Nimulid-MD 100 mg orodispersible tablets – nimesulide for acute pain and painful periods

Nimulid-MD is a medicine containing the active substance nimesulide, a non-steroidal anti-inflammatory drug (NSAID). Each orodispersible tablet contains 100 mg of nimesulide and is not swallowed but dissolves in the mouth.

It is used to treat acute pain and primary dysmenorrhoea (painful periods not caused by a disease). According to the SmPC, nimesulide is prescribed only as second-line therapy after assessing the overall risk for each patient, and must not be used for longer than 15 days per course of treatment.

What is Nimulid-MD (nimesulide) used for and how is it used safely?

Key facts about the medicine

What is Nimulid-MD used for?

According to the official documentation, Nimulid-MD is used for:

• the treatment of acute pain;
• the treatment of primary dysmenorrhoea (painful periods).

Nimesulide should be prescribed only as second-line therapy; the decision is based on an assessment of the overall risk for each patient.

How is it used and dosed?

• Adults and adolescents aged 12 to 18 years: one orodispersible tablet (100 mg) twice a day, after meals.
• The tablet is not swallowed – it is placed in the mouth, where it dissolves.
• Use the lowest effective dose for the shortest possible time; no longer than 15 days per course of treatment.

This is the general dosing from the leaflet and is not an individual recommendation.

Special patient groups

• Children under 12 years: the medicine is contraindicated.
• Elderly: a reduction of the daily dose is not necessary, but the doctor periodically checks that the medicine is not causing stomach, kidney, heart or liver problems.
• Kidney impairment: no dose adjustment in mild to moderate impairment (creatinine clearance 30–80 mL/min); contraindicated in severe impairment (below 30 mL/min).
• Liver impairment: the medicine is contraindicated.

Contraindications – when the medicine must not be used

Nimulid-MD must not be used:

• in hypersensitivity to nimesulide or the excipients;
• if you have had an allergic reaction (e.g. difficulty breathing, runny or blocked nose, hives) after acetylsalicylic acid or other NSAIDs;
• if you have previously had liver damage caused by nimesulide;
• together with other potentially hepatotoxic medicines (e.g. paracetamol or other NSAIDs);
• in alcoholism or dependence on psychoactive substances;
• in liver impairment or raised liver enzymes;
• in active stomach or duodenal ulcer, recurrent ulcers or bleeding (two or more episodes), or bleeding/perforation related to previous NSAID use;
• in cerebral haemorrhage, other active bleeding or serious blood clotting disorders;
• in severe heart failure and severe kidney impairment;
• in fever and/or flu-like symptoms;
• in children under 12 years;
• in the last trimester of pregnancy and during breastfeeding.

Precautions and warnings

• Liver risk: if loss of appetite, nausea, vomiting, abdominal pain, persistent tiredness or dark urine occur, stop the medicine immediately and contact a doctor.
• Cardiovascular risk: it may increase the risk of heart attack and stroke, particularly at high doses and with longer use; tell your doctor about heart disease, high blood pressure, diabetes, high cholesterol or smoking.
• Stomach and bowel: caution with a history of ulcer, bleeding, ulcerative colitis or Crohn’s disease; black stools or stomach pain require stopping the medicine.
• Fever or flu-like symptoms during treatment require stopping the medicine and contacting a doctor.
• Kidney function may worsen, especially with weakened heart or kidney function and high blood pressure.
• Skin reactions (rash, mucosal changes, fixed drug eruption – round or oval red patches): stop the medicine.
• The medicine may reduce fertility in women.
• Contains aspartame (a source of phenylalanine – harmful to people with phenylketonuria) and parahydroxybenzoates (E219, E217), which may cause allergic reactions, possibly delayed.

Interactions with other medicines, alcohol and food

• Anticoagulants (e.g. warfarin) and antiplatelet medicines (e.g. acetylsalicylic acid): increased risk of bleeding.
• Blood pressure medicines and diuretics: weakened effect and risk to the kidneys.
• Lithium and methotrexate: their blood levels and toxicity may increase (caution with methotrexate within 24 hours before or after nimesulide); ciclosporin: possible increased kidney toxicity.
• Selective serotonin reuptake inhibitors (antidepressants) and corticosteroids: increased risk of gastrointestinal bleeding.
• Other NSAIDs, including acetylsalicylic acid at anti-inflammatory doses (≥ 1 g single dose or ≥ 3 g daily): concomitant use is not recommended; other hepatotoxic medicines (e.g. paracetamol) are contraindicated with nimesulide.
• Alcohol: should not be consumed during treatment.

Pregnancy and breastfeeding

Nimulid-MD must not be used in the last three months of pregnancy; from the sixth month of pregnancy it must not be taken under any circumstances, as it may seriously harm the baby’s heart, lungs and kidneys. Use in the first and second trimesters is not recommended, nor in women trying to become pregnant. The medicine must not be used during breastfeeding.

Driving and using machines

There are no data showing that the medicine affects driving, but people who experience dizziness, fainting or drowsiness should not drive or use machines.

Possible side effects

• Common (up to 1 in 10): diarrhoea, nausea, vomiting, increased liver enzymes.
• Uncommon (up to 1 in 100): difficulty breathing, dizziness, high blood pressure, constipation, bloating, gastrointestinal bleeding, stomach or duodenal ulcer and perforation, itching, rash, increased sweating, swelling.
• Rare and very rare but serious: anaemia, blood disorders, severe allergic reactions, severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), kidney damage, hepatitis – sometimes fulminant and fatal, jaundice, asthma and bronchospasm.
• Frequency not known: heart failure, fixed drug eruption.

Report any suspected side effect to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose: most often lethargy, drowsiness, nausea, vomiting and upper abdominal pain; rarely high blood pressure, acute kidney injury, respiratory depression and coma. Contact a doctor or the nearest healthcare facility immediately.
• Missed dose: do not take a double dose; take the next dose at the usual time.
• Duration: do not use the medicine for longer than 15 days per course of treatment.

Related information

• Which is the safest painkiller?

For additional care and support with menstrual pain, see also the Menstrual pains category – products in this category do not replace the medicine you have been prescribed.

Composition, packaging and manufacturer

• Active substance: nimesulide, 100 mg per orodispersible tablet.
• Excipients: mannitol; croscarmellose sodium; magnesium stearate; aspartame; colloidal anhydrous silica; sodium starch glycolate; sodium methyl parahydroxybenzoate (E219); sodium propyl parahydroxybenzoate (E217); potassium sorbate; orange flavour.
• Appearance: round, flat, flavoured, uncoated light yellow tablets.
• Pack: PVC/aluminium blister with 10 tablets in a carton.
• Marketing authorisation holder: AMICUS SRB D.O.O., Milorada Jovanovića 9, Belgrade; manufacturer: YASENKA D.O.O., Vukovar, Croatia. Authorisation no.: 515-01-05091-22-001 of 14.11.2023.

Storage

• Store below 25 °C in the original package to protect from moisture and light.
• Keep out of the sight and reach of children; do not use after the expiry date; return unused medicine to a pharmacy that collects it.

Frequently asked questions

How long can Nimulid-MD be taken?

For a maximum of 15 days per course of treatment, at the lowest effective dose. The usual dose is 100 mg twice a day, after meals.

Can Nimulid-MD be combined with paracetamol?

No. The leaflet states that the medicine must not be taken with other medicines that affect liver function, such as paracetamol or other non-steroidal anti-inflammatory drugs.

How is an orodispersible tablet taken?

The tablet is not swallowed but placed in the mouth, where it dissolves. It is taken after meals.

Can Nimulid-MD be used for painful periods while breastfeeding or planning a pregnancy?

No. The medicine must not be used during breastfeeding, and use is not recommended for women trying to become pregnant, as nimesulide may reduce fertility.

Why must Nimulid-MD not be taken with a fever or flu symptoms?

Fever and flu-like symptoms are listed as a contraindication, and if they appear during treatment the medicine should be stopped and a doctor informed.

Sources

• ALIMS – Patient leaflet Nimulid®-MD, 100 mg, orodispersible tablets (November 2023)
• ALIMS – SmPC Nimulid®-MD, 100 mg, orodispersible tablets (November 2023)

Sources checked on: 23 October 2026.