What is nolotil?
Nolotil capsule is a synthetic pharmaceutical product used primarily to treat pain, as its chemical composition has a great analgesic effect.
It also has antipyretic effects, that is, it reduces febrile states, and supervised doses, reduces muscle spasms and pain associated with them.
It was not developed to treat inflammatory processes, however, at higher doses than those recommended therapeutically for pain, it has shown effectiveness in reducing inflammation, but at these high doses, it can present a high toxicity.
As an analgesic, this drug is more powerful than others such as paracetamol or ibuprofen. Nolotil belongs to the group of drugs defined as “other analgesics and antipyretics”.
Throughout the world its acquisition and purchase was free, that is, no medical prescription was required for its administration. In the 70s this changed, when it wasdiscoveredthat some patients suffered side effects that can lead to death.
Composition of nolotil
The active substance of this brand of medicine is magnesium metamizole, which belongs to the pyrazolone family (a group of medicines that are mainly used for the treatment of pain and fever, including metamizole).
The prototype of this drug is known as pyramidon. The rest of the components of nolotil are: magnesium stearate, indigotine, erythrosine, titanium dioxide and gelatin.
The person responsible for the synthesis of metamizole was the German company Hoechst AGin 1920 when it was synthesized for the first time. This company was later absorbed bySanofi .
Mass production began in 1922, and it was first introduced to the German market under the name of Novalgin.
Presentations and dose of nolotil
Metamizol is available in a wide variety of presentations, the most common being in the form of a hard capsule to be administered orally. It can also be found in the form of an ampoule or in a parenteral injectable presentation.
Nolotil caps are available in packs containing 10, 20, or 500 hard capsules. Each capsule contains 575 mg of metamizole magnesium.
On the other hand, the recommended dose of nolotil according to the drug’s data sheet , published by the Spanish Agency for Medicines and Health Products , is 6 capsules of 575 mg every four hours, in patients over 15 years of age.
After oral administration, it is converted in the stomach to its main metabolite, which is 4-methylaminoantipyrine. This metabolite is easily and almost completely absorbed.
What is nolotil used for?
Nolotil is indicated primarily to treat pain and fever, but under previously studied circumstances, it can be used in higher doses for inflammatory cases. Here we give you in detail its use:
Acute, moderate or severe pain
Nolotil is indicated to treat moderate or intense acute pain resulting from musculoskeletal or neuropathic disorders, which are pain caused after surgical interventions or after having suffered post-traumatic injuries.
Cancer Pain
They are related to patients with oncological pathologies, either due to the progression of the disease itself or due to treatment and associated diseases.
In cases of mild to moderate cancer pain, according to a documentPublished by a well-known website specializing in medical guidance, nolotil is indicated as an adjuvant in these cases.
High fever
In those cases where other medications are not effective in reducing fever, nolotil is used.
Visceral pain
It is also used in the treatment of colic-type pain in the smooth muscles of the viscera.
Contraindications of nolotil
Medications are made to treat specific pathologies. Its components can alter the chemistry of the organism, causing imbalance in its physiology and biology. Before using nolotil, you should know under what conditions you should not take it:
Hypersensitivity to metamizole medicinal products
Some people are sensitive to certain chemical components, which may come from nature itself or are synthesized in laboratories.
In the case of metamizole, it is a synthetic chemical compound and its use can cause certain undesirable reactions in the body such as allergies, general discomfort, among others.
If you notice any unusual reaction after starting treatment with metamizole, you may be hypersensitive to this compound. Consult your doctor immediately.
Intolerance to painkillers
If you have experienced undesirable effects while taking other pain relievers such as acetylsalicylic acid, acetaminophen or non-steroidal anti-inflammatory drugs, you may also have a sensitivity to metamizole (active substance of nolotil).
Acute intermittent hepatic porphyria
Acute intermittent hepatic porphyria is characterized by crises of abdominal pain, psychiatric disturbances, and neurological involvement. If you have been diagnosed with this pathology, avoid the use of medications that have metamizole as a component, including nolotil.
Genetic glucose deficiency
Also, if you have been diagnosed with glucose phosphate dehydrogenase, a disorder in which red blood cells break down when the body is exposed to certain drugs or the stress of infection, avoid using medications that contain metamizole, including nolotil.
Bone marrow disorders
If you have suffered from pathologies in the bone marrow, during or after receiving antitumor (antineoplastic) chemotherapy or if you have had diseases related to the formation of blood cells, the use of metamizole is contraindicated.
Previous allergic or hematological reactions
If you have previously suffered from allergic or hematological reactions (changes in blood values), during the administration of medicines containing metamizole, do not consume it.
Asthma, rhinitis urticaria
If your medical history includes asthma, rhinitis or urticaria during treatment with other analgesics such as acetylsalicylic acid, acetaminophen or non-steroidal anti-inflammatory drugs, do not take this medicine, as in these cases you may also be sensitive to metamizole.
Last 3 months of pregnancy
There are insufficient data on its use during pregnancy, but metamizole is known to cross the placenta and in the absence of sufficient human experience, its use during the first trimester is not recommended.
During the second trimester, it should only be used if the expected benefits clearly outweigh the risks. Although metamizole is only a weak inhibitor of prostaglandin synthesis, the possibility of associated pathologies cannot be excluded. Therefore, it is contraindicated during the third trimester of pregnancy.
Nolotil Side Effects
All medications have the possibility of producing undesirable side reactions and it depends on the main component and the sensitivity of the patient. Below we mention the most common after the consumption of metamizole:
Allergic reactions
With the use of nolotil, allergic reactions can occur from the skin and mucous membranes such as: itching, burning, redness, swelling.
It can also cause difficulty breathing and gastrointestinal discomfort such as: generalized hives, swelling of the feet, hands, lips, throat and respiratory tract, and severe bronchospasm.
Heart rhythm disturbances and decreased blood pressure may also manifest and in some cases, preceded by an increase in blood pressure.
Hypotension
According to the statistics presented in the the of nolotil, published by theSpanish Agency for Medicines and Health Products, it can occur with a frequency that can affect 1 in 10 people who consume nolotil.
Leukopenia
The use of nolotil can cause, due to the prescribed dose and the sensitivity of the patient, a reduction in the production of white blood cells.
Gastrointestinal disorders
With an overall incidence of less than 6%, the known allergic reactions that occurred in patients who were treated with metamizole were nausea, dry mouth, and vomiting. Gastric erosions were observed with 3 g daily of metamizole, this dose being able to mark the limit of gastric tolerance in chronic use.
This is how it is described in “Part IB1. Technical Sheet”, published by the Spanish Agency for Medicines and Health Products , in July 2019.
Respiratory conditions
There are groups of patients identified, who may suffer possible severe anaphylactoid reactions with the use of metamizole and whose symptoms may be due to a severe allergic reaction called anaphylactic shock.
This reaction is more likely if you suffer from bronchial asthma or allergic-type disorders.
Cardiac arrhythmia
If you take more nolotil than the dose recommended by your doctor, you may sometimes experience increased heart rate (tachycardia).
Renal problems
If you suffer from renal or hepatic insufficiency, then the rate of elimination of toxins decreases and metabolites decrease, including those of metamizole, then you should avoid the administration of high doses of nolotil.
Agranulocytosis
Another side effect of taking nolotil is agranulocytosis or neutropenia (the patient stops producing neutrophils), a serious condition that occurs when there is a very low number of granulocytes (a type of white blood cell) in the blood. It is the most serious side effect of metamizole.
In this sense, the Spanish Agency for Medicines and Health Products has made a series of recommendations to avoid this pathology derived from the use of nolotil.
Sepsis
With the reduction in neutrophils caused by the use of nolotil, the immune system is exposed to bacteria and viruses, which in extreme cases can cause sepsis in the body.
A degree thesis entitled “Is Metamizole a safe medicine? “ , gives an account of the toxicity in certain cases of nolotil on the production of neutrophils in the bone marrow.
Both agranulocytosis and sepsis have been the cause of the restriction on the sale of this medication through prescriptions and its sale has been prohibited in others, such as in Europe and the United Kingdom, and despite this, nolotil has a great marketing worldwide.

University Professional in the area of Human Resources, Postgraduate in Occupational Health and Hygiene of the Work Environment, 14 years of experience in the area of health. Interested in topics of Psychology, Occupational Health, and General Medicine.