Concerns about a widely prescribed painkiller in Spain are increasing after recent reports in the British press about a demand for a total ban on the drug.
Metamizole, marketed in Spain under the brand name Nolotil, can in rare instances cause a side-effect known as agranulocytosis, which depletes white blood cells and can cause greater vulnerability to infection.
This particular side-effect is known to be more common among people of certain genetic descent in Anglo-Saxon and Nordic countries, which is one of the reasons why the drug has long been banned in countries such as the UK, Ireland, Sweden, France, Denmark and the USA. According to Mabel Avila, of the Las Palmas College of Pharmacists, the risk of agranulocytosis is “two and a half times greater” in these groups.
On 14th November the Association of Drug Affected Patients (ADAF), a group based in Javéa, Spain, commenced legal action against the Spanish government in an attempt to ban Nolotil. The ADAF claims that it has details of 350 cases in which agranulocytosis may have caused serious illness, amputation or death. 170 of these cases involved Britons living in or visiting Spain.
In the Canaries, the use of Nolitil has fallen drastically since 2018. Once the most-prescribed drug on the islands, with 90,000 prescriptions a year, use has now fallen to 25,000 packets in 2023 following guidelines from the Spanish Medicines Agency which advised doctors not to prescribe the painkiller to “patients whose treatment they cannot control” (tourists) or “floating populations”.
Ignacio López Puech. chief of Rational Medicine Use at the Canarian Health Service, told Canarias7 that “serious adverse effects of Nolotil are very rare. That is why it is still used in Spain, although withdrawing it is being considered because there are people with a genetic make-up, mainly from Nordic countries, who are more susceptible to side-effects.”
Further information:
ADAF – www.adafspain.org/
Observer reports
(Sunday 26th November): https://www.theguardian.com/science/2023/nov/26/painkiller-banned-in-uk-linked-to-britons-deaths-in-spain
(Sunday 3rd December): https://www.theguardian.com/science/2023/dec/03/its-not-worth-risking-your-life-fears-over-painkiller-nolotil-grow-for-brits-in-spain
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