1
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Lupu G, Bel L, Andrei S. Pain Management and Analgesics Used in Small Mammals during Post-Operative Period with an Emphasis on Metamizole (Dipyrone) as an Alternative Medication. Molecules 2022; 27:7434. [PMID: 36364259 PMCID: PMC9657641 DOI: 10.3390/molecules27217434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 10/13/2023] Open
Abstract
Metamizole (dipyrone) is a widely used non-opioid analgesic in both human and animal medicine. Metamizole's safety has been the topic of numerous opposing debates, given the fact that in certain countries metamizole is frequently used as an over-the-counter (OTC) medicine, while in others it is banned due to the risk of agranulocytosis. Further, small mammals such as rabbits, ferrets, rodents, and hedgehogs have become some of the most common pets present in veterinary practice, and each of these species has specific analgesic needs due to their anatomy and physiology. The key to providing appropriate medical care is in finding a substance that has minimal negative effects. In small mammals, analgesia is an important factor and, it happens frequently that, pain in these patients is not well managed. Post-operative pain management is an important topic in the welfare of animals. The objectives of this review, thus, were to provide a concise overview of analgesics that are used in the treatment of postoperative pain in small mammals (e.g., rabbits and rodents) and to highlight the importance of this product, metamizole, in veterinary medicine, as well as the potential of this substance as an alternative analgesic for the treatment of postoperative pain in small mammals.
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Affiliation(s)
- Georgiana Lupu
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
| | - Lucia Bel
- Department of Paraclinical and Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
| | - Sanda Andrei
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
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2
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Bachmann F, Meyer Zu Schwabedissen HE, Duthaler U, Krähenbühl S. Cytochrome P450 1A2 is the most important enzyme for hepatic metabolism of the metamizole metabolite 4-methylaminoantipyrine. Br J Clin Pharmacol 2021; 88:1885-1896. [PMID: 34648192 PMCID: PMC9298350 DOI: 10.1111/bcp.15108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/04/2023] Open
Abstract
Aims Metamizole (dipyrone) is a prodrug not detectable in serum or urine after oral ingestion. The primary metabolite, 4‐methylaminoantipyrine (4‐MAA), can be N‐demethylated to 4‐aminoantipyrine (4‐AA) or oxidized to 4‐formylaminoantipyrine (4‐FAA) by cytochrome P450 (CYP)‐dependent reactions. We aimed to identify the CYPs involved in 4‐MAA metabolism and to quantify the effect of CYP inhibition on 4‐MAA metabolism. Methods We investigated the metabolism of 4‐MAA in vitro using CYP expressing supersomes and the pharmacokinetics of metamizole in the presence of CYP inhibitors in male subjects. Results The experiments in supersomes revealed CYP1A2 as the major CYP for 4‐MAA N‐demethylation and 4‐FAA formation with CYP2C19 and CYP2D6 contributing to N‐demethylation. In the clinical study, we investigated the influence of ciprofloxacin (CYP1A2 inhibitor), fluconazole (CYP2C19 inhibitor) and the combination ciprofloxacin/fluconazole on the pharmacokinetics of metamizole in n = 12 male subjects in a randomized, placebo‐controlled, double‐blind study. The geometric mean ratios for the area under the concentration–time curve of 4‐MAA after/before treatment were 1.17 (90% CI 1.09–1.25) for fluconazole, 1.51 (90% CI 1.42–1.60) for ciprofloxacin and 1.92 (90% CI 1.81–2.03) for ciprofloxacin/fluconazole. Fluconazole increased the half‐life of 4‐MAA from 3.22 hours by 0.47 hours (95% CI 0.13–0.81, P < .05), ciprofloxacin by 0.69 hours (95% CI 0.44–0.94, P < .001) and fluconazole/ciprofloxacin by 2.85 hours (95% CI 2.48–3.22, P < .001). Conclusion CYP1A2 is the major CYP for the conversion of 4‐MAA to 4‐AA and 4‐FAA. The increase in 4‐MAA exposure by the inhibition of CYP1A2 and by the combination CYP1A2/CYP2C19 may be relevant for dose‐dependent adverse reactions of 4‐MAA.
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Affiliation(s)
- Fabio Bachmann
- Division of Clinical Pharmacology & Toxicology, University Hospital, Basel, Switzerland.,Department of Clinical Research, University of Basel, Switzerland.,Department of Biomedicine, University of Basel, Switzerland
| | | | - Urs Duthaler
- Division of Clinical Pharmacology & Toxicology, University Hospital, Basel, Switzerland.,Department of Clinical Research, University of Basel, Switzerland.,Department of Biomedicine, University of Basel, Switzerland
| | - Stephan Krähenbühl
- Division of Clinical Pharmacology & Toxicology, University Hospital, Basel, Switzerland.,Department of Clinical Research, University of Basel, Switzerland
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3
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Bachmann F, Duthaler U, Meyer Zu Schwabedissen HE, Puchkov M, Huwyler J, Haschke M, Krähenbühl S. Metamizole is a Moderate Cytochrome P450 Inducer Via the Constitutive Androstane Receptor and a Weak Inhibitor of CYP1A2. Clin Pharmacol Ther 2020; 109:1505-1516. [PMID: 33336382 PMCID: PMC8247900 DOI: 10.1002/cpt.2141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/07/2020] [Indexed: 01/24/2023]
Abstract
Metamizole is an analgesic and antipyretic drug used intensively in certain countries. Previous studies have shown that metamizole induces cytochrome (CYP) 2B6 and possibly CYP3A4. So far, it is unknown whether metamizole induces additional CYPs and by which mechanism. Therefore, we assessed the activity of 6 different CYPs in 12 healthy male subjects before and after treatment with 3 g of metamizole per day for 1 week using a phenotyping cocktail approach. In addition, we investigated whether metamizole induces CYPs by an interaction with the constitutive androstane receptor (CAR) or the pregnane X receptor (PXR) in HepaRG cells. In the clinical study, we confirmed a moderate induction of CYP2B6 (decrease in the efavirenz area under the plasma concentration time curve (AUC) by 79%) and 3A4 (decrease in the midazolam AUC by 68%) by metamizole. In addition, metamizole weakly induced CYP2C9 (decrease in the flurbiprofen AUC by 22%) and moderately CYP2C19 (decrease in the omeprazole AUC by 66%) but did not alter CYP2D6 activity. In addition, metamizole weakly inhibited CYP1A2 activity (1.79‐fold increase in the caffeine AUC). We confirmed these results in HepaRG cells, where 4‐MAA, the principal metabolite of metamizole, induced the mRNA expression of CYP2B6, 2C9, 2C19, and 3A4. In HepaRG cells with a stable knockout of PXR or CAR, we could demonstrate that CYP induction by 4‐MAA depends on CAR and not on PXR. In conclusion, metamizole is a broad CYP inducer by an interaction with CAR and an inhibitor of CYP1A2. Regarding the widespread use of metamizole, these findings are of substantial clinical relevance.
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Affiliation(s)
- Fabio Bachmann
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Urs Duthaler
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Maxim Puchkov
- Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Jörg Huwyler
- Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Manuel Haschke
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Stephan Krähenbühl
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine, University of Basel, Basel, Switzerland
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4
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Savic IM, Gajic IMS, Sibinovic PS. Simultaneous Spectrophotometric Quantification of Metamizole Sodium, Pitofenone Hydrochloride, and Fenpiverinium Bromide in a Pharmaceutical Product Using Multivariate Calibration Methods. ANAL LETT 2020. [DOI: 10.1080/00032719.2020.1725541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ivan M. Savic
- Faculty of Technology, University of Nis, Leskovac, Republic of Serbia
| | | | - Predrag S. Sibinovic
- Pharmaceutical and Chemical Industry Zdravlje-Actavis, Leskovac, Republic of Serbia
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5
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Development and validation of an LC–MS/MS method for the bioanalysis of the major metamizole metabolites in human plasma. Bioanalysis 2020; 12:175-189. [PMID: 32052638 DOI: 10.4155/bio-2019-0251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Aim: Metamizole is a frequently used antipyretic and analgesic prodrug, yet its pharmacokinetics has not been thoroughly studied in infants and with coadministered medications. Thus, an LC–MS/MS method was developed to quantify the four major metamizole metabolites in human plasma. Methodology: Pre- and postcolumn infusion was installed to enable robust analyte retention and electrospray ionization following deproteinization of plasma samples. Results: The method was linear (R > 0.996), accurate (93.1–106.0%) and precise (≤12.7%). Mean recovery was more than 91.8% and ion suppression less than 13.1% for all analytes. Pharmacokinetic profiles were reproducible after 4 years at -80°C except for the formylated metabolite (-22.2%). Conclusion: The method fulfilled pertinent criteria of validation guidelines and required only little sample volume. The method therefore qualifies for metamizole analyses in children.
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6
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Lutz M. Metamizole (Dipyrone) and the Liver: A Review of the Literature. J Clin Pharmacol 2019; 59:1433-1442. [DOI: 10.1002/jcph.1512] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/31/2019] [Indexed: 01/17/2023]
Affiliation(s)
- Mathias Lutz
- Department of Medicine AUniversity Hospital of Münster Münster Germany
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7
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Collares EF, Troncon LEA. Effects of dipyrone on the digestive tract. ACTA ACUST UNITED AC 2019; 52:e8103. [PMID: 30652827 PMCID: PMC6328969 DOI: 10.1590/1414-431x20188103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 10/31/2018] [Indexed: 12/14/2022]
Abstract
Dipyrone (metamizole), acting through its main metabolites 4-methyl-amino-antipyrine and 4-amino-antipyrine, has established analgesic, antipyretic, and spasmolytic pharmacological effects, which are mediated by poorly known mechanisms. In rats, intravenously administered dipyrone delays gastric emptying (GE) of liquids with the participation of capsaicin-sensitive afferent fibers. This effect seems to be mediated by norepinephrine originating from the sympathetic nervous system but not from the superior celiac-mesenteric ganglion complex, which activates β2-adrenoceptors. In rats, in contrast to nonselective non-hormonal anti-inflammatory drugs, dipyrone protects the gastric mucosa attenuating the development of gastric ulcers induced by a number of agents. Clinically, it has been demonstrated that dipyrone is effective in the control of colic-like abdominal pain originating from the biliary and intestinal tracts. Since studies in humans and animals have demonstrated the presence of β2-adrenoceptors in biliary tract smooth muscle and β2-adrenoceptor activation has been shown to occur in dipyrone-induced delayed GE, it is likely that this kind of receptors may participate in the reduction of smooth muscle spasm of the sphincter of Oddi induced by dipyrone. There is no evidence that dipyrone may interfere with small bowel and colon motility, and the clinical results of its therapeutic use in intestinal colic appear to be due to its analgesic effect.
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Affiliation(s)
- E F Collares
- Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - L E A Troncon
- Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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8
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Kim TW, Łebkowska-Wieruszewska B, Sitovs A, Poapolathep A, Owen H, Lisowski A, Abilova Z, Giorgi M. Pharmacokinetic profiles of metamizole (dipyrone) active metabolites in goats and its residues in milk. J Vet Pharmacol Ther 2018; 41:699-705. [DOI: 10.1111/jvp.12679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/04/2018] [Accepted: 03/14/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Tae Won Kim
- College of Veterinary Medicine; Chungnam National University; Daejeon South Korea
| | | | - Andrejs Sitovs
- Faculty of Pharmacy; Department of Pharmacology; Rīga Stradiņš University; Riga Latvia
| | - Amnart Poapolathep
- Faculty of Veterinary Medicine; Department of Pharmacology; Kasetsart University; Bangkok Thailand
| | - Helen Owen
- School of Veterinary Science; The University of Queensland, Gatton Campus; Gatton QLD Australia
| | - Andrzej Lisowski
- Instytut Hodowli Zwierząt i Ochrony Bioróżnorodności; University of Life Sciences; Lublin Poland
| | - Zulkyya Abilova
- School of Veterinary Medicine; A. Baitursynov Kostanay State University; Kostanay Kazakhstan
| | - Mario Giorgi
- Department of Veterinary Sciences; University of Pisa; Pisa Italy
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9
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Bachmann F, Duthaler U, Rudin D, Krähenbühl S, Haschke M. N-demethylation of N-methyl-4-aminoantipyrine, the main metabolite of metamizole. Eur J Pharm Sci 2018; 120:172-180. [PMID: 29746911 DOI: 10.1016/j.ejps.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 04/17/2018] [Accepted: 05/06/2018] [Indexed: 12/15/2022]
Abstract
Metamizole is an old analgesic used frequently in some countries. Active metabolites of metamizole are the non-enzymatically generated N-methyl-4-aminoantipyrine (4-MAA) and its demethylation product 4-aminoantipyrine (4-AA). Previous studies suggested that 4-MAA demethylation can be performed by hepatic cytochrome P450 (CYP) 3A4, but the possible contribution of other CYPs remains unclear. Using human liver microsomes (HLM), liver homogenate and HepaRG cells, we could confirm 4-MAA demethylation by CYPs. Based on CYP induction (HepaRG cells) and CYP inhibition (HLM) we could identify CYP2B6, 2C8, 2C9 and 3A4 as major contributors to 4-MAA demethylation. The 4-MAA demethylation rate by HLM was 280 pmol/mg protein/h, too low to account for in vivo 4-MAA demethylation in humans. Since peroxidases can perform N-demethylation, we investigated horseradish peroxidase and human myeloperoxidase (MPO). Horse radish peroxidase efficiently demethylated 4-MAA, depending on the hydrogen peroxide concentration. This was also true for MPO; this reaction was saturable with a Km of 22.5 μM and a maximal velocity of 14 nmol/min/mg protein. Calculation of the entire body MPO capacity revealed that the demethylation capacity by granulocyte/granulocyte precursors was approximately 600 times higher than the liver capacity and could account for 4-MAA demethylation in humans. 4-MAA demethylation could also be demonstrated in MPO-expressing granulocyte precursor cells (HL-60). In conclusion, 4-MAA can be demethylated in the liver by several CYPs, but hepatic metabolism cannot fully explain 4-MAA demethylation in humans. The current study suggests that the major part of 4-MAA is demethylated by circulating granulocytes and granulocyte precursors in bone marrow.
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Affiliation(s)
- Fabio Bachmann
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Switzerland; Department of Biomedicine, University of Basel, Switzerland
| | - Urs Duthaler
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Switzerland; Department of Biomedicine, University of Basel, Switzerland
| | - Deborah Rudin
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Switzerland; Department of Biomedicine, University of Basel, Switzerland
| | - Stephan Krähenbühl
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Switzerland; Department of Biomedicine, University of Basel, Switzerland.
| | - Manuel Haschke
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern and Institute of Pharmacology, University of Bern, Switzerland
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10
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Giorgi M, Łebkowska-Wieruszewska B, Lisowski A, Owen H, Poapolathep A, Kim TW, De Vito V. Pharmacokinetic profiles of the active metamizole metabolites after four different routes of administration in healthy dogs. J Vet Pharmacol Ther 2018; 41:428-436. [DOI: 10.1111/jvp.12484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 12/11/2017] [Indexed: 01/01/2023]
Affiliation(s)
- M. Giorgi
- Department of Veterinary Sciences; University of Pisa; Pisa Italy
| | | | - A. Lisowski
- Department of Animal Hygiene and Environment; University of Life Sciences; Lublin Poland
| | - H. Owen
- Department of Veterinary Sciences; University of Queensland; Gatton Australia
| | - A. Poapolathep
- Department of Pharmacology; Faculty of Veterinary Medicine; Kasetsart University; Bangkok Thailand
| | - T. W. Kim
- College of Veterinary Medicine; Chungnam National University; Daejeon South Korea
| | - V. De Vito
- Department of Veterinary Medicine; University of Sassari; Sassari Italy
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11
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Lebkowska-Wieruszewska B, Kim TW, Chea B, Owen H, Poapolathep A, Giorgi M. Pharmacokinetic profiles of the two major active metabolites of metamizole (dipyrone) in cats following three different routes of administration. J Vet Pharmacol Ther 2017; 41:334-339. [DOI: 10.1111/jvp.12471] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
| | - T. W. Kim
- College of Veterinary Medicine; Chungnam National University; Daejeon South Korea
| | - B. Chea
- Faculty of Veterinary Medicine; Royal University of Agriculture; Phnom Penh Cambodia
| | - H. Owen
- Department of Veterinary Science; University of Queensland; Gatton, Brisbane QLD Australia
| | - A. Poapolathep
- Department of Pharmacology; Faculty of Veterinary Medicine; Kasetsart University; Bangkok Thailand
| | - M. Giorgi
- Department of Veterinary Sciences; University of Pisa; Pisa Italy
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12
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Giorgi M, Aupanun S, Lee HK, Poapolathep A, Rychshanova R, Vullo C, Faillace V, Laus F. Pharmacokinetic profiles of the active metamizole metabolites in healthy horses. J Vet Pharmacol Ther 2016; 40:165-171. [DOI: 10.1111/jvp.12342] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/28/2016] [Indexed: 11/30/2022]
Affiliation(s)
- M. Giorgi
- Department of Veterinary Sciences; University of Pisa; Pisa Italy
| | - S. Aupanun
- Interdisciplinary Graduate Program in Genetic Engineering; Graduate School; Kasetsart University; Bangkok Thailand
| | - H.-K. Lee
- College of Veterinary Medicine; Chungnam National University; Daejeon South Korea
| | - A. Poapolathep
- Department of Pharmacology; Faculty of Veterinary Medicine; Kasetsart University; Bangkok Thailand
| | - R. Rychshanova
- Veterinary School; Kostanay State A. Baitursynov University; Kostanay Kazakhstan
| | - C. Vullo
- School of Pharmacy; University Camerino; Macerata Italy
| | - V. Faillace
- School of Biosciences and Veterinary Medicine; University Camerino; Matelica Macerata Italy
| | - F. Laus
- School of Biosciences and Veterinary Medicine; University Camerino; Matelica Macerata Italy
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13
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Belal FF, Sharaf El-Din MK, Tolba MM, Elmansi H. Determination of Two Ternary Mixtures for Migraine Treatment Using HPLC Method with Ultra Violet Detection. SEP SCI TECHNOL 2014. [DOI: 10.1080/01496395.2014.957317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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14
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Nikolova I, Tencheva J, Voinikov J, Petkova V, Benbasat N, Danchev N. Metamizole: A Review Profile of a Well-Known “Forgotten” Drug. Part I: Pharmaceutical and Nonclinical Profile. BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.5504/bbeq.2012.0089] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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15
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Gyenge-Szabó Z, Szoboszlai N, Frigyes D, Záray G, Mihucz VG. Monitoring of four dipyrone metabolites in communal wastewater by solid phase extraction liquid chromatography electrospray ionization quadrupole time-of-flight mass spectrometry. J Pharm Biomed Anal 2014; 90:58-63. [DOI: 10.1016/j.jpba.2013.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/14/2013] [Accepted: 11/16/2013] [Indexed: 11/24/2022]
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16
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Kamiyama N, Yamamoto M, Saiga H, Ma JS, Ohshima J, Machimura S, Sasai M, Kimura T, Ueda Y, Kayama H, Takeda K. CREBH determines the severity of sulpyrine-induced fatal shock. PLoS One 2013; 8:e55800. [PMID: 23409047 PMCID: PMC3567110 DOI: 10.1371/journal.pone.0055800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 01/02/2013] [Indexed: 11/18/2022] Open
Abstract
Although the pyrazolone derivative sulpyrine is widely used as an antipyretic analgesic drug, side effects, including fatal shock, have been reported. However, the molecular mechanism underlying such a severe side effect is largely unclear. Here, we report that the transcription factor CREBH that is highly expressed in the liver plays an important role in fatal shock induced by sulpyrine in mice. CREBH-deficient mice were resistant to experimental fatal sulpyrine shock. We found that sulpyrine-induced expression of cytochrome P450 2B (CYP2B) family genes, which are involved in sulpyrine metabolism, in the liver was severely impaired in CREBH-deficient mice. Moreover, introduction of CYP2B in CREBH-deficient liver restored susceptibility to sulpyrine. Furthermore, ectopic expression of CREBH up-regulated CYP2B10 promoter activity, and in vivo knockdown of CREBH in wild-type mice conferred a significant resistance to fatal sulpyrine shock. These data demonstrate that CREBH is a positive regulator of CYP2B in response to sulpyrine administration, which possibly results in fatal shock.
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Affiliation(s)
- Naganori Kamiyama
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Laboratory of Immunoparasitology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Masahiro Yamamoto
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Laboratory of Immunoparasitology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi, Saitama, Japan
- * E-mail: (MY); (KT)
| | - Hiroyuki Saiga
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
| | - Ji Su Ma
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Laboratory of Immunoparasitology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Jun Ohshima
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Laboratory of Immunoparasitology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Sakaaki Machimura
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Laboratory of Immunoparasitology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Miwa Sasai
- Laboratory of Immunoparasitology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Taishi Kimura
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
| | - Yoshiyasu Ueda
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
| | - Hisako Kayama
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi, Saitama, Japan
| | - Kiyoshi Takeda
- Department of Microbiology and Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Laboratory of Mucosal Immunology, WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi, Saitama, Japan
- * E-mail: (MY); (KT)
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17
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High-performance liquid chromatographic assay for metamizol metabolites in rat plasma: Application to pharmacokinetic studies. J Pharm Biomed Anal 2012; 71:173-8. [DOI: 10.1016/j.jpba.2012.07.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 05/25/2012] [Accepted: 07/26/2012] [Indexed: 11/20/2022]
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18
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Roberts AG, Sjögren SEA, Fomina N, Vu KT, Almutairi A, Halpert JR. NMR-derived models of amidopyrine and its metabolites in complexes with rabbit cytochrome P450 2B4 reveal a structural mechanism of sequential N-dealkylation. Biochemistry 2011; 50:2123-34. [PMID: 21375273 DOI: 10.1021/bi101797v] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To understand the molecular basis of sequential N-dealkylation by cytochrome P450 2B enzymes, we studied the binding of amidopyrine (AP) as well as the metabolites of this reaction, desmethylamidopyrine (DMAP) and aminoantipyrine (AAP), using the X-ray crystal structure of rabbit P450 2B4 and two nuclear magnetic resonance (NMR) techniques: saturation transfer difference (STD) spectroscopy and longitudinal (T(1)) relaxation NMR. Results of STD NMR of AP and its metabolites bound to P450 2B4 were similar, suggesting that they occupy similar niches within the enzyme's active site. The model-dependent relaxation rates (R(M)) determined from T(1) relaxation NMR of AP and DMAP suggest that the N-linked methyl is closest to the heme. To determine the orientation(s) of AP and its metabolites within the P450 2B4 active site, we used distances calculated from the relaxation rates to constrain the metabolites to the X-ray crystal structure of P450 2B4. Simulated annealing of the complex revealed that the metabolites do indeed occupy similar hydrophobic pockets within the active site, while the N-linked methyls are free to rotate between two binding modes. From these bound structures, a model of N-demethylation in which the N-linked methyl functional groups rotate between catalytic and noncatalytic positions was developed. This study is the first to provide a structural model of a drug and its metabolites complexed to a cytochrome P450 based on NMR and to provide a structural mechanism for how a drug can undergo sequential oxidations without unbinding. The rotation of the amide functional group might represent a common structural mechanism for N-dealkylation reactions for other drugs such as the local anesthetic lidocaine.
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Affiliation(s)
- Arthur G Roberts
- The Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Drive, #0703, La Jolla, California 92093-0703, United States.
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19
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Zanrosso CW, Emerenciano M, Gonçalves BADA, Faro A, Koifman S, Pombo-de-Oliveira MS. N -Acetyltransferase 2 Polymorphisms and Susceptibility to Infant Leukemia with Maternal Exposure to Dipyrone during Pregnancy. Cancer Epidemiol Biomarkers Prev 2010; 19:3037-43. [DOI: 10.1158/1055-9965.epi-10-0508] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Gómez MJ, Sirtori C, Mezcua M, Fernández-Alba AR, Agüera A. Photodegradation study of three dipyrone metabolites in various water systems: identification and toxicity of their photodegradation products. WATER RESEARCH 2008; 42:2698-2706. [PMID: 18294672 DOI: 10.1016/j.watres.2008.01.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 01/15/2008] [Accepted: 01/22/2008] [Indexed: 05/25/2023]
Abstract
The photochemical behaviour of three relevant metabolites of the analgesic and antipyretic drug dipyrone, 4-methylaminoantipyrine (4-MAA), 4-formylaminoantipyrine (4-FAA) and 4-acetylaminoantipyrine (4-AAA), was evaluated under simulated solar irradiation (Suntest system). For 4-MAA, different aqueous solutions (synthetic seawater, freshwater and Milli-Q water) as well as different operational conditions were compared. According to the experimental results, 4-MAA resulted as being an easily degraded molecule by direct photolysis, with half-life times (t1/2) ranging from 0.12 to 0.58 h, depending on the irradiation conditions. Faster degradation was observed in synthetic waters, suggesting that the photolysis was influenced by the salt composition of the waters. However, no effect on the degradation rate was observed by the presence of natural photosensitizers (dissolved organic matter, nitrate ions). 4-FAA and 4-AAA showed slower photodegradation kinetics, with t1/2 of 24 and 28 h, respectively. A study of photoproduct identification was carried out by gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-time-of-flight mass spectrometry (LC-TOF-MS) (ESI positive mode), which allowed us to propose a tentative photodegradation pathway for 4-MAA and the identification of persistent by-products in all the cases. Finally, the application of an acute toxicity test (Daphnia magna) showed an increase in toxicity during the photolytic process, a consequence of the formation of toxic photoproducts.
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Affiliation(s)
- María J Gómez
- Pesticide Residue Research Group, University of Almería, 04120 Almería, Spain
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21
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Saussele T, Burk O, Blievernicht JK, Klein K, Nussler A, Nussler N, Hengstler JG, Eichelbaum M, Schwab M, Zanger UM. Selective Induction of Human Hepatic Cytochromes P450 2B6 and 3A4 by Metamizole. Clin Pharmacol Ther 2007; 82:265-74. [PMID: 17344806 DOI: 10.1038/sj.clpt.6100138] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The pyrazolone drug metamizole is a widely used analgesic. Analysis of liver microsomes from patients treated with metamizole revealed selectively higher expression of cytochromes P450, CYP2B6 and CYP3A4 (3.8- and 2.8-fold, respectively), and 2.9-fold higher bupropion hydroxylase activity compared with untreated subjects. Further investigation of metamizole and various derivatives on different potential target genes in human primary hepatocytes demonstrated time- and concentration-dependent induction by metamizole of CYP2B6 (7.8- and 3.1-fold for mRNA and protein, respectively, at 100 muM) and CYP3A4 (2.4- and 2.9-fold, respectively), whereas other genes (CYP2C9, CYP2C19, CYP2D6, NADPH:cytochrome P450 reductase, ABCB1, constitutive androstane receptor (CAR), pregnane X receptor (PXR)) were not substantially altered. Using reporter gene assays, we show that metamizole is not acting as a direct ligand to either PXR or CAR, suggesting a phenobarbital-like mechanism of induction. These data warrant further studies to elucidate the drug-interaction potential of metamizole, especially in patients with long-term treatment.
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MESH Headings
- Aged
- Anti-Inflammatory Agents, Non-Steroidal/pharmacology
- Aryl Hydrocarbon Hydroxylases/biosynthesis
- Aryl Hydrocarbon Hydroxylases/genetics
- Blotting, Western
- Catalysis
- Cells, Cultured
- Constitutive Androstane Receptor
- Cytochrome P-450 CYP2B6
- Cytochrome P-450 CYP3A
- Cytochrome P-450 Enzyme System/biosynthesis
- Cytochrome P-450 Enzyme System/genetics
- DNA/biosynthesis
- DNA/genetics
- Dipyrone/analogs & derivatives
- Dipyrone/pharmacology
- Dose-Response Relationship, Drug
- Enzyme Induction/drug effects
- Female
- Genotype
- Hepatocytes/drug effects
- Humans
- In Vitro Techniques
- Isoenzymes/metabolism
- Liver/drug effects
- Liver/enzymology
- Male
- Microsomes, Liver/drug effects
- Microsomes, Liver/enzymology
- Middle Aged
- Oxidoreductases, N-Demethylating/biosynthesis
- Oxidoreductases, N-Demethylating/genetics
- Plasmids
- Pregnane X Receptor
- RNA/biosynthesis
- RNA/genetics
- Receptors, Cytoplasmic and Nuclear/drug effects
- Receptors, Steroid/drug effects
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription Factors/drug effects
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Affiliation(s)
- T Saussele
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
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22
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Collares EF, Vinagre AM. Evidence of the effect of dipyrone on the central nervous system as a determinant of delayed gastric emptying observed in rats after its administration. Braz J Med Biol Res 2003; 36:1375-82. [PMID: 14502370 DOI: 10.1590/s0100-879x2003001000014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Dipyrone administered intravenously (iv) delays gastric emptying (GE) in rats. The objectives of the present study were to assess: 1) the effect of the dose of dipyrone and time after its iv administration on GE in rats, 2) the effect of subdiaphragmatic vagotomy (VgX) and bilateral electrolytic lesion of the paraventricular nucleus (PVNX) on the delayed GE induced by the drug, and 3) the intracerebroventricular (icv) action of dipyrone and of one of its metabolites, 4-aminoantipyrine on GE. Male Wistar rats received saline labeled with phenol red intragastrically as a test meal. GE was indirectly assessed by the determination of percent gastric retention (GR) of the test meal 10 min after administration by gavage. Dipyrone delays GE in a dose- and time-dependent manner. Thirty minutes after the iv administration of 80 mg/kg dipyrone, the animals showed significantly higher GR (mean = 62.6%) compared to those receiving vehicle (31.5%). VgX and PVNX significantly reduced the iv effect of 80 mg/kg dipyrone (mean %GR: VgX = 28.3 vs Sham = 55.5 and PVNX = 34.5 vs Sham = 52.2). Icv administration of 4 mol dipyrone caused a significant increase in GR (54.1%) of the test meal 10 min later, whereas administration of 4 mol 4-aminoantipyrine had no effect (34.4%). Although the dipyrone dose administered icv was 16 times lower than that applied iv, for the same time of action (10 min), the GR of animals that received the drug icv (54.1%) or iv (54.5%) did not differ significantly. In conclusion, the present results suggest that the effect of dipyrone in delaying GE is due to the action of the drug on the central nervous system, with the participation of the PVN and of the vagus nerve.
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Affiliation(s)
- E F Collares
- Departamento de Pediatria, Núcleo de Medicina e Cirurgia Experimental, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
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23
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Muñoz RA, Matos RC, Angnes L. Amperometric determination of dipyrone in pharmaceutical formulations with a flow cell containing gold electrodes from recordable compact discs. J Pharm Sci 2001; 90:1972-7. [PMID: 11745756 DOI: 10.1002/jps.1148] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A simple, rapid, and precise amperometric method for quantification of dipyrone in pharmaceutical formulations is presented. The proposed method permits determinations in the 10(-7) mol L(-1) of the analyte and enables 90 determinations h(-1), employing only 100 microL of sample per determination. This method is based on the direct quantification of dipyrone in many pharmaceutical products, avoiding cumbersome processes such as previous separations, solvent extraction, or sample filtration. This new procedure was applied to commercial pharmaceutical tablets, and the results obtained were in excellent agreement with the ones obtained by the classical iodometric method.
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Affiliation(s)
- R A Muñoz
- Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, 05508-900-São Paulo, SP, Brasil
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