Traumas, cuts, inflammations, infections… There are many elements that can cause us different types and degrees of physical pain. Despite the fact that the perception of pain is in principle adaptive since it allows us to know that something is not working properly or is causing us some damage (and we can try to do something to avoid it), the truth is that it is usually extremely aversive, being something that most people would prefer to avoid experiencing.

Furthermore, pain, when intense, can be highly disabling to the point of preventing our functionality, especially when it is due to elements over which we have no direct control or that require a process in order to be cured or resolved. Fortunately, throughout history, different substances have been discovered and subsequently synthesized that reduce the nociception or perception of pain. One of them is the drug known as Nolotil , which we will discuss in this article.

What is Nolotil and what is it for?

The name Nolotil refers to the commercial name of a relatively common drug in our country, whose main active ingredient is metamizole or dipyrone . The mechanism of action of this drug is not entirely known, although it has been observed to inhibit the synthesis of prostaglandins that contribute to the activation of nociceptors.

It is a drug whose best known use is that which comes from its effects as an analgesic, reducing and treating the pain inherent in different diseases and disorders . In addition, it also has an antipyretic effect, being able to reduce fever, and antispasmolytic (that is, it also has an effect on reducing muscle spasms and the pain associated with them). Although technically it is not an anti-inflammatory, in supratherapeutic doses it has been shown to be useful in calming and reducing inflammation, although the dose used for this purpose can generate toxicity.

It is available in a wide variety of possible presentations among which the most common is: in the form of a hard capsule to be taken orally . However, it can also be found in the form of an ampoule (also to be taken orally). It is also available as a parenteral injection (although this should only be used in very specific cases) or even as a suppository for anal use.

Nolotil has more potency than other commonly used drugs such as paracetamol or ibuprofen, but it also has greater risks and side effects and even toxicity, which has led to its being banned in some countries.

Main indications

As we have said, Nolotil has analgesic, antipyretic, antispasmodic and even in certain anti-inflammatory doses properties, and can be used for the treatment of a great variety of disorders.

The most common use is in acute pain, especially in the case of pain from surgery or trauma. Also is used to relieve oncological type pain (that is, generated by tumours) or in colic and spasms of visceral or muscular origin. It is also often used in dentistry.

Despite its power to lower fever, it is usually used only when fever is not reduced by other antipyretic drugs. Although popularly used on occasion for headache, it is not recommended because of the risks involved.

Side effects

Nolotil is a drug that enjoys great popularity and has shown great utility in the treatment of pain caused by various diseases and conditions. However, it can also generate a series of secondary and even toxic effects that are worth taking into account.

Among the most frequent we can find a probable drop in blood pressure, which can lead to hypotension. Allergic reactions and rashes, gastrointestinal discomfort and breathing difficulties may also occur.

More serious and less frequent are the presence of arrhythmias, severe allergic reactions (which may lead to anaphylactic shock), leukopenia or decrease in white blood cells, toxic necrolysis of the skin , difficulty in urination, renal inflammation, bleeding in the digestive tract or even the above-mentioned blood pressure dropping in a sudden and extreme way (something that is very dangerous).

One of the possible side effects of its administration and one of the causes that has been banned in countries such as the United Kingdom or the United States is agranulocytosis (a condition in which one of the types of leukocytes or white blood cells is reduced in such a way that the body is much more fragile and can lead to death). Another possible life-threatening side effect could be a generalized sepsis or infection , as well as kidney failure.

Contraindications

In addition to the above-mentioned side effects and partly based on them, it should be noted that Nolotil also presents contraindications or situations in which the suitability of its use should be carefully analysed .

To begin with, all those who present hypersensitivity or allergy to this drug or others of similar composition should avoid taking Nolotil, obviously including all those who have presented agranulocytosis derived from previous applications of the same. Also people with asthma of any type , allergic reactions to analgesics, cases of acute intermittent hepatic porphyria, bone marrow or blood problems or genetic problems relating to glucose 6-phosphate dehydrogenase.

It is also contraindicated during pregnancy and in the breastfeeding stage , both in the mother and in the child. It is not recommended either for very old people or those with renal or hepatic problems, as well as for those with already low or unstable blood pressure. Caution is also recommended in the use of vehicles or dangerous machinery if used in high doses, and their consumption should be avoided along with alcohol or other drugs (taking care also in the case of drugs).

Bibliographic references:

  • Spanish Agency for Medicines and Healthcare Products (2011). Nolotil 575 mg hard capsules. Metamizole magnesium. [Online]. Available at: https://www.aemps.gob.es/cima/pdfs/es/ft/47633/47633_ft.pdf
  • Buitrago-González, T.P.; Calderón-Ospina, C.A. and Vallejos-Narváez, A. (2014) Dipirona: Underestimated benefits or overestimated risks? Literature review. Revista Colombiana de Ciencias Químico-Farmacéuticas, 43 (1). Bogotá.