DESCRIPTION:-
Metamizole (dipyrone) is a popular analgetic, non-opioid drug, commonly used in human and veterinary medicine. In some cases, this agent is still incorrectly classified as a non-steroidal anti-inflammatory drug (NSAID). Metamizole is a pro-drug, which spontaneously breaks down after oral administration to structurally related pyrazolone compounds. Apart from its analgesic effect, the medication is an antipyretic and spasmolytic agent. The mechanism responsible for the analgesic effect is a complex one, and most probably rests on the inhibition of a central cyclooxygenase-3 and activation of the opioidergic system and cannabinoid system. Metamizole can block both PG-dependent and PG-independent pathways of fever induced by LPS, which suggests that this drug has a profile of antipyretic action distinctly different from that of NSAIDs. The mechanism responsible for the spasmolytic effect of metamizole is associated with the inhibited release of intracellular Ca2+ as a result of the reduced synthesis of inositol phosphate. Metamizole is predominantly applied in the therapy of pain of different etiology, of spastic conditions, especially affecting the digestive tract, and of fever refractory to other treatments. Co-administration of morphine and metamizole produces superadditive, antinociceptive effects. Metamizole is a relatively safe pharmaceutical preparation although it is not completely free from undesirable effects. Among these side-effects, the most serious one that raises most controversy is the myelotoxic effect. It seems that in the past the risk of metamizole- induced agranulocytosis was exaggerated. Despite the evidence showing no risk of teratogenic and embryotoxic effects, the drug must not be administered to pregnant women, although it is allowed to be given to pregnant and lactating animals. This paper seeks to describe the characteristics of metamizole in the light of current knowledge.
Pharmacodynamics
Dipyrone is a non-steroidal anti-inflammatory drug (NSAID), commonly used in the past as a powerful painkiller and fever reducer.
DRUG INTERACTION:-
1. Abciximab+ metamizole = Metamizole may increase the anticoagulant activities of Abciximab.
2. Acebutolol+ metamizole = Metamizole may decrease the antihypertensive activities of Acebutolol.
3. Aceclofenac+ metamizole = The risk or severity of adverse effects can be increased when Metamizole is combined with Aceclofenac.
4. Acenocoumarol+ metamizole = Metamizole may increase the anticoagulant activities of Acenocoumarol.
5. Acetylsalicylic acid+ metamizole = The risk or severity of adverse effects can be increased when Acetylsalicylic acid is combined with Metamizole.
6. Adapalene + metamizole = The risk or severity of adverse effects can be increased when Adapalene is combined with Metamizole.
7. Aldesleukin+ metamizole = The risk or severity of adverse effects can be increased when Metamizole is combined with Aldesleukin.
8. Alemtuzumab+ metamizole = The risk or severity of adverse effects can be increased when Metamizole is combined with Alemtuzumab.
9. Alendronic acid+ metamizole = The risk or severity of adverse effects can be increased when Metamizole is combined with Alendronic acid.
10. Aliskiren+ metamizole = Metamizole may decrease the antihypertensive activities of Aliskiren.
SIDE EFFECTS:-
The most serious side effect of Metamizol is the one mentioned above, a negative effect on the bone marrow. It causes a decrease in the white blood cell count, or agranulocytosis. This usually occurs on the second or subsequent use of the drug, because the body begins to build antibodies to it. Once antibodies are formed, your body can have an allergic reaction that can be fatal. Continuing to use it can be toxic to the kidneys and produce skin rashes and asthma. Other side effects come from the codeine that is part of the composition of this medication, which can cause constipation, drowsiness, and dizziness. To counteract this, you should eat a high-roughage diet while you are being treated with Metamizol.
THERAPEUTIC USES:-
It is primarily used for perioperative pain, acute injury, colic, cancer pain, other acute/chronic forms of pain and high fever unresponsive to other agents
REFERENCE:-Tripathi K D"Essential of medical pharmacology",7th edition ,page no-192,203
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