Neutropenia, agranulocytosis and dipyrone

Abstract

CONTEXT: Neutropenia and agranulocytosis may be defined as granulocyte counts of less than 1,500/mm³ and 500/mm³, respectively. Agranulocytosis is a rare and serious disease often caused by drugs. Its mortality rate is around 10%. The most common manifestations are infections such as tonsillitis, pharyngitis, stomatitis or pneumonia. Although dipyrone is one of the drugs known to be associated with agranulocytosis, the strength of the association has been a matter of much debate. Moreover, alternative analgesic and antipyretic agents are not devoid of serious side effects. CONCLUSIONS: It is therefore necessary to establish the incidence of agranulocytosis in Latin America and the role of dipyrone. The ongoing LATIN Study is a multicenter international case-control study that will provide answers for these questions.

Adjunct dipyrone in association with oral morphine for cancer-related pain: the sooner the better

“…Despite of the reported risks of agranulocytosis [5][6][7], dipyrone is frequently used as an over-the-counter medication by millions of patients all over the world. Many cancer patients also employ this medication in countries where it is approved for use [12,13].…”

“…Other countries such as the USA and UK restricted its use because of several reports in the literature of agranulocytosis linked to its utilization [5,6]. The real epidemiologic risk of agranulocytosis associated with dipyrone is still unknown and probably small, as judged by the scarcity of reports in view of its wide use for so many patients [7][8][9]. Other common side effects of dipyrone are somnolence, epigastric pain, and nausea [4]; however, in contrast to other NSAIDs, the incidence of upper gastrointestinal bleeding associated with dipyrone is not increased [10].…”

Efeito da Dipirona, do Naproxeno e do Diclofenaco de Potássio sobre Células Sanguíneas

“…A pesquisa realizada refere-se aos efeitos de fármacos anti-inflamatórios não esteroidais (Faines) sobre a produção leucocitária, sendo delimitada nos seguintes fármacos: dipirona, naproxeno e diclofenaco de potássio, os quais podem causar em neutrófilos a agranulocitose (contagem de neutrófilos inferior a 500/mm3) (HAMERSCHLAK; CAVALCANTI, 2005).…”

Detección de efectos secundarios asociados a la administración de tramadol y dipirona en un hospital de alta complejidad

“…Suecia y otros países industrializados, como Estados Unidos, retiraron el uso de dipirona hacia la década de los setenta, debido a los casos de agranulocitosis y anemia aplásica asociados a su uso, cuya mortalidad está cercana a 10%, y que se asocia a otras manifestaciones clínicas más comunes de tipo infeccioso, tales como amigdalitis, faringitis, estomatitis o neumonía (1). La incidencia de discrasias sanguíneas con la dipirona fue estimada en uno de cada 3.000 usuarios y, en 1981, The Deutsche Bundesgesundheitsamt calculó el riesgo de agranulocitosis con dipirona en uno de cada 20.000 usuarios por año, razón por lo cual también restringió su uso y prohibió todas sus indicaciones (2).…”