Dipyrone and blood dyscrasia revisited: "non-evidence based medicine"

Analgesic Effectiveness of Dipyrone (Metamizol) for Postoperative Pain after Herniorrhaphy: A Randomized, Double‐Blind, Dose–Response Study

“…Dipyrone, also known as metamizol or by the derogatory nickname “the mexican aspirin”, 9 is a controversial analgesic banned in the U.S.A., Canada, Japan, Sweden, and the U.K., due its association with agranulocytosis 10 . However, dipyrone is widely used in Brazil, Germany, Mexico, Spain, Argentina, Colombia, and some African countries, among others 11 . The mechanism of action of dipyrone is different from that of traditional NSAIDs; this is a nonacidic drug that works by a direct blockade of the peripheral inflammatory hyperalgesia as well as by spinal effect, that of stimulating the arginine/cGMP pathway in sensory neurons 12 .…”

“…10 However, dipyrone is widely used in Brazil, Germany, Mexico, Spain, Argentina, Colombia, and some African countries, among others. 11 The mechanism of action of dipyrone is different from that of traditional NSAIDs; this is a nonacidic drug that works by a direct blockade of the peripheral inflammatory hyperalgesia as well as by spinal effect, that of stimulating the arginine/cGMP pathway in sensory neurons. 12 Furthermore, recent studies have demonstrated that dipyrone can activate the opioid circuits involved in descending pain modulation.…”

Safe use of dipyrone

“…6 Como lo han informado los estudios más citados sobre farmacovigilancia y dipirona, la incidencia de agranulocitosis y anemia aplásica oscila entre 0,5 y 2,7 casos por millón de consumidores. 7 La incidencia de agranulocitosis, al parecer, depende de factores genéticos y de exposición previa al medicamento, lo que explica la gran disparidad entre estudios latinos 8 y estudios nórdicos. 9 Es tan baja la incidencia de agranulocitosis asociada a la dipirona que casi siempre resulta en un reporte de caso, como el que nos atañe en este momento.…”

Metamizole (Dipyrone) and the Liver: A Review of the Literature

“…A single‐site analysis in a US urban pediatric hospital revealed that over one‐third of all Spanish‐speaking Latino families had used metamizole before . Therefore, metamizole has received the (politically incorrect) nickname “Mexican aspirin” in some regions of the United States …”

“…43 Therefore, metamizole has received the (politically incorrect) nickname "Mexican aspirin" in some regions of the United States. [44][45][46] A new appearance of metamizole, especially in the United States, is associated with its growing application as an adulterant in illicit drugs. 47,48 For instance, metamizole has recently been detected in illegal fentanyl samples (which itself is often used to cut heroin) by different chromatography-based analyses.…”