metamizole / Generic mfg. - LARVOL DELTA

Cytokine release syndrome prophylaxis strategy with dipyrone in patients receiving bispecific Antibodies—Elranatamab, teclistamab, talquetamab and Epcoritamab—at a private hospital in southern Brazil: Preliminary Results (ASH 2025) - "Introduction: Bispecific antibodies have improved progression-free survival and overall survival inrelapsed/refractory haematologic malignancies, yet they are frequently associated with cytokine releasesyndrome (CRS), often necessitating tocilizumab and inpatient care during step-up dosing, therebyincreasing treatment costs. Preliminary data indicate that dipyrone prophylaxis may lower CRS incidence and eliminatethe need for tocilizumab without a clear rise in serious adverse events. Multivariate analyses are inprogress. Larger, controlled studies are warranted to confirm these findings and define the role ofdipyrone in prophylactic strategies for bispecific antibody therapy."

Clinical • Cytokine release syndrome • Gastrointestinal Disorder • Hematological Malignancies • Infectious Disease • Inflammation • Neutropenia • Thrombocytopenia

Chronic Ocular Complications in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: Clinical Features and Surgical Management in a Brazilian Tertiary Center. (PubMed, Cornea) - "Our findings highlight the significant burden of severe ocular surface disease, the predominance of dipyrone as a causative drug in this population, and the need for complex surgical interventions in a significant proportion of cases. These results underscore the importance of early management of ocular complications, long-term follow-up, and access to advanced therapeutic strategies."

Journal • Dry Eye Disease • Inflammation • Ophthalmology • Steven-Johnson Syndrome • Transplantation

Case Report: Acute generalized exanthematous pustulosis with psoriasis successfully treated with Secukinumab. (PubMed, Front Immunol) - "Herein we firstly reported a 56-year-old man with severe plaque psoriasis who developed metamizole-induced AGEP during a clinical trial for BEBT-305 (HSP90 inhibitor) that was successfully treated with Secukinumab. Biologics should be considered in patients with AGEP, especially those with a history of psoriasis. This can benefit both diseases."

Journal • Allergy • Dermatology • Immunology • Pruritus • Psoriasis • Pustular Psoriasis • CDC37 • CRP

Survey of German veterinarians' approaches to pain assessment and management of perioperative pain in pet rabbits. (PubMed, Vet Rec) - "Respondents used different indicators to detect pain in rabbits. Analgesic therapy in ovariohysterectomies, as reported by participants, can be considered suboptimal in several cases."

Journal • Preclinical • Anesthesia • Gynecology • Pain

NSAIDs beyond COX: In Silico and In Vitro Insights into Acetylcholinesterase Modulation. (PubMed, ACS Omega) - "Among the compounds that were tested, nimesulide displayed the highest binding affinity (ΔG = -24.2 kcal/mol), followed by dipyrone (-16.0 kcal/mol), ibuprofen (-11.0 kcal/mol), and paracetamol (-9.0 kcal/mol). These findings suggest that NSAIDs, particularly nimesulide, may act as dual modulators with both anti-inflammatory and cholinergic regulatory effects. This work underscores the translational potential of drug repurposing and highlights the importance of combining computational and biochemical methods to uncover novel therapeutic functions of established drugs."

Journal • Preclinical • Inflammation • Metabolic Disorders • Pain

A systematic review and pharmacovigilance analysis of the risk of agranulocytosis associated with metamizole use. (PubMed, Sci Rep) - "The reporting odds ratio (ROR) with a 95% confidence interval (95% CI) showed a higher likelihood of reporting agranulocytosis with metamizole compared to clozapine (ROR: 5.50, 95% CI 5.18-5.82), sulfasalazine (ROR: 7.31, 95% CI 6.58-8.14), penicillamine (ROR: 34.4, 95% CI 11.70-167.89), and NSAIDs (ROR: 41.7, 95% CI 38.24-45.52). Our results confirm an increased likelihood of reporting agranulocytosis with metamizole. Given this risk and the availability of safer, effective alternatives, further research is needed."

Adverse events • Journal • Agranulocytosis • Granulocytopenia • Pain

Program to Avoid NSAIDs in Patients With Advanced Chronic Liver Disease (clinicaltrials.gov) - P=N/A | N=84 | Active, not recruiting | Sponsor: Parc de Salut Mar

New trial • Cardiovascular • Fibrosis • Hepatology • Hypertension • Immunology • Portal Hypertension

Metamizole: Indications and Risks. (PubMed, Dtsch Arztebl Int) - "Metamizole is a powerful analgesic drug whose varying regulatory status from country to country reflects its mixed benefit-risk profile. Patients must be instructed about the risk of agranulocytosis and the symptoms by which it can be recognized early."

Journal • Review • Agranulocytosis • Granulocytopenia • Pain • CYP3A4

Optimal Timing of Endoscopic Intervention in the Treatment of Chronic Pancreatitis. (clinicaltrials.gov) - P=N/A | N=220 | Completed | Sponsor: Changhai Hospital | Enrolling by invitation ➔ Completed

Trial completion • Pancreatitis

Metamizole-Induced Agranulocytosis: A Case Report. (PubMed, Cureus) - "This case report highlights the diagnostic complexity and clinical management of a patient who presented with neutropenic fever and concurrent multidrug-resistant infections, ultimately found to be related to metamizole-induced agranulocytosis. It underlines the importance of considering drug-induced causes in the differential diagnosis of agranulocytosis and stresses the relevance of early identification and prompt discontinuation of the causative agent."

Journal • Agranulocytosis • Febrile Neutropenia • Granulocytopenia • Hematological Disorders • Infectious Disease • Pain

Treatment of Hypertensive Crisis in Primary Care Health Facilities in Peru, 2019-2024. (PubMed, High Blood Press Cardiovasc Prev) - "Short-acting antihypertensives and other agents remain common in Peruvian primary care hypertensive crises. Targeted strategies are needed to align practice with evidence-based recommendations."

Journal • Cardiovascular • Hypertension

Addition of metamizole to paracetamol at home after painful ambulatory arthroscopic shoulder surgery: A double-blind randomised controlled superiority trial. (PubMed, Eur J Anaesthesiol) - No abstract available

Head-to-Head • Journal • Orthopedics • Pain

Drug-induced fixed urticaria because of hypersensitivity to non steroidal anti-inflammatory drugs. (PubMed, Allergol Immunopathol (Madr)) - "An oral provocation test (OPT) was performed with ibuprofen, acetylsalicylic acid, and metamizole, which also caused the same fixed-location wheals and subsequent spontaneous resolution. She, however, tolerated an OPT with meloxicam...In this case, as in those of DIFU described in the literature, the hives appeared shortly after the drug was administered and resolved rapidly. This feature distinguishes it from FDE, and it resembles acute drug urticaria, as in the patient's father, which raises questions concerning the pathophysiology of DIFU."

Journal • Conjunctivitis • Dermatology • Immunology • Ocular Infections • Ocular Inflammation • Ophthalmology • Pediatrics • Urticaria

Comparison of Opioid Consumption During Paediatric Anaesthesia with and Without a Mandatory Protocol: A Retrospective Cohort Study. (PubMed, J Clin Med) - P4 | " The total fentanyl dose administered during anaesthesia was significantly lower in the standardised protocol cohort compared to the cohort without a protocol: 3.13 μg·kg-1 (IQR: 2.98-4.08) vs. 5.19 μg·kg-1 (IQR: 3.89-6.67), p < 0.001. In the protocol cohort, the percentage of patients who received acetaminophen and metamizole was significantly higher-increasing by 57% and 23%, respectively (p < 0.001)... The use of a mandatory anaesthetic protocol based on a multimodal approach had an opioid-sparing effect in children undergoing laparoscopic appendectomy. This retrospective analysis was approved by the Ethics Committee of the Medical University of Warsaw (identifier: AKBE/118/2025; date of acceptance: 12 May 2025), and the primary trial was registered in the U.S. National Library of Medicine Clinical Trials Registry (registration number: NCT05238506; date of first registration: 14 February 2022)."

Journal • Retrospective data • Anesthesia • Pain • Pediatrics

Allogeneic Hematopoietic Progenitor Cell from Peripheral Whole Blood in Acute Myeloid Leukemia (ASH 2024) - "Acute Myeloid Leukemia (AML) standard treatment involves initial induction therapy administrating two cycles of the 3+7 protocol (3 days anthracycline + 7 days cytarabine), and post-remission therapy of 3 cycles of high-dose cytarabine...Thus, whole peripheral blood obtained was transfused through patients' CVC after premedication with dexamethasone 8 mg and metamizole 1 g. FISH (Y chromosome, Vysis CEP-Y DYZ1) and RT-PCR (HUMARA gene) studies were performed for chimerism analysis.Recovery of neutrophils >500/ul was observed at day 9 and platelets >20,000/ul at day 6...None of the patients presented acute or chronic GVHD. Regarding the results of chimerism, one male patient (1year follow-up) showed mixed chimera by FISH (Y=95%) and by RT-PCR (HUMARA gene), such studies were still in progress in the other two women patients.Contrasting patients who received Allo-HPC from the ones who do not, statistically differences were found in neutrophils recovery and..."

Acute Graft versus Host Disease • Acute Myelogenous Leukemia • Chronic Graft versus Host Disease • Graft versus Host Disease • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Ocular Inflammation • Oncology • Ophthalmology • Optic Neuritis • CD34

Global metabolomic responses of dogwhelk and mussel during different stages of predation. (PubMed, Mar Environ Res) - "Following physical contact (FT stage), dogwhelks elevated 5-Hydroxy-L-tryptophan (a serotonin precursor), ADP, and Trichloroacetic acid (a shell-dissolving agent), whereas mussels upregulated tryptophan metabolism, alongside stress-alleviating metabolites like Oxybuprocaine and Metamizole...These results reveal divergent physiological strategies between predators and preys: dogwhelks optimize energy metabolism and toxin production to sustain predation, while mussels deploy stress-related metabolites, muscle-enhancing compounds, and pain-suppressing agents to resist capture. This study advances our understanding of predator-prey dynamics by linking metabolomic shifts to behavioral and physiological adaptations across interaction stages."

Journal • Inflammation • Mood Disorders • Pain

Omeprazole-Induced Anaphylaxis In A Patient With Rheumatoid Arthritis: Diagnosis By Skin Testing And Oral Challenge (ACAAI 2025) - "During subsequent evaluation in the allergy clinic, skin tests to rituximab, butylhyoscine, metamizole, and omeprazole were performed, with positive results only for omeprazole. Discussion This case highlights the importance of considering PPIs as possible triggers for anaphylactic reactions, even in patients with no prior history of drug allergy. A diagnostic approach with skin testing followed by controlled challenge tests is essential to confirm the etiology and avoid unnecessary exclusion of useful treatments."

Clinical • Allergic Rhinitis • Back Pain • Cardiovascular • Dermatology • Immunology • Inflammatory Arthritis • Musculoskeletal Pain • Rheumatoid Arthritis • Rheumatology • Urticaria

A probable case of metamizole-induced neutropaenia presenting 10 days after drug discontinuation. (PubMed, SAGE Open Med Case Rep) - "Given that late-onset neutropaenia after metamizole discontinuation may be underdiagnosed, we present the case of a 92-year-old woman who developed transient, likely drug-induced neutropaenia 10 days later, with spontaneous haematologic recovery. The patient remained asymptomatic, with no signs of infection or evidence of inflammatory or neoplastic systemic disease."

Journal • Agranulocytosis • Granulocytopenia • Hematological Disorders • Infectious Disease • Neutropenia • Oncology • Pain

Trypsin inhibitor isolated from the seeds of Inga laurina (sw.) Willd decreased inflammatory and nociceptive responses in mice. (PubMed, Inflammopharmacology) - "Male Swiss mice, 18-25 g, were distributed in the groups Saline (10 mL/kg); Dexamethasone (0.5 mg/kg); ILTi (0.3; 3 or 30 mg/kg); Dipyrone (500 mg/kg), in the abdominal writhing assay and Morphine (5 mg/kg), in the formalin test. Cytokine analysis revealed a decrease in IL-6 (35.6%) and TNF (79.2%) levels. These findings indicate that ILTi exhibits anti-inflammatory and antinociceptive effects, possibly through modulation of protease-mediated pathways or the blocking the activation of protease-activated receptors."

Journal • Preclinical • Inflammation • Pain • IL6

DIABETES INDUCTION MODEL FOR PRECLINICAL PANCREATIC ISLET TRANSPLANTATION RESEARCH (UEGW 2025) - "Analgesia was provided with dipyrone monohydrate and tramadol. Ceftriaxone 1g and metronidazole 0.5% were administered twice daily for three days... This study describes the technical aspects and main results of diabetic large animal model, representing a significant advancement in islet transplantation research. It is a challenging procedure that demands intensive animal care to ensure success."

Preclinical • Anesthesia • Diabetes • Gastrointestinal Disorder • Metabolic Disorders • Transplantation

Extensive upper aerodigestive tract involvement in metamizole-induced Stevens-Johnson syndrome/toxic epidermal necrolysis. (PubMed, Eur Ann Otorhinolaryngol Head Neck Dis) - No abstract available

Journal • Steven-Johnson Syndrome

MULTIMODAL ANALGESIA for Refractory NEUROPATHIC PAIN in End-Stage SÉZARY SYNDROME: A case report. (ASA 2025) - "The anesthesiology painteam implemented a multimodal regimen consisting of amitriptyline, gabapentin,oral morphine, and dipyrone. No adverse effects were observed. Pain remained well-controlled until the patient'speaceful death, without the need for sedation or cardiopulmonary resuscitation.This case highlights the pivotal role of the anesthesiology pain team in oncologic care and demonstrates the effectiveness of early multimodal analgesia in restoring comfort and dignity to terminal patients."

Case report • Clinical • Anesthesia • Cutaneous T-cell Lymphoma • Neuralgia • Pain • Sezary Syndrome

Pharmacogenetics of metamizole-induced agranulocytosis: a systematic review and drug regulation implications. (PubMed, Front Pharmacol) - "Additional studies are essential to evaluate the prevalence of MIA, better characterize populations, and explore potential genetic associations, particularly concerning the HLA-C*04:01 allele. https://www.crd.york.ac.uk/PROSPERO/view/CRD42024572038, identifier CRD42024572038."

Biomarker • Journal • Review • Agranulocytosis • Granulocytopenia • Pain • CYP2C19 • CYP2C9 • HLA-C • NAT2

Improving pain management for murine orthotopic xenograft models of acute lymphoblastic leukemia. (PubMed, Lab Anim (NY)) - "Combining the data with the relative severity assessment algorithm revealed that metamizole treatment appeared less effective than tramadol in mitigating the detrimental effects of the disease. Therefore, the opioid tramadol should replace metamizole as the analgesic compound of choice for hematological xenograft models to improve animal welfare in future studies."

Journal • Preclinical • Acute Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia • Oncology • Pain

Developing Quality Indicators for the Pharmacological Management of Chronic Non-Cancer Pain in Older Adult Inpatients: A RAND/UCLA Delphi Study. (PubMed, J Pain Res) - "The 51 QIs covered the categories of general pharmacotherapy and the appropriate use of opioids, non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol, metamizole and co-analgesics. Through consensus, we developed a first set of QIs for the pharmacological management of CNCP in older adult inpatients. This set will help standardise care, track and benchmark the quality of care, and be used as a trigger to prioritise patients for clinical or pharmacological interventions."

Journal • Oncology • Pain