Dipyrone (Metamizole)
- Atc Codes:N02BB02
- CAS Codes:5907-38-0#68-89-3
- PHARMGKB ID:5907-38-0#68-89-3
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Induces
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Novalgin; Belgium: Analgine, Novalgine; Bulgaria: Algozone, Analgin, Angetop, Dialgin, Metamizole, Tonialgin; Czech Republic: Analgin, Novalgin; Germany: Analgin, Berlosin, Metamizol, Novalgin, Novaminsulfon; Hungary: Algopyrin, Algozone, Panalgorin, Quarelin, Suppositorium Analgeticum, Suppositorium Spasmolyticum, Tabletta Analgetica; Italy: Dipirone, Metamizolo, Novalgina; Latvia: Analgin, Spasmalgon, Tempalgin; Lithuania: Analgin, Proalgin; Luxembourg: Analgine, Novalgine; Netherlands: Novalgin; Poland: Pyralgin, Pyralginum; Portugal: Dolocalma, Metamizol, Nolotil; Romania: Algiotop, Algoblock, Algocalmin, Algoremin, Algozone, Alindor, Analgin, Centralgin, Fabocalm, Nevralgin, Novocalmin; Slovakia: Novalgin, Quarelin; Spain: Algi-Mabo, Dolemicin, Lasain, Metamizol, Neomelubrina, Nolotil.
Latin America
Argentina: Analgina, Dipirona, Fiebrol, Integrove, Novacler, Novalgina, Novemina, Unibios Simple; Brazil: Analgesil, Apiron (Dipirona), Baralgin, Conmel, Dipimax, Dipiron, Dipirona, Dipix, Dornal, Dorona, Dorpinon, Maxiliv, Nofebrin, Novagreen, Novalgina, Pirogina, Prodopirona, Termonal-Dipirona; Mexico: Alnex, Anaprol, Avafontan, Conmel, Dalmasin, Dalsin, Defin, Dimetirol, Dypidol, Dofisan, Dolgan, Dolizol, Dolofur, Domenal, Exodalina, Fandall, Fardolpil, Farlin, Indigon, Infatem, Lozima, Mach-2, Macodin, Magnidol, Magnil, Magnol Atlantis, Magnolona-S, Magson’s, Mayoprina, Messelfenil, Metamizol Sódico, Metapirona, Midelin, Minoral, Mizoltec-I, Neomelin, Neo-Melubrina, Neosedal, Pirandall, Pirasod, Pirinovag, Piromebrina, Prodolina, Prolubrin, Pyranol, Pyron, Suprin, Uridol, Vegal.
Drug combinations
Dipyrone and Acetaminophen
Dipyrone and Destropropoxiphene
Dipyrone and Guaifenesin
Dipyrone and Homatropine
Dipyrone and Propoxyphene
Dipyrone and Scopolamine
Dipyrone, Ampicillin, and Guaifenesin
Dipyrone, Bendroflumethiazide, and Homatropine
Dipyrone, Caffeine, and Ergotamine
Dipyrone, Carisoprodol, and Piroxicam
Dipyrone, Homatropine, and Papaverine
Dipyrone, Polymyxin B, and Prednisolone
Dipyrone, Caffeine, Ergotamine, and Metoclopramide
Dipyrone, Acetaminophen, Caffeine, Codeine, and Phenobarbital
Dipyrone, Caffeine, Chlorpheniramine, Ergotamine, and Metoclopramide
Other Dipyrone combinations: Cyanocobalamin (Vitamin B~12~)
Chemistry
Dipyrone: C~13~H~16~N~3~O~4~SNa. Mw: 333.34. (1) Methanesulfonic acid, [2,3-dihydro-1,5-dimethyl-3-oxo-2-phenyl-1H-pyrazol-4-yl)methylamino]-,sodium salt, monhydrate; (2) Sodium (antipyrinylmethylamino)-methanesulfonate monohydrate. CAS-5907-38-0. CAS-68-89-3 (anhydrous)(1962).
Pharmacologic Category
Analgesics and Antipyretics; Other Nonsteroidal Anti-inflammatory Agents. (ATC-Code: N02BB02).
Mechanism of action
Metamizole is a drug of the pyrazolone group, possessing strong analgesic and antipyretic effects and moderate anti-inflammatory activity. It blocks the synthesis of endogenous pyrogens (prostaglandins D and E). The decrease of the prostaglandin production in the periphery (and respective decrease of nerve ending sensitivity) plays a relatively smaller role. Metamizole stimulates the release of β-endorphins, explaining its activity in cases of visceral pain. Has a slight spasmolytic activity on the smooth muscle cells of the biliary and urinary tracts and also on the muscle of the uterus.
Therapeutic use
Treatment of pains of different origin and variable intensity: toothache, headache, arthralgia, neuralgia, myositis, mild to moderate visceral pain, and high fever. Also used in cases of acute and severe pain after operations and traumas, pain associated with neoplastic diseases, colicky pain and others.
Pregnancy and lactiation implications
Contraindicated during pregnancy. Use caution during lactation.
Unlabeled use
Contraindications
Hypersensitivity to metamizole and other pyrazolone derivatives. Acute hepatic porphyria, Inborn G6PD deficiency. Severe renal or hepatic diseases. Blood diseases (aplastic anemia, leucopenia and agranulocytosis). Pregnancy (first and last trimester). Parenteral administration is contraindicated in children <1 year old.
Warnings and precautions
Should be used with increased caution in history of hypersensitivity to foods and drugs (particularly to analgesics and nonsteroidal anti-inflammatory agents) and also in patients suffering from bronchial asthma, Quincke’s edema, chronic pulmonary infections. Should not be used parenterally in hypotension and unstable blood pressure. High doses may diminish active attention.