salicylates and Anemia--Aplastic

The risks of agranulocytosis and aplastic anemia in relation to analgesic drug use were evaluated in a population-based case-control study conducted in Europe and Israel. Analgesic use in the week before the onset of illness was compared between 221 cases of agranulocytosis and 1425 hospital controls. Analgesics significantly associated with agranulocytosis were dipyrone (metamizol sodium), indomethacin, and butazones (phenylbutazone and oxyphenbutazone). For dipyrone, the rate ratio estimate was 23.7 in Ulm, West Germany, West Berlin, and Barcelona, Spain, and the estimated excess risk for any exposure in a one-week period was 1.1 per million. In Israel and Budapest, Hungary, where the rate ratio estimate was 0.8, there was no evidence of excess risk. In all of the regions combined, the rate ratio estimates were 8.9 for indomethacin and 3.8 for butazones, with excess risk estimates of 0.6 and 0.2 per million, respectively. Analgesic use 29 to 180 days before admission was compared between 113 cases of aplastic anemia and 1724 controls. Indomethacin (rate ratio estimate, 12.7), diclofenac sodium (8.8), and butazones (8.7) were significantly associated with aplastic anemia, with estimated excess risks for any exposure in a five-month period of 10.1, 6.8, and 6.6 per million, respectively.

Topics: Acetaminophen; Adult; Aged; Agranulocytosis; Aminopyrine; Analgesics; Anemia, Aplastic; Antipyrine; Dipyrone; Europe; Humans; Israel; Middle Aged; Phenylbutazone; Risk; Salicylates

Side effects of non-steroidal antirheumatic drugs (NSAD) may occur in any organ system, since the prostaglandins, the synthesis of which is inhibited by NSAD, play a role in numerous adverse cellular processes throughout the body. Besides these physiologic regulations there are adverse effects of NSAD, such as bone marrow aplasia, of unexplained etiology. The interactions of NSAD are of clinical relevance in drug types such as the salicylates, pyrazolons and fenamic acids (e.g. interactions with cumarin derivatives). The clinically relevant interactions of NSAD are discussed in detail.

Topics: Anemia, Aplastic; Anti-Inflammatory Agents, Non-Steroidal; Coumarins; Drug Interactions; Gastrointestinal Diseases; Humans; Indomethacin; Naproxen; ortho-Aminobenzoates; Phenylbutazone; Prostaglandins; Rheumatic Diseases; Salicylates; Stomach Ulcer

Topics: Anemia, Aplastic; Animals; Drug Synergism; Female; Hematopoiesis; Humans; Leukocyte Count; Leukopenia; Methotrexate; Mice; Retrospective Studies; Salicylates

Topics: Adolescent; Agranulocytosis; Anemia; Anemia, Aplastic; Anti-Bacterial Agents; Bone Marrow; Bone Marrow Diseases; Codeine; Depression; Dextropropoxyphene; Drug Hypersensitivity; Drug Therapy; Hydroxychloroquine; Lupus Erythematosus, Systemic; Methenamine; Prednisolone; Salicylates; Sulfonamides; Toxicology

Topics: Adrenal Cortex Hormones; Anemia; Anemia, Aplastic; Anticoagulants; Antipyrine; Blood Group Incompatibility; Chemical and Drug Induced Liver Injury; Chloramphenicol; Drug Eruptions; Drug Hypersensitivity; Drug Therapy; Hepatitis; Neurologic Manifestations; Penicillins; Phenylbutazone; Radiation Injuries; Salicylates; Shock; Streptomycin; Sulfanilamide; Sulfanilamides; Sulfonamides; Testosterone; Thiamine; Toxicology; Vaccines