Wednesday , May 25 2022

A drug is prohibited there but is available in Portugal?


A few days ago, there was a big debate with the medication – NOLOTIL – used in medicine for decades. The funny thing is that people give a medication of a relaxation and do not follow the medication simply because they have heard or seen the news …

Let's break the argument down from credible sources!
(Who can consult)

nolotyl, agranulocytosis

Basically, the Nolotil has magnesium metamizole as its active ingredient. There is also a substance that is marketed in Portugal in other brands. In particular, Dolocalma as in the Cinnamon Metamizole a Metamizol Sandoz, the last two generic medications.

Soluble disassembled metamizole is a protein that is structurally associated with pyrazolone-related compounds. In short, there is a popular analgic drug, do not opioid

Magnesium metamizole has analgic (against pain), anti-inflammatory (inflammation) and antipyretic (for fever). Especially acute pain in the retrospective or post-traumatic phase. Spasmodic pressure. High fever that does not respond to other antipyretic therapies. Pain of tumor.

Analytical school (from World Health Organization):

The use of drugs for pain management is based on the principle of using a three stage analgedd school based on:

nolotyl, agranulocytosis

  1. Resistant analogous anti-steroidal analog drugs and other analgesics (paracetamol a metamizole),
  2. Designated weak (codine or dramatic) opioids
  3. Opioids have been strongly designated (morphine, buprenorphine or fentanyl)

For any of these actions, assistants can be added, such as antidepressants,
anti-convulsants and others.

The aim of this school is to prevent the overuse of opioids, which could lead to additional tolerance and phenomena.

Although it is considered a complexity of effectiveness shown, metamizole, like most drugs, has an adverse effect!

However, there are health professionals, which are prescribing doctors to analyze the blood parameters (blood count) and to balance the risk.

Therefore, its use depends on the careful evaluation of the risk-benefit ratio taking account of the alternatives available.

Well, metamizole was withdrawn from the market in the US and a number of European countries after reporting deadly agranulocytosis among consumers! However, it is available in many countries in Europe, South America and Asia

But what is all acroulocytosis? What caused the death?

Agranulocytosis is the medical term for reducing leukocyte granulocyte cells (immune system) such as neuropathic.

These cells are responsible for "initial fights" against foreign agents or pathogenic particles. Having said that, the reduction in these cells increases the risk of contracting fatal infectious disease.

In short, this leads to death and, as a consequence, withdrawing the medication back in other countries!

Why is it still marketed in Portugal?

nolotyl, agranulocytosis

According to the Infarmed, "The use of drugs that contains this substance can cause adverse reaction – agranulocytosis – which is, of course, very rare"

"In Portugal, the surveillance pharmacy system reported a total of 11 cases of agranulocytosis that could be associated with the use of metamizole between 2008 and 2018, with a frequency of 1 to 2 cases per year (which is within the expected frequency of a very rare reaction ). "

In order to avoid such reactions, Infarmed advisers use "limited to short time" within a maximum of seven days.

If the use is longer than this, it is prudent to monitor the values ​​of the homogram, an examination that evaluates and counts the patient's blood cells.

"These medicines should not be used in patients with pre-metamizole hematological reactions, in treatment with other medicines or medicinal products that may cause agranopocytosis": "Special prescription should be given to prescribing these drugs in older patients," he warned.

Despite this warning, Infarmed warns that "prescribed patients should not prevent treatment": "Only if signs and symptoms of blood discomfortia, such as general misuse, infection, you will need to consult with your doctor immediately., persistent fever, bruising, bleeding or tired ".

In conclusion, the population is at risk – people at risk of infection and associated problems!

However, it is always free to ask your doctor not to prescribe this drug to you and to put another alternative in place for the same therapeutic purpose. (After all, try not to cost!)

However, read also:

Sources: 1, 2, 3, 4, 5

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