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Drug-induced urticaria
Eunice K H Tan1, Clive E H Grattan
1Department of Dermatology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk, NR4 7UY, UK. eunicetan@doctors.org.uk
Expert Opinion on Drug Safety
|September 1, 2004
Summary
Drug-induced urticaria and angio-oedema are linked to various medications, including NSAIDs and antibiotics. Further research is needed to establish the safety of certain drug classes in susceptible patients.
Area of Science:
- Dermatology
- Pharmacology
- Allergy and Immunology
Background:
- Urticaria presents as transient skin swelling, while angio-oedema involves deeper tissues.
- Drug-induced urticaria is a known adverse reaction to numerous medications and vaccines.
- Non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics are frequently implicated, though robust data is limited.
Purpose of the Study:
- To review the range of drugs associated with drug-induced urticaria and angio-oedema.
- To highlight emerging evidence regarding medication safety in specific patient populations.
- To identify gaps in current knowledge regarding drug-induced hypersensitivity reactions.
Main Methods:
- Analysis of spontaneous adverse event reports to the UK Committee on Safety of Medicines over 40 years.
- Review of existing literature on drug-induced urticaria and angio-oedema.
- Examination of new evidence concerning selective COX-2 inhibitors and angiotensin II receptor antagonists.
Main Results:
- Commonly implicated drugs include NSAIDs, antibiotics, bupropion, SSRIs, ACE inhibitors, antihistamines, and antifungals.
- Selective COX-2 inhibitors may be a safer alternative for patients with aspirin-sensitive urticaria.
- The safety profile of angiotensin II receptor antagonists in ACE inhibitor-induced angio-oedema remains undetermined.
Conclusions:
- A broad spectrum of medications can trigger urticaria and angio-oedema.
- Careful consideration of drug history is crucial in managing these conditions.
- Further controlled studies are necessary to clarify the safety of specific drug classes, particularly in patients with pre-existing hypersensitivity.