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Review

Metamizole [Dipyrone]

No authors listed
In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012.
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Review

Metamizole [Dipyrone]

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Excerpt

Metamizole, also known as dipyrone, is an oral analgesic that is not available in the United States but is available over-the-counter in many countries of the world. Therapy with metamizole has been associated with rare severe bone marrow and liver adverse events including agranulocytosis, acute hepatitis, and acute liver failure.

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References

    1. Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999.(Expert review and compendium of hepatotoxicity published in 1999 does not mention dipyrone or metamizole).
    1. Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013.(Textbook of hepatotoxicity published in the United States in 2013, does not mention dipyrone or metamizole).
    1. Grosser T, Smyth EM, FitzGerald GA. Pharmacotherapy of inflammation, fever, pain, and gout. In, Brunton LL, Hilal-Dandan R, Knollman BC, eds. Goodman & Gilman’s the pharmacological basis of therapeutics. 13th ed. New York: McGraw-Hill, 2018, pp. 685-709.(Textbook of pharmacology and therapeutics does not include mention or discussion of dipyrone or metamizole).
    1. Federmann G, Becker EW, Tautorat H, Penschuck C, Berg PA. [Demonstration by lymphocyte transformation test of the allergic genesis in a case of acute hepatitis]. Dtsch Med Wochenschr. 1988;113:1676-9. German.(50 year old man developed jaundice shortly after cholecystectomy and a single oral dose of metamizole for postoperative fever and pain having received this medication several times in the past for arthritis [bilirubin rising rapidly to 43.9 mg/dL, ALT to 222 U/L, and Alk P to 497 U/L], but bilirubin and enzymes then falling promptly over the next 1-2 weeks). - PubMed
    1. Herdeg C, Hilt F, Büchtemann A, Bianchi L, Klein R. Allergic cholestatic hepatitis and exanthema induced by metamizole: verification by lymphocyte transformation test. Liver. 2002;22:507-13.(66 year old man developed truncal rash 12 hours after taking a single dose of metamizole for fever, which became generalized and associated with eosinophilia and liver test abnormalities [bilirubin rising to 1.6 mg/dL, ALT to 636 U/L, Alk P to 719 U/L], treated with corticosteroids and with subsequent slow recovery). - PubMed

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