Evaluation of hematological alterations after therapeutic use of dipyrone in healthy adults: a prospective study

Abstract

Background Dipyrone is a non-narcotic analgesic/antipyretic widely used in some countries but prohibited in others due to suspected risk of agranulocytosis. The primary goal of this study was to evaluate hematological alterations in healthy adult volunteers after treatment with dipyrone. Methods The study enrolled 30 healthy volunteers of both genders, aged 19-37 years. They received tablets containing 500 mg of dipyrone sodium to be used four times daily for 7 consecutive days. Before the first administration, arterial pressure was measured and blood was collected in order to evaluate hematological baseline parameters. On the 8th day after the beginning of treatment, the volunteers had their blood pressure assessed once more and underwent a second blood draw. Total and specific leukocyte counts, creatinine, urea, aspartate aminotransferase (AST), alanine aminotransferase (ALT), erythrocytes, and platelets were quantitatively determined. Results No statistically significant difference was observed among total or specific leukocyte counts. Number of platelets, erythrocytes, hemoglobin, and hematocrit decreased after treatment. Diastolic pressure, mean arterial pressure (MAP), and urea concentration declined, while creatinine, AST, and ALT showed no significant alterations. It is noteworthy that, even for parameters that showed statistically significant changes, the highest and lowest values remained within the normal ranges. Conclusions Although dipyrone has historically been associated with agranulocytosis, leukocyte counts remained practically unchanged after oral administration of dipyrone. On the other hand, the present study adds evidence that dipyrone is able to produce statistically relevant decrease in number of platelets, erythrocytes, hemoglobin, and hematocrit in healthy adults, even after short-term treatment.

Accumulation of Major Linezolid Metabolites in Patients with Renal Impairment

“…S1 in the supplemental material). Metamizole and its structural analogs were removed from the U.S. market in the 1970s due to an increased risk of blood dyscrasias (13,14). Furthermore, the aniline functional group present in linezolid and its metabolites is an important structural alert in medicinal chemistry for myelosuppression risk (see Fig.…”

The Adequacy of Anesthesia Guidance for Vitreoretinal Surgeries with Preemptive Paracetamol/Metamizole

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The effects of metamizole on hematopoietic progenitor cells: Suppression of hematopoiesis stimulation in vitro

“…Although the mechanism of metamizole has not been fully elucidated, its effect is mainly related to the inhibition of cyclooxygenases. Although classifi ed as a non-steroidal anti-infl ammatory drug, metamizole has weak anti-infl ammatory properties (2). Despite a well-known good gastrointestinal safety profi le, the reports of spontaneous adverse drug reactions indicate the presence of metamizole-induced blood dyscrasias, including metamizole-induced neutropenia and agranulocytosis, a more severe form (1).…”