Sodium Metamizole: Regulatory Status around the World, Safety Problems and Medication Errors

Sodium metamizole (SM), analgin, was recalled from the pharmaceutical market by regulatory authorities of some countries in mid-60s because side effects (agranulocytosis). However, there has been a trend towards steady increase its prescription rates recent decades. The aim study to characterise status SM different world, assess effectiveness and safety, analyse available data on medication errors real clinical practice. According reviewed publications, is most frequently used analgesic surgical practice German-speaking countries, third prescribed Switzerland, widely one even where it previously recalled, such as USA. use SM, according experts, due opioid crisis high risk cardiotoxicity non-steroidal anti-inflammatory drugs (NSAIDs). In chronic pain, efficacy superior that not only paracetamol, but also NSAIDs; postoperative pain acute primary headache, lower than other commonly analgesics. pronounced effect cancer patients; doses are comparable narcotic analgesics have significantly more favourable safety profile. Randomised observational studies confirm short-term quite safe, including terms developing myelosuppressive effects. When administered course less 2 weeks, characterised frequency adverse events compared opioids an approximately equal placebo while longer courses associated with increased agranulocytosis. Adverse drug reactions may result errors. lethal outcome agranulocytosis increases when co-administered methotrexate or elderly patients. Russian Federation, over-the-counter medicinal product approved for wide range types; can be highly effective provided dose, route, administration appropriate, baseline characteristics patients taken into account, unreasonably long (more weeks) avoided.