Analgin harm and benefit. What we are treated with: Analgin. To numb the pain or defeat the disease. Panacea for pain
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Why is one of the most accessible and well-known painkillers in our country dangerous, against what types of pain is it effective, how do medical researchers fight for the lives of patients with pharmaceutical companies and with each other, why Sweden first banned Analgin, then allowed it, and then banned it again, read the material on the site from the section “How we are treated.”
Medicines designed to combat pain, fever and inflammation are among the most sought after on the pharmaceutical market. They are in any medicine cabinet and are often sold without a prescription in Russia, but in reality, many of them can seriously threaten health, especially if you do not first weigh all the pros and cons of such treatment and do not take into account risk factors.
The hero of today’s issue of the “How We Are Treated” column is the familiar Analgin - a cheap and accessible pain reliever and antipyretic. You may be surprised, but it is prohibited for sale in Western Europe and the USA, as well as several other countries.
From what, from what
The active ingredient in Analgin is called metamizole. It was first synthesized in 1920 by Ludwig Knorr, who is also known for discovering and studying several non-steroidal anti-inflammatory drugs, such as antipyrine; He was also interested in the properties of morphine and codeine. At the beginning of the 20th century, there were not as many rules and complex approval procedures for the drug as there are now, so the drug began to be produced just two years after its discovery. In the West, a drug based on metamizole is called Dipirone.
Metamizole molecule. Sulfur atoms are indicated in yellow, carbon in gray, oxygen in red, nitrogen in blue, and hydrogen in white.
Wikimedia Commons
Scientists have not fully established the exact mechanism of operation of this molecule, but metamizole presumably blocks the synthesis of prostaglandins in the brain and spinal cord. We have already told a heartbreaking story that the causes of pain and inflammation lie precisely in their incorrect behavior after meeting with the cyclooxygenase sisters in the article about Nurofen. However, Metamizole is not as hardworking as our previous heroes: he does not go to suppress the uprising of dissatisfied prostaglandins personally, but sends his derivatives. It was also not found to be associated with type 1 cannabinoid receptors located in the cells of the central system, which substances from hemp, as well as paracetamol, are blamed for. Although it most likely has some influence on this system. Other authors, on the contrary, argue that, although Analgin himself did not work there, his subordinate metabolites could well act on type 1 cannabinoid receptors at his “guidance.”
The Cochrane Collaboration reviewed our review, which looked at moderate to high quality studies assessing the ability of metamizole to help with post-operative acute pain. Despite the confusion, the review confirms that this medicine really works.
The Cochrane Library is a database of the international non-profit organization Cochrane Collaboration, which participates in the development of guidelines of the World Health Organization. The organization's name comes from its founder, the 20th-century Scottish medical scientist Archibald Cochrane, who championed the need for evidence-based medicine and good clinical trials and wrote the book Efficiency and Effectiveness: Random Reflections on Health Care. Medical scientists and pharmacists consider the Cochrane Database to be one of the most authoritative sources of such information: the publications included in it have been selected according to the standards of evidence-based medicine and report the results of randomized, double-blind, placebo-controlled clinical trials.
Compared to placebo, which helped only 30% of patients, a single dose of metamizole 500 mg improved the condition of 70% of study participants. True, the authors still had doubts about comparing the active substance Analgin with other painkillers: the results were too ambiguous, and the patient samples were small.
The effect of Dipiron (Analgin) against acute attacks of pain (for example, after the removal of a wisdom tooth) and in renal colic has also been proven. In the latter case, scientists have also proven that intravenous injections help better than intramuscular ones.
Side effects
Analgin can be dangerous in a completely different way: our granulocytes, one of the types of leukocytes, do not like it. Associated with them is a side effect of long-term use of the drug - agranulocytosis, that is, a drop in the level of granulocytes to 5% or even lower.
Granulocytes are granular leukocytes, white blood cells, which are characterized by a clearly visible nucleus and large granules inside. In every cubic millimeter of our blood you can find about 2-6 thousand of these cells. Their goal is to fight infections, or immune protection of the borders of our body. Agranulocytosis may be associated with the effect of Analgin on type 2 cannabinoid receptors.
There is scientific evidence to support this idea. Scientists from Germany, the USA and Italy prove that substances resulting from the breakdown of metamizole are able to bind both cannabinoid receptors. They also prove that these substances react with type 1 and type 2 cyclooxygenases both in vitro and in living tissue.
When the ranks of immune defenders are so thinned out, the body becomes vulnerable to many bacterial and fungal infections. Stomatitis, ulcers of the mucous membranes, fever, pain in the throat and joints are the first unpleasant manifestations of this condition. It can cause swelling of the larynx and even suffocation. This set of clinical signs can confuse the doctor, so it is not always possible to correctly determine the cause of these manifestations.
In case of complications, an atypical form of pneumonia occurs, which is difficult to diagnose due to the absence of cough and sputum, necrotic enteropathy (damage to the intestinal walls, pain and bloating in the abdomen, loose stools), which can lead to the death of the patient if bacteria from his intestines enter the blood . Also, with severe agranulocytosis, toxic hepatitis can develop - severe damage to liver tissue.
However, scientists continue to argue about how often taking Analgin leads to this disease.
The first articles about the dangers of Analgin began to be published back in the late 1960s, and one of them caused a stir among foreign doctors: according to this article, 0.79% of patients taking Dipiron also received agranulocytosis, and a third of patients with agranulocytosis died.
After this, Analgin-Dipirone was banned in the UK. The UK's example was followed by other countries where metamizole-based drugs disappeared from pharmacies in the seventies. At the same time, in Eastern Europe and Latin America, the same drugs were easily and freely sold, considering them to be safe analgesics. Therefore, the Europeans did not calm down and continued to look for evidence that would confirm the involvement of metamizole in the occurrence of agranulocytosis or justify the drug.
An international study was conducted, involving representatives from seven European cities and Jerusalem, but a large-scale search that lasted six years led to a rather modest figure: 1 case in 1.1 million patients per week. It looks like an excellent alibi, if you do not take into account that it included only patients in the hospital, and the controls were patients with agranulocytosis, from whom they found out whether they drank metamizole. Moreover, the case - the indicator that the scientists used - is quite unusual. If you recalculate the same data for a year, the figure will be completely different - 20,000.
Colleagues from Latin America saw a lot of bias in these studies: in their opinion, the risk estimates for using the drug were greatly overestimated. Thus, doctors from Sao Paulo did not find any particular dangers in the use of this medicine and stated that it, of course, increases the risk of developing agranulocytosis, but so weakly that this can be neglected without leaving people without an accessible medicine.
They also conducted another study, including Mexico and Argentina, but the results were the same. True, the author of the Russian review, Maria Avksentyeva, notes that this research was funded by a corporation that absorbed the manufacturers of metamizole. In both studies, the risk of agranulocytosis was about half a person per million per year.
The Swedes also banned the drug. After a large-scale European project, they returned it to pharmacies again, but not just like that, but for the purpose of study. The indications became narrower: only for short-term use for renal and hepatic colic and acute pain after operations, and then doctors began to record side effects. Then the results convinced Swedish doctors that there was a danger, and in 1999 the drug was banned again.
The Dutch studied the effect of medications on agranulocytosis for 20 years, and they also found metamizole dangerous for use, although in a small number of cases.
In a review from Barcelona doctors, metamizole took fourth place in the list of drugs that increase the risk of agranulocytosis, and for some reason no one is going to ban the winners from this “podium.” Leading the list, by the way, was methimazole, used to correct an overactive thyroid gland (that’s how important it is not to confuse the names).
In recent years, several more articles have appeared on this topic. The authors of another systematic review, examining 22 articles on the side effects of metamizole, also confirmed that the risk of agranulocytosis is increased, although its level varies greatly from one study to another. In another large study of a single dose of metamizole for post-operative pain, researchers assessed the drug's side effects in a group of 1,177 children under six years of age. The drug was administered once and intravenously, and no signs of agranulocytosis were found in patients. The same data for adults is confirmed
Scientific research data indicates the relative danger of the drug with long-term use, although not all scientists agree with this point of view. At the same time, in many developed countries the drug is either withdrawn from circulation or sold strictly according to a prescription, but in others it is freely sold, as in Russia. What to do? To be on the safe side, it is still better to heed the warnings and if you take Analgin, then do it for acute attacks of pain, but not for protracted, chronic pain. You can also make a choice in its favor if other painkillers do not help or are not suitable, but also do not get carried away with this drug and do not take it for more than a few days in a row.
Chronic use of analgesics can be dangerous: some, like many non-steroidal anti-inflammatory drugs, increase the risk of heart attack and gastrointestinal bleeding, others, like Analgin, can critically reduce the level of immune cells, a type of white blood cell, in the blood. And if this happens, you will become defenseless against a number of serious diseases, which can lead to pneumonia, hepatitis, and death at the end of this epic.
But always remember that numbing the pain does not mean defeating the disease itself. Therefore, it is better to try to find out the cause of the problem and eliminate it, if the pain does not go away after a couple of days, than to drink analgesics for weeks, turning a blind eye to a possible threat to your health not only from them, but also from the fact that while “treating” the symptoms you forget about the disease itself.
And if you still drink Analgin, listen carefully to your health: even severe stomatitis and an increase in temperature can be an alarming sign, after which it is better to go to the doctor and ask for a referral for a blood test so that these same leukocytes can be counted for you.
The feeling of pain is an unpleasant thing, even if the pain is mild. But sometimes an aching tooth causes much more suffering than a deep cut on your finger with a kitchen knife. And how nice it would be to live without pain at all, to have nerve endings insensitive to it! But pain is necessary - even veterinarians are in no hurry to give pain relief to an injured animal.
Wordless, with its violent reaction to palpating, it will make it clear where exactly the injury is localized. And if the heart did not hurt, how would it warn us that right now we should not engage in physical labor, but should take a horizontal position, and at the same time take a vasodilator? By the way, there are literate people who, with chest pain characteristic of angina pectoris, manage to swallow an analgin tablet - they are confident that it will completely cope with a tingling heart.
Why is analgin dangerous?
In general, painkillers are one of the most popular medications in the home medicine cabinet, and analgin is the king and god among them. Migraine or teeth, painful menstruation, severe hangover - everything is “extinguished” by inexpensive and familiar analgin. In addition, it is taken as an antipyretic. True, analgin does not eliminate the cause of the ailment, but only muffles the unpleasant sensations, but it is precisely because of these properties that it is in such great demand. Did you know that Russian pharmaceuticals are one of the last bastions of resistance to the World Health Organization (WHO), which is fighting against this universal medicine for pain.
WHO has long made a strict recommendation regarding analgin: its use should be limited as much as possible. In the USA, Norway, Great Britain, the Netherlands, Sweden, this medicine was excluded from the pharmacopoeia back in the 70s, and in general its consumption was forcibly reduced in 34 countries.
Our pharmacologists, of course, know that analgin causes serious side effects. It suppresses the function of the bone marrow, limiting its production of white blood cells - red blood cells that protect the body from infections. In large doses, analgin can lead to death. But many women and girls suffering from painful periods simply revel in analgin during their “critical days,” bringing its consumption to several packs monthly!
Analgin is cheaper than safer foreign drugs and can successfully compete with them. The Russian pharmaceutical company ICN alone, according to the newspaper Vremya MN, sells 8 thousand packs of analgin weekly through its network of pharmacies! This, apparently, lies the secret of our stubborn resistance to the alarming directives of WHO experts.
True, changes have now been made to the instructions for use of this medicine, but to be frank, who carefully studies the instructions for over-the-counter medicines? The same taste, the same analgin...
Where can I get harmless medicine?
Analgin and its “brothers” act directly on the peripheral nervous system. Their task is to suppress pain where it manifests itself. There is another type of analgesics - narcotics, which eliminate pain through the brain. The fact is that the body itself secretes painkillers - opiates. Narcotic analgesics are essentially artificial opiates that are added to natural ones to more effectively suppress unbearable pain - for example, in cancer.
But the body senses that opiates are coming in large quantities from the outside, and stops producing its own. Drug dependence occurs. The next dose of opiates did not arrive - withdrawal began. Such narcotic analgesics are known to be sold strictly by prescription. But you can also get used to an over-the-counter painkiller if you do not treat your poor health, but only eliminate the pain symptoms.
In principle, there are no harmless drugs; there are none among analgesics. It’s just that some have more side effects, others have fewer.
Two years ago, the Moscow publishing house Kron-Press published a very useful book, “The Best Medicines. The Worst Medicines.” This is the collective work of American doctors - members of the US Consumer Rights Protection Society. If you come across this guide, be sure to buy it. Indeed, according to statistics, patients should refuse every fifth (!) drug prescribed to them only because there are safer alternatives that doctors may not know about or are neglecting. The book describes many of our popular medications, including analgesics, from an unexpected angle for the patient.
What is Nurofen?
But if analgin is so harmful, what, you ask, should it be replaced with - what other safer drug? Of course, you should ask your doctor about this, not us. We will just give an interesting example. Several years ago, Nurofen appeared in Russia - English tablets, which advertising presented as a universal painkiller with a minimum of side effects. One of the declared merits of Nurofen is the relief of menstrual pain; it acts on hormone-like substances that cause pain in the uterus. Indeed, many women, having tested it for themselves, began to buy this by no means cheap medicine, which also helps with headaches.
Let's reveal a secret that you would never find out at the pharmacy - guess for yourself why. The active ingredient of Nurofen is ibuprofen. Ibuprofen has been known in Russia for a long time and costs literally pennies in pharmacies. Only as an anti-inflammatory agent is traditionally used more narrowly in rheumatology, for the treatment of diseased joints. The British, having learned about this omission of ours, hastened to sell us the same ibuprofen only under a different name and with “special properties”. By the way, there are many other imported over-the-counter medications based on ibuprofen in pharmacies - there is a choice, you just need to enlist the support of a doctor.
How much does Panadol cost?
Another drug that copes well with pain and at the same time has a pronounced antipyretic effect with a minimum of side effects is paracetamol. The same story: it came to us under the brand name "Panadol" (by the way, Nurofen manufacturers compete with Panadol manufacturers), it is expensive. But, widely advertised, it replaced cheap domestic paracetamol in modest packaging, but with exactly the same properties.
They say that the British buy paracetamol from the ICN company in Kursk as a raw material and return it to us in the form of Panadol, which has increased in price tenfold.
Well, in general, you shouldn’t get too carried away with painkillers. In addition, experts do not recommend buying new products, except those that have been on sale for at least five years: it happens that the negative effects of drugs appear much later than their clinical trials. For the first time taking a medicine, start with a small dose, even half a tablet - maybe this is “your” dosage. If you can no longer cope without analgesics (or other drugs), see a doctor: it is quite possible that you are developing a so-called drug addiction.
Analgin is perhaps the most popular painkiller in Russia. It is taken on one’s own initiative; fortunately, a prescription is not needed to buy it at the pharmacy. And it costs a penny compared to other related drugs. But is such accessibility always good? In other words, is analgin harmful?
August 30, 2016· Text: Svetlana Lyuboshits· Photo: GettyImages
To answer the question: “Is analgin harmful to the body?”, you need to carefully read the instructions. All side effects that may occur when taking analgin and contraindications to its use are described in it. Therefore, our first and main advice: read the package insert carefully, this will help to avoid many complications. Now let’s take it one by one and try to answer the question: “What is more beneficial or harmful from taking analgin?” The answer to this is far from clear.
Indications for use
Analgin (active ingredient - metamizole sodium) is a powerful analgesic, antipyretic and antispasmodic agent. It is taken for biliary, intestinal, renal colic, headache or toothache, radiculitis, and at high temperatures during ARVI.
Attention: analgin is a first-aid drug, and not a drug for the treatment of chronic diseases. And it should remain so!
It means that:
- Analgin should be taken only when strictly defined symptoms appear, listed in the instructions;
- we must remember: analgin eliminates only the symptom, but not the cause of the disease;
- Long-term use of analgin causes serious side effects and can provoke the appearance of other diseases. You can take analgin only for 2-3 days. In this case, it is necessary to strictly observe the frequency of administration per day, dosage depending on age, age restrictions and follow other recommendations listed in the instructions.
Why is analgin harmful?
One of the most serious side effects from long-term use is leukopenia. This is a serious blood disease in which the number of leukocytes in the blood decreases, since analgin can suppress the functions of the bone marrow and thereby affect the hematopoietic system. According to some reports, analgin can also cause a decrease in platelet levels in the blood. These cells are responsible for blood clotting.
Analgin is contraindicated for people diagnosed with kidney, liver and stomach diseases. Severe allergic reactions often occur while taking analgin. This drug is also contraindicated for asthmatics, as it can cause bronchospasm, and for those who have a lack of glucose in the body.
Analgin, like any other painkiller, should not be taken for acute abdominal pain, as taking it will blur the picture and make it difficult to make a correct diagnosis.
It is strictly forbidden to take analgin during pregnancy and breastfeeding. If this drug is prescribed during breastfeeding, breastfeeding should be discontinued.
IS IT TRUE THAT DRINKING ANALGIN IS HARMFUL? Metamizole sodium, or as we call it, analgin, was invented in the middle of the last century. At that time, it was the most progressive painkiller that helped get rid of pain. In addition to the analgesic effect, analgin had a number of other properties beneficial to human health. In particular, analgin turned out to be an effective anti-inflammatory agent, which made it possible to use it for the treatment of osteochondrosis and other diseases of the human musculoskeletal system. And currently, all more or less effective painkillers are based on this drug. Take baralgin or pentalgin, mig or spasmalgon. You will find metamizole sodium in any of these “modern” pain relievers. And this is the non-proprietary, pharmacological name of analgin. Is it worth believing various pseudoscientific sources that claim that analgin is prohibited and that the harm of analgin is greater than the benefits of its use. The instructions for its use on our website will help you get acquainted with analgin in more detail. In the meantime, we will talk to you about the harm of analgin that can be considered a threat and whether you should believe that analgin is prohibited. Is there any harm in analgin? The drug analgin belongs to the group of non-steroidal anti-inflammatory drugs. It also includes such widely used drugs as: Voltaren; diclofenac; indomethacin; ortofen. All these drugs are used in the treatment of rheumatic diseases and osteochondrosis. At the same time, they also pose certain harm to human health. But it just so happens that the modern pharmacological industry is simply not able to produce absolutely safe drugs. We are at the level of industrial development that even synthetic vitamin complexes that are offered for children are of chemical origin and have a negative effect on the human body when taken. In the debate between the effectiveness of treatment and the possible harm from taking a particular drug, effectiveness and the ability to bring relief to the patient always win. That's what doctors think. Today there is no analogue of analgin that would produce the same effect and cause absolutely no harm. Therefore, it is worth thinking about whether analgin will be harmful, but you should not dwell on this issue. In practice, it has been proven that harm to analgin can only occur with systematic use of this drug in large quantities. But even a 10-day course of treatment with analgin for pain due to osteochondrosis does not cause the harm that is reported in the media today. And, even more so, analgin will not cause harm if you have taken one tablet for toothache over the past 3 months. Preparations that contain analgin 1. Pentalgin 2. Baralgin 3. MIG - 150 4. Spazmalgon 5. Tempalgin Can I drink analgin? We still have the most important question - can we drink analgin. Let's try to answer very honestly. Most likely, you can drink analgin only in the amount necessary to relieve pain until the cause that caused it is eliminated. In other words, you should not use analgin to treat caries or a broken leg. With the help of analgin, you can only relieve pain for a short time and immediately consult a doctor. However, there is an exception to this rule. If you have acute abdominal pain, pain under the right rib, or pain in the left rib, taking analgin or any other painkiller is strictly prohibited. This may cause misdiagnosis. Analgin should be taken strictly according to the recommended dosage, i.e. no more than 2 tablets per dose, no more than 3 times a day, and no more than 3 days in a row. In this case, the harm of analgin will not be terrible for you. And it is unlikely that analgin will be banned in our country.
Analgin is often used as an analgesic, antipyretic and antispasmodic effect. The drug relieves pain of varying intensity well. But it should be noted that serious side effects may develop while taking the drug. Among them, one can highlight the negative effect of Analgin on, disruption of the central nervous system and blood composition.
Release form and composition
The dosage form of the drug is tablets and ampoules. The main active ingredient is metamizole sodium. Additional components are presented as:
- Sahara;
- starch;
- stearic acid;
- talc.
Tablets are available in 10 pcs. They have a white or yellowish tint. Ampoules are placed in a box of 10 pieces of 1 or 2 ml each.
How does analgin affect the heart?
Analgin is an anti-inflammatory non-steroidal drug. It acts primarily on the peripheral nervous system. Metamizole sodium suppresses exactly in the place where it manifests itself. Analgin is harmful to the heart if you take the drug regularly. The product should be taken only as prescribed by a doctor and strictly following the prescribed dosage. It is allowed to take no more than 2 tablets per day. When taking it, you should also take into account existing contraindications. Long-term and uncontrolled use disrupts the functioning of the cardiovascular and nervous systems.
Metamizole sodium is broken down in the gastrointestinal tract after administration. The therapeutic effect is achieved 20-30 minutes after consumption. The duration of the analgesic effect is approximately 1.5-2 hours. A small part of the active substance binds to plasma proteins. Analgin is excreted in the urine, it is able to penetrate the placenta and be absorbed into breast milk.
Indications for use
Metamizole sodium is usually prescribed as an “ambulance” to relieve pain of various origins. The drug also has antipyretic properties.
Mode of application
A single dose of the medication should not exceed two tablets, and the daily dose should not exceed 6 tablets. For children, a single dose is selected taking into account age and weight. It is recommended to take the tablet with enough water.
At elevated temperatures
Analgin effectively reduces fever, but it cannot be used for more than three days. If you need to continue taking it, you should consult your doctor.
For pain in the heart
When this occurs, the use of metamizole sodium is not permitted. Analgin is NOT USED for heart pain even when Validol or Valocordin is not available.
For headaches
Recurrent severe headaches usually do not respond to pain relief. It is recommended to undergo an examination and identify a painful focus in the body.
The drug also copes with dental, menstrual, and stomach pain. But it must be remembered that metamizole sodium does not fight the etiology of pain, it simply relieves symptoms.
Contraindications
Before taking the medication, you should familiarize yourself with the available contraindications. The drug should not be used by people suffering from:
- hematopoietic disorders;
- bronchospasm;
- individual intolerance.
The drug is also contraindicated at the beginning of pregnancy and in patients with systolic blood pressure.
Side effects
We have already described in detail the effect of analgin on the heart. Other side effects appear as:
- headache;
- disorders of the gastrointestinal tract;
- and general weakness;
- skin itching;
- allergic rash;
- hypotension;
- development of leukopenia;
- noise in the head;
- seizures
If any symptoms from the above list develop, it is recommended to stop taking the drug further. To eliminate symptoms, you must seek help from the nearest medical facility or call a doctor.
Overdose
Signs of an overdose are caused by:
- decreased blood pressure;
- nausea, vomiting;
- abdominal pain.
Analgin is also harmful to the heart if the prescribed dosage is not followed. When taken uncontrolled, a rapid heartbeat develops and its functional activity is disrupted. In severe cases, the patient falls into a semi-fainting state and kidney failure occurs.
Interaction with other drugs
It is not recommended to use other painkillers together with metamizole sodium. This combination enhances the development of toxic effects from medications. For example, simultaneous use of Analgin and Paracetamol can lead to a sharp decrease in temperature and cause hyperthermia. To safely reduce body temperature, it is enough to combine Analgin with Diphenhydramine. For chills, you can add Papaverine.
Conclusion
Metamizole sodium is a cheap pain reliever and antipyretic. The effect of its use is no worse than that of expensive painkillers. But it is better to take it once as an “ambulance”. The main thing is to follow the dosage and not abuse the drug.