Pediatr. praxi. 2020;21(5):323-329 | DOI: 10.36290/ped.2020.066

Metamizol in paediatric pain management

PharmDr. Petra Rozsívalová^1,2, MUDr. Radek Štichhauer, Ph.D.³, MUDr. Lucie Holická³, MUDr. Pavel Rozsíval⁴, MUDr. Marie Kopecká⁵, doc. MUDr. Sylva Skálová, Ph.D.⁵, doc. PharmDr. Josef Malý, Ph.D.²

¹ Odd. klinické farmacie, Nemocniční lékárna, Fakultní nemocnice Hradec Králové

² Katedra sociální a klinické farmacie, Farmaceutická fakulta UK v Hradci Králové

³ Oddělení dětské chirurgie a traumatologie, Fakultní nemocnice Hradec Králové, Lékařská fakulta UK v Hradci Králové

⁴ Dětské oddělenî, Orlickoústecká nemocnice, Nemocnice Pardubického kraje, Energeia o.p.s., Pardubice

⁵ Dětská klinika, Fakultní nemocnice Hradec Králové, Lékařská fakulta UK v Hradci Králové

Metamizole (dipyrone) has been used in clinical practice for almost 100 years as a non-opioid analgesic with spasmolytic activity (mostly higher doses) in the perioperative treatment of acute pain and as a second-line antipyretic. Metamizole has acceptable adverse effect profile with minor antiplatelet and gastrointestinal side effects. Metamizole remains a controversial analgesic for the occurrence of very rare idiosyncratic immunological adverse reactions such as neutropenia and agranulocytosis. Where metamizole is used, blood dyscrasias continue to be reported, but the actual prevalence in the adult and the paediatric population has not been elucidated. Metamizole sodium in oral dosage forms (tablets, drops) and injections is well tolerated, with good effect in the treatment of acute pain and as second line antipyretic. It is not the first option in the treatment of chronic pain due to the possible risk of hematopoietic disorders with long-term use, however its place is firmly entrenched in acute and chronic pain management, especially in German-speaking countries. Metamizol is a popular analgesic agent, widely used in our paediatric patients both in monotherapy and combination treatment. Monitoring and re-evaluation of metamizole safety are essential, especially in the paediatric population. The aim of this review was to provide an overview of metamizole use as non-opioid analgesic agent in pain management in paediatric population.

Keywords: metamizole, dipyrone, pain, postoperative pain, non‑opioid analgesia, drug formulation.

Published: October 16, 2020  Show citation