It’s been banned in Britain for decades over safety fears.
Even in countries where metamizole is still available, most only dish it out under a prescription because of its potential side effects.
Yet outraged campaigners say that rules designed to keep patients safe in nations where metamizole is available are being flouted, with concerns Brits still able to pick up the painkiller over-the-counter for as little as €4 in Spain.
A spotlight was shone onto the dangers of the little-known drug this week following the death of a British expat living in Spain.
Mark Brooks, originally from Derbyshire, was playing golf in October near his home in Alicante when he began to suffer from shoulder pain.
Mark Brooks, a father-of-one from Derbyshire, is thought to be the latest victim of the drug
The passing of Mr Brooks is the latest in a series of deaths linked to the drug in Spain. Nolotil is banned in more than 30 countries, including Britain
The father-of-one, 42, went to his local health clinic where, it is believed, he was given Nolotil, the branded version of the drug.
Four days later the gardener was dead, with him thought to be the latest victim of the drug.
Mark’s death is one of 40 British fatalities in Spain that campaigners have linked to taking metamizole.
Others include those of husband and wife Gloria and Alan Robson, both in their 80s, with their son blaming their deaths on the Nolotil they were prescribed on holiday in 2017.
A year later, Lorna Vincent, 75, a British expat living in Spain, died after being given the painkiller following an operation in hospital, with her family believing the two are related.
Another British holidaymaker William Smith, 66, also passed away in February 2016 in Torrevieja after developing sepsis in what is believed to a consequence of taking a five-day course of Nolotil.
However, as yet, there is no concrete proof the drug is to blame for many of the reported deaths but families suspect a link.
Most Brits have never even heard of metamizole given it has been banned in the UK since safety concerns emerged internationally in the 60-70s.
But it is the go-to painkiller for medics in countries such as Spain, with many doctors working by the phrase ‘Nolotil if pain’.
In theory, metamizole, which can be supplied as tablets or an injection, is a prescription only drug in Spain, meaning it should only be doled out after consultation with a doctor.
But there are reports from on the ground that this isn’t enforced.
Spanish medics have also been told by the country’s regulators to avoid prescribing the drug to British tourists since 2018.
This guidance emerged after an unpublished study found Brits have ’80 to 120 times higher’ chance of suffering agranulocytosis compared to Spanish patients.
The rare side effect occurs when levels of white blood cells, critical to helping the body avoid and fight off dangerous infections, collapse. This can lead to potentially deadly sepsis and organ failure.
The family of Gloria and Alan Robson claim they died after taking Nolotil in Spain
Lorna Vincent, left, with her daughter Kim Glasby. Lorna died in April 2018 of multi-organ failure after being given metamizole following an operation in Spain
Even survivors can suffer lifelong injuries from the complications, including needing amputations.
However, rigorous scientific analysis of this very issue has yet to be conducted and experts say further work is necessary to confirm the findings.
Estimates on the risk of developing agranulocytosis from taking metamizole vary but previous studies have calculated it at about 0.6-0.7 per cent, or seven in every 1,000 patients.
There is also a rare risk of an having an allergic reaction to metamizole similar to other medications.
Campaign groups, like the Association for Drug Affected People (ADAF) have urged for greater awareness of the dangers of Nolotil for tourists in Spain.
The group’s president, Cristina Garcia del Campo, told MailOnline: ‘Something is going to have to be done or people will keep dying.’
Del Campo claims the recommendation to stop health facilities handing out the drugs to Brits in 2018 hasn’t worked and they are often given it unaware of their potential increased risk.
The campaigner has now brought a criminal complaint of negligence to Spain’s public prosecutor, saying it is a question of ‘human rights’.
She claims that in many instances Nolotil is left off patient’s health records due to how commonly doctors use it.
ADAF’s criminal filing asks: ‘What is happening in Spain when in countries such as the United Kingdom, the United States and Ireland, to give just three examples out of more than 40, the product is banned because it is highly dangerous?’
The filing reports the ‘crime of serious negligence affecting public administration officials,’ claiming ‘the negligent actions of these officials are currently causing damage and even deaths’.
It states that the ‘people in charge of patient safety… are not responsibly doing their job’.
The document also calls on Spanish health officials to ‘urgently initiate a thorough investigation into the matter’.
Del Campo has vowed not to give up in her fight to protect people from the potentially deadly effects of the drug and said: ‘More and more people are going to die unless something is done immediately.’
Brits in search of the Spanish-sun aren’t alone in the risk of being given metamizole on a European holiday.
The painkiller is available in a host of other favourite European holiday hotspots including Portugal, Italy, Belgium and Germany.
Metamizole is also frequently sold, sometimes over the counter, in the developing world, particularly in Mexico and South America.
The UK isn’t alone in banning the drug, with 40 other countries, including the US, Canada and Australia, also barring medics from supplying it over safety fears.
A spokesperson for Boehringer Ingelheim, the manufacturer that makes Nolotil, said in a statement: ‘We take patient safety and public health seriously and closely cooperate with the regulators on product safety-related topics.
‘We are of the opinion that current approved prescribing information adequately addresses current knowledge about identified risks.’
