METAMIZOL ARISTO 575 mg CAPSULES

2. What you need to know before taking Metamizol Aristo

Do not take Metamizol Aristo

• If you are allergic to metamizol or any of the other ingredients of this medicine (listed in section 6).
• If you have previously had a significant decrease in a type of white blood cell called granulocytes, which was caused by metamizol or similar medicines called pyrazolones or pyrazolidines.
• If you have bone marrow problems or a disorder that affects the production or function of your blood cells.
• If you have had allergic reactions or hematological reactions (decrease in white blood cells, red blood cells, or platelets in the blood) with medicines containing metamizol or similar compounds.
• If you have had symptoms of asthma, rhinitis, or urticaria (red patches or hives on the skin that can cause itching) during treatment with other painkillers like acetylsalicylic acid, paracetamol, or non-steroidal anti-inflammatory drugs, as you may also be sensitive to metamizol.
• If you have acute intermittent porphyria (a disorder of the metabolism of blood pigments that are part of hemoglobin).
• If you have a genetic deficiency of glucose-6-phosphate dehydrogenase.
• If you are in the last three months of pregnancy.
• If you have had severe skin reactions (such as Stevens-Johnson syndrome or toxic epidermal necrolysis) with previous use of Metamizol Aristo or another medicine that contained metamizol.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Metamizol Aristo.

Low white blood cell count (agranulocytosis).

Metamizol Aristo may cause agranulocytosis, a very low level of a type of white blood cell called granulocytes, which are important for fighting infections (see section 4). You should stop taking metamizol and contact your doctor immediately if you experience any of the following symptoms, as they may indicate possible agranulocytosis: chills, fever, sore throat, and painful sores in the mucous membranes (wet surfaces of the body), especially in the mouth, nose, and throat or in the genital or anal area. Your doctor will perform laboratory tests to check your blood cell count.

If you take metamizol for fever, some symptoms of agranulocytosis may go unnoticed. Similarly, symptoms may be masked if you are taking antibiotics.

Agranulocytosis can occur at any time during treatment with Metamizol Aristo and even shortly after stopping treatment.

You may develop agranulocytosis even if you have used metamizol without problems in the past.

Be particularly careful:

• If you experience general discomfort, infection, persistent fever, sore throat, inflammation in the mouth, nose, or throat, lesions in the mucous membranes of the mouth or genitals, bruising, bleeding, or paleness, you should stop treatment and consult your doctor immediately. These disorders may be due to a decrease in the number of white blood cells in the blood (agranulocytosis), platelets (thrombocytopenia), or a failure in the production of all blood cells (aplastic anemia).
• If you experience dizziness, difficulty breathing, rhinitis, swelling of the face, decreased blood pressure, sudden onset of red patches on the skin, stop treatment and consult your doctor. These symptoms may be due to a severe allergic reaction called anaphylactic shock. This reaction is more likely if you have asthma or allergic disorders (atopy).
• If you have bronchial asthma (especially in the presence of nasal mucosa inflammation and nasal polyps), chronic urticaria, or if you are intolerant to colorants and/or preservatives or alcohol, as the risk of severe allergic reactions is higher.
• If you have low blood pressure or hypovolemia (decreased circulating blood volume or any other body fluid), dehydration, or unstable circulation, as the risk of a sudden drop in blood pressure is higher.
• If a skin rash appears that progresses to blistering or lesions in the mucous membranes, you should stop treatment and consult your doctor, as this may be due to severe skin disorders (Stevens-Johnson syndrome or toxic epidermal necrolysis). In these cases, you should not receive medicines containing metamizol again.
• If you have impaired liver or kidney function, as you may have difficulty eliminating the medicine.
• If you are an elderly patient, be especially alert to the appearance of any of the disorders described above, as they may occur more frequently.

Liver problems

Inflammation of the liver has been reported in patients taking metamizol with symptoms developing within a few days to a few months after starting treatment.

Stop using Metamizol Aristo and contact your doctor if you experience symptoms of liver problems, such as discomfort (nausea or vomiting), fever, feeling tired, loss of appetite, dark urine, pale stools, yellowing of the skin or the white part of the eyes, itching, rash, or upper abdominal pain. Your doctor will check your liver function.

You should not take Metamizol Aristo if you have previously taken a medicine containing metamizol and had liver problems.

Severe skin reactions

Severe skin reactions, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported in association with treatment with metamizol. Stop taking metamizol and seek medical attention immediately if you experience any of the symptoms related to these severe skin reactions described in section 4.

If you have ever had severe skin reactions, you should not restart treatment with Metamizol Aristo at any time (see section 4).

Other medicines and Metamizol Aristo

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines.

• If administered together with cyclosporin (a medicine that prevents transplant rejection), it may reduce cyclosporin blood levels and therefore these should be measured regularly.
• If administered with chlorpromazine (a medicine for the treatment of psychosis), it may cause a drop in body temperature.
• If administered together with methotrexate or other medicines for the treatment of tumors (antineoplastics), it may increase the toxic effects of antineoplastics on the blood, especially in elderly patients.
• If administered together with acetylsalicylic acid, it may reduce the effect of acetylsalicylic acid on platelet aggregation (antiplatelet) and therefore should be used with caution in patients taking it to protect the heart (cardioprotector).
• If administered together with bupropion, a medicine used to treat depression and/or help quit smoking, it may reduce bupropion blood levels, and therefore should be used with caution.
• Efavirenz, a medicine used to treat HIV/AIDS.
• Methadone, a medicine used to treat opioid dependence.
• Valproate, a medicine used to prevent organ rejection in transplant patients.
• Sertraline, a medicine used to treat depression.

Metamizol may modify the effect of antihypertensives (medicines that lower blood pressure) and diuretics (medicines that increase fluid elimination).

Taking Metamizol Aristo with food, drinks, and alcohol

Together with alcohol, the effects of both can be enhanced.

Pregnancy, breastfeeding, and fertility

Pregnancy

Consult your doctor or pharmacist before using this medicine.

Available data on the use of metamizol during the first three months of pregnancy are limited, but they do not indicate harmful effects on the embryo. In selected cases, when there are no other treatment options, single doses of metamizol during the first and second trimester may be acceptable after consulting your doctor or pharmacist and carefully evaluating the benefits and risks of using metamizol. However, in general, the use of metamizol is not recommended during the first and second trimester.

During the last three months of pregnancy, you should not take Metamizol Aristo due to the increased risk of complications for the mother and the baby (bleeding, premature closure of a blood vessel important for the fetus, called the ductus arteriosus, which closes naturally after birth).

Breastfeeding

Consult your doctor or pharmacist before using this medicine.

Metamizol degradation products are excreted in breast milk in significant amounts, and it cannot be excluded that there is a risk for the breastfed infant. Therefore, repeated use of metamizol should be avoided during breastfeeding. If a single dose of metamizol is administered, mothers are recommended to express and discard breast milk for 48 hours after administration.

Driving and using machines

Although no adverse effects on concentration and reaction are expected, at higher doses within the recommended range, it should be taken into account that these abilities may be affected, and you should avoid using machines, driving vehicles, or engaging in other hazardous activities.

3. How to take Metamizol Aristo

Follow your doctor's instructions for taking this medicine exactly. If you are unsure, consult your doctor or pharmacist again.

This medicine is for short-term use. Your doctor will indicate the duration of your treatment.

This medicine should be taken orally.

The dose is determined based on the intensity of the pain or fever and the individual's sensitivity to treatment with Metamizol Aristo. The lowest necessary dose should always be selected to control pain and fever. Your doctor will indicate how to take Metamizol Aristo.

Adults and adolescents 15 years of age or older

Adults and adolescents 15 years of age or older (weighing more than 53 kg) can take 1 capsule (575 mg of metamizol) as a single dose, which can be administered up to 6 times a day, at 4- to 6-hour intervals. The maximum daily dose is 3450 mg (corresponding to 6 capsules).

The effect of the medicine usually appears between 30 and 60 minutes after oral administration.

Metamizol Aristo should not be used in children under 15 years of age. Other presentations and doses of this medicine are available for younger children; consult your doctor or pharmacist.

Elderly patients and patients with poor general health/renal impairment

The dose should be reduced in elderly patients, debilitated patients, and those with decreased renal function, as the elimination of metamizol degradation products may be delayed.

Patient with renal or hepatic impairment:

Since the elimination rate decreases in cases of renal or hepatic impairment, repeated administration of high doses should be avoided. Only in short-term treatments is a dose reduction not necessary. There is no experience with long-term treatments.

If the pain persists or worsens, you should consult a doctor to investigate the cause of the symptoms.

If you take more Metamizol Aristo than you should

Nausea, vomiting, abdominal pain, deterioration of kidney function, and in rarer cases dizziness, drowsiness, coma, convulsions, decreased blood pressure, or even shock and increased heart rate (tachycardia) may occur.

After administration of very high doses of metamizol, a red coloration of the urine may occur, which disappears when treatment is stopped.

If you have taken more of the medicine than you should, consult your doctor or pharmacist, or the Toxicology Information Service, phone: 91 562 04 20.

Information for the doctor

No specific antidote is known. After overdose by oral administration, gastric lavage and forced vomiting may be performed. Forcing diuresis or dialysis may be considered, as metamizol is dialyzable.

In case of severe allergic reactions, other emergency measures such as placing the patient on their side, keeping the airways clear, or administering oxygen should be applied. Pharmacological emergency measures include the administration of adrenaline, fluid therapy, and glucocorticoids.

Careful monitoring of vital functions and taking general necessary measures is advised.

If you forget to take Metamizol Aristo

Do not take a double dose to make up for forgotten doses.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

The mildest allergic reactions (e.g. skin and mucous reactions such as itching, burning, redness, swelling as well as difficulty breathing and gastrointestinal discomfort can progress to severe forms e.g. generalized urticaria, swelling of feet, hands, lips, throat, and respiratory tract (angioedema), severe bronchospasm (narrowing of the bronchial walls), heart disorders, and decreased blood pressure (sometimes preceded by an increase in blood pressure).

Stop using Metamizol Aristo and contact a doctor immediately if you experience any of the following symptoms:

Feeling of illness (nausea or vomiting), fever, feeling of tiredness, loss of appetite, dark urine, light-colored stools, yellowish discoloration of the skin or the white part of the eyes, itching, rash, or pain in the upper abdominal area. These symptoms may be signs of liver damage. See also section 2 Warnings and Precautions.

Other adverse effects that may occur with the following frequencies are:

Frequent (may affect up to 1 in 10 people):

• hypotension (decrease in blood pressure).

Uncommon (may affect up to 1 in 100 people):

• skin eruptions and reactions.

Rare (may affect up to 1 in 1,000 people):

• allergic reactions that usually occur during or immediately after administration but also hours later.
• skin eruptions and appearance of hives.
• decrease in the number of white blood cells in the blood (leukopenia)
• asthma

Very Rare (may affect up to 1 in 10,000 people):

• skin reactions in which blisters or bubbles appear (toxic epidermal necrolysis, Stevens-Johnson syndrome),
• kidney problems with decreased or suppressed urine output
• increase in the amount of protein excreted in the urine
• inflammation of the kidney (interstitial nephritis)
• severe decrease in white blood cells (agranulocytosis) that can cause death due to severe infections
• decrease in the number of platelets in the blood (thrombocytopenia), in this case, inflammatory lesions in the mucous membranes, sore throat, and fever may occur.
• shock (drastic drop in blood pressure).

Frequency not known (cannot be estimated from the available data):

• sepsis (severe infection that involves an inflammatory reaction of the entire body and can cause death),
• aplastic anemia (failure in the production of bone marrow and blood cells),
• pancytopenia (low number of red, white, and platelet cells simultaneously),
• anaphylactic shock (severe allergic reaction that can cause death)
• Kounis syndrome (a type of cardiac disorder),
• gastrointestinal bleeding
• chromaturia (abnormal urine color).
• Inflammation of the liver, yellowish discoloration of the skin and the white part of the eyes, increase in blood levels of liver enzymes.
• Severe skin reactions

Stop taking metamizol and seek medical attention immediately if you observe any of the following serious adverse effects:

• Red patches that are not raised, or circular or target-shaped patches on the chest, often with central blisters, skin peeling, ulcers in the mouth, throat, nose, genitals, and eyes. These severe skin erythemas may be preceded by fever and flu-like symptoms (Stevens-Johnson syndrome, toxic epidermal necrolysis).
• Generalized erythema, elevated body temperature, and enlarged lymph nodes (DRESS or drug hypersensitivity syndrome).

Reporting of Adverse Effects

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that is not listed in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Conservation of Metamizol Aristo

Keep this medicine out of the sight and reach of children.

No special storage conditions are required.

Do not use this medicine after the expiration date that appears on the packaging. The expiration date is the last day of the month indicated.

Medicines should not be thrown away through the sewage system or in the trash. Deposit the packaging and medicines you no longer need at the SIGRE point in the pharmacy. Ask your pharmacist how to dispose of medicines you no longer need. This way, you will help protect the environment.

6. Package Contents and Additional Information

Composition of Metamizol Aristo

• The active ingredient is magnesium metamizole. Each capsule contains 575 mg of magnesium metamizole.
• The other components (excipients) are: magnesium stearate. The components of the capsule are: indigotine (E 132), erythrosine (E 127), titanium dioxide (E 171), and gelatin

Appearance of the Product and Package Contents

Metamizol Aristo capsules are hard capsules of a garnet color and the powder they contain is white.

The packages contain 10 or 20 capsules.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Aristo Pharma Iberia, S.L.

C/ Solana, 26

28850 Torrejón de Ardoz (Madrid)

Spain

Manufacturer

Laboratorios Medicamentos Internacionales, S.A. (Medinsa)

C/ Solana, 26

28850 – Torrejón de Ardoz (Madrid)

Spain

Date of the Last Revision of this Prospectus:August 2025

Detailed information about this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) https://www.aemps.gob.es/.