E-drug: Dipyrone and agranulocytosis (cont'd)
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I think there may be something to learn from looking at related
drugs. We have had two that I know of: Phenazone (antipyrine,
known to pharmacokineticians of the old school) and
propyphenazone. From our national spontaneous reporting system
we had indications during the 1990s that propyphenazone had a
much higher incidence of anaphylactoid reactions than the related
phenazone. So we contacted the manufacturer who promptly
exchanged propyphenazone with phenazone.
The caffeine combination (which may have an addiction problem) is
popular for headaches, and the neurologists say it is quite effective
for spinal headache.
Another (distant) member of the family is phenylbutazone, which is
a different chapter.
You would be surprised if you compared the structural formula of
celecoxib and, to a slighter degree, that of rofecoxib, with the
structural formula of phenylbutazone.
So much for the originality of the COX-2-inhibitors.
Gaut Gadeholt
MD, PhD, Former State Pharmacovigilante
Present work address:
Rikshospitalet University Hospital
Oslo, Norway
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