Metamizole: Current status of the safety and efficacy

Abstract

Metamizole is a nonsteroidal anti-infl ammatory drug, with analgesic, antipyretic, spasmolytic, and weak anti-infl ammatory properties. The analgesic eff ect of metamizole seems to be based on the inhibition of cyclooxygenase enzyme activity and stimulation of cannabinoid receptors. Its use is still controversial, mainly due to agranulocytosis, metamizole-induced serious adverse reaction. While in many countries it is withdrawn from the market, in some countries metamizole is available as a medication prescribed for strictly defi ned indications, while in the others like Mexico, Brazil and China it can be obtained as an Over-The-Counter drug. The most common adverse eff ects of metamizole are the skin and subcutaneous tissue disorders. Metamizole appears to be of similar effi cacy to analgesics which are frequently used in the treatment of moderate to severe postoperative pain.

Pain Management and Analgesics Used in Small Mammals during Post-Operative Period with an Emphasis on Metamizole (Dipyrone) as an Alternative Medication

“…According to other studies, the frequency of these reactions is quite low compared to the advantages offered. Metamizole is still a prescription medication, however it is also accessible over-the-counter (“OTC”) in pharmacies in some countries, including Brazil, Mexico, China, Switzerland, Germany, and Eastern Europe [ 21 ].…”

“…In Spain, metamizole has been one of the most widely used analgesics for treating postoperative pain in children. In Serbia, it is a licensed product for short-term use in post-traumatic pain and postoperative pain [ 21 ].…”

“…It has also been reported that metamizole has a dose-dependent effect on platelet aggregation. It also possesses a spasmolytic effect on smooth muscle [ 21 ].…”

The antipyretic effectiveness of dipyrone in the intensive care unit: A retrospective cohort study

“…Dipyrone (metamizol) is regularly used in critical care for treatment of pain and fever. While dipyrone has been withdrawn from the market for example in the United States of America, the United Kingdom and Japan, especially in Germany and Spain dipyrone is frequently used during perioperative treatments [ 1 ]. However, data for both the risk and benefit of dipyrone treatment in the intensive care environment are scarce [ 2 ].…”

Metamizole - 100 years since discovery

“…Řecku a ve Velké Británii (t. č. již mimo EU). Od prvotního zákazu metamizolu byla provedena celá řada studií, které udávají výskyt agranulocytózy v širokém rozsahu od 1 : 1 439 podání až po 1 : 16 666 667[9][10][11][12][13][14], přičemž většina novějších studií uvádí výskyt méně než 1 : 1 000 000 podání. Prakticky všechny studie byly kritizovány za různé nedostatky v jejich designu, ale skutečně je pravděpodobné,…”