Metamizole
Synonym(s)
Noramidopyrin methanesulfonate
DefinitionThis section has been translated automatically.
Pyrazole derivative with strong analgesic, as well as antipyretic, antiphlogistic and spasmolytic effects, which can be used as an intravenously administered alternative to other i.v. injectable non-opioids, if these cannot be used due to severe hepatic (paracetamol) or renal/cardiac risk factors ( parecoxib).
Pharmacodynamics (Effect)This section has been translated automatically.
Predominantly central inhibition of the COX-3 isoenzyme without effect on the constitutionally present COX-1; therefore no gastrointestinal damage!
Undesirable effectsThis section has been translated automatically.
- Rare: Bone marrow damage with agranulocytosis, severe anaphylactic reactions, drop in blood pressure, hyperhidrosis, possibly red coloration of the urine.
- Cutaneous NW: described are among others urticaria, angioedema, vasculitis allergica, fixed drug exanthema, erythema exsudativum multiforme, toxic epidermal necrolysis, pustulosis, acute generalized exanthematous (AGEP).
The relative risk of agranulocytosis with metamizole is stated to be between 1.5 and 40.2 (according to the Drug Commission of the German Medical Association). The pathomechanism is unclear; an immunological process is suspected. The reaction is dose-independent. Patients must be informed about the risk of agranulocytosis and the need to seek immediate medical attention in the event of suspicious symptoms (fever, sore throat and inflammation). Due to the risk of this side effect, metamizole is not approved in many countries (Kohn D et al 2025).
PreparationsThis section has been translated automatically.
Novalgin, Analgin, Novamine sulfone
LiteratureThis section has been translated automatically.
- Jage J (2009) Key questions on the treatment of postoperative pain. Georg Thieme Verlag, Stuttgart pp.16-21
- Kohn D, Wetzig T (2025). Metamizole-induced agranulocytosis. Dtsch Arztebl Int 122: 210b. DOI: 10.3238/arztebl.m2024.0245