Metamizol (Latin Metamizolum natricum) is a multifunctional organic chemical compound most commonly used as an analgesic. Today, this drug is very popular with patients. What are the indications and contraindications for the use of metamizole? Does taking it have any side effects?

Metamizolwas first obtained by the German company Hoechst AG in 1920. It was put into production and then on the wider market in 1922. It was available without a prescription until the 1970s ., until the associated risk of agranulocytosis - a very dangerous and unfortunately potentially fatal blood disease was discovered. However, there is no consensus among doctors as to the level of risk associated with metamizole therapy. However, in many countries, this drug has either been withdrawn completely or its availability has been severely restricted. In Poland, tablets taken orally are still available over the counter.

Contents :

  1. Metamizol: application
  2. Metamizol: contraindications
  3. Metamizol: dosage
  4. Metamizol: drug reactions
  5. Metamizol: allergic reactions
  6. Metamizol: allergic skin reactions
  7. Metamizol: hypotensive reactions
  8. Metamizol: drug interactions
  9. Metamizol: summary

Metamizol: application

Metamizol most often comes in the form of tablets, but it is also available in the form of a solution for injection (in this form only when it is impossible to give it in tablets, and in children - when it is also life-threatening in a feverish state).

Metamizol is used when symptoms such as fever and pain of various origins do not stop after taking other medications.

Metamizol: contraindications

You cannot use metamizole in such cases as:

  • hypersensitivity to this substance
  • hypersensitivity to other pyrazolone derivatives or any of the ingredients of the preparation
  • changes in the blood count (leukopenia, agranulocytosis, anemia)
  • hypersensitivity to other non-steroidal anti-inflammatory drugs

Metamizole should be administered with particular caution to patients with:

  • systolic pressure<100 mm Hg
  • gastric ulcer
  • heart failure
  • asthmabronchial
  • duodenal ulcer
  • kidney failure
  • liver failure

Metamizol: dosage

The use of metamizole in high doses or for a long time, unfortunately, increases the risk of a serious disease such as agranulocytosis, so it should not be used for more than 7 days. If long-term use of the drug is necessary, regular visits to the doctor and blood counts are necessary. In the event of a sore throat with mouth ulcers, elevated body temperature, the drug should be discontinued. These are symptoms of agranulocytosis and require treatment.

Also, if you experience symptoms of an anaphylactic reaction (e.g., shortness of breath, tongue edema, angioedema, rash or hives), stop taking the drug immediately and see a doctor as soon as possible.

Patients who suffer from liver disorders and kidney diseases should avoid high doses administered for a long time, because the excretion of the drug and its metabolites is slowed down in these conditions, which means that it may be accumulated in the body. Only short-term use does not require dose reduction.

Metamizol: drug reactions

The way a given patient reacts to metamizole is very different and depends on many factors. Here, elements such as:

  • individual features
  • environmental factors
  • age
  • gender
  • comorbidities
  • concomitantly consumed substances - including herbal medicines and dietary supplements

Therefore, it is difficult to predict both the effect of treatment with metamizole and the occurrence and intensity of side effects of using the drug. However, for their own safety, the patient must be informed of any risks associated with taking metamizole.

Seek medical attention if symptoms of blood dyscrasia appear, for example :

  • persistent fever
  • bleeding
  • infection
  • hematomas
  • pallor
  • generally feeling unwell

Metamizol: allergic reactions

An allergic reaction may also occur after taking metamizole. Therefore, the patient should be aware that in the event of symptoms of an anaphylactic or anaphylactoid reaction:

  • rashes or hives
  • tongue swelling
  • shortness of breath
  • angioedema

should stop taking the medication immediately and call for medical help, because in such a case there is a serious threat to life and only a quick reaction may protect against unpleasant consequences.

Reactionsanaphylactoid problems may appear in patients:

  • with intolerance to painkillers manifested by urticaria, angioedema, especially if accompanied by polypoid rhinitis and sinusitis
  • with chronic urticaria
  • with bronchial asthma - especially with simultaneous sinusitis and nasal polyps
  • intolerant to certain dyes or preservatives (e.g. benzoates)
  • with analgesic asthma syndrome
  • with alcohol intolerance manifested by sneezing, watery eyes and severe redness of the face in reaction even to small amounts of alcohol

If these patients require treatment with metamizole, it must be under strict medical supervision.

Metamizol: allergic skin reactions

Metamizole can cause life-threatening allergic skin reactions.

  • toxic epidermal necrolysis (TEN, Lyell's disease)
  • Stevens-Johnson syndrome (SJS)

If symptoms or signs of TEN or SJS are observed, treatment with metamizole should be discontinued as soon as possible and should never be re-administered. Patients should be sensitized to signs and symptoms and skin reactions should be closely monitored, particularly during the first weeks of treatment. The more aware the patient is, the faster his reaction will be and the easier the treatment will be.

Metamizol: hypotensive reactions

Metamizole can also cause hypotensive reactions. Most often this happens when the drug is administered parenterally.

A drop in blood pressure is most likely in people:

  • with systolic blood pressure less than 100 mmHg
  • with high fever
  • with heart failure
  • multi-organ injuries
  • circulatory disorders - e.g. a heart attack
  • dehydrated
  • with reduced circulating blood volume

In such situations, after administering the drug, the patient and his reactions should be carefully monitored.

You may need to take preventive measures, such as correcting for circulatory problems or staying hydrated, to reduce the risk of hypotensive reactions.

In patients in whom it is necessary for some other reason to avoid lowering blood pressure, e.g. in the case of severe coronary artery disease or significant stenosis of the intracerebral vessels, metamizole should only be used in a hospital setting and under strict supervision.

Metamizol: drug interactions

Before starting treatment with metamizole, the patient should be sure to informa doctor or pharmacist about all medicines taken at the same time - including over-the-counter medicines. Metamizol reacts with the following drugs:

  • MAO inhibitors increase the effect of metamizole
  • enhances the effect of medicinal products: coumarin anticoagulants, oral antidiabetic drugs, phenytoin and antibacterial sulphonamides - therefore patients taking simultaneously e.g. drugs for diabetes and metamizole may have difficulties maintaining normal blood glucose levels
  • reduces the concentration of cyclosporin in the blood serum - a dose change may be required during concomitant use
  • drug methotrexate haemotoxicity
  • barbiturates weaken the effect of metamizole
  • using metamizole with chlorpromazine may cause severe hypothermia

However, it should be remembered that the intensity of drug interactions is unpredictable and depends on many factors.

Due to the lack of studies on the pregnant group, and thus the lack of sufficient data, metamizole is contraindicated in pregnant women just in case. Despite the fact that metamizole is a weak inhibitor of prostaglandin synthesis, unfortunately premature closure of the arterial duct and perinatal complications related to the reduction of the ability of mother's and child's platelets to aggregate cannot be ruled out, which poses a threat to the life and he alth of both the child and mother.

Due to the lack of studies on the pregnant group, and thus the lack of sufficient data, metamizole is contraindicated in pregnant women just in case. Despite the fact that metamizole is a weak inhibitor of prostaglandin synthesis, unfortunately premature closure of the arterial duct and perinatal complications related to the reduction of the ability of mother's and child's platelets to aggregate cannot be ruled out, which poses a threat to the life and he alth of both the child and mother.

Metamizol: summary

Metamizole, despite the risk of causing agranulocytosis (but less than a number of other drugs used today - such as furosemide), is still a relatively safe drug and quite often recommended by doctors - especially in the treatment of perioperative pain or severe pain with fever in hospital postoperative wards and intensive care units.

However, it should be remembered that, like every drug and every chemical substance, also metamizole can have a negative and unpredictable effect on the body, and considering that it is an over-the-counter drug - just keep " common sense ”, and if anyIf you are unsure, consult your doctor or pharmacist.

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