Doctors warned not to prescribe Metamizole to holidaymakers or northern Europeans

HEALTHCARE professionals in Spain have been warned not to prescribe an everyday painkiller to tourists or anyone of northern European origin after research by a medical interpreter in the province of Alicante found that certain nationalities are at risk of fatal sepsis.

Metamizole, which retails as Nolotil, is taken regularly by Spaniards for mild to moderate pain and no known serious side-effects have ever been reported.

But the drug is banned in the UK, and a small number of mostly British, but also Scandinavian patients have developed life-threatening cases of a plunging white blood cell count, causing a dangerously-suppressed immune system.

Known as Agranulocytosis, the condition produces symptoms including fever, sore throat and stiffness, and leaves the patient extremely vulnerable to infection.

Pneumonia, urinary tract infection and septicaemia are common complications of Agranulocytosis and can appear and progress very rapidly, at times too rapidly to be treated in time to save the patient's life.

Cristina García, from Jávea, who works interpreting for English-speaking expatriates and holidaymakers at hospital and doctor appointments, decided to delve deeper after finding only British and Nordic DNA seem to present a deadly infection risk with Metamizole, and that Spanish patients were not apparently affected.

Now, the Spanish Agency for Medicines and Healthcare Products (AEMPS) has warned medics not to prescribe or recommend Nolotil to holidaymakers of any nationality, or to any members of the 'floating population', such as holiday-home owners visiting the area or the country, especially if they are middle-aged or elderly.

This is because the prescribing medic cannot monitor the patient for adverse effects.

Also, Nolotil should not be prescribed for long-term pain relief, only for periods of a maximum of seven days.

Where longer-term prescriptions cannot be avoided, regular haematology checks should be made to ensure the white blood-cell count is at the correct level.

AEMPS has told doctors to carry out blood tests and a detailed study of patients' medical history before prescribing Nolotil and avoid giving it to anyone with previous incidents of hypersensitivity or adverse reactions, or has been treated with immune-suppressing drugs or any other medication that can cause Agranulocytosis.

Sra García travelled to Madrid a few weeks ago to present her findings to the office of the Spanish Pharmaceutical Vigilance System, which has fed the information to AEMPS.