job. In my experience physicians prescribe much more
    aggresssive antibiotic regimens than dentists (this is not always good
    - I had a couple of patients with toothaches and a busted stomach).
    Or maybe she was bound to get better even without any medication? Guess
    we'll never know!

    I'm glad your wife feels better now.

    Regards,
    George
     
    George, Sep 19, 2006
    #7
  8. Anonymous

    Anonymous Guest

    George wrote:
    She hasn't been prescribed any antibiotics after the first 10 days.
    Not good again. Was very good for 1 day after the mouthwash/
    nimesulide & probiotics. But some ear pain & teeth pain again
    today. Wits end now.
     
    Anonymous, Sep 19, 2006
    #8
  9. Anonymous

    Bill Guest

    George wrote:
    _____________________


    Even paracetamol can easily produce problems. From the Wikipedia:

    "Paracetamol has a narrow therapeutic index - the therapeutic dose is
    close to the toxic dose. Additionally, paracetamol is contained in many
    preparations (both over-the-counter and prescription only medications).
    This means that, despite being one of the safest analgesics available
    at recommended doses, there is a large potential for overdose and
    toxicity.

    "Without timely treatment, paracetamol overdose can lead to liver
    failure and death within days.

    "Because of the wide over-the-counter availability of the drug, it is
    sometimes used in suicide attempts by those unaware of the prolonged
    timecourse and high morbidity associated with paracetamol-induced
    toxicity.

    "In the UK, sales of over-the-counter Paracetamol in pharmacies are
    restricted to packs of 32 tablets per customer per occasion (only 16
    tablets in non-pharmacy stores). In Ireland, the limits are 24 and 12
    tablets respectively."

    - dentaldoc
     
    Bill, Sep 21, 2006
    #9
  10. Anonymous

    George Guest

    Bill wrote:
    I think easily is an overstatement here.Paracetamol has very few common
    side-effects and is the painkiller of choice for pregnant women - this
    alone should demonstrate its safety. If it has one problem is that the
    difference between the effective and the toxic dose is not great, so
    one should strictly adhere to his doctor's instructions when taking
    paracetamol.
    Overdose is certainly much more life-threatening than say aspirins.

    Regards,
    George
     
    George, Sep 21, 2006
    #10
  11. Anonymous

    Anonymous Guest

    George wrote:
    What is the toxic dose for paracetamol?

    Anyway, news about the wife is that the doc has increased
    nimesulide/serrawhatever to 100 mg/15 m twice a day &
    added a pseudopedrine - the pseduapedrine has helped
    some with the ear & she is feeling better. Doc says there
    seems to be no infection but if it's not ok by Monday he
    will give another course of antibiotic.
     
    Anonymous, Sep 21, 2006
    #11
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