Metamizole-induced agranulocytosis revisited: results from the prospective Berlin Case–Control Surveillance Study

Huber, Matthias; Andersohn, Frank; Sarganas, Giselle; Bronder, Elisabeth; Klimpel, Andreas; Thomae, Michael; Konzen, Christine; Kreutz, Reinhold; Garbe, Edeltraut

doi:10.1007/s00228-014-1777-8

Cited by 68 publications

(74 citation statements)

References 33 publications

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“…Even the authors of the Cochrane review on the use of metamizole for acute post‐operative pain declared that it is unlikely to expect any future studies to be included in their review . On the other hand, there is an increasing use of metamizole particularly for less serious pain conditions for which it is not approved …”

Section: Resultsmentioning

confidence: 99%

“…3 However, it has been the focus of considerable controversy regarding its (long-term) safety. Metamizole can cause potentially life-threatening blood disorders such as agranulocytosis, [4][5][6] which have been increasingly reported over recent years. 7 However, the extent of this risk remains uncertain, and its incidence has not been adequately quantified.…”

Section: What Is Known and Objectivementioning

confidence: 99%

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Who gets dipyrone (metamizole) in Germany? Prescribing by age, sex and region

et al. 2015

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Section: Resultsmentioning

confidence: 99%

Section: What Is Known and Objectivementioning

confidence: 99%

Who gets dipyrone (metamizole) in Germany? Prescribing by age, sex and region

et al. 2015

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“…The overall most often used step I substance, however, was metamizole, an analgesic with low anti‐inflammatory properties and a relatively narrow spectrum of indications. Because of its risk of acute agranulocytosis, there is a long‐standing controversy regarding the safety of metamizole, and the substance has been withdrawn from the market or never approved in many countries . However and probably influenced by underlying co‐morbidities, metamizole has shown high prevalences of use in Germany especially in older populations …”

Section: Discussionmentioning

confidence: 99%

Pain, depressive symptoms and medication in German patients with rheumatoid arthritis—results from the linking patient‐reported outcomes with claims data for health services research in rheumatology (PROCLAIR) study

Jobski

Ramos

Albrecht

et al. 2017

Pharmacoepidemiology and Drug

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“…It is popular for its additional spasmolytic properties and use in visceral pain [33]. However, it is unlicensed in most countries for its association with life-threatening agranulocytosis although the extent of this risk remains controversial [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Analgesic Drug Prescription Patterns on Five International Paediatric Wards

et al. 2016

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Key points• Use of analgesic and anti-inflammatory drugs was in line with local recommendations and WHO guidelines • Oral paracetamol and oral ibuprofen are the most commonly used analgesic drugs on general paediatric wards • Differences regarding dose and frequency of ibuprofen and paracetamol use were observed, indicating that safety concerns for individual drugs are perceived differently among countries BOTZENHARDT et al. 2/1 2016-09-16 ABSTRACT AimAnalgesic and anti-inflammatory drugs are frequently prescribed in paediatrics. Prescribing and dosing patterns in hospitalised children are not well known. This study explores analgesic drug utilisation on five paediatric wards and discusses its findings in comparison with WHO guidelines. MethodA sub-analysis of a prospective, multi-centre, observational cohort study was undertaken. Prescription data of children aged up to ≤18 years were collected between October 2008 and December 2009 on paediatric general medical wards in five hospitals in Australia, Germany, the United Kingdom (UK), Hong Kong (HK) and Malaysia. Analgesic drug prescriptions were analysed for prescribing patterns in terms of dosing, frequency and route of administration. Dosing data were compared with local recommendations and WHO guidelines for children. ResultsIn the study cohort 56.8% (726/1,278) of paediatric patients received at least one analgesic drug prescription (1,227 prescriptions). Median age of patients with analgesics was 2.2 years (IQR 0.8-7.3) and median number of prescriptions per patient was 1 (IQR 1-2). Most commonly prescribed drugs were oral paracetamol (45.9%, 563/1,227) and oral ibuprofen (19.9%, 244/1,227). Daily doses of paracetamol ranged from 30 mg/kg/day in Germany to 67-68 mg/kg/day in UK and HK (p<0.05). For ibuprofen, single doses ranged from 5-6 mg/kg in HK and UK to 10 mg/kg in GER and AUS (p<0.001). Opioid use prevalence was statistically different between the centres and ranged from 0% to 17.6% (p<0.001). ConclusionThis study provides a comprehensive overview of analgesic drug use of hospitalised children. Similar to primary care data, paracetamol is the most commonly used analgesic. As recommended by WHO guidelines, oral medication was favoured and opioids used in addition to paracetamol and ibuprofen. Overall drug utilisation was in line with local recommendations and WHO guidelines. Differences in use of paracetamol and ibuprofen among countries was seen indicating that safety concerns are perceived differently. More large-scale safety studies are needed. BOTZENHARDT et al.

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Metamizole-induced agranulocytosis revisited: results from the prospective Berlin Case–Control Surveillance Study

Abstract: MIA persists as a severe condition in current pharmacotherapy. The continuous increase of metamizole applications should be critically assessed, especially in regard to indications in the outpatient setting and with respect to metamizole treatment duration.

Cited by 68 publications

References 33 publications

Who gets dipyrone (metamizole) in Germany? Prescribing by age, sex and region

Who gets dipyrone (metamizole) in Germany? Prescribing by age, sex and region

Pain, depressive symptoms and medication in German patients with rheumatoid arthritis—results from the linking patient‐reported outcomes with claims data for health services research in rheumatology (PROCLAIR) study

Analgesic Drug Prescription Patterns on Five International Paediatric Wards

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