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| | style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Systemic lupus erythematosus | | | style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Systemic lupus erythematosus |
| | style="background: #F5F5F5; padding: 5px 5px;" valign=top | ▸ Arthralgia, myalgias, fever, malaise | | | style="background: #F5F5F5; padding: 5px 5px;" valign=top | ▸ Arthralgia, myalgias, fever, malaise |
| | style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Hydralazine]], [[procainamide]], [[isoniazid]], [[Levonorgestrel and Ethinyl estradiol]]|- | | | style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Hydralazine]], [[procainamide]], [[isoniazid]], [[Levonorgestrel and Ethinyl estradiol]] |
| | |- |
| | style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Vasculitis | | | style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Vasculitis |
| | style="background: #F5F5F5; padding: 5px 5px;" valign=top | ▸ Cutaneous or visceral vasculitis | | | style="background: #F5F5F5; padding: 5px 5px;" valign=top | ▸ Cutaneous or visceral vasculitis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2], Jolanta Marszalek, M.D. [3]
Overview
The types of drugs that can cause drug allergies vary. Drugs containing sulfa are common in causing drug allergy reactions. Other common drugs implicated in leading to an allergic reaction are antibiotics, insulin, and iodinated drugs.
Causes
Common Causes
When a medication causes an allergic reaction, it is called an allergen. The following is a short list of the most common drug allergens
- Antibiotics
- Analgesics
- Anticonvulsives
Causes by Organ System
| Cardiovascular
|
No underlying causes
|
| Chemical / poisoning
|
No underlying causes
|
| Dermatologic
|
No underlying causes
|
| Drug Effect
|
Abciximab, Acetazolamide, Albuterol, Allopurinol, Amifostine, Aminocaproic acid, Amiodarone, Amlodipine, Antihemophilic factor, Anti-inhibitor coagulant complex, Antithrombin III, Aripiprazole, Atenolol, Atorvastatin calcium, Barbiturates, Benazepril, Bendamustine,Benoxaprofen, Betaxolol, Bevacizumab, Bisoprolol, Brentuximab vedotin, Brimonidine, Brinzolamide, Budesonide And Formoterol Fumarate Dihydrate, Bumetanide, Buprenorphine Hydrochloride, Naloxone Hydrochloride, Cabergoline, Captopril, Carbamazepine, Carteolol, Carvedilol, Cefdinir, Celecoxib, Cephalosporins, Cetuximab, Chlorambucil, Chlormezanone, Chlorothiazide, Chlorthalidone, Clindamycin, Codeine, Diclofenac, Diltiazem, Doxycycline Hyclate, Dutasteride, Efavirenz, Emtricitabine, and Tenofovir disoproxil fumarate, Erlotinib, Ethotoin, Etravirine, Exenatide, Fosamprenavir, Gold, Ibandronic acid, Ibritumomab tiuxetan, Interferon beta-1b, Ipilimumab, Insulin, Insulin glulisine, Irbesartan, Isoniazid, Lamotrigine, Leflunomide, Lenalidomide, Levonorgestrel and Ethinyl estradiol, Mesalamine, Methyldopa, Methylphenidate, Moxifloxacin, Nebivolol, Nevirapine, NSAIDs, Penicillamine, Phenacetin, Phenobarbitol, Phenylbutazone, Phenytoin, Primidone, Procainamide, Quinidine, Risedronate, Rosiglitazone, Sorafenib, Streptomycin, Sulfacetamide sodium And Prednisolone acetate, Sulfasalazine, Sulfonamide, Sulfonylurea, Suramin, Terbinafine, Tetracycline, Thiabendazole, Thioacetazone, Vancomycin, Vandetanib, Zonisamide
|
| Ear Nose Throat
|
No underlying causes
|
| Endocrine
|
No underlying causes
|
| Environmental
|
No underlying causes
|
| Gastroenterologic
|
No underlying causes
|
| Genetic
|
No underlying causes
|
| Hematologic
|
No underlying causes
|
| Iatrogenic
|
No underlying causes
|
| Infectious Disease
|
No underlying causes
|
| Musculoskeletal / Ortho
|
No underlying causes
|
| Neurologic
|
No underlying causes
|
| Nutritional / Metabolic
|
No underlying causes
|
| Obstetric/Gynecologic
|
No underlying causes
|
| Oncologic
|
No underlying causes
|
| Opthalmologic
|
No underlying causes
|
| Overdose / Toxicity
|
No underlying causes
|
| Psychiatric
|
No underlying causes
|
| Pulmonary
|
No underlying causes
|
| Renal / Electrolyte
|
No underlying causes
|
| Rheum / Immune / Allergy
|
No underlying causes
|
| Sexual
|
No underlying causes
|
| Trauma
|
No underlying causes
|
| Urologic
|
No underlying causes
|
| Miscellaneous
|
No underlying causes
|
Causes in Alphabetical Order
Causes by Specific Allergic Reactions[1][2]
| Cutaneous reactions
|
Clnical features
|
Implicated medications
|
| Exanthems
|
▸ Delayed-type hypersensitivity
▸ Evolve over days after drug initiation
▸ Diffuse macules and papules
|
Allopurinol, Amlodipine, amphotericin, barbiturates, captopril, carbamazepine, cephalosporins, chloramphenicol, erythromycin, furosemide, gentamicin, gold salts, lithium, nalidixic acid, nitrofurantoin, penicillins, phenothiazines, phenylbutazone, phenytoin, sulfonamides, thiazides
|
| Urticaria/ angioedema
|
▸ Often IgE mediated
▸ Onset within minutes of drug initiation
|
Abatacept, ACE inhibitors, Acyclovir, adalimumab, Albuterol, alendronate, alteplase, aminosalicylic acid, Amlodipine, anticonvulsants, Antihemophilic factor, Anti-inhibitor coagulant complex, Antithrombin III, Aripiprazole, aspirin, atomoxetine, atropine, Benazepril, Budesonide And Formoterol Fumarate Dihydrate, Captopril, Carvedilol, Celecoxib, cephalosporins, darunavir, desvenlafaxine, dextran, Dutasteride, eszopiclone, Exenatide, hydralazine, ipratropium bromide, Levonorgestrel and Ethinyl estradiol, metolazone, monoclonal antibodies, Moxifloxacin, NSAIDs, opioids, penicillins, pentamidine, procainamide, quinine, quinidine sulfate, Risedronate, sitagliptin, sulfonamides, tenofovir, tetracyclines, thiouracil, ticlopidine, tubocurarine, ustekinumab, vancomycin, zolpidem
|
| Fixed drug eruption
|
▸ Hyperpigmented plaques that recur at same skin or mucosal site
|
ACE inhibitors, adalimumab, allopurinol, amlodipine, aspirin, barbiturates, benzodiazepines, carbamazepine, cephalosporins, clindamycin, co-trimoxazole, dextromethorphan, diltiazem, fluconazole, lamotrigine, lansoprazole, metronidazole, NSAIDs, paclitaxel, paracetamol, penicillin, phenolphthalein, omeprazole, quinine, salicylates, sulfonamides, terbinafine, tetracyclines, trimethoprim
|
| Pustules
|
▸ Acute generalized eczematous pustulosis or acneiform rash
|
antibiotics, calcium-channel blockers, corticosteroids, sirolimus
|
| Bullous
|
▸ Flaccid or tense blisters
|
Bendamustine, Captopril, penicillamine, furosemide, Risedronate, vancomycin
|
| Cutaneous lupus erythematosus
|
▸ Erythematous/scaly plaques in photodistribution
|
Hydrochlorothiazide, calcium-channel blockers, ACEIs
|
| Stevens-Johnson syndrome (SJS)
|
▸ Purpuric macules on face and trunk with <10% epidermal detachment, fever, stomatitis, ocular involvement
|
Antibiotics, acyclovir, alendronate, atazanavir, barbiturates, Bendamustine, β-lactam antibiotics, Brinzolamide, carbamazepine, Carvedilol, Celecoxib, chlorpropamide, co-trimoxazole, darunavir, Efavirenz, Emtricitabine, and Tenofovir disoproxil fumarate, escitalopram, gold, H2 antagonists, histamine, lamotrigine, leflunomide, macrolides, metolazone, mefloquine, minoxidil, Moxifloxacin, NSAIDs, olmesartan Medoxomil-Hydrochlorothiazide, phenothiazines, phenytoin, rifampicin, sitagliptin, Sulfacetamide sodium And Prednisolone acetate, sulfonamides, tetracyclines, thiazides, ticlopidine
|
| Toxic epidermal necrolysis (TEN)
|
▸ Similar to SJS but >30% epidermal detachment
|
Acyclovir, alendronate, allopurinol, atazanavir, barbiturates, Bendamustine, Brinzolamide, carbamazepine, Celecoxib, escitalopram, gold, griseofulvin, lamotrigine, leflunomide, metolazone, Moxifloxacin, nitrofurantoin, NSAIDs, olmesartan Medoxomil-Hydrochlorothiazide, penicillins, phenytoin, salicylates, sitagliptin, Sulfacetamide sodium And Prednisolone acetate, sulfonamides, tetracyclines
|
| Organ-specific reactions
|
Clnical features
|
Implicated medications
|
| Pulmonary
|
▸ Pulmonary fibrosis, hypersensitivity pneumonitis
|
Nitrofurantoin, bleomycin, Cabergoline, Cetuximab, methotrexate
|
| Hepatic
|
▸ Hepatitis, cholestasis
|
Para-aminosalicylic acid, Brinzolamide, Sulfacetamide sodium And Prednisolone acetate, sulfonamides, phenothiazines
|
| Renal
|
▸ Interstitial nephritis, membranous glomerulonephritis
|
Penicillin, sulfonamides, gold, penicillamine, allopurinol
|
| Hematologic
|
▸ Hemolytic anemia, thrombocytopenia, granulocytopenia
|
▸ Hemolytic anemia — 5-Azacytidine, Acetophenazine, Aclarubicin, Actinomycin D, Albendazole, Alemtuzumab, Aminopyrine, Amitriptyline, Amodiaquine, Anakinra, Antipyrine, Azathioprine, Bevacizumab, Bortezomib, Captopril, Carbimazole, Caspofungin, Chloramphenicol, Chlorpromazine, Cidofovir, Cilazapril, Clofarabine, Clozapine, Deferiprone, Desipramine, Docetaxel, Dothiepin, Doxorubicin, Eflornithine, Ethosuximide, Ethotoin, Flucytosine, Fludarabine, Ganciclovir, Gemcitabine, Gold salts, Hydroxycarbamide, Hypersplenism, Ibritumomab tiuxetan, Idarubicin, Imatinib mesylate, Interferon alpha, Interferon beta, Irinotecan, Isoniazid, Levomepromazine, Mercaptopurine, Methimazole, Mirtazapine, Mitoxantrone, Nortriptyline, Paclitaxel, Penicillamine, Pentamidine, Pentostatin, Perazine, Phenylbutazone, Phenytoin, Pipothiazine, Procainamide, Propylthiouracil, Pyrimethamine, Quinidine, Remoxipride, Riluzole, Stiripentol, Sulfasalazine, Sulphonamides, Ticlopidine, Topotecan, Trastuzumab, Trimetrexate, Valganciclovir, Zidovudine, Zileuton
▸ Thrombocytopenia — Aldesleukin, Amobarbital, Amrinone, Capreomycin, Carboplatin, Cefotaxime, Cefotetan, Cefoxitin, Ceftizoxime, Chloramphenicol, Chlorpropamide, Cinoxacin, Claforan, Diabinese, Estrogens, Ethanol, Exna, Paraplatin, Phenylbutazone, Procainamide, Proleukin, Secobarbital, Sulfonamides, Thiazides, Tuinal
▸ Granulocytopenia — Aripiprazole, Benzthiazide, Bortezomib, Brinzolamide, Bumetanide, Capecitabine, Captopril, Ceftazidime, Celecoxib, Chlorpropamide, Dapsone, Diabinese, Exna, Fortaz, Penicillin, quinine, salicylate, Sulfacetamide sodium And Prednisolone acetate, sulfonamides
|
| Multiorgan reactions
|
Clnical features
|
Implicated medications
|
| Anaphylaxis
|
▸ Urticaria, angioedema, bronchospasm, gastrointestinal symptoms, hypotension
|
Albuterol, Aminocaproic acid, Antihemophilic factor, Anti-inhibitor coagulant complex, Aripiprazole, β-lactam antibiotics, Betaxolol, Bisoprolol, Bivalirudin, Bortezomib, Buprenorphine Hydrochloride, Naloxone Hydrochloride, monoclonal antibodies, adalimumab, Benazepril, Bendamustine, Captopril, Carteolol, Carvedilol, Celecoxib, epoetin alfa, Exenatide, Ibandronic acid, Insulin glargine, Insulin glulisine, Interferon beta-1b, Levonorgestrel and Ethinyl estradiol, Moxifloxacin, Nebivolol, Olmesartan, protamine, tinzaparin, triamterene, urokinase
|
| Systemic lupus erythematosus
|
▸ Arthralgia, myalgias, fever, malaise
|
Hydralazine, procainamide, isoniazid, Levonorgestrel and Ethinyl estradiol
|
| Vasculitis
|
▸ Cutaneous or visceral vasculitis
|
Allopurinol, aspirin, β-lactam antibiotics, carbamazepine, carbimazole, co-trimoxazole, diltiazem, erythromycin, furosemide, gold, G-CSF, GM-CSF, hydralazine, interferons, methotrexate, minocycline, NSAIDs, penicillamine, propylthiouracil, retinoids, sulfasalazine, sulfonamides, thiazides, thrombolytics,Adalimumab,Amiodarone,Cefdinir,Methyldopa,Amoxapine,Moxifloxacin,Fluticasone,Acyclovir,Allopurinol,Amlodipine,Bortezomib,Captopril,Captopril and Hydrochlorothiazide,Chlorothiazide,Chlorthalidone,Clopidogrel,Delavirdine,Enalapril,maleate,Filgrastim,Fosinopril,Furosemide,Hydrochlorothiazide,,Imatinib,Lisinopril,Lisinopril/Hydrochlorothiazide,Losartan,Lovastatin,Methyclothiazide,Metolazone,Pravastatin,Prazosin,Ramipril,Abatacept,Spironolactone,Spironolactone/Hydrochlorothiazide,Ticlopidine,Valsartan,Colchicine,Quinidine,Quinidine gluconate,Dronedarone,Enoxaparin,Thiazide,Fluticasone/salmeterol,Infliximab,Sitagliptin,Enalaprilat,Fluoxetine,Hydrochloride,Hydroflumethiazide,Polythiazide,Valaciclovir,Simvastatin,Methylphenidate,Dexlansoprazole,Sumatriptan,Bisoprolol,Rituximab,Aggrenox,Dexlansoprazole,Penicillin G,Norfloxacin,Isoniazid,Penicillin G procaine,Famciclovir,Cefuroxime,Rifampin isoniazid,Rifampin,Interferon alfa-2a,Amoxicillin-clavulanate potassium,Interferon alfa-2a,Pegylated interferon alfa-2a,vancomycin,Atovaquone proguanil，Terbinafine，Indinavir，Ciprofloxacin Hydrochloride，Lamivudine zidovudine，Interferon alfa-2b，Gemifloxacin mesylate，Pentamidine Isethionate，Abacavir lamivudine zidovudine，Nitrofurantoin，Zidovudine，Quinine Sulfate，Valproic acid，Divalproex sodium，Niacin/Simvastatin，Ezetimibe/Simvastatin，Felodipine，Fosinopril/Hydrochlorothiazide，Moexipril/Hydrochlorothiazide，Quinapril/Hydrochlorothiazide，Enalapril maleate/Hydrochlorothiazide，Enalapril/Felodipine，Perindopril ，Fluvastatin，Diltiazem,Metoprolol succinate and hydrochlorothiazide,Nebivolol,Amiodarone,Olmesartan Medoxomil-Hydrochlorothiazide,Amlodipine Besylate,Divalproex,Pioglitazone/Glimepiride,Aspirin/Dipyridamole
|
| Serum sickness
|
▸ Urticaria, arthralgia, fever
|
Heterologous antibodies, infliximab,Cefdinir,Bupropion,Levothyroxine, Tetracycline hydrochloride,Antivenom,Glatiramer acetate,Antivenin,,Measles,Ticlopidine,Clopidogrel,Novobiocin,Epinephrine,Omalizumab,Rituximab,Immunosuppressive drug,Digoxin,Levothyroxine,Ciprofloxacin,Cefprozil,Cefaclor,Oxacillin,Amoxicillin,Penicillin G benzathine,Ampicillin,Ceftibuten,Cefpodoxime,Terbinafine,Gemifloxacin,Metronidazole,Cefadroxil,Doxycycline,Levofloxacin,Minocycline,Moxifloxacin,Sulfadiazine,Lincomycin,Sulfamethoxazole
|
| Drug reaction with eosinophilia and systemic symptoms (DRESS)
|
▸ Cutaneous eruption, fever, eosinophilia, hepatic dysfunction, lymphadenopathy
|
Allopurinol, anticonvulsants, atazanavir, minocycline, sulfonamides
|
References