Double-blind, placebo-controlled, multi-centre trial of the efficacy and tolerance of niflumic acid (‘Nifluril’) capsules in the treatment of tonsillitis in adults

Sauvage, J.-P.; Ditisheim, Agnès; Bessede, J.; David, Norman A.

doi:10.1185/03007999009112689

Cited by 10 publications

(7 citation statements)

References 6 publications

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“…After both 2 and 4 days, the patients receiving niflumic acid showed greater improvements in fever, pain, adenopathy, pharyngeal congestion, dysphagia and health-related quality-of-life (HRQoL) than those receiving placebo. 54 Similar results were obtained in a doubleblind, placebo-controlled trial evaluating the efficacy of morniflumate suppositories plus phenoxymethylpenicillin versus phenoxymethylpenicillin alone in children with acute tonsillitis (n ¼ 101). 55 Children were randomized to receive 400 mg morniflumate or placebo suppository twice daily for 4 days, in addition to phenoxymethylpenicillin (1.5 Â 10 6 IU daily).…”

Section: Therapeutic Efficacy Upper and Lower Airwayssupporting

confidence: 62%

“…[54][55][56][57] A randomized, placebo-controlled study was conducted in 231 adult patients with acute pharyngitis or acute tonsillitis with fever and dysphagia. 54 Patients were randomized to receive four capsules of 250 mg niflumic acid or placebo daily, in addition to phenoxymethylpenicillin (1.5 Â 10 6 IU), for 4 to 5 days. After both 2 and 4 days, the patients receiving niflumic acid showed greater improvements in fever, pain, adenopathy, pharyngeal congestion, dysphagia and health-related quality-of-life (HRQoL) than those receiving placebo.…”

Section: Therapeutic Efficacy Upper and Lower Airwaysmentioning

confidence: 99%

“…The efficacy of niflumic acid/morniflumate for the treatment of pharyngitis and tonsillitis has been evaluated in four randomized trials. 54–57 A randomized, placebo-controlled study was conducted in 231 adult patients with acute pharyngitis or acute tonsillitis with fever and dysphagia. 54 Patients were randomized to receive four capsules of 250 mg niflumic acid or placebo daily, in addition to phenoxymethylpenicillin (1.5 × 10 6 IU), for 4 to 5 days.…”

Section: Therapeutic Efficacymentioning

confidence: 99%

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Efficacy and Safety of Morniflumate for the Treatment of Symptoms Associated with Soft Tissue Inflammation

Cremonesi

Cavalieri

2015

J Int Med Res

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The effectiveness of nonsteroidal antiinflammatory drugs (NSAIDs) for the management of pain in osteoarthritis and other musculoskeletal diseases is well documented. The role of NSAIDs is less clear in the treatment of conditions involving soft tissue inflammation, including the airways, earnose-throat (ENT) system and urogenital tract. These conditions are often treated inappropriately with antibiotics. Morniflumate, the ß-morpholinoethyl ester of niflumic acid, is a member of the fenamate family of NSAIDs indicated for the treatment of inflammatory conditions (with or without pain) affecting airways, the ENT system, urogenital tract and the osteoarticular system. Morniflumate has a 30-year history of clinical use, particularly for the treatment of pain associated with paediatric ENT infection. This article reviews evidence supporting the efficacy and safety of morniflumate. Based on available evidence and the favourable tolerability profile emerging from extensive clinical use, morniflumate appears to be a valid and well-tolerated alternative to other NSAIDs, or to antibiotics, for the treatment of pain and other symptoms of soft tissue inflammation.

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Section: Therapeutic Efficacy Upper and Lower Airwayssupporting

confidence: 62%

Section: Therapeutic Efficacy Upper and Lower Airwaysmentioning

confidence: 99%

Section: Therapeutic Efficacymentioning

confidence: 99%

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Efficacy and Safety of Morniflumate for the Treatment of Symptoms Associated with Soft Tissue Inflammation

Cremonesi

Cavalieri

2015

J Int Med Res

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“…This drug and its derivatives are used worldwide clinically for the relief of chronic and acute pain conditions (Vincent et al, 1999; Kang et al, 2008; Cremonesi and Cavalieri, 2015). As a compound with anti-inflammatory, antipyretic, and analgesic therapeutic activity, NFA has been successfully used in clinical trials in adults (Sauvage et al, 1990; Mero et al, 2013) and children (Manach and Ditisheim, 1990; Lantz et al, 1994; Sturkenboom et al, 2005). The primary mechanism of NFA action is the inhibition of enzymes involved in the synthesis of proinflammatory prostaglandins (Smith, 1992; McCarberg and Gibofsky, 2012): cyclooxygenase (prostaglandin synthase) (Barnett et al, 1994; Johnson et al, 1995) and phospholipase A2 (PLA 2 ) (Jabeen et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Voltage-Dependent Inhibition of Glycine Receptor Channels by Niflumic Acid

Maleeva

Peiretti

Zhorov

et al. 2017

Front. Mol. Neurosci.

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Niflumic acid (NFA) is a member of the fenamate class of nonsteroidal anti-inflammatory drugs. This compound and its derivatives are used worldwide clinically for the relief of chronic and acute pain. NFA is also a commonly used blocker of voltage-gated chloride channels. Here we present evidence that NFA is an efficient blocker of chloride-permeable glycine receptors (GlyRs) with subunit heterogeneity of action. Using the whole-cell configuration of patch-clamp recordings and molecular modeling, we analyzed the action of NFA on homomeric α1ΔIns, α2B, α3L, and heteromeric α1β and α2β GlyRs expressed in CHO cells. NFA inhibited glycine-induced currents in a voltage-dependent manner and its blocking potency in α2 and α3 GlyRs was higher than that in α1 GlyR. The Woodhull analysis suggests that NFA blocks α1 and α2 GlyRs at the fractional electrical distances of 0.16 and 0.65 from the external membrane surface, respectively. Thus, NFA binding site in α1 GlyR is closer to the external part of the membrane, while in α2 GlyR it is significantly deeper in the pore. Mutation G254A at the cytoplasmic part of the α1 GlyR pore-lining TM2 helix (level 2′) increased the NFA blocking potency, while incorporation of the β subunit did not have a significant effect. The Hill plot analysis suggests that α1 and α2 GlyRs are preferably blocked by two and one NFA molecules, respectively. Molecular modeling using Monte Carlo energy minimizations provides the structural rationale for the experimental data and proposes more than one interaction site along the pore where NFA can suppress the ion permeation.

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“…In cases that are refractory to such remedies, systemic (paracetamol [52], NSAIDs such as acetylsalicylic acid [53], ibuprofen [52,[54][55][56], niflumic acid [57], tiaprofenic acid [58], morniflumate [59], corticosteroids [60], etc.) might be considered.…”

Section: Non-antibiotic Treatments For Sore Throat?mentioning

confidence: 99%

Efficacy and Safety of Ambroxol Lozenges in the Treatment of Acute Uncomplicated Sore Throat

Mey

Peil

Kölsch

et al. 2011

Arzneimittelforschung

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Sore throat is the hallmark of acute pharyngitis. Although usually caused by viral infections, it is frequently treated with antibiotics. Such inappropriate use of antibiotics might best be challenged by offering efficacious and safe symptomatic pain relief instead. However, there is need for robust evidence to support such alternatives. Presently, the evidence from randomised, placebo-controlled, double-blind clinical trials (RCT) with the local anaesthetic ambroxol (CAS 23828-92-4) in the treatment of sore throat is being reviewed. This relates to five RCT in 1,772 patients; 1,713 were evaluable with regard to efficacy. Treatment with ambroxol lozenges was statistically significantly superior to placebo in reducing sore throat pain intensity with a high level of consistency of the estimated effect across the different studies. The effect had an early onset and lasted up to at least 3 h after a single first lozenge. The pain relief was associated with a statistically superior regression of pharyngeal redness and inflammation; with ambroxol, the overall efficacy was more frequently rated as at least "good". Treatment with the ambroxol lozenges was well tolerated. There was heterogeneity in reporting adverse events: in one later study with less severe baseline pain intensity there was more frequent reporting of hypoaesthesia of the oral cavity and tongue as an untoward phenomenon. In patients with more severe baseline pain this reflection of the medication's pharmacological action was only rarely reported as untoward. It is concluded that lozenges containing 20 mg ambroxol are a safe and efficacious treatment for acute uncomplicated sore throat of recent onset in adult patients.

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Double-blind, placebo-controlled, multi-centre trial of the efficacy and tolerance of niflumic acid (‘Nifluril’) capsules in the treatment of tonsillitis in adults

Cited by 10 publications

References 6 publications

Efficacy and Safety of Morniflumate for the Treatment of Symptoms Associated with Soft Tissue Inflammation

Efficacy and Safety of Morniflumate for the Treatment of Symptoms Associated with Soft Tissue Inflammation

Voltage-Dependent Inhibition of Glycine Receptor Channels by Niflumic Acid

Efficacy and Safety of Ambroxol Lozenges in the Treatment of Acute Uncomplicated Sore Throat

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