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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

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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.

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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.