Is it time to restrict the clinical use of dipyrone?

  • Oscar Gilberto Gómez Duarte Division of Pediatric Infectious Diseases, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, New York, USA.


1. Nassini R, Fusi C, Materazzi S, et al. The TRPA1 channel mediates the analgesic action of dipyrone and pyrazolone derivatives. Br J Pharmacol 2015;172:3397-3411.

2. Benemei S, Nassini R, Materazzi S, et al. Keep in mind TRPA1 when prescribing metamizole!. Pain Pract 2016;16:E110.

3. Zajaczkowska R, Popiolek-Barczyk K, Pilat D, et al. Involvement of microglial cells in the antinociceptive effects of metamizol in a mouse model of neuropathic pain. Pharmacol Biochem Behav 2018;175:77-88.

4. [No Authors Listed] Risks of agranulocytosis and aplastic anemia. A first report of their relation to drug use with special reference to analgesics. The International Agranulocytosis and Aplastic Anemia Study. JAMA 1986;256: 1749-1757.

5. Hassan K, Khazim K, Hassan F, et al. Acute kidney injury associated with metamizole sodium ingestion. Ren Fail 2011;33: 544-547.

6. Redondo-Pachon MD, Enriquez R, Sirvent AE, et al. Acute renal failure and severe thrombocytopenia associated with metamizole. Saudi J Kidney Dis Transpl 2014;25:121-125.

7. Andrade S, Bartels DB, Lange R, et al. Safety of metamizole: a systematic review of the literature. J Clin Pharm Ther 2016;41: 459-477.

8. Couto AC, Ferreira JD, Pombo-de-Oliveira MS, et al. Pregnancy, maternal exposure to analgesic medicines, and leukemia in Brazilian children below 2 years of age. Eur J Cancer Prev 2015;24:245-252.

9. Van der Klauw MM, Goudsmit R, Halie MR, et al. A population based case-cohort study of drug-associated agranulocytosis. Arch Intern Med 1999;159:369-374.

10. De Leeuw TG, Dirckx M, González Candel A, et al. The use of dipyrone (metamizol) as an analgesic in children: what is the evidence? A review. Paediatr Anaesth 2017;27: 1193-1201.

11. Huguley CM. Agranulocytosis induced by dipyrone, a hazardous antipyretic and analgesic. JAMA 1964;189:938-941.

12. Hoerder U, König HJ, Hartwich G. Agranulocytosis and metamizole. Dtsch Med Wochenschr 1982;107:1923-1926.

13. Larregina A, Aggio MC, Alvarez RV. Incidence and probable etiology of toxic agranulocytosis in a definite population in the province of Buenos Aires (1963-1976). Medicina 1994;54: 13-16.

14. Zeiner E, Blaser LS, Tisljar K, et al. Fatal agranulocytosis after metamizole re exposure. Praxis 2015;104:151-154.

15. Blanca-López N, Pérez-Sánchez N, Agundez JA, et al. Allergic reactions to metamizole: immediate and delayed responses. Int Arch Allergy Immunol 2016;169:223-230.

16. Sterzik V, Wild V, Weishaupt J, et al. Fatal visit to the general practitioner. Arch Kriminol 2016;238:120-127.

17. Arneborn P, Palmblad J. Drug-induced neutropenia-a survey for Stockholm 1973-1978. Acta Med Scand 1982;212:289-292.

18. Huber M, Andersohn F, Sarganas G, et al. Metamizole-induced agranulocytosis revisited: results from the prospective Berlin Case-Control Surveillance Study. Eur J Clin Pharmacol 2015;71: 219-227.

19. Bozzine I, Bunch C. Dipyrone, Health Care Series. Greenwood Village, CO: Micromedex Inc; 2000.

20. National Library of Medicine. Dipyrone section in Drugs and Lactation Database (LactMed). 2006; National Library of Medicine, Bethesda, MD. [Cited 2018 Sep 07]. Available from:

21. Bonkowsky JL, Frazer JK, Buchi KF, et al. Metamizole use by Latino immigrants: a common and potentially harmful home remedy. Pediatrics 2002;109:e98.

22. Dorr VJ, Cook J. Agranulocytosis and near fatal sepsis due to “Mexican aspirin” (dipyrone). South Med J 1996;89: 612-614.

23. Machado-Alba JE, Sanchez-Morales LV, Rodriguez-Ramirez LF. Dipyrone-related granulocytopenia: case report. Colomb J Anesthesiol 2018;46:327-330.

24. Chang AK, Bijur PE, Esses D, et al. Effect of a single dose of oral opioid and non opioid analgesics on acute extremity pain in the emergency department: a randomized clinical trial. JAMA 2017;318:1661-1667.

25. Constance JE, Campbell SC, Somani AA, et al. Pharmacokinetics, pharmacodynamics and pharmacogenetics associated with nonsteroidal anti-inflammatory drugs and opioids in pediatric cancer patients. Expert Opin Drug Metab Toxicol 2017;13:715-724.

26. Hung KKC, Graham CA, Lo RSL, et al. Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: single centre double-blind, randomized controlled clinical trial. PLoS One 2018;13:e0192043.
How to Cite
Gómez Duarte OG. Is it time to restrict the clinical use of dipyrone?. Colomb. J. Anesthesiol. [Internet]. 2019 Apr. 1 [cited 2024 May 25];47(2):81-3. Available from:


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How to Cite
Gómez Duarte OG. Is it time to restrict the clinical use of dipyrone?. Colomb. J. Anesthesiol. [Internet]. 2019 Apr. 1 [cited 2024 May 25];47(2):81-3. Available from:


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