Agranulocytosis and other blood dyscrasias associated with dipyrone (metamizole)

Hedenmalm, Karin; Spigset, Olav

doi:10.1007/s00228-002-0465-2

Cited by 223 publications

(139 citation statements)

References 24 publications

(23 reference statements)

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“…therefore, in September 1995, metamizole was re-approved based on the results from the international Agranulocytosis and Aplastic Anaemia Study (iAAAS) (45) and then later, again suspended in April 1999 based on pharmacy sales data and spontaneous reporting of blood dyscrasias in Sweden. hedenmalm and Spigset (43) estimated that the risk of agranulocytosis related to metamizole appears to be at least 1:1439 prescriptions, a much higher figure than previously estimated. Ninety-two percent of the cases of blood dyscrasias occurred during the first 2 months of treatment.…”

Section: Agranulocytosismentioning

confidence: 65%

Metamizole: A Review Profile of a Well-Known “Forgotten” Drug. Part II: Clinical Profile

Nikolova

Petkova

Tencheva

et al. 2013

Biotechnology & Biotechnological Equipment

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Section: Agranulocytosismentioning

confidence: 65%

Metamizole: A Review Profile of a Well-Known “Forgotten” Drug. Part II: Clinical Profile

Nikolova

Petkova

Tencheva

et al. 2013

Biotechnology & Biotechnological Equipment

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“…4 They estimated an incidence of 1 case per 1431 prescriptions on eight cases resulting from 10 892 outpatient prescriptions between 1995 and 1999. If this high incidence was reflected in populations in which dipyrone is commonly used, as in Spain or Brazil, many individuals would succumb to agranulocytosis every year.…”

Section: Discussionmentioning

confidence: 99%

“…It is still widely used in many parts of the world, including the Far East, Africa and Latin and South America. 4 It is available without prescription in places such as Brazil, Israel, Mexico, Russia and Turkey. In Turkey, dipyrone is available in oral tablet, drop and syrup, rectal suppository and injectable forms and almost all forms are cheap in price.…”

Section: Dipyrone Great Killer or Innocent As Any Drug: Two Case Repmentioning

confidence: 99%

Dipyrone, Great Killer or Innocent as Any Drug: Two Case Reports Presenting Rare and Life-Threatening Adverse Effects of Dipyrone

Yiğit¹,

Söyüncü²

2012

Turkiye Klinikleri J Med Sci

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832ipyrone (metamizole) is an antipyretic analgesic that was introduced into clinical practice in 1922. The drug is indicated for severe pain conditions, especially those associated with smooth muscle spasm or colic affecting the gastrointestinal, biliary or urinary tracts. Moreover, it is useful for the treatment of cancer pain and migraine as well as fever refractory to other treatments. 1Dipyrone is a pro-drug that undergoes non-enzymatic hydrolysis in the stomach to form 4-methylamino-antipyrine (4-MAA). This active metabolite is rapidly and almost completely absorbed. Nausea, vomiting, gastric irritaDipyrone, Great Killer or Innocent as Any Drug: Two Case Reports Presenting Rare and Life-Threatening Adverse Effects of Dipyrone A AB BS ST TR RA AC CT T Dipyrone is a potent analgesic and antipyretic drug that has been used clinically for more than 80 years. In some parts of the world, it has been banned because of its association with agranulocytosis. We reported two different cases, presenting with rare but life-threatening adverse effects of dipyrone. First case was a 63-year-old woman that presented to the emergency department with fever. She had developed neutropenia after taking a 500 mg oral dipyrone tablet and following further evaluation was diagnosed with dipyrone-induced agranulocytosis. Second case was a 70-year-old man who presented to the emergency department with diffuse erythematous skin rash after dipyrone injection and was diagnosed with toxic epidermal necrolysis associated with dipyrone. The balance between the benefit and harm is particularly important. Nevertheless, agranulocytosis is not the only life-threatening risk with dipyrone use and limiting the discussion of risks of dipyrone to agranulocytosis leads to an underestimation of the dangers of the drug.K Ke ey y W Wo or rd ds s: : Dipyrone; adverse effects; agranulocytosis; epidermal necrolysis, toxic Ö ÖZ ZE ET T Dipiron, 80 yıldır kullanılan güçlü bir analjezik ve antipiretiktir. Dünyanın bazı bölgele-rinde agranülositoz riski nedeniyle bu ilacın kullanımı yasaklanmıştır. Bu makalede, dipirona bağlı nadir fakat ölümcül olabilen yan etkiler ortaya çıkan iki olgu sunulmuştur. Birinci olgu ateş nedeniyle ağızdan 500 mg dipiron tablet kullandıktan sonra acil servise nötropeni ile başvuran 63 yaşında bir kadındır. İkinci olgu, dipiron enjeksiyonundan sonra acil servise difüz eritematöz döküntülerle başvuran ve toksik epidermal nekroliz tanısı alan 70 yaşında bir erkektir. Bir ilaç için fayda-zarar dengesi çok önemlidir. Dipiron kullanımına bağlı hayatı tehdit eden tek yan etki agranülositoz değildir ve tartışmaları sadece bununla sınırlamak, potansiyel diğer tehlikelerin dikkatten kaçmasına yol açabilir.A An na ah ht ta ar r K Ke el li im me el le er r: : Dipiron; istenmeyen etkiler; agranülositoz; epidermal nekrolizis, toksik T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 12 2; ;3 32 2( (3 3) ): :8 83 32 2--6 6

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“…к нескольким летальным исходам, причиной которых были агра-нулоцитоз и шок. Существует ряд доказательств того, что при длительном назначении метамизола может наступить повреждение системы кроветворе-ния с последующей лейкопенией, агранулоцитозом и даже апластической анемией [5,6]. Это послужи-ло причиной его отзыва с фармацевтического рынка многих стран, в то время как в других он продолжа-ет широко использоваться, в том числе и как безре-цептурное средство [6][7][8].…”

Section: ам овечкин 2001unclassified

“…По расчетам, 1 случай агра-нулоцитоза приходился на 30 тыс. случаев примене-ния препарата [11]. Эти данные стали основанием для принятия регуляторных мер.…”

Section: ам овечкин 2001unclassified

Анальгін — Ефективно? Дешево? Безпечно? Яка Альтернатива?

Sokolov¹,

Nikonov²,

Feskov³

2022

ЕМ

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Agranulocytosis and other blood dyscrasias associated with dipyrone (metamizole)

Cited by 223 publications

References 24 publications

Metamizole: A Review Profile of a Well-Known “Forgotten” Drug. Part II: Clinical Profile

Metamizole: A Review Profile of a Well-Known “Forgotten” Drug. Part II: Clinical Profile

Dipyrone, Great Killer or Innocent as Any Drug: Two Case Reports Presenting Rare and Life-Threatening Adverse Effects of Dipyrone

Анальгін — Ефективно? Дешево? Безпечно? Яка Альтернатива?

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