van Diepen Anouk T N, Simons Pieter, Bos Jacqueline M, Kramers C
Radboud Universitair Medisch Centrum, afd. Interne Geneeskunde, Nijmegen.
Contact: Anouk T.N. van Diepen (
Ned Tijdschr Geneeskd. 2022 Jan 19;166:D6182.
Metamizole is a non-selective NSAID with a strong analgesic and spasmolytic effect. In the late 1970s, metamizole has been withdrawn from the market in many industrialized countries because of an allegedly unacceptable high risk of agranulocytosis. The absolute risk of metamizole-related agranulocytosis is estimated to be less than 1 per million daily doses. The incidence of agranulocytosis may be reduced by short-term use and careful consideration when prescribing to specific patient categories. Metamizole has a relatively favorable safety profile with respect to morbidity and mortality compared to other NSAIDs. In the Netherlands the official registration of metamizole has been limited for years to intravenous and postoperative use. In March 2021, the Dutch Medicine Assessment Board certified one oral formulation of metamizol under strict conditions. The debate about the wider application of (oral) metamizole in the Netherlands should be re-opened.
安乃近是一种具有强大镇痛和解痉作用的非选择性非甾体抗炎药。在20世纪70年代后期,由于据称存在不可接受的高粒细胞缺乏风险,安乃近已在许多工业化国家退市。据估计,与安乃近相关的粒细胞缺乏的绝对风险低于每百万日剂量1例。短期使用以及在给特定患者类别开处方时仔细考虑,可降低粒细胞缺乏的发生率。与其他非甾体抗炎药相比,安乃近在发病率和死亡率方面具有相对良好的安全性。在荷兰,安乃近的官方注册多年来一直限于静脉内和术后使用。2021年3月,荷兰药品评估委员会在严格条件下批准了一种安乃近口服制剂。关于(口服)安乃近在荷兰更广泛应用的辩论应该重新展开。