Introduction Though registration of metamizol (dipyrone) has been cancelled in some countries (e. g. USA) due to rare cases of drug-induced agranulocytosis, this drug is a widely used analgesic in Switzerland and other European countries. The creatinine determinations of patients receiving "Novalgin®" gave surprisingly low values with the dry slide enzymatic method of Kodak Ektachem. This first observation was later confirmed by Gascon et al. (1). The other enzymatic method from Boehringer gave similar interferences. In order to study drug interference in chemical tests, the in vivo relevant drug and/or metabolites at their respective concentration after usual dosage are to be considered. The metabolism of metamizol has been extensively studied (2). It has been shown that after iv. or oral administration of the drug in healthy humans, the hydrolysed compound, methyl-amino-antipyrine, is mainly detected. Metamizol can thus be considered as a prodrug, methyl-amino-antipyrine being the acEtir. J. Clin. Chem. Clin. Biochera. / Vol. 31,1993 / No. 11 tive substance. A l g iv. administration of metamizol in man, rapidly gives the hydrolysis product, methylamino-antipyrine (serum cmax = 57 mg/1) which undergoes either oxidation to formyl-amino-antipyrine (Cmax = 3 mg/1) or demethylation to amino-antipyrine (Cmax -- 3 mg/1). Amino-antipyrine
Clinical Chemistry and Laboratory Medicine – de Gruyter
Published: Jan 1, 1993
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