Efficacy and safety of metamizole sodium for pain syndrome in adults and children: a systematic review

Kukushkin M.L.; Davydov O.S.; Bakhtadze M.A.; Churyukanov M.V.; Azimova Yu.E.; Maslakov A.S.; Garusova M.Yu.

doi:https://doi.org/10.17116/pain20242204165

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OBJECTIVE

To conduct a systematic review of data on efficacy and safety of metamizole sodium (MS) for pain syndrome in adults and children.

MATERIAL AND METHODS

A systematic review was conducted. At the first stage, we reviewed available databases regarding efficacy and safety of MS for pain syndrome in adults and children compared to other analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Analysis included 38 randomized clinical trials and 5435 patients (children over 3 years old and adults).

RESULTS

MS significantly reduces pain syndrome compared to placebo within 30-60 min after administration. VAS scores decrease by more than 50% in 70-100% of cases. Effectiveness of MS is not inferior to paracetamol, acetylsalicylic acid, diclofenac, ibuprofen, ketorolac, ketoprofen and parecoxib. Effectiveness of different forms of MS is similar. At the same time, parenteral MS provides longer pain control compared to oral forms. MS in postoperative period reduces the need for reserve analgesics, including opioids. Unlike other NSAIDs, MS does not lead to gastric erosions, peptic ulcers or gastrointestinal bleeding. There is no effect on blood clotting. MS has good tolerability and safety comparable to the most popular NSAIDs. The risk of adverse events is lower compared to opioid analgesics. No serious adverse events were registered.

CONCLUSION

MS is effective and safe in adolescents over 15 years old and adults with pain syndrome.

Keywords:

metamizole sodium

pain

pain syndrome

pharmacological safety

non-steroidal anti-inflammatory drugs

non-opioid analgesics

Authors:

Kukushkin M.L.

Research Institute of General Pathology and Pathophysiology

ORCID: 0000-0002-9406-5846

Davydov O.S.

Research Institute of General Pathology and Pathophysiology

ORCID: 0000-0003-3252-4311

Bakhtadze M.A.

Research Institute of General Pathology and Pathophysiology;
Pirogov Russian National Research Medical University;
Clinic of restorative medicine «Quality of Life»

ORCID: 0000-0001-9282-3319

Churyukanov M.V.

Sechenov First Moscow State Medical University;
Petrovsky National Research Center of Surgery

ORCID: 0000-0001-6542-1963

Azimova Yu.E.

Research Institute of General Pathology and Pathophysiology;
University’s Headache Clinic LLC

SPIN RSCI: 6802-3979
Scopus AuthorID: 23494670700
ORCID: 0000-0002-3713-4884

Maslakov A.S.

Opella Healthcare LLC

ORCID: 0000-0003-1676-3128

Garusova M.Yu.

Opella Healthcare LLC

ORCID: 0009-0005-7386-8788

Received:

26.09.2024

Accepted:

13.10.2024

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References:

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