Hypersensitivity to metamizole and other pyrazolone derivatives, acute hepatic porphyria, inborn glucose-6-phosphate dehydrogenase deficiency, severe renal or hepatic diseases, blood diseases (such as aplastic anemia, leucopenia and agranulocytosis), pregnancy (the first and the last trimester). Parenteral administration of Analgin is contraindicated in under 1 year-old children. Analgin is used with increased caution in patients with a history for hypersensitivity to foods and drugs (particularly to analgesic and no steroidal anti-inflammatory agents) and also in patients suffering from bronchial asthma, Quincke’s edema, chronic pulmonary infections. In patients with hypotension and unstable blood pressure, Analgin should not be used parentarally. If Analgin application is quite necessary, the blood pressure and the heart rate should be monitored. In cases of prolonged Analgin treatment, regular blood count checks are necessary (differential count of the white blood cells). The high Analgin doses can influence unfavorably the active attention. Because of this in these cases driving and working with machines are not advised. Side Effects The most serious adverse effect of Analgin is on the bone marrow. It depresses the bone marrow activity which results in a decrease of protective white blood cells (agranulocytosis). This adverse effect occurs on the second or repeated exposure to the drug due to the formation of antibodies against it. Once these are formed, a subsequent use produces an allergic effect which can be fatal. The incidence of this adverse effect has been approximately 0.8% in UK and 0.01% in erstwhile West Germany. The figures for India are not available as no attempt has ever been made to record the incidence of its adverse effects. Other adverse effects include irritation of the stomach which is considerably more than that caused by aspirin. Prolonged use may prove to be toxic to the kidneys. Skin rashes and asthma can also be caused due to allergy. Side Effects Codeine occasionally causes constipation. Drowsiness and dizziness occur when it is taken repeatedly to relieve moderate pain. Children are more susceptible to its adverse effects and it should be avoided in children below one year of age. Precautions 1. Codeine causes constipation. Take a high roughage diet while taking this drug. 2. Alcohol and anti-allergic drugs enhance its sedative effect. Avoid them while taking a formulation containing codeine. 3. Avoid its use in children, especially below one year of age, as they are more susceptible to its adverse effects. 4. It should be avoided by patients of bronchial asthma and other breathing problems.
In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services.
