Dipyrone (oral)

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to aspirin or other non-steroidal anti-inflammatory drugs
• First trimester and last 6 weeks of pregnancy
• Blood dyscrasias
• Bone marrow suppression

Cautions

• Second trimester and first 6 weeks of third trimester
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Cardiac diseases
• Glucose 6 phosphatase dehydrogenase deficiency 
• History of gastrointestinal ulceration, bleeding, or perforation
• Pre-existing infection
• Porphyria

Pregnancy

• Caution: second and first 6 weeks of third trimester
• Contraindicated: First trimester and last 6 weeks of third trimester
• Dipyrone crosses the placenta. It is contraindicated during the first three months and the last six weeks of pregnancy
• Use during the other periods of pregnancy should be guided by an assessment of the benefit-risk profile, that is, the benefit of treatment to the mother should outweigh any potential risks to the mother or the foetus

Breastfeeding

• Caution; not recommended
• Dipyrone and its metabolites are excreted in breast milk and infants may be exposed to rather large amounts. Avoid use during breastfeeding and consider safer alternatives
• Breastfeeding should be avoided within 48 hours of maternal administration

Renal Impairment

• Caution; no dose adjustment recommended
  Consider safer alternatives, as the benefit-risk ratio may be unfavourable

Hepatic Impairment

• Caution; no dose adjustment recommended
  Consider safer alternatives, as the benefit-risk ratio may be unfavourable

Elderly

• Caution; no information available

Central Nervous System Disorders

• Seizures

Cardiovascular Disorders

• Hypotension

Respiratory Disorders

• Bronchospasm

Gastrointestinal Disorders

• Nausea and vomiting

Genitourinary Disorders

• Acute kidney injury
• Interstitial nephropathy

Endocrine and Metabolic Disorders

• Loss of appetite

Skin and Subcutaneous Tissue Disorders

• Allergic skin rash

Immune, Blood and Lymphatic System Disorders

• Anaphylactic reactions
• Agranulocytosis
• Haemolytic anaemia
• Aplastic anaemia

• Antiplatelets
• Anticoagulants
• Amiloride
• Thiazides
• Amitriptyline

Dipyrone (metamizole) is pyrazolone nonsteroidal anti-inflammatory agent. It is a sodium sulfonate derivative of aminopyrine. It has anti-inflammatory, antispasmodic, analgesic, antipyretic and anti-platelet effects.