Efficacy and safety of metamizole sodium for pain syndrome in adults and children: a systematic review

Objective. To conduct a systematic review of data on efficacy and safety of metamizole sodium (MS) for pain syndrome in adults and children. Material and methods. A systematic review was conducted. At the first stage, we reviewed available databases regarding efficacy and safety of MS for pain syndrome in adults and children compared to other analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Analysis included 38 randomized clinical trials and 5435 patients (children over 3 years old and adults). Results. MS significantly reduces pain syndrome compared to placebo within 30-60 min after administration. VAS scores decrease by more than 50% in 70-100% of cases. Effectiveness of MS is not inferior to paracetamol, acetylsalicylic acid, diclofenac, ibuprofen, ketorolac, ketoprofen and parecoxib. Effectiveness of different forms of MS is similar. At the same time, parenteral MS provides longer pain control compared to oral forms. MS in postoperative period reduces the need for reserve analgesics, including opioids. Unlike other NSAIDs, MS does not lead to gastric erosions, peptic ulcers or gastrointestinal bleeding. There is no effect on blood clotting. MS has good tolerability and safety comparable to the most popular NSAIDs. The risk of adverse events is lower compared to opioid analgesics. No serious adverse events were registered. Conclusion. MS is effective and safe in adolescents over 15 years old and adults with pain syndrome.