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Agranulocytosis associated with dipyrone (metamizol)
Luisa Ibáñez1, Xavier Vidal, Elena Ballarín
1Fundació Institut Català de Farmacologia, WHO Collaborating Centre for Research and Training in Pharmacoepidemiology, Department of Pharmacology, Therapeutics and Toxicology, Institut Català de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
European Journal of Clinical Pharmacology
|December 8, 2004
Summary
Metamizole use is rarely associated with agranulocytosis, a severe blood disorder. Risk factors include longer duration of use and concurrent medications, with geographical variations in incidence.
Area of Science:
- Hematology
- Pharmacovigilance
- Epidemiology
Background:
- Estimates of agranulocytosis risk from metamizole vary significantly.
- A large-scale surveillance database for blood dyscrasias was utilized to assess this risk.
Purpose of the Study:
- To accurately estimate the risk of agranulocytosis associated with metamizole use.
- To investigate factors influencing the observed geographical disparities in metamizole-associated agranulocytosis.
Main Methods:
- A case-control study was conducted using a surveillance database of blood dyscrasias from 1980 onwards.
- Cases of agranulocytosis and matched controls were interviewed regarding drug exposure, specifically metamizole.
- Relative risks were calculated for different categories of metamizole exposure.
Main Results:
- A total of 177 cases and 586 controls were included in the analysis.
- Thirty cases (16.9%) and nine controls (1.5%) were exposed to metamizole in the week prior.
- The adjusted relative risk of agranulocytosis associated with metamizole was 25.8, with an attributable incidence of 0.56 per million person-years.
Conclusions:
- Agranulocytosis attributable to metamizole is rare in this population.
- Differences in metamizole usage patterns (dose, duration, concomitant medications) contribute to geographical variations in risk.
- The risk of agranulocytosis decreased after 10 days of metamizole cessation.
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