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From: (Steve Harris
Subject: Re: What is phenazone (antipyrine) ?
Date: 5 Oct 2003 20:34:57 -0700
Message-ID: <> (John Paul Osborne) wrote in message

> Hi.
> My girlfriend is Norwegian and she gets the occasional headache.  She
> prefers to use an OTC pain reliever that she gets in Norway.  Its
> brand name is Fanalgin (made by NycoMed Pharma) and it contians
> phenazone (which I've learned is also known as antipyrine).
> My questions are:
> -What is phenazone/antipyrine?  Is there an OTC equivalent in the USA?
>  I don't think there is.
> -If there isn't a US equivalent ... why isn't there?  Are there any
> dangers?  Norwegian drug stores are REALLY strict (for example, NyQuil
> and other cold-relief drugs are not sold in Norway at all), so I'd be
> surprised if it were a "dangerous" OTC drug.
> Thanks experts!

This is an old fever/pain drug which is chemically a pyrazolone. Not
really like anything else I know of. There is no strict US equivalent
as the drug was long ago taken off the market here because it
occasionally caused agranulocytosis (no white cells in the blood).
With acetominophen and NSAIDS available as alternatives to treat fever
and pain probably more safely, out went phenazone/antipyrine.  That's
the official story, anyway. In truth, it's a drug that has been
generic for a century at least, so it really had no big pharma
defenders. Drugs are victims of witchhunts too, if they have no big
money defense.

There's still some phenazone in USP otic drops for ear aches, when it
functions as a local antiinflammatory (along with benzocaine as a
local anasthetic), but since that's essentially a topical use with
less absorption, it's allowed.

Steve Harris

From: (Steve Harris
Subject: Re: What is phenazone (antipyrine) ?
Date: 6 Oct 2003 18:53:08 -0700
Message-ID: <> (Beverly Erlebacher) wrote in message

> Look, there's no point in even a generic drug manufacturer re-introducing
> something like phenazone.  It's known to "occasionally" cause a serious
> condition, agranulocytosis.  It belongs to a group of compounds that are
> known to cause cancer and birth defects.  It has no benefits over equally
> effective drugs that don't have these problems.

Er, yes, but those problems wouldn't include APAP and most NSAIDS,
which are all reported to occasionally cause agranulocytosis.
Including naproxen and ibuprofen. It all comes down to how often this
happens. I can't come up with any numbers for any of these drugs. I
don't think it's known. Which leads us back to my original comment. I
don't think anybody really knows if phenazone is safer than our
standard OTC NSAIDS or not.  And with no money available to find out,
we're not ever going to find out. Is there then any rational reason
why this drug is not in the USP, but NSAIDS are?  Considering the 10's
of thousands of deaths that OTC NSAIDS cause each and every year? I
think not. We jolly well KNOW OTC NSAIDS kill people. GI bleeding does
most of it, but you're just as dead of die from a GI bleed as if you
die from an infection.


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