Metamizole as an Analgesic in Primary Care – an Analysis of 10 Years of Discussion in the Listserver
DOI: 10.3238/zfa.2016.0079-0083german translation / full article
Background: Metamizole is an analgesic frequently prescribed by German family practitioners. Evidence regarding the risk-benefit ratio of medium- to long-term prescriptions is scarce. In many, even neighboring European, countries metamizole is not commercially available due to safety concerns. Among family practitioners in Germany, there is an ongoing debate about the pros and cons of metamizole.
Methods: Applying qualitative content analysis, the listserver postings of German family practitioners from the last ten years were coded by two investigators independently. Categories were formed and a final category system describing the listserver discussion was developed.
Results: The central topics of the discussion are the effectiveness of metamizole compared to other analgesics and the safety aspects of the drug. The effectiveness was rated consistently positive and the advantages as compared to non-steroidal anti-inflammatory drugs were emphasized. For the safety estimation, individual experiences and cases were cited. Existing evidence was considered but individual expertise played a bigger role in decision-making.
Conclusions: Metamizole polarises its users. German family practitioners are uncertain in light of the patchy evidence base. Due to safety concerns about other analgesics, metamizole is viewed in many situations as “the lesser evil”.