Pharmacokinetics of metamizole (dipyrone) as an add-on in calves undergoing umbilical surgery

PLoS One. 2022 Mar 15;17(3):e0265305. doi: 10.1371/journal.pone.0265305. eCollection 2022.

Abstract

This preliminary clinical investigation of the pharmacokinetic behavior of the main metamizole (dipyrone) metabolites 4-methylaminoantipyrine (4-MAA) and 4-aminoantipyrine (4-AA) in calves undergoing umbilical surgery is part of an already published main study. A single intravenous dose of metamizole was added to ketamine/xylazine/isoflurane anesthesia. Eight Simmental calves weighing 90 ± 10.8 kg and aged 47.6 ± 10.4 days received 40 mg/kg metamizole intravenously 10 minutes prior to general anesthesia. Blood samples were collected over 24 hours and analyzed for 4-MAA and 4-AA. Meloxicam was additionally given twice: 2.5 hours pre- and 20.5 hours postsurgically. The pharmacokinetic profile of 4-MAA was best fitted to a two-compartment model and was characterized by a fast distribution half-life and slow elimination half-life (t½alpha = 5.29 minutes, t½beta = 9.49 hours). The maximum concentration (Cmax 101.63 μg/mL) was detected at the first measurement time point 15 minutes after administration. In contrast, 4-AA showed fast, high and biphasic plasma peak concentration behavior in five calves (2.54-2.66 μg/mL after 15-30 minutes, and 2.10-2.14 μg/mL after 2-3.5 hours) with a t½beta of 8.87 hours, indicating a rapid distribution and subsequent redistribution from well-perfused organs. Alternatively, three calves exhibited a slower and lower monophasic plasma peak concentration (1.66 μg/mL after 6.5 hours) with a t½beta of 6.23 hours, indicating slow accumulation in the intravascular compartment. The maximum concentration and area under the plasma concentration curve (AUC) of 4-AA were lower than those of 4-MAA. This metabolic behavior supports our already published data on clinical monitoring and plasma cortisol concentrations (PCCs). Compared to those of saline controls, lower PCCs correspond to the t½alpha of 4-MAA. Data on Tmax and t½beta also match these clinical observations. However, further studies are required to assess the exact analgesic mechanism and potency of the metamizole metabolites in calves.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ampyrone
  • Analgesics
  • Animals
  • Cattle
  • Dipyrone*
  • Ketamine*
  • Xylazine

Substances

  • Analgesics
  • Ampyrone
  • Xylazine
  • Dipyrone
  • Ketamine

Grants and funding

Magdalena Behrendt-Wippermann got a grant from the H. Wilhelm Schaumann Stiftung Germany (https://www.schaumann-stiftung.de/de/forderung-1764.htm). The study was additionally supported by Richter Pharma AG, Austria (https://www.richter-pharma.at/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.