Metamizole in the Management of Musculoskeletal Disorders: Current Concept Review

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Aug 29

PMID 39200936

Authors

Naveen Jeyaraman

Filippo Migliorini

Shrideavi Murugan

Swaminathan Ramasubramanian

Sangeetha Balaji

Nicola Maffulli

Madhan Jeyaraman

Affiliations

Soon will be listed here.

Abstract

Metamizole, or dipyrone, has been used for decades as a non-narcotic analgesic, providing pain relief from musculoskeletal disorders and antipyretic and antispasmolytic properties. Despite being in use since the 1920s, its mechanism of action still needs to be discovered. Despite causing fewer adverse effects when compared to other analgesics, its harmful effects on the blood and lack of evidence regarding its teratogenicity make the usage of the drug questionable, which has led to it being removed from the drug market of various countries. This narrative review aims to provide a detailed insight into the mechanism of action and efficacy, comparing its effectiveness and safety with other classes of drugs and the safety profile of metamizole.

References

Zhang J, Ding E, Song Y . Adverse effects of cyclooxygenase 2 inhibitors on renal and arrhythmia events: meta-analysis of randomized trials. JAMA. 2006; 296(13):1619-32. DOI: 10.1001/jama.296.13.jrv60015. View

Stessel B, Boon M, Pelckmans C, Joosten E, Ory J, Wyckmans W . Metamizole vs. ibuprofen at home after day case surgery: A double-blind randomised controlled noninferiority trial. Eur J Anaesthesiol. 2019; 36(5):351-359. DOI: 10.1097/EJA.0000000000000972. View

Sener M, Yilmazer C, Yilmaz I, Bozdogan N, Ozer C, Donmez A . Efficacy of lornoxicam for acute postoperative pain relief after septoplasty: a comparison with diclofenac, ketoprofen, and dipyrone. J Clin Anesth. 2008; 20(2):103-8. DOI: 10.1016/j.jclinane.2007.09.009. View

Jasiecka A, Maslanka T, Jaroszewski J . Pharmacological characteristics of metamizole. Pol J Vet Sci. 2014; 17(1):207-14. DOI: 10.2478/pjvs-2014-0030. View

. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023; 5(6):e316-e329. PMC: 10234592. DOI: 10.1016/S2665-9913(23)00098-X. View

da Costa B, Vieira E . Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies. Am J Ind Med. 2009; 53(3):285-323. DOI: 10.1002/ajim.20750. View

Izhar T . Novalgin in pain and fever. J Pak Med Assoc. 2000; 49(9):226-7. View

Peiro A, Martinez J, Martinez E, de Madaria E, Llorens P, Horga J . Efficacy and tolerance of metamizole versus morphine for acute pancreatitis pain. Pancreatology. 2008; 8(1):25-9. DOI: 10.1159/000114852. View

Gaertner J, Stamer U, Remi C, Voltz R, Bausewein C, Sabatowski R . Metamizole/dipyrone for the relief of cancer pain: A systematic review and evidence-based recommendations for clinical practice. Palliat Med. 2016; 31(1):26-34. DOI: 10.1177/0269216316655746. View

10.

Hearn L, Derry S, Moore R . Single dose dipyrone (metamizole) for acute postoperative pain in adults. Cochrane Database Syst Rev. 2016; 4:CD011421. PMC: 6540653. DOI: 10.1002/14651858.CD011421.pub2. View

11.

Andres E, Zimmer J, Mecili M, Weitten T, Alt M, Maloisel F . Clinical presentation and management of drug-induced agranulocytosis. Expert Rev Hematol. 2011; 4(2):143-51. DOI: 10.1586/ehm.11.12. View

12.

Witte K, West D . Immunology of adverse drug reactions. Pharmacotherapy. 1982; 2(1):54-65. DOI: 10.1002/j.1875-9114.1982.tb03173.x. View

13.

Yelin E, Weinstein S, King T . The burden of musculoskeletal diseases in the United States. Semin Arthritis Rheum. 2016; 46(3):259-260. DOI: 10.1016/j.semarthrit.2016.07.013. View

14.

Mock C, Gloyd S, Adjei S, Acheampong F, Gish O . Economic consequences of injury and resulting family coping strategies in Ghana. Accid Anal Prev. 2002; 35(1):81-90. DOI: 10.1016/s0001-4575(01)00092-6. View

15.

Gomez-Galan M, Perez-Alonso J, Callejon-Ferre A, Lopez-Martinez J . Musculoskeletal disorders: OWAS review. Ind Health. 2017; 55(4):314-337. PMC: 5546841. DOI: 10.2486/indhealth.2016-0191. View

16.

Pavlik I, Suchy J, Pacik D, Bokr R, Sust M, Villoria J . Comparison of cizolirtine citrate and metamizol sodium in the treatment of adult acute renal colic: a randomized, double-blind, clinical pilot study. Clin Ther. 2004; 26(7):1061-72. DOI: 10.1016/s0149-2918(04)90178-6. View

17.

Rohdewald P, Granitzki H, Neddermann E . Comparison of the analgesic efficacy of metamizole and tramadol in experimental pain. Pharmacology. 1988; 37(4):209-17. DOI: 10.1159/000138468. View

18.

Kotter T, da Costa B, Fassler M, Blozik E, Linde K, Juni P . Metamizole-associated adverse events: a systematic review and meta-analysis. PLoS One. 2015; 10(4):e0122918. PMC: 4405027. DOI: 10.1371/journal.pone.0122918. View

19.

Guvenc Y, Billur D, Aydin S, Ozeren E, Demirci A, Alagoz F . Metamizole Sodium Induces Neural Tube Defects in a Chick Embryo Model. Turk Neurosurg. 2016; 26(3):445-8. DOI: 10.5137/1019-5149.JTN.13037-14.0. View

20.

Zhang Y, Wang C . Acupuncture and Chronic Musculoskeletal Pain. Curr Rheumatol Rep. 2020; 22(11):80. PMC: 8719359. DOI: 10.1007/s11926-020-00954-z. View