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Pharmacology and relevant drug interactions of metamizole

David J Brinkman1,2,3, Linda C Hendriksen4, Irma M Rigter4

  • 1Department of Anaesthesiology, Amsterdam UMC, Amsterdam, Netherlands.

British Journal of Clinical Pharmacology
|May 15, 2025
PubMed

Insights

Metamizole is a widely used pain reliever, but it can interact with other medications. Healthcare providers should consider these drug interactions, especially when using high doses of metamizole.

Area of Science:

  • Pharmacology
  • Drug Interactions
  • Clinical Practice

Background:

  • Metamizole is a common analgesic with a favorable benefit/risk profile compared to NSAIDs.
  • Emerging research highlights significant drug interactions relevant to clinical practice.

Purpose of the Study:

  • To review the literature on metamizole's pharmacology.
  • To summarize the most clinically relevant drug interactions of metamizole.

Main Methods:

  • Literature review of metamizole's pharmacological properties.
  • Analysis of documented drug interactions.

Main Results:

  • Metamizole exhibits a fast analgesic effect but a short duration of action.
  • It induces CYP3A4, CYP2B6, CYP2C19, and weakly CYP2C9; inhibits CYP1A2.
  • Metamizole inhibits acetylsalicylic acid and warrants caution with drugs causing agranulocytosis.

Conclusions:

  • Clinicians must consider metamizole's pharmacokinetic and dynamic interactions, particularly with high-dose, long-term use.
  • Careful patient management is essential to mitigate risks associated with metamizole drug interactions.
Keywords:
CYPacetylsalicylic aciddipyroneinteractionsmetamizolepharmacology

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