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DDI of the Month Podcast

Episode 8: Metamizole Meets Quetiapine: A Metabolic Interaction

02 Jul 2025

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 DDI of the Month returns with Episode 8! Tune in as we explore new data on the metamizole-quetiapine interaction and its clinical impact.In this episode of DDI of the Month, we’re excited to welcome two distinguished quests from Germany: Dr. Arnim Gaebler and Dr. Michael Paulzen. Together, we dive into their recent published paper in the British Journal of Clinical Pharmacology, titled: “Discovering interactions in polypharmacy: Impact of metamizole on the metabolism of quetiapine”Metamizole, a widely used analgesic in several European countries, has long been considered safe in acute care. However, with an increasing number of indications for chronic use being explored, managing potential drug interactions is becoming more important. Despite being on the market for decades, little is known about metamizole’s interaction potential.New evidence suggests that metamizole may substantially reduce plasma concentrations of quetiapine – an antipsychotic frequently prescribed in psychiatric and geriatric populations – by more than 50%. The likely mechanism? Induction of CYP3A4, the key enzyme responsible for quetiapine metabolism.Tune in to hear:•The motivation behind the study•Surprising finding from the KONBEST database analysis•Why metamizole may be a stronger enzyme inducer than previously though•The implications for therapeutic drug monitoring (TDM)•How these finding could influence prescribing practices in psychiatryDon’t miss this insightful conversation – listen now!

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