Metamizol Stada (Metamizole)

Metamizole acts on the cyclooxygenase pathway and is indicated for several acute pain and fever conditions.

• Pain relief: Provides analgesic effect for moderate to severe acute pain, such as musculoskeletal injuries or dental pain.
• Fever reduction: Lowers elevated body temperature in febrile states, including infection‑related fever.
• Post‑operative analgesia: Controls pain following surgical procedures, facilitating recovery and patient comfort.
• Severe cancer‑related pain: Offers additional analgesia when other agents are insufficient.

• Metamizole inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis, and simultaneously modulates endogenous opioid pathways. The combined effect decreases peripheral and central sensitization to pain stimuli and lowers the hypothalamic set‑point for temperature regulation, resulting in analgesic and antipyretic actions. Additionally, Metamizole may influence calcium channels and nitric oxide production, contributing further to its analgesic profile. These mechanisms together provide rapid onset of pain relief and fever control in acute settings.

Metamizole may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea: mild gastrointestinal upset that may resolve without intervention.
• Vomiting: occasional emesis that can be managed with anti‑emetics.
• Dizziness: transient light‑headedness, often occurring shortly after dosing.
• Skin rash: mild erythematous reactions, usually limited to localized areas.

Serious or Rare Side Effects

• Agranulocytosis: severe reduction of neutrophils leading to increased infection risk; requires immediate medical attention.
• Anaphylaxis: acute allergic reaction with respiratory distress, hypotension, and possible shock; emergency treatment is essential.
• Stevens‑Johnson syndrome: rare severe skin eruption with blistering and mucosal involvement, necessitating prompt discontinuation of the drug.

When prescribing Metamizole, several precautions should be observed to minimize risk.

• Blood monitoring: regular complete blood counts are recommended to detect agranulocytosis early.
• Renal function: assess kidney function, especially in patients with pre‑existing impairment.
• Hepatic function: evaluate liver enzymes as Metamizole is metabolized hepatically.
• Concomitant drugs: avoid use with other myelosuppressive agents without supervision.
• Pregnancy and lactation: use only if benefits outweigh potential risks, as safety data are limited.
• Store at ambient temperature: keep below 25 °C in the original packaging, protected from moisture and direct sunlight.

Metamizole can interact with other medicines, influencing efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants: may enhance bleeding risk; concurrent use requires close monitoring.
• Immunosuppressants: combined myelosuppression can increase risk of severe neutropenia.

Moderate Interactions (Monitor Closely)

• NSAIDs: additive gastrointestinal irritation and potential renal effects.
• Antihypertensives: may reduce antihypertensive efficacy due to fluid shifts.
• Diuretics: increased risk of electrolyte imbalance when combined.