Introduction
Novalgin® is a trade name, i.e. only the name chosen by the manufacturer, behind which the active ingredient metamizole is hidden. Metamizole is alternatively also sold under the names Novaminsulfon®, Sintetica® and Minalgin®.
Application
Novalgin® or Metamizol belongs to the class of painkillers (analgesics). This group can be roughly divided into active ingredients with (typical) and without (atypical) additional anti-inflammatory effects according to their mode of action and effect. Novalgin belongs to the class of atypical analgesics, which merely improve the sensation of pain without containing inflammatory processes, as for example the drugs acetylsalicylic acid (Aspirin®) or diclofenac (Voltaren®) do on the side.
Novalgin® has a very good pain-relieving effect and is generally used when moderate to severe pain occurs. It also has an antipyretic and antispasmodic effect. The latter property ensures that the preparation has priority in the treatment of severe pain in the biliary and urinary tracts, e.g. when blocked by a “stone”. In general Novalgin® is suitable for spasmodic pain, which often originates from internal organs of the abdominal cavity.
Side effects
Novalgin® is generally well tolerated and undesirable side effects occur occasionally to rarely. Overall Novalgin® seems to be better tolerated with less frequent side effects than comparable painkillers such as Aspirin® or Ibuprofen®. Due to the not yet fully elucidated mechanism of action of Metamizole, which obviously differs from comparable drugs, typical side effects of long-term pain therapy such as blood thinning (anticoagulation) or gastric ulcers do not occur.
Nevertheless, Novalgin® has been available only on prescription again since 1987, as in the past isolated but serious cases of haematopoietic disorders have been noticed due to its use. Such a dreaded blood formation disorder is called agranulocytosis. This leads to an intolerance reaction by the drug, which causes the death of special white blood cells.
The body forms defense cells (antibodies) against the body’s own blood cells, which have formed a compound with the Novalgin active ingredient in the blood. Since the affected blood cells themselves are part of the natural defense system, this disease manifests itself concretely 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 areas. However, the above-mentioned symptoms may appear in a weaker form if antibiotics are taken at the same time.
The risk of agranulocytosis increases if Novalgin® is used for longer than one week. An unexpected worsening of your general condition and fever that does not subside or recurs can be an indication of agranulocytosis. Decisive for the further course or the healing process is the prompt clarification with your doctor and immediate discontinuation of the medication.
The actual occurrence of agranulocytosis is generally very unlikely and should not unnecessarily limit the administration. The combination of Novalgin® with other substances that can trigger agranulocytosis should be avoided at best. These drugs include clozapine, so-called neuroleptics for the treatment of psychoses and schizophrenia, and also carbamazepine, for use in the treatment of epilepsy and phenylbutazone, which is occasionally added to the immediate pain therapy for joint complaints (e.g. rheumatism).
The parallel intake of so-called thioamide thyrostatics should also be avoided, as these are frequently used in cases of hyperthyroidism. Further precautionary measures are e.g. to limit the duration of the intake to one week and to refrain completely from taking metamizole preparations in case of pre-existing bone marrow damage. In addition to the rare agranulocytosis, other, mostly less serious side effects can occur when Metamizol is used.
Occasionally, skin rashes may develop due to an hypersensitive (allergic) reaction. Such a hypersensitivity reaction can manifest itself as a so-called “fixed drug exanthema” or other rashes, which are conspicuous by violet to dark red, equally distributed, sometimes flat-round skin lesions, sometimes with additional blisters. In individual cases, serious allergic reactions of the skin such as Stevens-Johnson syndrome or Lyell syndrome can be caused by the use of Novalgin®.Large patches and skin defects on various parts of the body are noticeable, often accompanied by 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 a too fast injection into venous blood vessels, which is why Novalgin® is administered by infusion diluted in saline or isotonic solutions in medical facilities. In exceptional cases the direct injection of Novalgin® may be absolutely necessary, whereby care must be taken to ensure slow administration.
If you experience one or more symptoms of acute shock such as cold sweat, dizziness, light-headedness, paleness, chest tightness 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 may also occur if you have tolerated Metamizol or Novalgin® well so far. In addition, it should be mentioned that Novalgin® can in rare cases trigger a disturbance of the kidney function.
Especially at high doses, the urine can be stained red due to the formed degradation product of Metamizol (“rubazonic acid”). This discoloration usually disappears again after treatment. Furthermore, Novalgin® can provoke nausea and vomiting, especially when opioids such as morphine are taken at the same time.
The active substance of Novalgin® is the novamine sulfone/metamizole. It is an analgesic and belongs to the NSAIDs (non-steroidal anti-inflammatory drugs). The special thing about Novalgin® that distinguishes it from other painkillers from the NSAID group is that Novalgin®, in addition to its analgesic (pain-relieving) and antipyretic (antipyretic) effect, also has an antispasmodic (spasmolytic) effect.
Therefore it is often used for cramp-like pain in the abdomen, for example in renal colic. Side effects may occur when taking Novalgin®. However, these do not affect the psyche.
Novalgin® is not suspected to be the cause of depression. The mechanism of action of Novalgin® has not yet been conclusively clarified. Probably Novalgin® acts like all other NSAIDs by inhibiting COX 1 and 2 enzymes.
An effect on the central nervous system is currently under discussion. The fact that Novalgin® acts on receptors in the brain could lead to fatigue. It is certain, however, that Novalgin® leads to a drop in blood pressure at high doses and a pre-existing low blood pressure.
This can lead to a feeling of tiredness even at a low drop. This can also lead to tiredness, exhaustion, nausea and a tendency to collapse. If hypotension (low blood pressure) occurs, it helps to lie down and avoid exertion.
In this way a possible impending collapse can be avoided. The dreaded side effect of agranulocytosis (blood formation disorder) can also be accompanied by fatigue and exhaustion. Although this side effect is rare, it must be taken seriously.
In case of prolonged severe fatigue and exhaustion a doctor should be consulted during or after a therapy with Novalgin®. Sweating, just like 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 being discussed. This could be an explanation for sweating when taking Novalgin. Another reason for sweating could be hypotension.
The sudden drop in blood pressure activates mechanisms that counteract the drop in blood pressure (sympathetic nervous system). This leads to an activation of the heart rate and respiration. This can lead to sudden hot flushes and sweating.
Like all drugs from the group of NSAIDs (non-steroidal anti-inflammatory drugs), Novalgin can cause gastritis (inflammation of the mucous membrane of the stomach) or gastric ulcer (stomach ulcer). This is caused by an increased production of stomach acid by the medication. If you are taking these medicines for a long time, you should therefore be given an additional proton pump inhibitor (e.g. omeprazole or pantoprazole).
If Novalgin is used for several weeks, a stomach ulcer may occur. This is characterized by a defect in the mucous membrane of the stomach. The important complication here is acute perforation of the ulcer, which can lead to gastric bleeding with vomiting of blood.General symptoms of gastritis or ulcer are stomach upset, especially when eating/drinking acidic food/beverages such as wine, coffee, fruit etc.
A bad taste in the mouth, bad breath, reflux, joking when pressure is applied to the upper abdomen, flatulence and diarrhoea are further symptoms. Gastritis can definitely only be distinguished from an ulcer by a gastroscopy. Since Novalgin should not be taken for longer than a week due to the danger of agranulocytosis, a gastric ulcer is rather rare.
Nausea caused by Novalgin is a known side effect and can have various causes. Taking Novalgin drops may cause nausea in some people. Another reason is nausea in the context of a beginning gastritis or irritation of the stomach lining with possible reflux.
The third reason for nausea is hypotension. Here, the low blood pressure, which the affected person is not used to, causes nausea, dizziness and a tendency to collapse. The following topic might be of interest to you: Therapy for nauseaHeadache or migraine are not typical side effects of Novalgin®.
However, if painkillers are used too frequently, a so-called painkiller-induced headache may occur. If this disease is suspected, painkillers such as Novalgin® should be avoided to a large extent, even if pain is present. Novalgin® has cardiovascular toxicity.
This means that taking Novalgin® leads to an increased risk of coronary heart disease (CHD), heart attack or arterial hypertension (high blood pressure). If any of these conditions exist before taking Novalgin®, it should be avoided if possible. Taking Novalgin® can lead to a so-called drug exanthema.
This manifests itself in a skin rash which can affect the whole body. A special form is the Steven-Johnson syndrome. In addition, the rash on the skin can be accompanied by high fever.
The most serious form of the drug exanthema is the Lyell syndrome. In the drug-induced Lyell syndrome, the upper layers of the skin (epidermis) become detached with blistering. Lyell syndrome is caused by an allergic reaction to Novalgin®.
Agranulocytosis refers to a complete absence of granulocytes in the blood. The reason for this is that due to an allergic reaction to Novalgin® no more granulocytes are formed by the bone marrow. The missing granulocytes lead to the fact that the body is no longer able to react adequately to pathogens, the immune defense is therefore weakened. If agranulocytosis is suspected, Novalgin® should be discontinued immediately.
