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Angioedema caused by bupropion treatment.

R Bhella¹, J Southgate

¹BM BSc FRCP (Corresponding author) Consultant Acute Physician Norfolk and Norwich University Foundation Trust Colney Lan, Norwich, NR4 7UY.

|May 21, 2011

Summary

Bupropion, used for smoking cessation, can cause skin reactions like rash and urticaria. A rare case presented with angioedema and arthralgia, resolving with prompt treatment and drug discontinuation.

Area of Science:

Pharmacology
Clinical Medicine
Dermatology

Background:

Bupropion is frequently associated with cutaneous adverse reactions, including urticaria and rash, with an incidence of 1-4%.
More severe adverse events such as seizures and angioedema are less common but can be dose-dependent.
Rarely, bupropion may trigger a serum sickness-like reaction characterized by fever, arthralgia, and myalgia.

Purpose of the Study:

To report a case of angioedema and arthralgia associated with bupropion use for smoking cessation.
To review the literature on bupropion-induced hypersensitivity reactions.
To discuss recommendations for safer bupropion prescribing in light of recent concerns.

Main Methods:

A case study of a 30-year-old male patient presenting with rash, angioedema, and arthralgia after 19 days of bupropion treatment.

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Review of existing literature on bupropion adverse effects, focusing on hypersensitivity reactions.

Analysis of management strategies and prescribing recommendations.

Main Results:

The patient experienced rash, angioedema, and arthralgia, consistent with a hypersensitivity reaction to bupropion.
Symptomatic improvement occurred within 3 hours of initiating antihistamines and steroids.
Complete resolution of symptoms was achieved within 3 days after discontinuing bupropion.

Conclusions:

Bupropion can induce hypersensitivity reactions, including angioedema and arthralgia, which are treatable with standard medical interventions.
Discontinuation of the causative agent is crucial for managing bupropion-induced hypersensitivity.
Clinicians should be aware of the potential for serious adverse reactions and consider safer prescribing practices.