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Instruction for use: Metamizole sodium + Triacetonamino-4-toluenesulfonate (Metamizolum natrium + Triacetonamino-4-toluensulfonas)

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Pharmacological groups

NSAIDs - Pyrazolones in combinations

Nosological classification (ICD-10)

G43 Migraine

The pain of migraine, Migraine, hemiplegic migraine, Migraine headache, A migraine attack, Continuous headache, hemicranias

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

K80.2 Stones of the gallbladder without cholecystitis

Cholesterol cholesterol

K80.5 stones of bile duct without cholangitis or cholecystitis

Obstruction of common bile duct, Stones of the common bile duct, biliary colic, Colic liver, Hepatic colic, Cholesterol gallstones in the common bile duct

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

M54.4 Lumbago with sciatica

Pain in the lumbosacral spine, Lumbago, Sciatica, Lumbar syndrome

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

N94.6 Dysmenorrhea Unspecified

Pain during menstruation, Functional disorders of the menstrual cycle, Menstrual cramps, Emmeniopathy, Pain during menstruation, Painful menstrual irregularities, algomenorrhea, algomenoreya, Pain smooth muscle spasm, Pain spasm of smooth muscles (renal and biliary colic, intestinal spasms, dysmenorrhea), Pain spasm of smooth muscles of internal organs (kidney and biliary colic, intestinal spasms, dysmenorrhea), Disalgomenoreya, dysmenorrhea, Dysmenorrhea (essential) (Exfoliative), menstrual disorder, menstruation painful, metrorrhagia, Violation of the menstrual cycle, Menstrual irregularities, Prolaktinzavisimoe menstrual disorders, Prolaktinzavisimoe menstrual dysfunction, Pain spasm of smooth muscles of internal organs, Spasmodic dysmenorrhea, Primary disalgomenoreya

R10.4 Other and unspecified abdominal pain

Abdominal pain, Gastrointestinal spasm, intestinal colic, Colic in infants, The feeling of fullness, Resi abdominal, Spasm of smooth muscle in diseases of the digestive tract, The spasm of the biliary tract, Biliary tract spasm, enterospasm, Spasm of the digestive tract, Spasms of the digestive tract smooth muscle, stomach Cramps, gastrointestinal spasms, Spastic condition of the gastrointestinal tract, intestinal tenesmus, Feeling of fullness, Baby colic

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

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

Characteristics of Metamizol sodium + Triacetonamino-4-toluenesulfonate

Combined drug, which includes metamizol sodium and triacetonamine-4-toluenesulfonate.


Pharmacological action - anti-inflammatory, antipyretic, analgesic, sedative.

Metamizole sodium inhibits the synthesis of prostaglandins, indiscriminately blocking COX (cyclooxygenase) -1 and COX-2, stabilizes cell membranes and inhibits the formation of endogenous pyrogenic compounds.

Triacetonamine-4-toluenesulfonate has anxiolytic activity, reduces anxiety, fear, and tension. Reduces motor excitation, has central n-holinoliticheskim action. Strengthens and 2-3 times prolongs the analgesic effect of metamizole sodium.

Application of Metamizol sodium + Triacetonamino-4-toluenesulfonate

Pain syndrome is mild and mild (including headache and toothache, migraine, neuritis, lumbago, neuralgia, myalgia, arthralgia, algodismenorea), especially in patients with increased nervous excitability. Pain syndrome with renal, hepatic, intestinal colic weakly expressed (in combination with antispasmodics). Pain syndrome after surgical and diagnostic interventions (as part of combination therapy). Feverish syndrome in ARVI and other infectious and inflammatory diseases.


Hypersensitivity, expressed renal / hepatic insufficiency, chronic heart failure, arterial hypotension (SAD (systolic blood pressure) below 100 mm Hg), oppression of hematopoiesis (granulocytopenia, leukopenia, agranulocytosis, cytostatic or infectious neutropenia), glucose-6- phosphate dehydrogenase, aspirin asthma, pregnancy (I trimester and last 6 weeks), lactation period, children's age (up to 14 years).

Restrictions for use

Kidney disease (pyelonephritis, glomerulonephritis, including in the anamnesis), moderate renal and / or liver failure, bronchial asthma, a predisposition to the development of arterial hypotension, prolonged abuse of alcohol.

Side effects of Metamizol sodium + Triacetonamino-4-toluenesulfonate

On the part of the digestive tract (gastrointestinal tract): rarely - burning in the epigastric region, dry mouth, cholestasis, jaundice, increased activity of hepatic transaminases, hyperbilirubinemia.

From the nervous system and sensory organs: rarely - headache, dizziness; in isolated cases - hallucinations.

From the cardiovascular system and blood (hematopoiesis, hemostasis): a decrease or increase in blood pressure (arterial pressure), tachycardia, cyanosis; agranulocytosis, leukopenia, thrombocytopenia.

On the part of the respiratory system: bronchospasm (in predisposed patients).

On the part of the genitourinary system: a violation of kidney function (when using high doses) - oliguria, anuria, proteinuria, interstitial nephritis.

Allergic reactions: urticaria (including conjunctiva and mucous membranes of the nasopharynx), skin rash, itching, angioedema, in rare cases - multiforme exudative erythema (including Stevens-Johnson syndrome), toxic epidermal necrolysis (syndrome Lyell), bronchospasm, anaphylactic shock.


Enhances the effects of ethanol; simultaneous use with chlorpromazine or other phenothiazine derivatives can lead to the development of severe hyperthermia. Sedative and anxiolytic drugs (drug) (tranquilizers) increase the analgesic effect of metamizole sodium. Thiamazole and cytostatics increase the risk of developing leukopenia. With the simultaneous administration of metamizole sodium and cyclosporine, the concentration of the latter in the blood decreases. Metamizole sodium, displacing from the bond with proteins, oral hypoglycemic drugs, indirect anticoagulants, glucocorticoids and indomethacin, increases their activity. Phenylbutazone, barbiturates and other hepatoinducers with simultaneous administration reduce the effectiveness of metamizole sodium. Simultaneous administration with other non-narcotic analgesics, tricyclic antidepressants, contraceptive hormonal drugs and allopurinol may lead to increased toxicity. The effect is enhanced by codeine, H2-histamine receptor blockers and propranolol (slows inactivation). Radiocontrast drugs, colloidal blood substitutes and penicillin should not be used during treatment with metamizole sodium.


Symptoms: nausea, vomiting, gastralgia, oliguria, hypothermia, tachycardia, lowering of blood pressure, dyspnea, tinnitus, drowsiness, ataxia, delirium, impaired consciousness, acute agranulocytosis, hemorrhagic syndrome, acute renal and / or hepatic insufficiency, convulsions, respiratory paralysis musculature.

Treatment: gastric lavage, saline laxatives, activated charcoal, hemodialysis or forced diuresis, symptomatic therapy, with the development of convulsive syndrome - intravenous injection of diazepam and high-speed barbiturates.

Routes of administration


Precautions for Metamizol sodium + Triacetonamino-4-toluenesulfonate

During the intake of the drug should be excluded from the use of ethanol. In the treatment of patients receiving cytotoxic drugs, metamizole sodium should be administered only under medical supervision. Against the background of taking metamizole sodium, the development of agranulocytosis is possible, therefore, if an unmotivated rise in body temperature, chills, sore throats, difficulty swallowing, stomatitis, as well as the development of the phenomena of vaginitis or proctitis, immediate withdrawal of the drug is necessary. With long-term use (more than 1 week), it is necessary to control the picture of peripheral blood and liver function parameters.

It is inadmissible to use to relieve acute pain in the abdomen (until the cause is clarified).

It is possible to stain the urine in red (it has no clinical significance). During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

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