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U M Stamer, U Gundert-Remy, E Biermann, J Erlenwein, W Meiβner, S Wirz, T Stammschulte
BACKGROUND: Dipyrone (metamizole) is a non-opioid analgesic commonly used in Germany, which can, in very rare cases, cause life-threatening agranulocytosis. The prescribing information calls for regular monitoring of the differential blood count in cases of long-term treatment. However, there is uncertainty about how this testing should be handled in practice. OBJECTIVES: Which recommendations can be derived from the published literature for evaluating blood cell counts during treatment with metamizole and which other options for monitoring exist? METHODS: Data from recent epidemiological studies, reviews, and spontaneously reported cases were evaluated...
October 20, 2016: Der Schmerz
Josef Donnerer, Ingrid Liebmann
Allyl isothiocyanate (AITC, mustard oil, 50-200 µmol/l), depending on specific dosages, inhibited the cholinergic twitch response in the longitudinal muscle-myenteric plexus (LMMP) strip of the guinea-pig ileum. AITC also induced short-lasting contractile responses, and decreases of the basal tone of the LMMP strip at low concentrations and increases at high concentrations. Hexamethonium, a blocker of nicotinic ganglionic transmission, was able to prevent the AITC-evoked inhibitory effect, an effect that was also observed with the opioid antagonist naloxone...
October 19, 2016: Pharmacology
Fabian Kahl, Andreas Frewer
Background: In 2015 the number of refugees who sought asylum in Germany has increased dramatically. Therefore, the medical care for these refugees faces huge challenges. The treatment of mental illness of refugees is a particular difficult topic. Objective of this study is the acquisition of the outpatient prescriptions of drugs for newly arrived refugees in Erlangen, focused on psychotropic drugs. Methods: Evaluation of all outpatient prescribed drugs (n=1 137), which were prescribed between 10/01/2014 and 09/30/2015 for asylum seekers living in the refugee center in Erlangen, a branch of the "Central Admission Institution" ("ZAE") Zirndorf...
October 17, 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Abdurrahman Emir, Yıldıray Kalkan, Habib Bostan
OBJECTIVES: We investigated the histopathological effects of metamizole sodium (MS) on the sciatic nerve. MATERIALS AND METHODS: This study was performed using 48 adult male Wistar albino rats. Ten groups were constituted with 6 rats in each group. MS injection into the sciatic nerve (group 1), MS injection into the muscle [group 3 (50 mg/kg, 0.4 ml) and group 5 (50 mg/kg, 0.8 ml)], MS injection into the muscle cavity in the vicinity of the sciatic nerve [group 2 (50 mg/kg, 0...
August 2016: Iranian Journal of Basic Medical Sciences
Gemma Amo, José A Cornejo-García, Jesus M García-Menaya, Concepcion Cordobes, M J Torres, Gara Esguevillas, Cristobalina Mayorga, Carmen Martinez, Natalia Blanca-Lopez, Gabriela Canto, Alfonso Ramos, Miguel Blanca, José A G Agúndez, Elena García-Martín
The high-affinity IgE receptor (Fcε RI) is a heterotetramer of three subunits: Fcε RIα, Fcε RIβ, and Fcε RIγ (αβγ2) encoded by three genes designated as FCER1A, FCER1B (MS4A2), and FCER1G, respectively. Recent evidence points to FCERI gene variability as a relevant factor in the risk of developing allergic diseases. Because Fcε RI plays a key role in the events downstream of the triggering factors in immunological response, we hypothesized that FCERI gene variants might be related with the risk of, or with the clinical response to, selective (IgE mediated) non-steroidal anti-inflammatory (NSAID) hypersensitivity...
2016: Frontiers in Pharmacology
B E Brito, E Vazquez, P Taylor, Y Alvarado, H Vanegas, A Millan, V Tortorici
BACKGROUND: Opioid effectiveness to treat cancer pain is often compromised by the development of tolerance and the occurrence of undesirable side effects, particularly during long-term treatment. Hence, the search for more efficient analgesics remains a necessity. The main goal of this study was to relieve neuropathic symptoms associated with tumour growth by administering the non-opioid analgesic dipyrone (DIP) alone or in combination with magnesium chloride (MgCl2 ), an adjuvant that blocks the NMDA receptor channel...
October 10, 2016: European Journal of Pain: EJP
Daniel Ruiz-Pérez, Javier Benito, Carlota Largo, Gonzalo Polo, Susana Canfrán, Ignacio Alvarez Gómez de Segura
Unlike non-steroidal anti-inflammatory drugs (NSAIDs), metamizole has poor anti-inflammatory effects; and is suitable for models where analgesia, but not anti-inflammatory effects, is desirable. Like opioids, these drugs produce perioperative analgesia while reducing anaesthetic requirements, but it remains unclear whether they may develop tolerance or hyperalgesia, and thus decrease in analgesic efficacy. The aim was to determine whether tolerance or hyperalgesia to metamizole occurred in rats, and whether the sevoflurane minimum alveolar concentration (MAC) was affected...
September 30, 2016: Laboratory Animals
Björn Stessel, Michiel Boon, Elbert A Joosten, Jean-Paul Ory, Stefan Evers, Sander M J van Kuijk, Jasperina Dubois, Daisy Hoofwijk, Luc Jamaer, Wolfgang F F A Buhre
BACKGROUND: Postoperative pain and, in a more extended perspective, quality of recovery (QOR) should be considered the principal endpoints after day surgery. Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol are a cornerstone of pain treatment after painful day surgery. Nevertheless, NSAIDs are not always sufficiently effective, have numerous contraindications, and consequently are not suitable in up to 25 % of all patients. Metamizole is a non-opioid compound with a favourable gastrointestinal, cardiovascular and cerebrovascular profile compared to NSAIDs...
September 26, 2016: Trials
Jorge Enrique Machado-Alba, Manuel José Londoño-Builes, Luis Felipe Echeverri-Cataño, Sergio Andrés Ochoa-Orozco
INTRODUCTION: Recognizing adverse drug reactions (ADRs) is becoming more important in clinical practice.  OBJECTIVE: To determine the frequency of adverse drug reactions and ADR suspicions among the population affiliated to the Colombian health system and to describe the drugs, reactions and associated variables.  MATERIALS AND METHODS: We revised ADRs and ADRs suspicion databases from drugs dispensed by Audifarma, S.A., both for inpatient and outpatient care from 2007 to 2013...
2016: Biomédica: Revista del Instituto Nacional de Salud
Robert Sümpelmann, Melanie Fieler, Christoph Eich, Karin Becke, Gregor Badelt, Klaus Leimkühler, Nils Dennhardt
Background Due to possible serious adverse drug reactions (ADRs), the use of metamizole for postoperative pain therapy in infants is a subject of debate. Safety studies with large sample sizes are missing. Aim This prospective multicenter observational study was conducted to evaluate the use of metamizole in infants younger than 1 year undergoing surgery with a particular focus on possible serious ADRs (e.g., hemodynamic, anaphylactic or respiratory reactions, and agranulocytosis). Methods Infants aged up to 1 year (American Society of Anesthesiologists [ASA] I-III) receiving a single dose of metamizole for postoperative pain therapy were enrolled...
September 5, 2016: European Journal of Pediatric Surgery
Marcel A Souki
No abstract text is available yet for this article.
October 2016: European Journal of Anaesthesiology
Robert Sümpelmann, Karin Becke, Christoph Eich
No abstract text is available yet for this article.
October 2016: European Journal of Anaesthesiology
Tarik Ocak, Erdal Tekin, Mustafa Basturk, Arif Duran, Mustafa Serinken, Mucahit Emet
BACKGROUND: There is a lack of specificity of the analgesic agents used to treat headache and underlying acute carbon monoxide poisoning. OBJECTIVE: To compare effectiveness of "oxygen alone" vs "metoclopramide plus oxygen" vs "metamizole plus oxygen" therapy in treating carbon monoxide-induced headache. DESIGN: A prospective, multicenter, double-blind, controlled trial. SETTING: Three emergency departments in Turkey...
August 5, 2016: American Journal of Emergency Medicine
Sevket Arslan, Ramazan Ucar, Ahmet Zafer Caliskaner
Metamizole, a non-steroidal anti-inflammatory drug with weak anti-inflammatory and spasmolytic effects, is used as an analgesic and antipyretic agent. Many adverse reactions to metamizole, such as early or late-onset systemic reactions and bone marrow suppression, have been identified. In this report, we present a case of systemic reaction after the application of parenteral metamizole (Novalgin(®) ampoule; Sanofi Aventis, İstanbul, Turkey) and discuss the mechanism underlying the reaction.
June 2016: Eurasian Journal of Medicine
Annegret Winkler, Silke Kietz, Hagen Bahlmann, Gunel Jafarzade, Holger N Lode, Matthias Heckmann
This case report describes the successful use of granulocyte and macrophage colony-stimulating factor as salvage therapy and an alternative to hematopoietic stem cell transplantation in a 14-year-old adolescent with metamizole (dipyrone)-induced agranulocytosis and severe septic shock.
August 2016: Clinical Case Reports
M Giorgi, S Aupanun, H-K Lee, A Poapolathep, R Rychshanova, C Vullo, V Faillace, F Laus
Metamizole (MT) is an analgesic and antipyretic drug labelled for use in humans, horses, cattle, swine and dogs. MT is rapidly hydrolysed to the active primary metabolite 4-methylaminoantipyrine (MAA). MAA is formed in much larger amounts compared with other minor metabolites. Among the other secondary metabolites, 4-aminoantipyrine (AA) is also relatively active. The aim of this research was to evaluate the pharmacokinetic profiles of MAA and AA after dose of 25 mg/kg MT by intravenous (i.v.) and intramuscular (i...
July 31, 2016: Journal of Veterinary Pharmacology and Therapeutics
Jan Gaertner, Ulrike M Stamer, Constanze Remi, Raymond Voltz, Claudia Bausewein, Rainer Sabatowski, Stefan Wirz, Gabriele Müller-Mundt, Steffen T Simon, Anne Pralong, Friedemann Nauck, Markus Follmann, Lukas Radbruch, Winfried Meißner
BACKGROUND: Dipyrone (metamizole) is one of the most widely used non-opioid analgesics for the treatment of cancer pain. AIM: Because evidence-based recommendations are not yet available, a systematic review was conducted for the German Guideline Program in Oncology to provide recommendations for the use of dipyrone in cancer pain. DESIGN: First, a systematic review for clinical trials assessing dipyrone in adult patients with cancer pain was conducted...
July 19, 2016: Palliative Medicine
S Andrade, D B Bartels, R Lange, L Sandford, J Gurwitz
WHAT IS KNOWN AND OBJECTIVE: Metamizole was withdrawn from the market in the United States and several European countries following reports of fatal agranulocytosis among users, but is still available in many countries in Europe, South America and Asia. Over the past several decades, a number of epidemiologic studies have been conducted to quantify the risk of agranulocytosis and other adverse effects associated with metamizole and other non-narcotic analgesics. The objective of this study was to perform a systematic review of the safety of metamizole...
October 2016: Journal of Clinical Pharmacy and Therapeutics
D Pérez-Alzate, J A Cornejo-García, N Pérez-Sánchez, I Andreu, A García-Moral, J A Agúndez, J Bartra, I Doña, M J Torres, M Blanca, N Blanca-López, G Canto
BACKGROUND: Subjects who develop drug hypersensitivity reactions (DHRs) to chemically unrelated non-steroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this category is that they present a reaction after ASA intake or challenge. Whether patients react to two or more NSAIDs with tolerance to ASA remains to be studied (selective reactions, SRs). OBJECTIVE: To identify patients with SRs to two or more NSAIDs including strong COX-1 inhibitors...
May 18, 2016: Journal of Investigational Allergology & Clinical Immunology
Paweł Węgorowski, Andrzej Stanisławek, Renata Domżał-Drzewicka, Justyna Sysiak, Marcin Rząca, Joanna Milanowska, Mariola Janiszewska, Anna Dziubińska
AIM OF THE STUDY: Dynamic development of research on pain has resulted in the formulation of the concept of pre-emptive analgesia, which involves administration of analgesics before the first pain-producing stimulus appears. It is meant to prevent increased sensitivity to pain in the postoperative period. The aim of this study was to assess the possibilities of modifying the intensity of postoperative pain evaluated with the visual analogue scale (VAS) in patients after surgical treatment for breast neoplasm offered by pre-emptive analgesia...
2016: Contemporary Oncology Współczesna Onkologia
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