摘要
尼美舒利是非甾体类抗炎药,为选择性环氧化酶-2(COX-2)抑制剂,其耐受性好,不良反应尤其是胃肠道不良反应少。近年,尼美舒利引致肝脏损害,甚至死亡,而在一些国家停止销售。然而,欧洲药品管理局对尼美舒利进行安全性评估后认为,其利益大于风险,但需限制其使用。尼美舒利致肝脏损害的发病机制尚不清楚,可能和免疫及个体代谢差异有关。预防尼美舒利肝脏损害的措施为:严格掌握适应证;疗程应限制在15d之内;避免大剂量用药和联合用药;高龄和女性患者慎用,儿童尽量不用;用药>1周应监测肝功能。
Nimesulide is a non-steroidal anti-inflammatory drug, and is a selective inhibitor of cyclooxygenase type 2 （cox-2）. It is well tolerated, and has a relatively low occurrence of adverse drug reactions especially in the gastrointestinal tract. Recently, in some countries nimesulide has been withdrawn from the market because of nimesulide-induced severe liver injury and death. However, finalising a review of liver safety of nimesulide the European Medicines Agency （EMEA） has concluded that the benefits of the drug still outweigh its risks, but that there is need to restrict its use. The pathogenic mechanisms of nimesulide-induced liver injury are unclear, possibly associated with the immunologic and metabolic idiosyncratic reactions. The precautions against nimesulide-induced liver injury include administering nimesulide only in a good indication; limiting the drug to a maximum duration of 15 days; avoiding high dosage and drug combinations; administering the medication with cautions in the elder and women; avoiding use in children; monitoring liver function in case the duration of nimesulide use is more than 1 week.
出处
《药物不良反应杂志》
2007年第6期400-403,共4页
Adverse Drug Reactions Journal
