Hexalgin (Metamizole Sodium Monohydrate)

Hexalgin is indicated for the management of several painful or febrile conditions where conventional analgesics may be insufficient. It is commonly prescribed when moderate to severe pain, high fever, or visceral colic require rapid relief.

• Moderate to severe acute pain, such as postoperative or trauma‑related discomfort.
• High fever that does not respond adequately to standard antipyretics.
• Visceral colic, including biliary or renal colic, where smooth‑muscle spasm contributes to pain.
• Cancer‑related pain as part of a multimodal analgesic regimen.
• Situations where non‑opioid analgesia is preferred to minimize opioid exposure.

• Metamizole Sodium Monohydrate exerts its analgesic and antipyretic actions primarily by inhibiting cyclooxygenase (COX) enzymes, which reduces prostaglandin synthesis involved in pain and fever signaling. In addition, the compound modulates endogenous opioid pathways, enhancing the activity of μ‑opioid receptors and contributing to central analgesia. This dual mechanism provides effective relief without the strong anti‑inflammatory effects seen in traditional NSAIDs for patients.

Like all medicines, Hexalgin may cause unwanted reactions. Reported adverse events are grouped into common and serious categories based on frequency and clinical impact.

Common

• Mild gastrointestinal discomfort such as nausea or dyspepsia.
• Transient dizziness or light‑headed feeling.
• Low‑grade skin rash or pruritus.
• Temporary reduction in blood pressure leading to mild hypotension.

Serious

• Agranulocytosis or severe neutropenia, which can increase infection risk.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Severe hypersensitivity reactions, including anaphylaxis.
• Hepatic dysfunction manifesting as elevated liver enzymes.

Healthcare providers should evaluate patient history and clinical status before prescribing Hexalgin to minimize risks and ensure appropriate use.

• Avoid use in patients with known hypersensitivity to metamizole or other pyrazolones.
• Caution in individuals with a history of bone‑marrow suppression or hematologic disorders.
• Assess renal and hepatic function prior to initiation, especially in elderly patients.
• Use only when alternative analgesics or antipyretics are ineffective or contraindicated.
• Monitor complete blood counts regularly during prolonged therapy.
• Discontinue promptly if signs of infection, rash, or unexplained fever develop.

Hexalgin can affect the activity of other medicines; certain combinations should be avoided while others require careful monitoring.

Avoid

• Concurrent use with other myelosuppressive agents such as chemotherapy drugs.
• Combination with other pyrazolone or non‑steroidal anti‑inflammatory drugs (NSAIDs) that increase risk of agranulocytosis.
• Co‑administration with anticoagulants like warfarin when high bleeding risk is a concern.

Use with caution

• Concurrent opioid therapy, as additive central nervous system depression may occur.
• Drugs that affect renal clearance, for example high‑dose aminoglycosides.
• Medications that prolong the QT interval, such as certain antiarrhythmics.