Nimesulide is a new nonsteroidal anti-pyretic drug which is now commonly being used in pediatric practice. Some studies have shown a better antipyretic effect than para-cetamol and salicylates(1).

Nimesulide is considered to be a safe drug with no significant side effects. It can cause mild gastrointestinal symptoms, excessive perspiration, heart burn, flushing and skin rashes. Hematuria has recently been reported after administration of this drug(2).

I have observed hypothermia in six cases administrated Nimesulide recently in the age group of 6 months to 5 years. The temperature of one child fell to 94ºF (axillary) after giving a therapeutic dose (5 mg/kg/day with a measured cup in divided doses). The child, suffering from acute tonsillitis with a temperature of 105ºF, developed hypothermia after 2 hours of medication in the summer season. The mother complained of severe cold, shivering and ice cold skin. There was no sweating but mild tachycardia was recorded. Blood pressure and other vitals were within normal limits. The child was wrapped in a blanket. Intravenous fluids were given prophy-lactically and vitals were observed closely. The temperature improved after 5-6 hours. The therapeutic dose was repeated next time and the child again developed the same symptoms. Similar observations were made subsequently in 5 other children during a period of 10 months. This side effect of severe hypothermia has not been reported earlier.

Small children below 1 year of age should be given this drug cautiously. More observa-tions are required to substantiate hypothermia as a side-effect of nimasulide administration.