NIFLAM ® Niflumic Acid

NIFLAM ® is a drug based on Niflumic Acid

THERAPEUTIC GROUP: Non-steroidal anti-inflammatory and antirheumatic drugs

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications NIFLAM ® Niflumic Acid

NIFLAM ® is indicated in the symptomatic treatment of pathological manifestations associated with the presence of inflammatory states both of an acute and chronic nature.

Its excellent clinical efficacy allows its use both in rheumatic, traumatic and infectious diseases.

Action mechanism NIFLAM ® Niflumic Acid

NIFLAM ® owes its great therapeutic efficacy to the presence, as an active ingredient, of niflumic acid, a molecule belonging to the chemical category of fenamates and, due to its therapeutic properties, included among the non-steroidal anti-inflammatory drugs.

With these latter, niflumic acid shares the mechanism of action, characterized by the non-selective inhibition of cyclooxygenases and the consequent reduction in the production of prostaglandins.

More precisely, during phlogistic processes, the increased expression of enzymes such as cyclooxygenases is able to increase the rate of conversion of membrane phospholipids such as arachidonic acid into chemical mediators endowed with vasodilatory, vasopermeabilizing, chemotactic and algogenic activity such as the prostaglandins.

Niflumic acid, by exerting a competitive inhibiting action against the aforementioned enzymes and thus reducing the production of the related chemical mediators downstream, enables the control of the edema associated with the inflammatory process, pain, and even in some cases the pyrogenic stimulus exercised from molecules such as prostaglandin E 2 and interleukin 1 to hypothalamic thermoregulatory centers.

All these activities are further facilitated by particularly advantageous pharmacokinetic and toxicological properties, which allow niflumic acid to be used in different clinical settings.

Studies carried out and clinical efficacy

1.NIFLUMIC ACID AND INSULIN ACTIVITY

Diabetologia. 2009 May; 52 (5): 863-72. Epub 2009 Mar 6.

Interesting experimental work with important clinical implications that shows how the activation of some ionic channels induced by niflumic acid can be important in the control of glucose homeostasis by regulating what is the normal pattern of insulin activity

2. THE FLUID ACID AS AN IMMUNOMODULATOR

Int Immunopharmacol. 2008 Jul; 8 (7): 997-1005. Epub 2008 Apr 1.

Immunological work that demonstrates how niflumic acid can contribute to the tolerogenic activity of the human organism, modulating the expression of molecules such as ILT 3 and ILT 4, normally expressed by dendritic cells.

3. NIFLUMIC ACID AND CIGARETTE SMOKE

Chest. 2007 Apr; 131 (4): 1149-56.

Study demonstrating how niflumic acid can reduce the expression of mucins normally induced by cigarette smoke. This evidence could be important in the treatment and control of mucipar hypersecretion.

Method of use and dosage

NIFLAM ®

250 mg hard capsules of niflumic acid;

Suppositories for adults from 700 mg of beta-morpholinoethyl ester of niflumic acid (equivalent to 500 mg of niflumic acid);

Suppositories for children from 400 mg morfolinoethyl ester-beta of niflumic acid (equivalent to 285 mg of niflumic acid):

niflumic acid therapy should be defined by your doctor based on the patient's health and the severity of his clinical picture.

In principle, the intake of one capsule 3/4 times a day, preferably on a full stomach, should be sufficient to manage most of the symptoms associated with both acute and chronic inflammatory manifestations.

As for the suppositories, it is recommended to take two suppositories a day in adults, one in the morning and one in the evening;

NIFLAM ® Niflumic Acid Warnings

In order to reduce the incidence and severity of the side effects associated with niflumic acid therapy, it is recommended to use the minimum effective dose for the shortest period possible, taking care to take the drug preferably on a full stomach.

The doctor should also carefully monitor, through periodic checks, the health status of patients suffering from cardiovascular, coagulative, renal, hepatic, allergic and gastrointestinal diseases, and at the same time undergoing therapy with NIFLAM ®, given the greater susceptibility of these to the side effects of NSAID therapy.

If undesired effects appear, the patient, after contacting his doctor, should seriously consider suspending therapy.

The use of NIFLAM ® in suppositories, could determine the appearance of local irritations in place.

PREGNANCY AND BREASTFEEDING

Given the key role of prostaglandins in appropriately controlling cell proliferation and differentiation processes, it is clear that the administration of non-steroidal anti-inflammatory drugs, including niflumic acid, during pregnancy can seriously compromise normal embryonic and fetal development, thus facilitating the onset of malformations of the respiratory and cardiovascular system, further increasing the risk of unwanted abortions.

For this reason the use of NIFLAM ® is contraindicated during pregnancy and lactation.

Interactions

Like other non-steroidal anti-inflammatory drugs taken by mouth, niflumic acid may also interact with numerous active ingredients, causing significant variations in both the tolerability and the effectiveness of the active ingredient.

Particular attention should be paid to the simultaneous assumption of:

Oral anticoagulants and inhibitors of serotonin reuptake, due to the increased risk of bleeding;
Diuretics, ACE inhibitors, angiotensin II antagonists, methotrexate and cyclosporin, due to their ability to enhance the hepatotoxic and nephrotoxic effects of acetylsalicylic acid;
Non-steroidal anti-inflammatory and corticosteroids, for damage to the gastro-intesintal mucosa
Antibiotics, due to the variations induced in terms of pharmacokinetic and pharmacodynamic properties;
Sulfonylureas, for alterations affecting glucose metabolism, potentially responsible for sudden and severe hypoglycemia.

NIFLAM ® Niflumic Acid Contraindications

Taking NIFLAM ® is contraindicated in case of hypersensitivity to the active ingredient or to one of its excipients, angioedema, peptic ulcer, history of intestinal bleeding, ulcerative colitis, Crohn's disease or previous history for the same diseases, cerebrovascular bleeding, haemorrhagic diathesis or concomitant anticoagulant therapy, renal failure, liver failure, asthma, hypophosphataemia and viral infections.

Undesirable effects - Side effects

Although NIFLAM ® was generally well tolerated and lacking in any particular side effects, the intake of niflumic acid, especially orally and at particularly intense or prolonged dosages, can be associated with a series of commonly observable symptoms in pharmacological therapies based on non-steroidal anti-inflammatory drugs.

Among the most frequently observed adverse reactions are those related to:

Gastrointestinal system with gastric pyrosis, gastralgia, nausea and vomiting, constipation and in more severe cases ulcers and hemorrhages;
Hematopoietic system with increased bleeding time accompanied in severe cases by pan cytopenia;
Nervous and sensory system with loss of hearing and sight, headache, insomnia, drowsiness, confusion and tremors;
Integumentary system with erythema, rash, urticaria and in severe cases bullous reactions.

The intake of NIFLAM ® should also be carried out with particular care in patients suffering from cardiovascular diseases, given the numerous studies that combine prolonged therapy with NSAIDs with an increased risk of cerebral and cardiovascular accidents.