Instruction for use: Metamizole sodium (Metamizolum natrium)

Pharmacological groups

NSAIDs - Pyrazolones

Nosological classification (ICD-10)

G25.5 Other types of chorea

Hyperkinesis of chorea, Chorea, Chorea small, Chorea, Secondary chorea, Acute chorea, Chronic chorea, St Witt's Dance, Chorea Sidengama (small, rheumatic), Senile chorea, Sydenham chorea

J06 Acute upper respiratory infections of multiple and unspecified

Frequent colds viral diseases, Infections of the upper respiratory tract, Acute respiratory disease influenza character, for colds Pain, Acute colds,Cold, respiratory infection,Seasonal colds, Pain in infectious and inflammatory diseases of the upper respiratory tract, Bacterial infections of the upper respiratory tract, Bacterial respiratory infections, Viral disease of the respiratory tract, Viral respiratory tract infections, Inflammatory disease of the upper respiratory tract, Inflammation of the upper respiratory tract disease, Inflammation of the upper respiratory tract illness with difficult sputum, Inflammatory airway disease, Secondary infections with colds, Shortness of sputum in acute and chronic respiratory diseases, Upper respiratory tract infection, Infections of the upper respiratory tract, Respiratory Tract Infections, Infections of the respiratory tract and lungs, Infectious-inflammatory diseases of the upper respiratory tract, Infectious-inflammatory diseases of the upper respiratory tract and ENT-organs, Infectious-inflammatory diseases of the upper respiratory tract in children and adults, Infectious-inflammatory diseases of the upper respiratory tract, Infectious inflammation of the airways,respiratory infection, Qatar upper respiratory tract, Catarrh of the upper respiratory tract, Catarrhal disease of the upper respiratory tract, Catarrhal symptoms of the upper respiratory tract, Coughing with a cold, SARS, ARI, ARI with rhinitis phenomena, Acute respiratory infection, Acute infectious and inflammatory disease of the upper respiratory tract, Acute respiratory disease, Sore throat or nose, Respiratory viral infections, Respiratory diseases, Respiratory infections, Recurrent respiratory infections, Secondary infection with influenza, cold in the chest, Feverish condition with flu usitis, acute sinusitis, genyantritis, purulent sinusitis

J11 Influenza, virus not identified

Flu, Influenza in the early stages of the disease, Flu in children, cold in the chest, Begins flu-like condition, Acute disease parainfluenza, parainfluenza, parainfluenza state, influenza epidemics, The pains of the flu, Influenza

K08.8.0 * Painful toothache

Dentinal pain, Dentinal pains, Pain pulpitis, Anesthesia in dentistry, Pain syndromes in dental practice, Pain after removal of tartar, Pain when extracting a tooth, Toothache, Pain after dental interventions

M25.5 Pain in the joint

Arthralgia, Pain syndrome in musculo-articular diseases, Pain syndrome in osteoarthritis, Pain syndrome in osteoarthritis, Pain syndrome in acute inflammatory diseases of the musculoskeletal system, Pain syndrome in chronic inflammatory diseases of the musculoskeletal system, Pain in the joints, Soreness of the joints, Soreness of joints in severe physical exertion, Painful inflammatory joint damage, Painful conditions of the musculoskeletal system, Painful joint conditions, Painful traumatic affection of joints, Pain in the musculoskeletal system, Pain in Shoulder Joints, Pain in the joints, Joint pain, Joint pain with injuries, Musculoskeletal pain, Pain with osteoarthritis, Pain in the pathology of the joints, Pain in rheumatoid arthritis, Pain in chronic degenerative bone diseases, Pain in chronic degenerative joint diseases, Bone-joint pain, Joint pain, Arthritic pain of rheumatic origin, Articular pain syndrome, Joint pain, Rheumatic pain, Rheumatic pains

M35.3 Rheumatic polymyalgia

Pseudoarthritis rhizomelic, Rheumatic polymyalgia, Pain syndrome in rheumatic diseases, Muscle pain with rheumatism, Extra-articular rheumatism, Extra-articular rheumatic syndrome, Extra-articular rheumatic diseases, Extra-articular rheumatic soft tissue injury, Extra-articular forms of rheumatism, Rheumatic soft tissue damage, Rheumatism of soft tissues, Rheumatic diseases of soft tissues, Rheumatic diseases of the periarticular soft tissues, Rheumatic affections of soft tissues, Rheumatic collagen diseases

M54.3 Sciatica

Ishialgia, Neuralgia of the sciatic nerve, Sciatic neuritis

M79.1 Myalgia

Myofascial pain syndromes ,Pain syndrome in musculo-articular diseases, Pain syndrome in chronic inflammatory diseases of the musculoskeletal system, Pain in the muscles, Tenderness of muscles, Muscular soreness in severe physical exertion, Painful conditions of the musculoskeletal system, Pain in the musculoskeletal system, Pain in the muscles, Pain at rest, Muscle aches, Muscle pain, Musculoskeletal pain, Myalgia, Muscle pain, Muscle pain at rest, Muscle pain, Muscular pain of non-rheumatic origin, Muscle pain of rheumatic origin, Acute muscle pain, Rheumatic pain, Rheumatic pains, Myofascial syndrome, Fibromyalgia

M79.2 Neurology and neuritis, unspecified

Pain syndrome with neuralgia, Brachialgia, Occipital and intercostal neuralgia, Neuralgia, Neuralgic pain, Neuralgia, Neuralgia of intercostal nerves,Neuralgia of the posterior tibial nerve, Neuritis, Neuritis traumatic, Neuritis, Neurological Pain Syndromes, Neurological contractures with spasms, Acute neuritis, Peripheral neuritis,Post-traumatic neuralgia,Severe pain of a neurogenic nature, Chronic neuritis, Essential neuralgia

N23 Renal colic unspecified

Pain in renal colic, Pain smooth muscle spasm, Pain spasm of smooth muscles (renal and biliary colic, intestinal spasms, dysmenorrhea), Pain spasm of smooth muscles of internal organs, Pain spasm of smooth muscles of internal organs (kidney and biliary colic, intestinal spasms, dysmenorrhea), renal Colic, ureteral colic, Renal colic, Renal colic with urolithiasis, Kidney disease, Spasm of smooth muscle in diseases of the urinary system, The spasm of the urinary tract, The spasm of the ureter, The spasm of the ureters, Spasms of the urinary tract, Spasms of the urinary tract

N94.0 Pain in the middle of the menstrual cycle

Algomenorea, Painful menstruation, Menalgia, Pain in menstruation

R07.2 Pain in the heart

neuroses of the heart, Myocardial ischemic pain, Pain syndrome in myocardial infarction, cardialgia, cardioneurosis, Cardiac syndrome, Pain in cardiac patients, Cardialgia on background dyshormonal myocardial dystrophy, Functional cardialgia, Psevdostenokardiya, pericardial pain

R50 Fever of unknown origin

Malignant hyperthermia, Hyperthermia malignant

R51 Headache

Pain in the head, Cephalgia, Pain with sinusitis, Pain in the back of the head, Painful headache, Headache of vasomotor genesis, Headache of vasomotor origin, Headache with vasomotor disorders, Headache, Neurological headache, Serial headache

R52 Pain, not elsewhere classified

Pain syndrome of radicular origin, Pain syndrome of small and medium intensity of different genesis, Pain syndrome after orthopedic surgery, Pain syndrome in superficial pathological processes, Radicular pain in the background of osteochondrosis of the spine, Radicular pain syndrome, Pleural pain, Chronic pain

R52.0 Acute pain

Acute pain syndrome, Acute pain syndrome with osteoarthritis, Acute pain syndrome of traumatic origin, Severe pain of a neurogenic nature, Severe pain, Pain syndrome at delivery

Z100 * CLASS XXII Surgical practice

Abdominal surgery, adenomectomy, Amputation, Coronary angioplasty, Angioplasty of the carotid arteries, Antiseptic skin treatment for wounds, Antiseptic Hand, Appendectomy, atherectomy, Balloon coronary angioplasty, Vaginal hysterectomy, The coronary bypass, Interventions in the vagina and cervix, Interventions on the bladder, Intervention in the mouth, Restoration and reconstructive surgery, Hand hygiene of medical personnel, Gynecologic surgery, Gynecological intervention, Gynecological surgery, Hypovolemic shock during operations, Disinfection of purulent wounds, Disinfection of wounds edges, Diagnostic intervention, Diagnostic procedures, Cervical Diathermocoagulation, Long-surgery, Replacing the fistula catheters, Infection in orthopedic surgery, Artificial heart valve, cystectomy, Short-term outpatient surgery, Short-term operation, Short surgical procedures, Krikotireotomiya, Blood loss during surgery, Bleeding during surgery and in the postoperative period, Kuldotsentez, laser photocoagulation, laser coagulation, retinal laser coagulation, Laparoscopy, Laparoscopy in Gynecology, CSF fistula, Small gynecological operations, Small surgical procedures, Mastectomy and subsequent plastic, mediastinotomy, Microsurgical operations on the ear, Mukogingivalnye operation, suturing, Minor surgery, neurosurgical operation, Immobilization of the eyeball in ophthalmic surgery, testectomy, pancreatectomy, Perikardektomiya, The period of rehabilitation after surgery, The period of, convalescence after surgery, Percutaneous transluminal coronary angioplasty, Pleural thoracentesis, Pneumonia postoperative and posttraumatic, Preparation for surgical procedures, Preparation for surgery, Preparation of the surgeon's hands before surgery, Preparation of the colon for surgical procedures, Postoperative aspiration pneumonia in neurosurgical and thoracic surgery, Postoperative nausea, Postoperative bleeding, postoperative granuloma, postoperative shock, The early postoperative period, myocardial revascularization, Radiectomy, gastric Resection, bowel resection, uterine Resection, liver Resection, enterectomy, Resection of part of the stomach, Reocclusion of the operated vessel, Bonding tissues during surgical procedures, Removal of sutures, Condition after eye surgery, Condition after surgery, Condition after surgery in the nasal cavity, Condition after gastrectomy, Status after resection of the small intestine, Condition after tonsillectomy, Condition after removal of the duodenum, Condition after phlebectomy, Vascular surgery, Splenectomy, Sterilization of surgical instruments, Sterilization of surgical instruments, sternotomy, Dental surgery, Dental intervention in periodontal tissues, strumectomy, Tonsillectomy, Thoracic surgery, total gastrectomy, Transdermal intravascular coronary angioplasty, Transurethral resection, Turbinektomiya, Removal of a tooth, cataract surgery, Removal of cysts, tonsillectomy, Removal of fibroids, Removing the mobile primary teeth, Removing polyps, Removing broken tooth, Removal of the uterus body, Removal of sutures, Urethrotomy, Fistula likvoroprovodyaschih ways, Frontoetmoidogaymorotomiya, Surgical infection, Surgical treatment of chronic limb ulcersm, Surgery, The surgery in the anal area, The surgery on the colon, Surgical practice, The surgical procedure, Surgical interventions, Surgery on the gastrointestinal tract, Surgical procedures on the urinary tract, Surgical procedures on the urinary system, Surgical intervention of the genitourinary system, Surgical procedures on the heart, Surgical manipulation, surgery, Surgery on the veins, Surgical intervention, Vascular surgery, Surgical treatment of thrombosis, cholecystectomy, Partial gastric resection, transabdominal hysterectomy, Percutaneous transluminal coronary angioplasty, Percutaneous transluminal angioplasty, Coronary artery bypass, tooth Extirpation, Extirpation of milk teeth, pulpectomy, pulsative cardiopulmonary bypass, tooth Extraction, teeth Extraction, cataract extraction, Electrocoagulation, endourological intervention, episiotomy, Etmoidotomiya, Complications after tooth extraction

Code CAS 68-89-3

Characteristics of the substance Metamizol sodium

The pyrazolone derivative. White or white with a barely noticeable yellowish hue, crystalline powder, quickly decomposes in the presence of moisture. Easily soluble in water (1: 1.5), the aqueous solution has a pH of 6-7.5. It is soluble in ethanol (1: 60-1: 80), practically insoluble in ether, chloroform, acetone.

Pharmacology

Pharmacological action - anti-inflammatory, antipyretic, analgesic.

Oppresses the activity of cyclooxygenase, reduces the formation of endoperoxides, bradykinins, certain PG (prostaglandins), free radicals, inhibits lipid peroxidation. It prevents painful extra- and proprioceptive pulses along the Gaull and Burdach beams, raises the threshold of excitability of thalamic centers of pain sensitivity, increases heat transfer.

When ingested quickly and fully absorbed. In the intestinal wall it hydrolyzes with the formation of an active metabolite - unchanged metamizole in the blood is absent (only after intravenous administration its insignificant concentrations are detected in the plasma). The level of binding of the active metabolite with proteins is 50-60%. Destroyed in the liver. Excretion passes through the kidneys.

The action develops in 20-40 minutes and reaches a maximum after 2 hours.

Application of Metamizol sodium

Arthralgia, rheumatism, chorea, pain: headache, dental, menstrual, neuralgia, sciatica, myalgia, with colic (renal, hepatic, intestinal), lung infarction, myocardial infarction, exfoliating aortic aneurysm, thrombosis of major vessels, inflammatory processes (pleurisy, pneumonia , lumbago, myocarditis), trauma, burns, decompression sickness, shingles, tumors, orchitis, pancreatitis, peritonitis, esophageal perforation, pneumothorax, posttransfusion complications, priapism; febrile syndrome with acute infectious, purulent and urological diseases (prostatitis), insect bites (including mosquitoes, bees, gadflies).

Contraindications

Hypersensitivity, oppression of hematopoiesis (agranulocytosis, cytostatic or infectious neutropenia), severe violations of liver or kidney function, prostaglandin bronchial asthma, hereditary hemolytic anemia associated with deficiency of glucose-6-phosphate dehydrogenase, pregnancy, breast-feeding.

pregnancy and lactation

The FDA action category is not defined.

Side effects of Metamizol sodium

Granulocytopenia, agranulocytosis, thrombocytopenia, hemorrhages, hypotension, interstitial nephritis, allergic reactions (including Stevens-Johnson syndromes, Lyell, bronchospasm, anaphylactic shock).

Interaction

The effect is enhanced by barbiturates, codeine, caffeine, H2-antihistamines, propranolol (slows inactivation). Sarcolysin and thiamazole increase the likelihood of developing leukopenia. Sedatives and tranquilizers increase the analgesic effect of metamizole sodium. Tricyclic antidepressants, oral contraceptives, allopurinol disrupt metabolism and increase toxicity. Simultaneous use with other analgesics-antipyretics, NSAIDs (non-steroidal anti-inflammatory drugs) can lead to mutual enhancement of toxic effects, with chlorpromazine or other phenothiazine derivatives - to the development of severe hyperthermia. Myelotoxic drugs (drug) increase the manifestation of hematotoxicity of metamizole sodium. Phenylbutazone and other inducers of microsomal liver enzymes weaken the effect.

Metamizole sodium, displacing from the connection with blood proteins, increases the activity of oral hypoglycemic drugs, indirect anticoagulants, HA, indomethacin. Strengthens the sedative effect of alcohol. Reduces the concentration of cyclosporine in plasma. Radiocontrast agents, colloidal blood substitutes and penicillin should not be used during treatment with metamizole sodium. Because of the high probability of pharmaceutical incompatibility, one should not mix with other drugs in one syringe.

Overdose

Symptoms: hypothermia, severe hypotension, palpitation, shortness of breath, tinnitus, nausea, vomiting, weakness, drowsiness, delirium, impaired consciousness, convulsive syndrome; it is possible to develop acute agranulocytosis, hemorrhagic syndrome, acute renal and hepatic insufficiency.

Treatment: induction of vomiting, over-probe gastric lavage, the appointment of salt laxatives, activated charcoal and conducting forced diuresis, blood alkalization, symptomatic therapy aimed at maintaining vital functions.

Routes of administration

Intramuscularly (intramuscularly), intravenously (intravenously), rectally.

Precautions for Metamizol sodium

We need medical control (high incidence of allergic reactions, including fatal, especially with parenteral administration). It is not recommended regular long-term administration due to myelotoxicity. Excludes use to relieve acute pain in the abdomen (until finding out the cause). When appointing patients with acute cardiovascular pathology, careful monitoring of hemodynamics is necessary. FROM