Can a cyclo-oxygenase type-2 selective tocolytic agent avoid the fetal side effects of indomethacin?

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 108; no. 3; pp. 325 - 326
• Main Authors: LOCATELLI, Anna, VERGANI, Patrizia, BELLINI, Primula, STROBELT, Nicola, GHIDINI, Alessandro
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01-03-2001
• Subjects: Administration, Oral; Adult; Biological and medical sciences; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors - adverse effects; Female; Genital system. Reproduction; Humans; Indomethacin - adverse effects; Isoenzymes - antagonists & inhibitors; Medical sciences; Membrane Proteins; Obstetric Labor, Premature - prevention & control; Oligohydramnios - chemically induced; Pharmacology. Drug treatments; Pilot Projects; Pregnancy; Prostaglandin-Endoperoxide Synthases; Sulfonamides - administration & dosage; Sulfonamides - adverse effects; Tocolytic Agents - administration & dosage; Tocolytic Agents - adverse effects; Treatment Outcome; Human; Prostaglandin-endoperoxide synthase; Intravenous administration; Pregnancy disorders; Enzyme; Treatment efficiency; Indometacin; Oral administration; Non response; Tocolytic; Chemotherapy; Analog; Pilot test; Indoleacetic acid derivatives; Female; Threatened premature delivery; Ritodrine; Oxidoreductases; Nimesulide; Safety
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1016/S0306-5456(00)00071-1

We evaluated the efficacy and safety of nimesulide (100 mg orally twice daily for > 48 hours) in a pilot series of five women (two with twin pregnancies) at 24(+6) weeks (range 21(+3) - 27(+2)) in preterm labour which was unresponsive to intravenous ritodrine. Nimesulide therapy was continued for eight days (5-16) and was associated with a prolongation of pregnancy of 27 days (6-69). Oligohydramnios occurred in all seven fetuses after three to nine days of therapy, and in the five pregnancies that continued after discontinuation of nimesulide, it resolved within four days (2-7). None of the babies manifested permanent renal damage.