Prevention of dipyrone (metamizole) induced inhibition of aspirin antiplatelet effects

Thrombosis and Haemostasis
Amin PolzinTobias Zeus

Abstract

We have recently shown that dipyrone (metamizole), a non-opioid analgesic, can nullify aspirin (acetylsalicylic acid; ASA) antiplatelet effects in patients with coronary artery disease (CAD). In this study, we analysed the aspirin and dipyrone drug-drug interaction in order to identify strategies to prevent the dipyrone induced inhibition of asprin antiplatelet effects. Platelet function was measured by arachidonic acid-induced light-transmission aggregometry, thromboxane (TX) B2- formation by immunoassay. Dipyrone metabolite plasma levels were determined by high-performance-liquid-chromatography (HPLC). In seven healthy individuals, in vitro ASA (30 µM/ 100 µM/ 300 µM/ 1,000 µM) and dipyrone (10 µM) coincubation revealed, that the aspirin and dipyrone interaction can be overcome by increasing doses of aspirin. In 36 aspirin and dipyrone comedicated CAD patients, addition of ASA (30 µM/ 100 µM) in vitro inhibited, but did not completely overcome the dipyrone induced reduction of aspirin antiplatelet effects. Notably, the inhibition of thromboxane formation in aspirin and dipyrone comedicated CAD patients coincided with dipyrone plasma levels. In a cross-over designed study in four healthy individuals, we were able to prove that...Continue Reading

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Citations

Dec 9, 2015·Journal of Thrombosis and Haemostasis : JTH·A PolzinT Zeus
Jun 16, 2016·Vascular Pharmacology·Lisa DannenbergAmin Polzin
May 14, 2018·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Jan HartingerJaroslav Lindner
Jul 10, 2018·Journal of Cardiovascular Pharmacology·Dimitrios DimitroulisAmin Polzin
Jan 10, 2020·European Journal of Clinical Pharmacology·Christian PfrepperSirak Petros
Jun 6, 2020·European Journal of Clinical Pharmacology·Carolin HeltenAmin Polzin
Dec 12, 2018·Der Schmerz·J SchneiderJ Bolbrinker
Jun 16, 2017·Zeitschrift für Rheumatologie·H Bornemann-CimentiG Rumpold Seitlinger

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