Review Aulin^® 100 mg 

Indications: Painkiller

Supplements and medicines are examined and evaluated here solely from the point of view of their chemical composition, based on relevant scientific studies. No medical opinion is expressed on curative functions. The opinion must be expressed by the treating physician.

Ingredients:

Let us look at the most significant ingredients in order of quantity as indicated on the label. For reasons of space, here is a brief summary. For the full text, studies and bibliography, just click on the ingredient and, if you want to go deeper, it is perhaps a little complex reading because it deals with scientific studies, but it clarifies the ingredient/health relationship. 

There are three versions of Aulin® : tablets, sachets and suppositories. I have only tried two: tablets and sachets.

Active ingredient: Nimesulide

Non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties, launched on the market in 1985 in Italy and marketed in more than 50 countries worldwide with relatively low risk of gastrointestinal side effects. Not available in the United States.

A brief history

Nimesulide was reported to be hepatotoxic in 1997 and its use was restricted or banned in 2002 first in Finland and then in Spain due to the high frequency of associated hepatotoxicity. However, several studies have downgraded the problem and the European Medicines Agency, after an extensive study, recognised its analgesic efficacy in

• intense pain
• dysmenorrhoea
• pain from osteoarthritis 
• pain from traumatic sprains and tendonitis

taking into account the risk/benefit ratio, only recommended a maximum daily dose for the 100mg dose. Stricter restrictions apply to the 200mg dose. 

An important study from 2010 clarifies the risk/benefit ratio comprehensively: "Results suggest that implementation of regulatory actions regarding nimesulide may have prevented 79 admissions for liver damage, but increased admissions for UGIB by 859 cases."

Nimesulide as a preferential inhibitor of cyclooxygenase-2 could play a potential therapeutic role in the management of patients with cerebral ischaemia and, together with silver complexes, a potential safe agent for the topical treatment of skin cancer in humans.

Antidiabetic activity of Nimesulide has also been demonstrated.

However, recently, a study by the Universities of Brazil, Spain and Argentina has re-proposed, this time negatively, the risk/benefit ratio of Nimesulide.  Frankly, from the consumer's point of view, it is difficult to make a choice since studies differ in their conclusions. The only solution is to ask your doctor for advice.

Tablet excipients:

Docusato sodico Emulsifier in tablets and pharmaceutical preparations. It is also an effective remedy against constipation and in particular as a stool softener. although Psyllium has been shown to be more effective.

Idrossipropilcellulosa is used for its biocompatibility as a drug carrier, emulsion stabiliser, binder, thickener. In particular, as hydroxypropylcellulose exhibits both organic and water solubility, it is suitable for solvent methods of drug delivery to produce solid dispersions. At low viscosity, hydroxypropylcellulose is an excellent pharmaceutical excipient. Due to its bioadhesive and hydrophilic properties it can be used mainly in topical and oral pharmaceutical formulations.

Lattosio monoidrato filling binder and compression aid in pharmaceutical mixtures.

Carbossimetalamido sodico is a plant polysaccharide extracted mainly from maize. It acts as a superdisintegrator for all solid oral dosage forms. It has a capacity to swell to 280 - 320 times its original granule volume. It is an excipient especially used for wet or dry granulation and direct compression and can be incorporated in intra- or extra-granular mode. or both. It generally has a potato starch base. It is produced in two types: Type A with low viscosity and low residual solvent and Type B which is particularly suitable for strongly acidic drug formulations to maintain stability and resist acidic pH.

E460 Cellulosa microcristallina,  thickener and stabiliser.

E572 Magnesio stearato A classic excipient for solid oral dosage forms. It is used as an essential lubricant in production for dissolution, disintegration and hardness of the tablet, or in this case, the powder.

Excipients of sachets:

Cetomacrogol 1000  Solubiliser for poorly soluble drugs.

Acido citrico   is used in pharmacological formulations such as 'gummy' formulations and to suppress the bitter taste of certain ingredients. This gives it the effect of a 'flavour enhancer'.

Amido di mais  has the task of facilitating the disintegration of the tablet or powder.

Aroma arancio is a generic term for a fragrance. Flavours may be natural products, but most are of chemical origin. No manufacturer declares which chemical compound is behind it. 

Conclusions

Aulin^® is a well-known drug and, in my experience, I much prefer the tablet version to the sachet version. The reason for this is that the two chemical compounds 'Cetomacrogol 1000' and 'Aroma' are included in the formula for the sachets, which I prefer to avoid, as can be seen from the descriptions and scientific studies cited. Nothing serious, of course, but I think the tablet version is much better.