Metamizol Dr. Max (Metamizole Sodium Monohydrate)

Metamizole acts as an analgesic and antipyretic within the pyrazolone class, addressing pain and fever pathways.

• Pain: provides rapid analgesic relief for acute severe and postoperative pain.
• Fever: lowers elevated body temperature in cases of high fever.
• Cancer‑related pain: helps manage breakthrough pain in oncology patients when other options are insufficient.

• Metamizole Sodium Monohydrate inhibits cyclooxygenase enzymes, primarily COX‑1 and COX‑2, leading to reduced synthesis of prostaglandins. This decrease in prostaglandin levels diminishes peripheral sensitization of nociceptors and lowers the hypothalamic set‑point for temperature regulation, producing analgesic and antipyretic effects.

Metamizole may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Dizziness: transient light‑headedness.
• Hypotension: occasional drop in blood pressure, especially with rapid IV administration.
• Sweating: increased perspiration.
• Rash: mild skin irritation.
• Leukopenia: reduced white‑blood cell count.

Serious or Rare Side Effects

• Agranulocytosis: severe depletion of neutrophils, potentially life‑threatening.
• Anaphylaxis: acute allergic reaction with airway compromise.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatotoxicity: liver enzyme elevation or injury.
• Blood dyscrasias: aplastic anemia or thrombocytopenia.
• Renal impairment: acute kidney injury in susceptible individuals.

Metamizole should be used with caution and under medical supervision.

• Medical supervision: prescribe only after evaluating benefit‑risk ratio.
• Blood monitoring: perform regular complete blood counts to detect agranulocytosis early.
• Hypersensitivity: avoid in patients with known allergy to pyrazolones.
• Renal/hepatic impairment: adjust use in patients with reduced organ function.
• Pediatric use: restrict to children only when clearly indicated by a physician.
• Store at ambient temperature: keep in the original packaging, protect from moisture and direct sunlight.

Metamizole can interact with several drug classes, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Other myelosuppressive agents: increased risk of severe blood dyscrasias.
• Concurrent NSAIDs: heightened potential for agranulocytosis and gastrointestinal toxicity.
• Anticoagulants: may amplify bleeding risk.

Moderate Interactions (Monitor Closely)

• ACE inhibitors: possible additive hypotensive effect.
• Diuretics: may enhance blood pressure lowering.
• Alcohol: can increase dizziness and hypotension.
• CYP450 substrates: potential alteration of metabolism requiring dose adjustment.