How big is the risk of agranulocytosis when taking metamizole?

Question

In some countries, metamizole is completely banned because of the risk of agranulocytosis. In other countries (like mine) it is available as a prescription drug and I hear in other countries it is even available over the counter.

Given that it isn't taken long term (so, say, for less than two weeks at a time), how big is the risk of developing agranulocytosis, and how risky is that condition in those patients (meaning, can it usually be treated or does it lead to long-term complications / death)?

Answer 1

This German report covering 22 years of prescribing and millions of prescriptions identified 161 cases of reported agranulocytosis of which there were 38 deaths, and 30% of the cases developed within 7 days and some even after 1-2 doses.

http://www.ncbi.nlm.nih.gov/pubmed/26169297

Based on this report the risk is minute but detectable, and perhaps one should consider using another drug with potentially less severe side effects.