Metamizole

The metamizol or Nolotil as its trademark best known in our country, is a potent analgesic and anti – inflammatory to reduce acute pain in many cases. However, it should always be dispensed under a medical prescription and following the specialist’s instructions.

Precisely, in order to avoid interactions and adverse reactions, its use should be limited to cases of strict need, assessed by a doctor. Its administration (often indiscriminate) corroborates that we are not aware of its interactions with other medications, its contraindications or the recommended daily doses.

How to take metamizole: recommended doses

This drug, also called dipyrone, is a soluble derivative of amiropyrin that has proven analgesic, antipyretic, spasmolytic and anti-inflammatory properties thanks to its ability to inhibit prostaglandins.

In fact, its effect to calm pain is more effective than that obtained with Paracetamol and its anti-inflammatory activity, similar to that of Ibuprofen , is less harmful to the stomach and kidneys.

Therefore, this non-steroidal drug that acts on the central nervous system is indicated to mitigate pain of various origin and intensity :

• dental
• Cephalex.
• Oncological.
• Neuralgic (in nerves or nerve endings).
• Articulate.
• Muscular, due to microbial infections.
• Visceral, as, for example, in renal colic .
• Gastrointestinal cramps.
• Menstrual or genitourinary spasms.
• After surgery or severe trauma.
• To lower the fever , if other antipyretics have not worked.

Both the relevance of its use and its dosage are the responsibility of the doctor , who will attend to the particular characteristics of each patient and the severity of their symptoms.

The usual dose for adults and adolescents over 15 years of age, taken by mouth, is 3-4 capsules of 575 mg per day, for no more than 5 days. It should not be administered to children under 15 years of age.

In the case of the parenteral route, the guideline is one ampoule every 12-24 hours, by intravenous injection; to which an additional 6 grams can be added, three times a day, if there is cancer pain.

The ampoules can also be taken orally dissolved in liquid (preferably water). 30-60 minutes after ingestion, we will notice a notable improvement. In no case should it exceed 5,000 mg per day.

They will alert us to possible overdose poisoning:

• Nausea or vomiting
• Headache or abdominal pain.
• Tachycardia.
• Dizziness or fainting

They will be more atypical symptoms: vertigo , drowsiness or seizures. In all of them prompt medical attention will be necessary.

Contraindications of metamizole

Apart from anaphylactic symptoms, common to all drugs and manifested as rashes, itching, swelling or difficulty breathing, this drug is not recommended in patients with :

• Asthma or respiratory conditions.
• Patients with bone marrow. Metamizole is known to increase the incidence of agranulocytosis in these people.
• Congenital deficiency of certain enzymes .
• Pregnancy and breastfeeding. Its transfer to the mother’s blood and, consequently, to milk, advises against its administration, especially during the first and third trimesters of gestation; as well as during the 48 hours after taking it, if you are breastfeeding.
• Anemia.
• Kidney or liver failure.
• Cardiomyopathies.
• Stomach or duodenal ulcer.
• Smoking
• Alcoholism .
• Under 15 years (especially babies less than 3 months or less than 5 kg in weight).

Side effects of metamizole

Its most common and feared consequences are agranulocytosis and hypotension .

The first consists of a sudden and abrupt drop in white blood cells, which leaves the patient defenseless and exposed to infections. Its symptoms are very similar to those of the flu (joint and throat pain, fever …) and can be fatal. However, its presence in Spain is minimal. It seems that there is a certain genetic predisposition to contract it.

In the 1970s, its sale was banned in countless countries (United States, Australia, England, Sweden, Japan …). In Spain, its consumption, under medical prescription, is safe and its marketing has never been suspended.

In addition, a study published in 1998 by the scientific journal Journal of Clinical Epidemiology compared the side effects of the main analgesic and anti-inflammatory drugs on the market and concluded that metamizole is safer than Aspirin, Paracetamol or Diclofenac .

The drop in blood pressure is more pronounced if the administration is carried out parenterally or in dehydrated patients or with cardiac pathologies.

Complete the list of possible side effects of metamizole :

• Gastrointestinal complaints, such as nausea, vomiting, diarrhea, and stomach pain.
• Change in the color of urine or blood in it.
• Nervous system disorders in the form of drowsiness, restlessness, dizziness or migraines.
• Anemia.
• Fever.
• Fatigue.
• Difficulty to swallow.
• Dry mouth .

Interactions with other medications

It is always convenient to inform the doctor who is treating us about the ingestion of other drugs , in order to discriminate the foreseeable interactions between them and adopt alternative measures.

This is especially significant if, previously, we are taking:

• Drugs indicated to cure infections, such as penicillin.
• Metformin or other medicines for diabetes .
• Medication for bleeding disorders.
• Corticosteroids
• Methotrexate or breast cancer medication.
• Cyclosporine, in those involved in an organ transplant.

How to store metamizole

The usual recommendations on the conservation of metamizole, as in the case of most drugs, are to do so in a place free of humidity and high temperatures (those that exceed 30 ºC). It must be kept out of the sight of children and, if possible, in its original container, to check its expiration date at all times and do not take it once it has expired.

Other tips that will undoubtedly contribute to the recovery of our health and not harm it are:

• Do not suspend or resume treatment on your own initiative.
• Do not reduce or double the dose if the doctor has not told us to do so.
• Use presentations that help us to accurately divide the prescribed dosage.
• Do not drive or operate heavy machinery if the dosage is high, thus avoiding possible accidents.
• Inform the doctor if we observe that the medication causes us an invaluable, very strong effect or any other detail that surprises us.

Applying the measure and practicing these tips we will achieve the restoration of our health in the estimated timeframes and without unnecessary risks.