Dipyrone is widely acknowledged to be an effective antipyretic analgesic with an additional intrinsic spasmolytic activity. It has stood the test of time over the last 75 years in many clinical settings throughout the world. Some 20 years ago, however, concern arose over the implications of isolatยญ ed reports of agranulocytosis following use of dipyrone. Based on these initial cases the Swedish authorities ordered the withdrawal of the drug from the market. Subsequently, dipyrone has been subjected to extensive comparative epidemiological and clinical studies. The results of these inยญ vestigations have allayed the earlier concerns and have shown dipyrone to be a versatile analgesic drug with an overall risk of serious adverse events lower than most other non-opioid analgesics. Based on these results, the Swedish authorities (Lakemedelsverket) have approved the reintroducยญ tion of dipyrone to clinical use as a valuable contribution to pain treatยญ ment. In connection with this further milestone in the story of the drug, a symposium was held in Stockholm on March 14, 1996, under the chairmanยญ ship of Professor N. Rawal to review the current understanding of the acยญ tion, efficacy and safety of dipyrone. The highlights of this Hoechst symposium emphasize particularly the therapeutic basis for the use of dipyrone in the modern treatment of acute post-operative pain. 9 Mode of action of dipyrone Professor K. Brune, M. D. Erlangen, Germany Most non-opioid analgesic drugs are inhibitors of cydo-oxygenase, the enยญ zyme catalysing the formation of prostaglandins (PGs)
CONTENT
Mode of action of dipyrone -- Clinical pharmacokinetics of dipyrone and its metabolites -- Dipyrone in acute postoperative and colic pain -- Non-opioid analgesics in the treatment of acute pain -- Comparative safety of analgesics -- Routines, practice and needs for analgesics in out-patients surgery in Sweden -- Perspectives
