Agranulocytosis and complications from the use of the drugs dypirone and clozapine

Agranulocytosis is a type of blood dyscrasia, characterized by low levels of total granulocytes in peripheral blood, which can be caused by several drugs, from over-the-counter drugs, such as dipyrone, to controlled substances, such as clozapine. As it is available and without a medical prescription, self-medication with dipyrone is common in all age groups. Clozapine, on the other hand, is a second-generation antipsychotic used to treat schizophrenia in patient’s refractory to other drugs. The use of any of the drugs is associated with agranulocytosis, a serious and potentially lethal side effect. Therefore, this study aims to discuss the epidemiological data and the mechanisms by which these drugs can induce the occurrence of agranulocytosis. For the preparation of this review, scientific articles were used, written in English and Portuguese, found using the descriptors "agranulocytosis; dipyrone; clozapine" or "agranulocytosis; dipyrone; clozapine", in the Pubmed, Scielo and Google Scholar databases. Studies show that there are reports of cases of agranulocytosis associated with dipyrone, however, in general, with low incidence. Regarding clozapine, this drug remains the first choice in the pharmacological treatment of refractory schizophrenia and, in addition, studies show that the incidence of agranulocytosis caused by clozapine is low and, therefore, the use of this drug is safe if there is strict monitoring of the patient.