A recent article in The Guardian’s “Observer” section illustrates how confusing the field of medicine can be when it comes to assessing the risk involved in use of a particular medication. In this instance, it’s the painkiller metamizole, brand name Nolotil, that’s causing the fuss. We’re talking serious problems in some cases. Including the fatal sort.
Here’s a link:
Many of the fatalities cited in the article happen to be among older British citizens living overseas. There are quite a few of them. British people like to vacation and even retire to the Spanish coast — principally because it’s less expensive and a whole lot sunnier than the UK. But that means they also patronize the Spanish healthcare system, where Nolotil is approved for everyday use as a painkiller. That’s not true every place. In fact, the medication is banned in 30 other nations.
For instance, in Sweden, where the authorities estimate that a particular complication called agranulocytosis appears to occur in one out of every 2000 cases involving Nolotil. The mortality (death) rate from that complication is 26%.
The Spanish authorities, on the other hand, are using different numbers. According to their data, agranulocytosis is rare, and the benefits of Nolotil outweigh the risks.
That’s not been the case for British tourists and residents in Spain, however. There has been speculation that something about people from the UK makes them especially vulnerable to agranulocytosis. Perhaps there’ll be a guideline for physicians strongly suggesting the medication not be used with travelers from other lands.
One other wrinkle: Though Nolotil is available in Spanish pharmacies by prescription only, the Observer reports no difficulty in making a purchase of the drug, in a licensed pharmacy, without a prescription.
No back-alley drug transaction involved.