A pediatric case of anaphylactic shock induced by tipepidine hibenzate (Asverin)

Area of Science:

• Pediatric Allergy
• Clinical Pharmacology
• Adverse Drug Reactions

Background:

• Tipepidine hibenzate (Asverin) is a widely used antitussive for cough relief across age groups.
• It is generally considered safe and well-tolerated in clinical practice.

Observation:

• A 1-year-old boy experienced anaphylactic shock after ingesting cold medication containing tipepidine hibenzate.
• Symptoms included erythema, urticaria, facial swelling, coughing, wheezing, vomiting, hypotension, and decreased consciousness.

Findings:

• Skin prick tests (SPTs) were negative for all tested drugs.
• Oral drug provocation tests (DPTs) elicited a positive reaction exclusively to tipepidine hibenzate at a full therapeutic dose.

Implications:

• Clinicians should consider tipepidine hibenzate as a potential cause of anaphylaxis in patients presenting with severe allergic reactions after cough or cold medication use.
• This case highlights the importance of considering less common but severe adverse drug reactions, even with generally safe medications.
• Accurate diagnosis through DPTs is crucial for identifying the specific causative agent in complex allergic reactions.