Novotel has indications and pharmacological actions, such as treating pain or fever. As the experts point out, the active principle of this commercial brand of medication is metamizole, which belongs to the pyrazolone family and can be presented in the form of sodium or magnesium metamizole.
This compound was synthesized in 1920, but it was not until 1922 that it was first introduced to the market under the brand name Novalgin in Germany. It was in many countries without restrictions until its toxic effects, such as agranulocytosis or neutropenia, were discovered.
Today, metamizole is marketed under numerous brand names worldwide, such as Nolotil, although it is also sold under the generic name. Next, we will see how it works, what it is used for, and what effects it can have.
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Nolotil: analgesic, antipyretic, and spasmolytic
Nolotil acts as an analgesic because it calms moderate and intense acute pain, antipyretic because it lowers fever -especially high ones- and spasmolytic because it softens visceral pain produced by muscle spasms. However, its mechanism of action has not yet been fully understood, that is, how it acts in our body to produce the above effects. Despite this, it has been suggested that its analgesic effect is based on the inhibition of a central cyclooxygenase-3 and the activation of the opioidergic system and the cannabinoid system. Also, an important fact is that technically it is not an anti-inflammatory, although it is usually thought that it is. The drug belongs to a group known as “other analgesics and antipyretics.” This is so because supratherapeutic doses are necessary to reduce inflammation, which can produce toxic effects.How does it act in the body?
Nolotil acts on pain and fever thanks to its ability to reduce the synthesis of proinflammatory prostaglandins. It achieves this by inhibiting prostaglandin synthetase’s activity, an enzyme that catalyzes, as its name suggests, the synthesis of new prostaglandins. These lipid compounds participate in inflammatory responses, among numerous other processes. Likewise, they stimulate the nerve terminals of pain and act in the production of fever. However, Nolotil can also inhibit fever induced by lipopolysaccharides, which differentiates it from non-steroidal anti-inflammatory drugs or NSAIDs. On the other hand, its analgesic action is because it is a non-selective inhibitor of the cyclooxygenase enzyme, as already mentioned. It also has a spasmolytic action associated with the inhibition of intracellular calcium. This is useful in nephritic or renal colic situations and muscle spasms. Therefore, we can say that Nolotil is analgesic, antipyretic, and spasmolytic. It is anti-inflammatory when the dose is increased.What is it for?
Nolotil is widely used in Spain and even in doses above those recommended. It is a fairly safe drug, although it is not marketed in other European countries due to the side effects we will see later. This drug is recommended for many indications, such as the following:- Abdominal pains.
- dental pains
- Pain after trauma.
- Colic.
- Post-surgical pain.
- Oncological pains.
- Fever that other antipyretic drugs cannot control.
How to take Nolotil?
It is important to note that Nolotil is used for short periods to avoid adverse effects. Although in each case, it is necessary to follow the dosage indicated by the doctor, as a guide, the indicated and recommended doses in those over 15 years of age are usually the following:- By mouth: the usual dose is one 575 mg capsule, which can be taken up to 6 times daily every 4 to 6 hours.
- Parenterally: intramuscularly or slowly intravenously, a 2-gram ampoule is administered every 8 hours.
What happens if I take more Nolotil than I should?
If you miss a Nolotil dose, you simply take the next dose as usual. Do not double the dose as compensation. Excessive intake of the drug can generate multiple symptoms, among which the following stand out:- Nausea and vomiting.
- Pain in the abdomen.
- Impaired renal function.
- Hypotension and shock .
- Tachycardia.
- Drowsiness.
- Seizures.
Adverse reactions
Unlike other non-opioid analgesic drugs that act on the synthesis of prostaglandins, metamizole does not cause significant gastrointestinal effects. However, it produces a series of adverse reactions that must be considered. The main adverse effects of Nolotil are due to hypotension and hypersensitivity reactions. The most important reactions are changes in blood cells, among which are the following:- Leukopenia.
- Agranulocytosis.
- Thrombocytopenia.
- General discomfort.
- Light-colored stools.
- Fatigue.
- Dark or black urine.
- Itching.
- Yellow discoloration of the skin, mucous membranes, or sclera.
Contraindications and recommendations
It has not been shown to harm the fetus during the first months of pregnancy, but it should be avoided in the last trimester. The elderly and people with renal insufficiency should consume lower doses of the drug since its elimination will be slower. The compound is excreted in breast milk, so it can cause unwanted effects in the nursing infant. In this sense, stopping breastfeeding at least 48 hours after a dose of Nolotil is recommended. In addition, the drug can interact with other medications, so it is important to notify the specialist if additional treatment is being followed. As if that were not enough, it should not be administered to children under 15 years of age or weighing less than 53 kilograms. High doses of Nolotil can cause drowsiness, thus affecting the ability to drive and decreasing concentration. The drug is also contraindicated in the following situations:- History of allergic reactions to metamizole or any NSAID.
- History of analgesic asthma syndrome.
- Glucose-6-phosphate dehydrogenase enzyme deficiency.
- Acute intermittent hepatic porphyria.
- History of impaired bone marrow function.