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Metamizole, better known by its brand name: Nolotil, is a drug that serves to lower fever, soothe pain and reduce inflammation, but it has been associated with a shadow for years that has made it return to the news in recent days.

All because a British patients' association has taken legal action against the Government of Spain. But can it be dangerous to take a drug that is so commonly consumed in our country? Should I stop taking it? If you have any doubts, I invite you to read on to resolve them.

Why this complaint?

The ADAF, a patients' association representing British victims, has sued our country for the adverse effects that Nolotil (or metamizole in its generic form) would be causing to Britons visiting Spain.

According to his complaint, when British and Irish citizens arrive in our country,Spanish doctors prescribe this drug, and this could cause reactions that could lead to death.

This association states that, in the last 27 years, there are 170 cases of British people suspected of suffering side effects derived from the consumption of Nolotil. All while they were on holiday or living in Spain.

Is this controversy new?

The denunciation yes, but the controversy does not. Already in 2018 the Spanish Medicines Agency published a note aimed at health professionals in which it recommended, and I quote, "not to use Metamizole in patients in whom it is not possible to carry out controls, for example floating population".

This note was accompanied by an update of the technical data sheet of this medicine, which included the text "the recent notification to the Spanish Pharmacovigilance System of cases of agranulocytosis, particularly in patients of British origin".

It becomes quite clear, already in 2018, that Nolotil should not be sold or prescribed to tourists.

But is it dangerous or not?

We must start from the premise that it is a drug, and like any drug it has side effects that are included in the leaflet and therefore cannot be taken without further ado. We should always take it under medical prescription.

But in the case of Nolotil or metamizole, what is at the center of the controversy is agranulocytosis: a side effect that is listed as "very rare" in the leaflet and that would occur in 1 in 10,000 patients who consume it... except in the case of the British and citizens of other northern European countries, where it seems that it could be more frequent due to a genetic particularity. We would need even more scientific studies to ensure that this is the case.

What is agranulocytosis?

To put it simply, it's a drop in defenses. Our immune system, the one that protects us against viruses, bacteria and other microorganisms, would suffer a drop and we would be exposed to suffer multiple infections, and in the worst case those infections could lead to death.

Why is it sold in Spain?

Because the authorities responsible for medicines, the AEMPS, after assessing the risks and benefits that Nolotil has on patients, have decided that the balance is favourable, that it is a safe drug.

This is something that is taken into account with all medications, since as we have seen they all have some side effect but it compensates for the benefit they would bring to those who need them as long as they are used in the indicated way.

Is it consumed a lot?

It is one of the best-selling painkillers. According to the latest figures, more than 22 million boxes of this popular drug are dispensed in Spanish pharmacies every year.

Is Nolotil sold outside of Spain?

In some countries, yes and in others no. For example, it is forbidden to be sold in the United Kingdom, Ireland, the United States, India or Australia. Perhaps these countries should include among the recommendations to their citizens traveling to Spain not to take Metamizole, as is done with other advice in the so-called Traveler's Consultation where information on international vaccination is reported.

  • Pharmacology
  • Saturated Nurse