Pyralgin
Generic Name
Metamizole (Dipyrone)
Manufacturer
Example Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| pyralgin 500 mg tablet | ৳ 1.20 | ৳ 12.00 |
Description
Overview of the medicine
Pyralgin (Metamizole) is an effective analgesic, antipyretic, and antispasmodic medicine used for moderate to severe pain and high fever. It belongs to the pyrazolone class of drugs.
Uses & Indications
Dosage
Adults
500-1000 mg (1-2 tablets) orally, up to 3-4 times daily. Maximum daily dose is 4000 mg (4g).
Elderly
Lower doses may be required, and renal function should be monitored due to potential for reduced drug clearance.
Renal_impairment
Use with caution. Dosage reduction may be necessary due to accumulation of metabolites. Avoid in severe renal impairment.
How to Take
Take the tablet orally with water, with or without food. Do not chew or crush the tablet.
Mechanism of Action
Metamizole's exact mechanism is not fully understood but is thought to involve inhibition of prostaglandin synthesis, particularly central COX-3, and direct action on smooth muscle to produce antispasmodic effects. It also interferes with pain transmission pathways in the central nervous system.
Pharmacokinetics
Onset
Analgesic effect begins within 30-60 minutes.
Excretion
Primarily excreted via the kidneys (90%), with a small amount excreted in feces.
Half life
The active metabolite (4-methylaminoantipyrine) has a half-life of 2.7-3.5 hours, and other metabolites have longer half-lives (up to 10 hours).
Absorption
Rapid and almost complete absorption from the gastrointestinal tract. Peak plasma levels occur within 1-2 hours.
Metabolism
Extensively metabolized in the liver to several active metabolites (e.g., 4-methylaminoantipyrine, 4-aminoantipyrine) and inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to metamizole, other pyrazolones, or pyrazolidines.
- Bone marrow suppression, agranulocytosis (current or history).
- Acute intermittent hepatic porphyria.
- Congenital glucose-6-phosphate dehydrogenase (G6PD) deficiency.
- Pregnancy (especially 3rd trimester) and lactation.
- Infants under 3 months of age or weighing less than 5 kg.
Drug Interactions
Bupropion
Metamizole may reduce plasma concentrations of bupropion and its active metabolite.
Cyclosporine
Metamizole may reduce cyclosporine blood levels, potentially reducing its efficacy. Monitor cyclosporine levels.
Methotrexate
May increase methotrexate toxicity, especially in patients with impaired renal function. Avoid concomitant use.
Chlorpromazine
Concomitant use may lead to severe hypothermia.
Oral Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect, increasing bleeding risk. Monitor INR.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, abdominal pain, renal impairment, acute renal failure, dizziness, drowsiness, convulsions, hypotension, shock, and coma. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal if recent ingestion.
Pregnancy & Lactation
Avoid during pregnancy, especially during the third trimester, due to the risk of premature closure of the ductus arteriosus and renal dysfunction in the fetus. Not recommended during lactation as metabolites are excreted in breast milk and may pose a risk to the infant.
Side Effects
Contraindications
- Hypersensitivity to metamizole, other pyrazolones, or pyrazolidines.
- Bone marrow suppression, agranulocytosis (current or history).
- Acute intermittent hepatic porphyria.
- Congenital glucose-6-phosphate dehydrogenase (G6PD) deficiency.
- Pregnancy (especially 3rd trimester) and lactation.
- Infants under 3 months of age or weighing less than 5 kg.
Drug Interactions
Bupropion
Metamizole may reduce plasma concentrations of bupropion and its active metabolite.
Cyclosporine
Metamizole may reduce cyclosporine blood levels, potentially reducing its efficacy. Monitor cyclosporine levels.
Methotrexate
May increase methotrexate toxicity, especially in patients with impaired renal function. Avoid concomitant use.
Chlorpromazine
Concomitant use may lead to severe hypothermia.
Oral Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect, increasing bleeding risk. Monitor INR.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, abdominal pain, renal impairment, acute renal failure, dizziness, drowsiness, convulsions, hypotension, shock, and coma. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal if recent ingestion.
Pregnancy & Lactation
Avoid during pregnancy, especially during the third trimester, due to the risk of premature closure of the ductus arteriosus and renal dysfunction in the fetus. Not recommended during lactation as metabolites are excreted in breast milk and may pose a risk to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved in many countries (e.g., Bangladesh, India, Mexico, Russia, Spain), but banned or restricted in others (e.g., USA, UK, Canada, Australia) due to risk of agranulocytosis. Available under DGDA approval in Bangladesh.
Patent Status
Off-patent
Clinical Trials
Metamizole has been subject to numerous clinical trials focusing on its efficacy in various pain conditions and fever, as well as its safety profile, particularly regarding agranulocytosis risk. Ongoing research continues to assess its benefit-risk ratio in different populations.
Lab Monitoring
- Complete Blood Count (CBC) including white blood cell differential, especially if treatment is prolonged or if symptoms of agranulocytosis (e.g., fever, sore throat, mouth ulcers) occur.
- Renal function tests (e.g., creatinine, BUN) in patients with pre-existing renal impairment or during long-term therapy.
Doctor Notes
- Emphasize the rare but serious risk of agranulocytosis to patients.
- Advise patients to immediately seek medical attention if they develop fever, sore throat, or mouth ulcers.
- Avoid concomitant use with other myelosuppressive agents.
- Use with caution in elderly patients and those with impaired renal or hepatic function.
Patient Guidelines
- Do not exceed the recommended dose.
- Report any signs of infection (e.g., fever, chills, sore throat) immediately to your doctor.
- Avoid alcohol consumption while taking this medicine.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Driving Precautions
May cause dizziness or drowsiness in some individuals. Exercise caution when driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain good hydration.
- Avoid self-medication for prolonged periods without consulting a doctor.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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