Side effects of Novalgin®

introduction

Novalgin® is a trade name, i.e. just the name chosen by the manufacturer, behind which the active ingredient metamizole is hidden. Alternatively, Metamizol is also sold under the names Novaminsulfon®, Sintetica® and Minalgin®.

application

Novalgin® or. Metamizole belongs to the class of Painkiller (Analgesics). According to their mode of action and effect, this group can be roughly divided into active ingredients with (typical) and without (atypical) additional anti-inflammatory effects. Novalgin is one of the atypical pain medication that only improves the sensation of pain without curbing inflammatory processes, such as drugs Acetylsalicylic acid (Aspirin®) or Diclofenac (Voltaren®) do it on the side.

Novalgin® has a very good analgesic effect and is usually used when moderate to severe pain occurs. It also works fever lowering (antipyretic) and antispasmodic (spasmolytic). The latter property ensures that the preparation has priority in treatment when severe pain in the biliary and urinary tract, e.g. should be treated if it is closed by a "stone".

Generally is Novalgin® suitable for cramp-like pain that often originates from internal organs of the abdomen.

Side effects

Novalgin® is usually well tolerated and undesirable side effects occur occasionally or rarely. Overall seems Novalgin® to show better tolerance with less frequently occurring side effects than comparable ones Painkiller how Aspirin® or Ibuprofen®.

Due to the not yet fully understood mechanism of action of metamizole, which obviously differs from comparable drugs, typical side effects of long-term pain therapy such as blood thinning (anticoagulant) or stomach ulcers do not occur.

Nevertheless, Novalgin® has been subject to prescription again since 1987, as isolated but serious cases of blood formation disorders due to use have occurred in the past.

One such dreaded blood formation disorder is called agranulocytosis. This leads to an intolerance reaction to the drug, which leads to the death of special white blood cells. The body forms defense cells (antibodies) against the body's own blood cells, which have combined with the active ingredient Novalgin in the blood. Since the affected blood cells themselves belong to the natural defense system, this disease expresses itself specifically as a severe feeling of illness, which can manifest itself in bacterial infections with fever, chills and palpitations and / or as the death of the mucous membrane in the throat or genital and anal area. However, the symptoms mentioned may be reduced if antibiotics are taken at the same time.

The risk of agranulocytosis increases if Novalgin® is used for more than a week. An unexpected deterioration in your general condition and a persistent or recurrent fever may be an indication of agranulocytosis. Prompt clarification by the doctor and immediate discontinuation of the medication are decisive for the further course or the healing process.

The actual occurrence of agranulocytosis is altogether very unlikely and should not unnecessarily restrict the administration.

Read more on the subject at: Agranulocytosis - what are the causes?

The combination of Novalgin® with other substances that can cause agranulocytosis should be avoided at best. These drugs include Clozapine, so-called Neuroleptics used to treat psychosis and schizophrenia, as well Carbamazepine, for use in the therapy of epilepsy and phenylbutazone, which is occasionally used for immediate pain therapy for joint problems (e.g. rheumatism). It should also avoid the parallel intake of so-called Thioamide thyrostatics apart from that at Hyperthyroidism (Hyperthyroidism) are often set.

Further precautionary measures are e.g. the duration of the Limit intake to one week and with pre-existing ones Bone marrow damage all the way up Refrain from metamizole preparations.

In addition to the rare agranulocytosis, the use of metamizole can cause other, mostly less serious, side effects. Occasionally, rashes may develop due to an oversensitive (allergic) reaction. Such a hypersensitivity reaction can appear as a so-called "Fixed drug eruption“Or express other skin rashes that are noticeable by purple to dark red, evenly distributed, sometimes flat-round skin changes on both sides, sometimes with additional blisters. In individual cases, serious allergic skin reactions such as Stevens-Johnson syndrome or Lyell syndrome can be caused by taking Novalgin®. Large spots and skin defects appear on various parts of the body, often accompanied by a high fever and physical exhaustion.

Another very rare but dangerous complication is a drop in blood pressure with narrowing of the airways as part of a severe allergic shock reaction (anaphylactic shock). Such serious complications are known in connection with an injection that is too rapid into venous blood vessels, which is why Novalgin® is diluted in saline or isotonic solutions and administered by infusion in medical facilities. In exceptional cases, direct injection (injection) of Novalgin® may be absolutely necessary, whereby care must be taken to give it slowly.

If you feel one or more symptoms of acute shock such as cold sweat, dizziness, lightheadedness, paleness, tightness in the chest and shortness of breath, it is necessary to consult a doctor immediately, as this condition can quickly become life-threatening. Life-threatening side effects such as allergic shock or agranulocytosis can also occur if you have tolerated Metamizole or Novalgin® well up to now.

It should also be mentioned that Novalgin® can in rare cases trigger a kidney disorder. Especially at high doses, the urine can be colored red due to the degradation product of metamizole (“rubazonic acid”). This discoloration usually disappears after the treatment. Furthermore, Novalgin® can provoke nausea and vomiting, especially when taking opioids such as morphine at the same time.

Side effects on the psyche / depression

The active ingredient in Novalgin® is that Novaminsulfone / metamizole. It is a pain reliever and belongs to the NSAIDs (non-steroidal anti-inflammatory drugs). The special thing about Novalgin®, what distinguishes the active ingredient from other painkillers from the NSAID group, is that Novalgin® has an antispasmodic (spasmolytic) effect in addition to its analgesic (pain-relieving) and fever-lowering (antipyretic) effect. It is therefore often used for cramping pain in the abdomen, for example renal colic. When taking Novalgin®, side effects can occur. However, these do not affect the psyche. Novalgin® is not suspected to be the cause of depression.

fatigue

The mechanism of action of Novalgins® has not yet been conclusively clarified. Like all other NSAIDs, Novalgin® probably works by inhibiting COX 1- and 2 Enzymes. An effect on the central nervous system is currently under discussion. The fact that Novalgin® works on receptors in the brain could lead to fatigue. What is certain, however, is that Novalgin® leads to a drop in blood pressure at high doses and pre-existing low blood pressure. Even with a small amount of waste, this can lead to a feeling of fatigue. This can also lead to tiredness, exhaustion, nausea and a tendency to collapse. Kick a Hypotension (low blood pressure), it helps to lie down and avoid exertion. In this way a possible collapse can be avoided. Also the dreaded side effect of a Agranulocytosis (Hematopoietic disorder) can be associated with tiredness and fatigue. This side effect is rare but serious. If you are very tired and exhausted for a long time, you should consult a doctor during or after therapy with Novalgin®.

You might also be interested in the following topic: When your blood pressure is too low!

Sweating as a side effect

The sweating, like the nausea caused by Novalgin, can have various reasons. The mechanism of action of Novalgin is not yet fully understood. A central effect on receptors that influence heat regulation is discussed. This could explain the sweating when taking Novalgin. Another reason of sweating could be that Hypotension be. The sudden drop in blood pressure activates mechanisms that counteract the drop in blood pressure (sympathetic nervous systemThis activates the heart rate and breathing. This can cause sudden hot flashes and sweating.

Side effects on the stomach

Like all drugs from the NSAID group (non-steroidal anti-inflammatory drugs) Novalgin can become a gastritis (Inflammation of the stomach lining) or a Gastric ulcer (Stomach ulcer). This is due to the increased production of stomach acid by the drugs. If these drugs are used for a long time, a proton pump inhibitor (e.g. omeprazole or pantoprazole) should therefore also be given. Using Novalgin for several weeks can lead to a stomach ulcer. This is characterized by a mucous membrane defect in the stomach. The important complication here is the acute perforation of the ulcer, which can lead to gastric bleeding with vomiting of blood. General symptoms of gastritis or an ulcer are stomach pains, especially when eating / drinking acidic foods / beverages such as wine, coffee, fruit etc. Bad taste in the mouth, bad breath, reflux, joking when pressure on the upper abdomen, gas and diarrhea are other symptoms. A gastritis can definitely only be distinguished from an ulcer by a gastroscopy. Since Novalgin due to the risk of Agranulocytosis Should not be taken for longer than a week, a stomach ulcer is rare.

nausea

Novalgin nausea is a known side effect and can have a number of causes. Taking Novalgin drops may make some people feel sick. Another reason is nausea due to the onset of gastritis or gastric mucosal irritation with possible reflux. The third way that can cause nausea is that Hypotension. The low blood pressure, which the affected person is not used to, leads to nausea, dizziness and a tendency to collapse.

You might be interested in the following topic: Nausea therapy

Headache / migraine as a side effect

Headaches or migraines are not typical side effects of Novalgin®. However, if painkillers are used too often, a so-called painkiller-induced headache can occur. If this disease is suspected, pain medication such as Novalgin® should be avoided as far as possible, even if pain is present.

Side effects on the heart

Novalgin® has cardiovascular toxicity. This means that taking Novalgin® leads to an increased risk of coronary heart disease (CHD), a heart attack or arterial hypertension (high blood pressure). If you have one of these diseases before taking Novalgins®, it should be avoided if possible.

Side effects on the skin

Taking Novalgin® can cause a so-called drug eruption. This manifests itself in a skin rash that can affect the whole body. This is a special form Steven Johnson Syndrome. In addition, the rash on the skin can be accompanied by a high fever. The most serious form of drug eruption is that Lyell syndrome In the drug Lyell syndrome it comes to the detachment of the upper skin layers (epidermis) with blistering. Lyell's syndrome is caused by an allergic reaction to Novalgin®.

The following article might also interest you: Rash - What to do?

Side effects on blood formation / agranulocytosis

Agranulocytosis refers to a complete absence of the Granulocytes in blood. The reason for this is that due to an allergic reaction to the Novalgin®, no more granulocytes are formed by the bone marrow. The lack of granulocytes means that the body is no longer able to react adequately to pathogens, so the immune defense is weakened. If agranulocytosis is suspected, Novalgin® should be discontinued immediately.

You can find more information on the subject here: Agranulocytosis

Allergy to Novalgin

The rash and agranulocytosis are among the consequences of an allergic reaction to Novalgin®. An allergic reaction with the release of histamine can also occur. This leads to reddening of the skin, itching and difficulty breathing. In the worst case, the allergic reaction leads to anaphylactic shock with a drop in blood pressure, a rapid heartbeat and cardiovascular arrest.

Further information can be found here: Allergy

Novalgin® for asthma

Bronchial asthma is characterized by a narrowing of the bronchi ( Bronchospasm). This leads to no more air from the alveoli (Alveoli) can escape. Stand against an acute asthma attack Beta symphatomimetics available (e.g. salbutamol), which can be administered in the event of an acute asthma attack. Other beta-symthatomimetics can also be used for long-term therapy. Novalgin® is contraindicated for bronchospasm, as well as for existing bronchial asthma. It should therefore not be given.

Summary

Novalgin® is usually a very well tolerated and extremely effective drug, which is often prescribed. In the hospital, it is used as the standard for the treatment of moderate to severe pain.

The interactions and side effects are significantly rarer than with other groups of painkillers and most of the possible side effects mentioned occur rarely (1-10 in 10,000 patients) to very rarely (less than 1 in 10,000 patients).

You should experience side effects that are not listed in this article and with the use of Novalgin® could be related to inform Please one Doctor or pharmacist.