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Litt's Drug Eruption & Reaction Manual 24E
Litt's Drug Eruption & Reaction Manual 24E
EDITION
Jerome Z. Litt
Neil H. Shear
This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts
have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any
legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear
that any views or opinions expressed in this book by individual editors, authors or contributors are personal to
them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained
in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a sup-
plement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history,
relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in
medical science, any information or advice on dosages, procedures or diagnoses should be independently verified.
The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device
or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the
drugs, devices or materials mentioned in this book. This book does not indicate whether a particular treatment is
appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional
to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and
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Introduction v
Drug profiles: generic names A–Z 1
Descriptions of important reactions 305
Drugs that cause important reactions 311
Main classes of drugs 345
Classes of drugs that can cause important interactions 351
Class reactions 353
ACE inhibitors 353
Antiarrhythmics 355
Antibiotics, macrolide 357
Anticonvulsants 358
Antidepressants, tricyclic 361
Antihistamines (H1) 362
Antimalarials 363
Antipsychotics 365
Benzodiazepines 367
Beta blockers 368
Biologics 369
Bisphosphonates 374
Calcium channel blockers 375
Cephalosporins 377
Disease-modifying antirheumatic drugs (DMARDS) 378
DPP-4 inhibitors 383
Epidermal growth factor receptor (EGFR) inhibitors 384
Fluoroquinolones 387
Non-steroidal anti-inflammatory drugs (NSAIDS) 389
Proton pump inhibitors (PPI) 392
Statins 394
TNF inhibitors 395
Tyrosine-kinase inhibitors 398
Concordance of synonyms and trade names with
generic names 403
iii
To Vel – my Muse
JZL
Editors’ introductory notes
Any drug has the potential to cause an adverse reaction. An adverse drug reaction (ADR) is an unwanted, unpleasant, noxious,
or harmful consequence associated with the use of a medication that has been administered in a standard dose by the proper
route, for the purpose of prophylaxis, diagnosis, or treatment. Death is the ultimate adverse drug event.
ADRs are a major problem in drug therapy. They are the most common of all iatrogenic illnesses that complicate up to 15%
of therapeutic drug courses, and are a leading cause of morbidity and mortality in healthcare. ADRs should therefore be con-
sidered in the differential diagnosis of a wide variety of medical disorders. Many more people – particularly the elderly – are
taking more and more prescription and over-the-counter medications. In addition, new drugs are appearing in the medical
marketplace on an almost daily basis. It is unsurprising, then, that more and more drug reactions and cutaneous eruptions are
emerging.
Prevention, diagnosis and treatment of adverse drug events are becoming increasingly complex, and it is to be expected that
physicians in all specialties are often perplexed by the nature of ADRs. To this end, I now offer a new and improved edition
that has evolved from the treasured Drug Eruption Reference Manual of previous editions. I hope that you will find this new
edition informative and valuable.
Enjoy!
Jerome Z. Litt, M.D.
“Is it safe?”
I am frequently asked that big question from a patient: "Is it safe?" This text is meant to help all prescribers, dispensers and
patients understand what the risk of harm might be; whether it is from a drug reaction or interaction, Litt's is the go-to infor-
mation source. How does this information help answer the unanswerable? Simply put, safety is a process, not a question. With
the right information at hand a safe environment can thrive; the most up-to-date relevant data help peel away background
noise from a seemingly infinite number of sources. This new edition adds additional support to a risk management environ-
ment, and we will continue to provide the most up-to-date and relevant information. I look forward to feedback and sugges-
tions. I thank Jerry Litt for this great opportunity and the awesome work of the team at T&F to keep on top of all new
medications that are making the landscape even more complex.
Neil H. Shear, M.D., F.R.C.P.C., F.A.C.P.
v
A note on ADRs
The incidence and severity of ADRs are influenced by a number of factors:
1. Patient-related factors:
• Age – geriatric, pediatric, adolescent . . . older patients are taking more medications—hence more of a possibility of
developing reactions; pediatric patients have more delicate skins; hormonal changes occur in adolescents . . . All these
factors play roles in the development of possible adverse reactions.
• Gender – male or female – and if the latter, then pregnant/breast-feeding/menopausal . . .
• Disease – not only the disease being treated, but also other pre-existing health conditions and comorbid diseases. For
example, atopic patients are at increased risk for serious allergic reactions. Also, there would be an increased risk for
hypersensitivity drug reactions if the patient has asthma or lupus erythematosus.
• Genetics – a patient could have abnormal drug metabolism by cytochrome P450 due to inheriting abnormal alleles.
• Geography – patients living in sunny climes could develop photoxicities from photosensitizing drugs more readily than
those who inhabit cooler, less sunny climates.
2. Drug-related factors:
• Type/class of drug – for example, there is a heightened risk of hypersensitivity with the use of beta-blockers (see further the
tables on class reactions).
• Duration of therapy – the longer a patient maintains the therapy, the greater the possibility that he/she could develop a
reaction.
• Dosage – the greater the dosage, the more likely an adverse side effect.
• Bioavailability – the extent to and rate at which the drug enters systemic circulation, thereby accessing the site of action.
• Interactions with other drugs – for example, synergistic QT prolongation can occur when two QT prolonging agents, such
as erythromycin + ritonavir, are used together.
• Route of administration – intramuscular, intravenous, subcutaneous, and topical administrations are more likely to cause
hypersensitivity reactions; oral medications are less likely to result in drug hypersensitivity.
The terms “drug allergy,” “drug hypersensitivity,” and “drug reaction” are often used interchangeably. Drug allergy specific-
ally refers to a reaction mediated by IgE; drug hypersensitivity is an immune-mediated response to a drug agent in a sensitized
patient; and drug reactions comprise all adverse events related to drug administration, regardless of etiology.
vi
Trade (Brand) name(s) are then listed alphabetically. When there are many trade names, the ten (or so) most
commonly recognized ones are listed.
Following the trade names is – in parentheses – the latest name of the pharmaceutical company that markets the drug.
Many of the names of the companies have changed from earlier editions of this manual because of acquisitions,
mergers, and other factors in the pharmaceutical industry.
Next appear the Indication(s), the Class in which the drug belongs, and the Half-life of each drug, where known.
Drug interactions: many severe, hazardous drug–drug interactions are recorded. Only clinically significant drug inter-
actions that have been reported to trigger potential harm and that could be life threatening have been included here in
the profile. These interactions are predictable and well documented in controlled studies; they should be avoided.
Pregnancy category: for new drugs approved on or after 30 June, 2015 this field gives (where available) a brief sum-
mary of the full statement reflecting the risk for pregnant women as given in the prescribing guidelines; health care
providers are advised to check the individual label where necessary.
An explanation of the categories for older drugs (A, B, C, D and X) can be found on our website
www.drugeruptiondata.com.
Adverse Drug Reactions: under each drug profile is a list of related ADRs. These adverse events have been classified
under the following categories: Skin, Hair, Nails, Mucosal, Cardiovascular, Central Nervous System,
Neuromuscular/Skeletal, Gastrointestinal/Hepatic, Respiratory, Endocrine/Metabolic, Genitourinary,
Renal, Hematologic, Otic, Ocular, Local, Other.
Within each category, the reactions are listed alphabetically. Thus, the order of listing does not reflect severity or
frequency in any way.
The terminology used to list reaction patterns has been simplified as far as possible by eliminating, for the most part,
tags such as “like” (as in “-Psoriasis-like”), “-reactivation,” “-syndrome,” “-dissemination,” “-iform,” etc.
The number of reports is given for each reaction in square brackets. The incidence of the most important reactions is
given in parentheses where indicated (usually from the full prescribing information for the relevant drug). For
example, the profile for Amoxicillin begins:
Skin
AGEP [28]
Anaphylactoid reactions/Anaphylaxis [15]
Angioedema (<10%) [5]
This means that we have 28 journal articles referring to occurrence of AGEP (acute generalized exanthematous
pustulosis ); 15 articles mentioning the occurrence of anaphylaxis; and 5 articles discussing angioedema, as reactions to
Amoxicillin within the Skin category. All these articles appear on the website www.drugeruptiondata.com together
with links to the article abstracts on PubMed®. Additionally, the incidence of angioedema as a reaction has been
reported as up to 10%.
On some occasions, there are very few adverse reactions to a specific drug. These drugs are still included in the
manual as there is a positive significance in negative findings.
vii
3. The Concordance
The final part of the manual is a concordance to match synonyms (noted in italic) and trade names with the generic
drug name. If you know only the synonym or trade name, you can use this list to find the corresponding generic name
to look up in the main A–Z listing section of the book.
viii
Hypertriglyceridemia (2–6%)
ABACAVIR Renal
ABATACEPT
Trade names: Epzicom (ViiV), Triumeq (ViiV), Fanconi syndrome [2] Trade name: Orencia (Bristol-Myers Squibb)
Trizivir (ViiV), Ziagen (ViiV) Hematologic Indications: Rheumatoid arthritis, juvenile
Indications: HIV infections in combination with Agranulocytosis [3] idiopathic arthritis in pediatric patients 6 years of
other antiretrovirals Neutropenia (2–5%) age and older
Class: Nucleoside analog reverse transcriptase Other Class: Disease-modifying antirheumatic drug
inhibitor Adverse effects [4] (DMARD), T-cell co-stimulation modulator
Half-life: 1.5 hours Infection (5%) Half-life: 1223 days
Clinically important, potentially hazardous Clinically important, potentially hazardous
interactions with: alcohol, arbutamine, interactions with: adalimumab, anakinra,
argatroban, arsenic, darunavir, ganciclovir, certolizumab, denosumab, echinacea, etanercept,
lopinavir, methadone, phenobarbital, phenytoin, ABALOPARATIDE * golimumab, infliximab, lenalidomide, live vaccines,
protease inhibitors, ribavirin, rifampin, tipranavir, natalizumab, pimecrolimus, sipuleucel-T,
valganciclovir Trade name: Tymlos (Radius Health) tacrolimus, TNF antagonists, trastuzumab
Pregnancy category: C Indications: Osteoporosis in postmenopausal Pregnancy category: C
Important contra-indications noted in the women Important contra-indications noted in the
prescribing guidelines for: nursing mothers Class: Parathyroid hormone analog prescribing guidelines for: nursing mothers;
Note: Epzicom is abacavir and lamivudine; Half-life: <2 hours pediatric patients
Triumeq is abacavir, dolutegravir and lamivudine; Clinically important, potentially hazardous
Trizivir is abacavir, lamivudine and zidovudine. interactions with: none known
Pregnancy category: N/A (Not indicated for Skin
Warning: HYPERSENSITIVITY REACTIONS, Basal cell carcinoma [3]
LACTIC ACIDOSIS and SEVERE use in females of reproductive potential)
Important contra-indications noted in the Eczema [2]
HEPATOMEGALY, and EXACERBATIONS OF Herpes simplex (<5%) [3]
HEPATITIS B prescribing guidelines for: pediatric patients
Warning: RISK OF OSTEOSARCOMA Herpes zoster [3]
Hypersensitivity [2]
Skin Malignancies [10]
Anaphylactoid reactions/Anaphylaxis (3%) Cardiovascular Psoriasis [13]
[3] Orthostatic hypotension (<4%) Rash (4%) [6]
Exanthems [2] Palpitation (5%) Sjögren’s syndrome [4]
Hypersensitivity (8–9%) [69] Tachycardia (2%) Squamous cell carcinoma [5]
Lipoatrophy [2] Central Nervous System Vasculitis [2]
Rash (5–7%) [17] Headache (8%) Mucosal
Stevens-Johnson syndrome [2] Vertigo (dizziness) (2–10%) Stomatitis [3]
Toxic epidermal necrolysis [2] Neuromuscular/Skeletal Cardiovascular
Cardiovascular Asthenia (fatigue) (3%) Hypertension (7%) [4]
Myocardial infarction [9] Gastrointestinal/Hepatic Hypotension [2]
Central Nervous System Abdominal pain (3%) Central Nervous System
Abnormal dreams (10%) [2] Nausea (8%) Fever (5%) [2]
Anxiety (5%) Endocrine/Metabolic Headache (5–18%) [6]
Chills (6%) Hypercalcemia (3%) [2] Vertigo (dizziness) (9%) [3]
Depression (6%) Hyperuricemia (25%)
Fever (6%) [2] Neuromuscular/Skeletal
Headache (7–13%) [4] Genitourinary Asthenia (fatigue) [2]
Insomnia [2] Hypercalciuria (11%) Back pain (7%) [2]
Migraine (7%) Urolithiasis (2%) Pain in extremities (3%)
Neuropsychiatric disturbances [3] Local Gastrointestinal/Hepatic
Sleep related disorder (10%) Injection-site edema (10%) Abdominal pain (5%)
Vertigo (dizziness) (6%) [3] Injection-site erythema (58%) Diarrhea (5%) [3]
Neuromuscular/Skeletal Injection-site pain (9%) Dyspepsia (6%)
Asthenia (fatigue) (7–12%) [2] Gastroenteritis [5]
Bone or joint pain (5–6%) Nausea (5%) [2]
Myalgia/Myopathy (5–6%) [2] ABARELIX Vomiting [2]
Gastrointestinal/Hepatic Respiratory
Abdominal pain (6%) See: www.drugeruptiondata.com/drug/id/1011 Bronchitis (<13%) [4]
Diarrhea (7%) [2] Cough (5–8%)
Gastritis (6%) Influenza (5–13%) [2]
Hepatotoxicity [4] Nasopharyngitis (12%) [6]
Nausea (7–19%) [5] Pharyngitis [3]
Vomiting (2–10%) Pneumonia (<5%) [7]
Pulmonary toxicity [2]
Respiratory Rhinitis (<5%) [2]
Bronchitis (4%) Sinusitis (5–13%) [3]
Cough [2] Tuberculosis [2]
Pneumonia (4%) Upper respiratory tract infection (>10%)
Endocrine/Metabolic [9]
ALT increased (6%) Genitourinary
AST increased (6%) Urinary tract infection (5–13%) [10]
Hyperamylasemia (2–4%)
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Litt’s Drug Eruption & Reaction Manual ALPRAZOLAM
Endocrine/Metabolic Gastrointestinal/Hepatic
Creatine phosphokinase increased [2] Diarrhea [5] ALOGLIPTIN
Hypertriglyceridemia [2] Hepatotoxicity [7]
Nausea [3] Trade name: Nesina (Takeda)
Indications: Type II diabetes mellitus
Respiratory Class: Antidiabetic, Dipeptidyl peptidase-4 (DPP-
ALLOPURINOL Nasopharyngitis [2] 4) inhibitor
Upper respiratory tract infection [4] Half-life: 21 hours
Trade names: Duzallo (AstraZeneca), Zyloprim Endocrine/Metabolic Clinically important, potentially hazardous
(Prometheus) ALT increased [2] interactions with: none known
Indications: Gouty arthritis AST increased [3] Pregnancy category: B
Class: Purine analog, Xanthine oxidase inhibitor Important contra-indications noted in the
Half-life: <3 hours Renal
Nephrotoxicity [3] prescribing guidelines for: nursing mothers;
Clinically important, potentially hazardous pediatric patients
interactions with: acenocoumarol, amoxicillin, Other
ampicillin, ampicillin/sulbactam, azathioprine, Adverse effects [13]
benazepril, capecitabine, captopril, cilazapril, Allergic reactions (severe) [2] Skin
cyclopenthiazide, dicumarol, enalapril, fosinopril, Death [9] Hypersensitivity [2]
imidapril, lisinopril, mercaptopurine, Pruritus [2]
pantoprazole, quinapril, ramipril, trandolapril, Central Nervous System
uracil/tegafur, vidarabine, zofenopril Headache (4%) [8]
Pregnancy category: C
ALMOTRIPTAN Vertigo (dizziness) [3]
Note: HLA-B*5801 confers a risk of allopurinol- Trade names: Almogran (Almirall), Axert Neuromuscular/Skeletal
induced serious skin reactions like SJS/TEN and (Ortho-McNeil) Arthralgia [2]
DRESS. Indications: Migraine headaches
Duzallo is allopurinol and lesinurad (see separate Gastrointestinal/Hepatic
Class: 5-HT1 agonist, Serotonin receptor agonist, Constipation [2]
entry). Triptan Diarrhea [2]
Half-life: 34 hours Pancreatitis [3]
Skin Clinically important, potentially hazardous
AGEP [6] interactions with: conivaptan, darunavir, Respiratory
DRESS syndrome [45] delavirdine, dihydroergotamine, ergotamine, Nasopharyngitis (4%) [8]
Eosinophilic pustular folliculitis [2] indinavir, ketoconazole, methysergide, SNRIs, Upper respiratory tract infection (4%) [6]
Erythema multiforme [7] SSRIs, telithromycin, triptans, voriconazole Endocrine/Metabolic
Exanthems (<5%) [20] Pregnancy category: C Hypoglycemia [14]
Exfoliative dermatitis (>10%) [15] Important contra-indications noted in the Other
Fixed eruption [11] prescribing guidelines for: pediatric patients Adverse effects [6]
Granuloma annulare (disseminated) [2] Note: Contra-indicated in patients with history, Infection [3]
Hypersensitivity [49] symptoms, or signs of ischemic cardiac,
Lupus erythematosus [3] cerebrovascular, or peripheral vascular
Pityriasis rosea [2] syndromes, or with uncontrolled hypertension.
Pruritus [7] ALOSETRON
Purpura (>10%) [2] Cardiovascular
Rash (>10%) [11] See: www.drugeruptiondata.com/drug/id/18
Chest pain [3]
Stevens-Johnson syndrome (>10%) [53]
Toxic epidermal necrolysis [72] Central Nervous System
Toxic pustuloderma [3] Headache [2] ALPHA-LIPOIC ACID
Toxicity [2] Neurotoxicity [2]
Urticaria (>10%) [6] Paresthesias [4] See: www.drugeruptiondata.com/drug/id/1224
Vasculitis [7] Somnolence (drowsiness) [5]
Vertigo (dizziness) [6]
Hair
Alopecia (<10%) [2] Neuromuscular/Skeletal ALPRAZOLAM
Asthenia (fatigue) [4]
Mucosal
Oral ulceration [3] Gastrointestinal/Hepatic Trade name: Xanax (Pfizer)
Stomatitis [2] Nausea [6] Indications: Anxiety, depression, panic attacks
Vomiting [3] Class: Benzodiazepine
Cardiovascular Half-life: 1116 hours
Polyarteritis nodosa [3] Respiratory
Flu-like syndrome (12%) Clinically important, potentially hazardous
Central Nervous System Upper respiratory tract infection (20%) interactions with: alcohol, amprenavir,
Chills (<10%) aprepitant, boceprevir, clarithromycin, CNS
Fever [2] Other depressants, darunavir, delavirdine, digoxin,
Headache [3] Adverse effects [10] efavirenz, fluconazole, fluoxetine, fluvoxamine,
Vertigo (dizziness) [3] grapefruit juice, indinavir, itraconazole,
Neuromuscular/Skeletal ivermectin, kava, ketoconazole, posaconazole,
Arthralgia [3] propoxyphene, ritonavir, saquinavir, St John’s
Asthenia (fatigue) [2] wort, telaprevir, tipranavir
Back pain [2] Pregnancy category: D
Bone or joint pain [2] Important contra-indications noted in the
Joint disorder [2] prescribing guidelines for: the elderly; nursing
Myalgia/Myopathy [3] mothers; pediatric patients
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Skin
Gastrointestinal/Hepatic AMCINONIDE
Hemorrhagic colitis (5%)
Edema (<10%) See: www.drugeruptiondata.com/drug/id/1096
Penile rash (<10%) Hematologic
Bleeding [2]
Mucosal Hemorrhage (4%)
Nasal congestion (<10%)
Other AMIFOSTINE
Cardiovascular Death [4]
Bradycardia (<10%) See: www.drugeruptiondata.com/drug/id/24
Flushing (>10%)
Hypertension (<10%)
Hypotension (<10%) ALTRETAMINE
Tachycardia (<10%)
See: www.drugeruptiondata.com/drug/id/22
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Litt’s Drug Eruption & Reaction Manual AMINOSALICYLATE SODIUM
Respiratory
AMIKACIN Cough (<10%) AMINOPHYLLINE
Dyspnea (<10%)
Trade name: Amikacin sulfate (Bedford) Synonym: theophylline ethylenediamine
Indications: Short-term treatment of serious Endocrine/Metabolic Trade names: Elixophyllin (Forest), Phyllocontin
infections due to gram-negative bacteria Gynecomastia (<10%) (Napp), Quibron (Monarch)
Class: Antibiotic, aminoglycoside Hyperkalemia [2] Indications: Prevention or treatment of
Half-life: 1.52.5 hours (adults) Genitourinary reversible bronchospasm
Clinically important, potentially hazardous Impotence (<10%) Class: Xanthine alkaloid
interactions with: adefovir, aldesleukin, Half-life: 315 hours (in adult nonsmokers)
aminoglycosides, atracurium, bumetanide, Clinically important, potentially hazardous
cephalexin, doxacurium, ethacrynic acid,
furosemide, succinylcholine, teicoplanin,
AMINOCAPROIC ACID interactions with: adenosine, anagrelide,
arformoterol, azithromycin, BCG vaccine,
torsemide See: www.drugeruptiondata.com/drug/id/27 caffeine, capsicum, carbimazole, cimetidine,
Pregnancy category: D ciprofloxacin, clorazepate, cocoa, erythromycin,
Important contra-indications noted in the eucalyptus, febuxostat, fluvoxamine, halothane,
prescribing guidelines for: nursing mothers; indacaterol, influenza vaccine, levofloxacin,
pediatric patients AMINO- mebendazole, methylprednisolone, moxifloxacin,
Note: Aminoglycosides may cause neurotoxicity nilutamide, norfloxacin, obeticholic acid,
and/or nephrotoxicity.
GLUTETHIMIDE ofloxacin, oral contraceptives, prednisolone,
prednisone, propranolol, rasagiline, raspberry
See: www.drugeruptiondata.com/drug/id/28
Skin leaf, roflumilast, ropivacaine, roxithromycin, St
Dermatitis [2] John’s wort, torasemide, torsemide,
Exanthems [2] triamcinolone, zafirlukast
AMINOLEVULINIC Pregnancy category: C
Central Nervous System Important contra-indications noted in the
Neurotoxicity (<10%) ACID prescribing guidelines for: the elderly; nursing
Renal mothers
Trade names: Ameluz (Biofrontera), Levulan
Nephrotoxicity (<10%) [11]
Kerastick (Dusa)
Otic Indications: Non-hyperkeratotic actinic Skin
Hearing loss [5] keratoses of face and scalp Dermatitis [7]
Ototoxicity (<10%) [8] Class: Photosensitizer, Protoporphyrin IX (PpIX) Exanthems [5]
Tinnitus [3] (wakefulness promoting agent) Exfoliative dermatitis [6]
Ocular Half-life: 20–40 hours Hypersensitivity [6]
Macular infarction [3] Clinically important, potentially hazardous Pruritus [3]
interactions with: none known Stevens-Johnson syndrome [3]
Pregnancy category: C Urticaria [6]
Important contra-indications noted in the Cardiovascular
AMILORIDE prescribing guidelines for: nursing mothers; Arrhythmias [2]
pediatric patients Palpitation [3]
Trade names: Midamor (Merck), Moduretic
Note: In photodynamic therapy: to be used in Tachycardia [2]
(Merck)
conjunction with the relevant illuminator as
Indications: Prevention of hypokalemia Central Nervous System
approved by the manufacturer.
associated with kaliuretic diuretics, management Insomnia [2]
of edema in hypertension Seizures [11]
Class: Diuretic, potassium-sparing Skin Tremor [2]
Half-life: 69 hours Burning (>50%) [6] Neuromuscular/Skeletal
Clinically important, potentially hazardous Crusting (6471%) [2] Rhabdomyolysis [5]
interactions with: ACE inhibitors, benazepril, Dermatitis [2]
captopril, cyclosporine, enalapril, fosinopril, Desquamation [2] Gastrointestinal/Hepatic
lisinopril, magnesium, metformin, moexipril, Edema (35%) [9] Abdominal pain [2]
potassium salts, quinapril, quinidine, ramipril, Erosions (14%) [2] Nausea [5]
spironolactone, trandolapril, zofenopril Erythema (99%) [13] Vomiting [2]
Pregnancy category: B Exfoliative dermatitis (from topical Endocrine/Metabolic
Note: Moduretic is amiloride and treatment) [3] SIADH [2]
hydrochlorothiazide. Hydrochlorothiazide is a Hypomelanosis (22%)
Other
sulfonamide and can be absorbed systemically. Photosensitivity [3]
Adverse effects [3]
Sulfonamides can produce severe, possibly fatal, Pigmentation (from topical treatment) (22%)
Allergic reactions [5]
reactions such as toxic epidermal necrolysis and [7]
Death [2]
Stevens-Johnson syndrome. Pruritus (25%) [2]
Pustules (<4%)
Scaling (6471%)
Skin AMINOSALICYLATE
Stinging (>50%) [2]
Photosensitivity [4]
Ulcerations (4%)
Central Nervous System Vesiculation (4%) [2] SODIUM
Headache (<10%)
Central Nervous System See: www.drugeruptiondata.com/drug/id/30
Vertigo (dizziness) (<10%)
Dysesthesia (2%)
Neuromuscular/Skeletal Pain [12]
Asthenia (fatigue) (<10%)
Myalgia/Myopathy (<10%)
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 13
AMIODARONE See all our books at www.crcpress.com
Hair Other
AMIODARONE Alopecia [5] Adverse effects [5]
Mucosal Death [8]
Trade names: Cordarone (Wyeth), Pacerone Side effects (12%) [4]
(Upsher-Smith) Sialorrhea (<10%)
Indications: Ventricular fibrillation, ventricular Cardiovascular
tachycardia Arrhythmias (<3%) [3]
Class: Antiarrhythmic, Antiarrhythmic class III, Atrial fibrillation (paroxysmal) [3] AMISULPRIDE
CYP1A2 inhibitor, CYP3A4 inhibitor Atrioventricular block [3]
Half-life: 26107 days Bradycardia [18] See: www.drugeruptiondata.com/drug/id/1281
Clinically important, potentially hazardous Cardiotoxicity [3]
interactions with: abarelix, acebutolol, Flushing (<10%)
acenocoumarol, afatinib, amisulpride, Hypotension (16%) [4] AMITRIPTYLINE
amitriptyline, amprenavir, anisindione, QT prolongation [24]
anticoagulants, arsenic, artemether/lumefantrine, Tachycardia [2] Trade names: Elavil (AstraZeneca), Limbitrol
asenapine, astemizole, atazanavir, atorvastatin, Thrombophlebitis [2] (Valeant)
azoles, betrixaban, boceprevir, bosentan, Torsades de pointes [35] Indications: Depression
carbimazole, celiprolol, cholestyramine, Ventricular arrhythmia [2] Class: Antidepressant, tricyclic, Muscarinic
cimetidine, ciprofloxacin, clopidogrel, cobicistat/ Central Nervous System antagonist
elvitegravir/emtricitabine/tenofovir alafenamide, Anorexia (10–33%) Half-life: 1025 hours
cobicistat/elvitegravir/emtricitabine/tenofovir Coma [2] Clinically important, potentially hazardous
disoproxil, colchicine, cyclosporine, dabigatran, Dysgeusia (taste perversion) (<10%) interactions with: adrenergic neurone blockers,
daclatasvir, darunavir, degarelix, delavirdine, Headache (3–40%) alcohol, alfuzosin, altretamine, amiodarone,
dextromethorphan, dicumarol, digoxin, diltiazem, Insomnia (3–40%) amphetamines, amprenavir, anticholinergics,
disopyramide, dronedarone, droperidol, Neurotoxicity [5] antiepileptics, antihistamines, antimuscarinics,
echinacea, enoxacin, fentanyl, flecainide, Paresthesias (49%) antipsychotics, apraclonidine, arsenic,
fosamprenavir, gatifloxacin, grapefruit juice, Parkinsonism [4] artemether/lumefantrine, aspirin, atomoxetine,
indinavir, ledipasvir & sofosbuvir, lesinurad, Parosmia (<10%) baclofen, barbiturates, brimonidine, bupropion,
levofloxacin, levomepromazine, lidocaine, Peripheral neuropathy [4] cannabis extract, carbamazepine, cimetidine,
lomefloxacin, lopinavir, loratadine, macrolide Syncope [2] cinacalcet, ciprofloxacin, cisapride, clonidine,
antibiotics, methotrexate, moxifloxacin, Tremor (3–40%) [4] clozapine, cobicistat/elvitegravir/emtricitabine/
naldemedine, nelfinavir, nevirapine, nilotinib, Vertigo (dizziness) (3–40%) tenofovir alafenamide, cobicistat/elvitegravir/
norfloxacin, ofloxacin, orlistat, oxprenolol, emtricitabine/tenofovir disoproxil, conivaptan,
pentamidine, phenytoin, pimavanserin, Neuromuscular/Skeletal coumarins, CYP2D6 inhibitors, desmopressin,
procainamide, propranolol, quinidine, quinine, Ataxia [4] dexmethylphenidate, diltiazem, disopyramide,
quinolones, ribociclib, rifabutin, rifampin, Myoclonus [2] disulfiram, diuretics, dronedarone, droperidol,
rifapentine, ritonavir, ropivacaine, rosuvastatin, Rhabdomyolysis [7] duloxetine, entacapone, ephedra, epinephrine,
simvastatin, sofosbuvir & velpatasvir, sofosbuvir/ Gastrointestinal/Hepatic estrogens, eucalyptus, flecainide, gadobutrol,
velpatasvir/voxilaprevir, sotalol, sparfloxacin, St Abdominal pain (<10%) general anesthetics, gotu kola, grapefruit juice,
John’s wort, sulpiride, tacrolimus, telaprevir, Constipation (10–33%) guanethidine, histamine, interferon alfa,
tetrabenazine, thalidomide, tipranavir, trazodone, Hepatic failure [2] iobenguane, isocarboxazid, isoproterenol, kava,
vandetanib, venetoclax, verapamil, warfarin, Hepatic steatosis [2] linezolid, lithium, MAO inhibitors,
zuclopenthixol Hepatitis (<3%) [3] methylphenidate, metoclopramide,
Pregnancy category: D Hepatotoxicity [27] moclobemide, moxifloxacin, moxonidine,
Important contra-indications noted in the Nausea (10–33%) nefopam, nicorandil, nilotinib, nitrates, NSAIDs,
prescribing guidelines for: the elderly; nursing Pancreatitis [4] opioid analgesics, paroxetine hydrochloride,
mothers; pediatric patients Vomiting (10–33%) pentamidine, phenelzine, phenothiazines,
Warning: PULMONARY TOXICITY phenytoin, pimozide, pramlintide, primidone,
Respiratory
propafenone, propoxyphene, protease inhibitors,
Cough [2]
Skin QT interval prolonging agents, quinidine, quinine,
Eosinophilic pneumonia [2]
Anaphylactoid reactions/Anaphylaxis [2] quinolones, rasagiline, ritonavir, saquinavir,
Pneumonia [4]
Angioedema [2] selegiline, sibutramine, sodium oxybate, sotalol,
Pneumonitis [5]
Diaphoresis [2] sparfloxacin, SSRIs, St John’s wort, sulfonylureas,
Pulmonary toxicity [24]
Edema (<10%) terbinafine, tetrabenazine, thioridazine, thyroid
Endocrine/Metabolic hormones, tramadol, tranylcypromine, valerian,
Erythema nodosum [2] Hyperthyroidism (<3%) [10]
Exanthems [5] valproic acid, verapamil, vitamin K antagonists,
Hyponatremia [2] yohimbine, ziprasidone
Facial erythema (3%) [2] Hypothyroidism (<3%) [18]
Iododerma [2] Pregnancy category: C
SIADH [10] Important contra-indications noted in the
Linear IgA bullous dermatosis [6] Thyroid dysfunction [25]
Lupus erythematosus [5] prescribing guidelines for: the elderly; nursing
Thyrotoxicosis [19] mothers; pediatric patients
Myxedema [3]
Photosensitivity (10–75%) [41] Genitourinary Note: Limbitrol is amitriptyline and
Phototoxicity [3] Epididymitis [2] chlordiazepoxide.
Pigmentation (blue) (<10%) [68] Warning: SUICIDALITY AND
Ocular
Pruritus (<5%) [2] ANTIDEPRESSANT DRUGS
Corneal deposits (>90%) [2]
Psoriasis [2] Keratopathy [6]
Purpura (2%) Ocular adverse effects [4] Skin
Toxic epidermal necrolysis [2] Ocular toxicity [2] Diaphoresis (<10%)
Toxicity [5] Optic neuropathy [7] DRESS syndrome [2]
Vasculitis [6] Visual disturbances (2–9%) Photosensitivity [3]
Pigmentation [4]
14 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual AMOXAPINE
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 15
AMOXAPINE Over 100 updates per week on www.drugeruptiondata.com
16 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual ANDROSTENEDIONE
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 17
ANIDULAFUNGIN See all our books at www.crcpress.com
18 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual APREPITANT
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 19
APROBARBITAL Over 100 updates per week on www.drugeruptiondata.com
20 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual ASCORBIC ACID
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 21
ASENAPINE See all our books at www.crcpress.com
Skin
ASENAPINE ASFOTASE ALFA Anaphylactoid reactions/Anaphylaxis (340%)
[4]
Trade name: Saphris (Merck) Trade name: Strensiq (Alexion) Angioedema [3]
Indications: Schizophrenia, bipolar disorder Indications: Perinatal/infantile-and juvenile-onset Hypersensitivity (640%) [14]
Class: Antipsychotic hypophosphatasia Toxic epidermal necrolysis [2]
Half-life: 24 hours Class: Enzyme replacement Toxicity [2]
Clinically important, potentially hazardous Half-life: 5 days Urticaria (<15%) [5]
interactions with: alcohol, amiodarone, Clinically important, potentially hazardous
chlorpromazine, CYP2D6 substrates and interactions with: none known Mucosal
inhibitors, fluvoxamine, gatifloxacin, moxifloxacin, Pregnancy category: N/A (No available data) Aphthous stomatitis (<10%)
paroxetine hydrochloride, procainamide, QT Important contra-indications noted in the Oral lesions (26%)
prolonging drugs, quinidine, sotalol, thioridazine, prescribing guidelines for: the elderly; nursing Stomatitis (<10%)
ziprasidone mothers Central Nervous System
Pregnancy category: C Chills (>10%)
Important contra-indications noted in the Skin Coma (25%)
prescribing guidelines for: the elderly; nursing Anaphylactoid reactions/Anaphylaxis Depression (>10%)
mothers; pediatric patients (<10%) Encephalopathy [2]
Warning: INCREASED MORTALITY IN Calcification (4%) Fever (>10%)
ELDERLY PATIENTS WITH DEMENTIA- Erythema (<10%) Leukoencephalopathy [3]
RELATED PSYCHOSIS Neurotoxicity [4]
Cardiovascular Seizures (10–60%) [2]
Flushing (<10%) Somnolence (drowsiness) (>10%)
Skin
Peripheral edema (3%) Central Nervous System Stroke [2]
Chills (<10%) Gastrointestinal/Hepatic
Mucosal Fever (<10%)
Oral numbness [4] Abdominal pain (70%)
Headache (<10%) Hepatotoxicity [3]
Salivary hypersecretion (2%) Hypoesthesia (oral) (<10%)
Xerostomia (2–3%) Pancreatitis (15%) [22]
Irritability (<10%) Vomiting (50–60%)
Cardiovascular Pain (<10%)
Hypertension (2–3%) [2] Rigors (<10%) Endocrine/Metabolic
Hyperglycemia [2]
Central Nervous System Gastrointestinal/Hepatic Hyperlipidemia [2]
Akathisia (4–6%) [10] Nausea (<10%) Hypertriglyceridemia [4]
Anxiety (4%) Vomiting (5%)
Depression (2%) [3] Genitourinary
Local Azotemia (66%)
Dysgeusia (taste perversion) (3%) [4] Injection-site bruising (8%)
Extrapyramidal symptoms (6–10%) [11] Injection-site edema (13%) Hematologic
Headache (12%) [3] Injection-site erythema (41%) Sepsis [2]
Hypersomnia [2] Injection-site hemorrhage (<17%) Thrombosis [9]
Hypoesthesia (4–5%) [7] Injection-site induration (13%) Other
Insomnia (6–15%) [3] Injection-site lipoatrophy/lipohypertrophy Adverse effects [2]
Irritability (2%) (5–8%) Allergic reactions (15–35%) [2]
Sedation [9] Injection-site pain (14%)
Somnolence (drowsiness) (13–24%) [15] Injection-site papules and nodules (3%)
Tardive dyskinesia [2] Injection-site pigmentation (15%)
Vertigo (dizziness) (4–11%) [5] Injection-site pruritus (13%)
ASPARAGINASE
Neuromuscular/Skeletal Injection-site reactions (9%) ERWINIA
Arthralgia (3%) Other
Asthenia (fatigue) (3–4%) Adverse effects [2] CHRYSANTHEMI
Pain in extremities (2%)
Gastrointestinal/Hepatic See: www.drugeruptiondata.com/drug/id/2697
Abdominal pain [2]
Constipation (5%)
ASPARAGINASE
Dyspepsia (3–4%) Synonym: L-asparaginase ASPARTAME
Vomiting (5%) Trade names: Elspar (Merck), Kidrolase (EUSA
Endocrine/Metabolic Pharma) See: www.drugeruptiondata.com/drug/id/49
Appetite increased (2–4%) Indications: Acute lymphoblastic leukemia,
Weight gain (3–5%) [12] lymphoma
Other Class: Antineoplastic, Enzyme
Adverse effects [4] Half-life: 830 hours (intravenous); 3449 hours
(intramuscular)
Clinically important, potentially hazardous
interactions with: none known
Pregnancy category: C
Important contra-indications noted in the
prescribing guidelines for: nursing mothers
22 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual ATAZANAVIR
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 23
ATENOLOL Over 100 updates per week on www.drugeruptiondata.com
Local
ATENOLOL ATEZOLIZUMAB Infusion-related reactions (3%)
Trade names: Beta-Adalat (Bayer), Kalten (BPC), Trade name: Tecentriq (Genentech) Other
Tenif (AstraZeneca), Tenoret 50 (AstraZeneca), Indications: Locally advanced or metastatic Adverse effects [3]
Tenoretic (AstraZeneca), Tenormin urothelial carcinoma in patients having disease Infection (38%)
(AstraZeneca) progression following platinum-containing
Indications: Angina, hypertension, acute chemotherapy
myocardial infarction Class: Monoclonal antibody, Programmed death- ATOMOXETINE
Class: Antiarrhythmic class II, Beta adrenergic ligand (PD-L1) inhibitor
blocker, Beta blocker Half-life: 27 days Trade name: Strattera (Lilly)
Half-life: 67 hours (adults) Clinically important, potentially hazardous Indications: Attention deficit hyperactivity
Clinically important, potentially hazardous interactions with: none known disorder
interactions with: alfuzosin, calcium channel Pregnancy category: N/A (Can cause fetal Class: Norepinephrine reuptake inhibitor
blockers, cisplatin, clonidine, digitalis glycosides, harm) Half-life: 5 hours
diltiazem, disopyramide, epinephrine, Important contra-indications noted in the Clinically important, potentially hazardous
indomethacin, reserpine, verapamil prescribing guidelines for: nursing mothers; interactions with: albuterol, amitriptyline,
Pregnancy category: D pediatric patients cinacalcet, citalopram, delavirdine, droperidol,
Important contra-indications noted in the duloxetine, levalbuterol, levomepromazine,
prescribing guidelines for: the elderly; nursing Skin linezolid, lisdexamfetamine, MAO inhibitors,
mothers; pediatric patients Peripheral edema (18%) moxifloxacin, paroxetine hydrochloride, sotalol,
Note: Contra-indicated in patients with sinus Pruritus (13%) [2] terbinafine, terbutaline, tipranavir, venlafaxine,
bradycardia, heart block greater than first degree, Rash (15%) [3] zuclopenthixol
cardiogenic shock, or overt cardiac failure. Beta- Pregnancy category: C
Adalat and Tenif are atenolol and nifedipine. Cardiovascular Important contra-indications noted in the
Kalten, Tenoret 50 and Tenoretic are atenolol and Venous thromboembolism (>2%) prescribing guidelines for: nursing mothers;
chlorthalidone. Chlorthalidone is a sulfonamide Central Nervous System pediatric patients
and can be absorbed systemically. Sulfonamides Fever (21%) Warning: SUICIDAL IDEATION IN CHILDREN
can produce severe, possibly fatal, reactions such Neuromuscular/Skeletal AND ADOLESCENTS
as toxic epidermal necrolysis and Stevens-Johnson Arthralgia (14%)
syndrome. Asthenia (fatigue) (52%) [3] Skin
Warning: CESSATION OF THERAPY Back pain (15%) Pruritus (>2%)
Neck pain (15%) Mucosal
Skin Gastrointestinal/Hepatic Xerostomia (>5%) [9]
Anaphylactoid reactions/Anaphylaxis [2] Abdominal pain (17%)
Lupus erythematosus [2] Cardiovascular
Colitis [2] Cardiotoxicity [2]
Necrosis [3] Constipation (21%)
Pruritus (<5%) Tachycardia [2]
Diarrhea (18%)
Psoriasis [7] Gastric obstruction (>2%) Central Nervous System
Raynaud’s phenomenon [2] Nausea (25%) Aggression [3]
Urticaria [2] Vomiting (17%) Anorexia [5]
Cardiovascular Depression (>2%) [3]
Respiratory Headache [9]
Atrial fibrillation (5%) [2] Cough (14%)
Atrial flutter (2%) Hypomania [2]
Dyspnea (16%) Insomnia [7]
Bradycardia (3–18%) [8] Pneumonia (>2%)
Cardiac arrest (2%) Irritability [8]
Pneumonitis (3%) Mania [2]
Cardiac failure (19%)
Heart block (5%) Endocrine/Metabolic Mood changes [5]
Hypotension (25%) [2] ALP increased (4%) Nervousness [3]
Postural hypotension (12%) ALT increased (2%) [2] Somnolence (drowsiness) [11]
Supraventricular tachycardia (12%) Appetite decreased (26%) Suicidal ideation [6]
Ventricular tachycardia (16%) AST increased (2%) [3] Tic disorder [7]
Dehydration (>2%) Tremor (>2%) [2]
Central Nervous System Diabetes mellitus [2] Vertigo (dizziness) (>5%) [10]
Depression (12%) Hyperglycemia (5%)
Somnolence (drowsiness) (2%) Neuromuscular/Skeletal
Hyperthyroidism (2%) Asthenia (fatigue) [11]
Stroke [2] Hyponatremia (10%)
Syncope [2] Hypothyroidism (6%) Gastrointestinal/Hepatic
Vertigo (dizziness) (15%) Serum creatinine increased (3%) Abdominal pain [12]
Neuromuscular/Skeletal Constipation [2]
Genitourinary Dyspepsia [3]
Asthenia (fatigue) (26%) Hematuria (14%)
Leg pain (3%) Hepatotoxicity [12]
Urinary tract infection (22%) Nausea [18]
Gastrointestinal/Hepatic Renal Vomiting [10]
Diarrhea (3%) Nephrotoxicity (>2%)
Nausea (3%) Endocrine/Metabolic
Hematologic Appetite decreased [27]
Respiratory Anemia (8%) Weight loss [5]
Dyspnea (6%) Lymphopenia (10%)
Wheezing (3%) Genitourinary
Sepsis (>2%) Erectile dysfunction [4]
Other Urinary hesitancy [2]
Adverse effects [5]
24 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual ATROPINE SULFATE
Other Mucosal
Adverse effects [10] Cheilitis (<2%) ATOVAQUONE/
Bruxism [2] Glossitis (<2%)
Oral ulceration (<2%)
PROGUANIL
Stomatitis (<2%)
Trade name: Malarone (GSK)
ATORVASTATIN Cardiovascular Indications: Malaria prophylaxis and treatment
Hypotension [2] Class: Antimalarial
Trade names: Caduet (Pfizer), Lipitor (Pfizer), Central Nervous System Half-life: 24 hours
Liptruzet (Merck Sharpe & Dohme) Ageusia (taste loss) (<2%) Clinically important, potentially hazardous
Indications: Hypercholesterolemia Cognitive impairment [2] interactions with: artemether/lumefantrine,
Class: HMG-CoA reductase inhibitor, Statin Depression [3] dapsone, etoposide, hypoglycemic agents,
Half-life: 14 hours Dysgeusia (taste perversion) (<2%) indinavir, metoclopramide, phenothiazines,
Clinically important, potentially hazardous Headache [4] rifabutin, rifampin, ritonavir, tetracycline, typhoid
interactions with: alcohol, aliskiren, Neurotoxicity [2] vaccine
amiodarone, amprenavir, antifungals, atazanavir, Paresthesias (<2%) Pregnancy category: C
azithromycin, bexarotene, boceprevir, bosentan, Parosmia (<2%) Important contra-indications noted in the
ciprofibrate, clarithromycin, clopidogrel, prescribing guidelines for: the elderly; nursing
cobicistat/elvitegravir/emtricitabine/tenofovir Neuromuscular/Skeletal mothers
alafenamide, cobicistat/elvitegravir/emtricitabine/ Arthralgia (4–12%)
tenofovir disoproxil, colchicine, conivaptan, Asthenia (fatigue) [5]
Back pain [3] Skin
cyclosporine, CYP3A4 inhibitors, dabigatran,
Muscle spasm [2] Erythema multiforme [2]
danazol, daptomycin, darunavir, dasatinib,
Myalgia/Myopathy (3–8%) [30] Pruritus (<10%)
delavirdine, digoxin, diltiazem, dronedarone,
efavirenz, elbasvir & grazoprevir, eltrombopag, Pain in extremities (6%) Mucosal
erythromycin, estradiol, etravirine, everolimus, Rhabdomyolysis [41] Oral ulceration (6%) [3]
fenofibrate, fenofibric acid, fibrates, fluconazole, Tendinopathy/Tendon rupture [2] Central Nervous System
fosamprenavir, fusidic acid, gemfibrozil, Gastrointestinal/Hepatic Abnormal dreams (7%)
glecaprevir & pibrentasvir, grapefruit juice, Cholelithiasis (gallstones) [2] Anorexia (5%)
imatinib, imidazoles, indinavir, itraconazole, Diarrhea (5–14%) Headache (10%) [4]
liraglutide, lopinavir, macrolide antibiotics, Hepatitis [2] Insomnia (3%)
midazolam, nefazodone, nelfinavir, niacin, Hepatotoxicity [11] Vertigo (dizziness) (5%) [3]
niacinamide, norethisterone, oral contraceptives, Nausea (4–7%)
Neuromuscular/Skeletal
P-glycoprotein inhibitors, posaconazole, protease Pancreatitis [8]
Asthenia (fatigue) (8%)
inhibitors, quinine, red rice yeast, rifampin, Respiratory
ritonavir, rivaroxaban, saquinavir, silodosin, St Gastrointestinal/Hepatic
Nasopharyngitis (4–13%)
John’s wort, telaprevir, telithromycin, tipranavir, Abdominal pain (17%) [5]
topotecan, trabectedin, verapamil, voriconazole, Endocrine/Metabolic Diarrhea (8%)
warfarin ALT increased [3] Dyspepsia (2%)
Pregnancy category: X Creatine phosphokinase increased [5] Gastritis (3%)
Important contra-indications noted in the Diabetes mellitus [2] Hepatotoxicity [2]
prescribing guidelines for: the elderly; nursing Gynecomastia (<2%) Nausea (12%)
mothers; pediatric patients Genitourinary Vomiting (12%) [2]
Note: Caduet is atorvastatin and amlodipine; Urinary tract infection (4–8%) Respiratory
Liptruzet is atorvastatin and ezetimibe. Cough [3]
Renal
Nephrotoxicity [3] Ocular
Skin Vision impaired (2%)
Otic
Acneform eruption (<2%)
Hearing loss [2] Other
Angioedema [2]
Dermatitis (<2%) Other Adverse effects [3]
Dermatomyositis [4] Adverse effects [10]
Diaphoresis (<2%) Allergic reactions (<2%)
Ecchymoses (<2%) Death [6] ATRACURIUM
Eczema (<2%) Multiorgan failure [2]
Edema (<2%) See: www.drugeruptiondata.com/drug/id/55
Facial edema (<2%)
Jaundice [2] ATOVAQUONE
Lupus erythematosus [2]
Petechiae (<2%)
ATROPINE SULFATE
See: www.drugeruptiondata.com/drug/id/54
Photosensitivity (<2%) Trade name: Lomotil (Pfizer)
Pruritus (<2%) Indications: Salivation, sinus bradycardia, uveitis,
Rash (>3%) [2] peptic ulcer
Seborrhea (<2%) Class: Muscarinic antagonist
Toxic epidermal necrolysis [2] Half-life: 23 hours
Toxicity [2] Clinically important, potentially hazardous
Ulcerations (<2%) interactions with: anticholinergics,
Urticaria (<2%) zuclopenthixol
Xerosis (<2%) Pregnancy category: C
Hair Note: Many of the trade name drugs for atropine
Alopecia (<2%) sulfate contain phenobarbital, scopolamine,
hyoscyamine, hydrocodone, methenamine, etc.
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 25
ATROPINE SULFATE See all our books at www.crcpress.com
Respiratory
Skin
Anaphylactoid reactions/Anaphylaxis [3] Bronchitis (<2%) AXITINIB
Dermatitis [3] Influenza (<2%)
Nasopharyngitis (<5%) [5] Trade name: Inlyta (Pfizer)
Erythema multiforme [2] Indications: Advanced renal cell carcinoma (after
Photosensitivity (<10%) Sinusitis (<2%) [2]
Upper respiratory tract infection (<3%) failure of one prior systemic therapy)
Mucosal Class: Tyrosine kinase inhibitor
Xerostomia (>10%) [4]
Other Half-life: 2–6 hours
Adverse effects [4] Clinically important, potentially hazardous
Cardiovascular
interactions with: ketoconazole, rifampin
Arrhythmias [2]
Pregnancy category: D
Atrial fibrillation [2]
Bradycardia [3] AVELUMAB * Important contra-indications noted in the
prescribing guidelines for: nursing mothers;
Tachycardia [5]
Trade name: Bavencio (Merck Serono) pediatric patients
Central Nervous System Indications: Metastatic Merkel cell carcinoma
Confusion [2] Class: Monoclonal antibody, Programmed death- Skin
Ocular ligand (PD-L1) inhibitor Erythema (2%)
Amblyopia [5] Half-life: 6 days Hand–foot syndrome (27%) [15]
Hallucinations, visual [3] Clinically important, potentially hazardous Pruritus (7%)
Periocular dermatitis [3] interactions with: none known Rash (13%) [3]
Pregnancy category: N/A (Can cause fetal Xerosis (10%)
Local
harm)
Injection-site irritation (>10%) Hair
Important contra-indications noted in the
Other prescribing guidelines for: nursing mothers; Alopecia (4%) [2]
Allergic reactions [2] pediatric patients Mucosal
Central anticholinergic syndrome [2] Mucosal inflammation (15%) [2]
Skin Stomatitis (15%)
Peripheral edema (20%) Cardiovascular
AVANAFIL Pruritus (10%) Hypertension (40%) [34]
Rash (22%) Central Nervous System
Trade name: Stendra (Vivus)
Cardiovascular Anorexia [5]
Indications: Erectile dysfunction
Hypertension (13%) Dysgeusia (taste perversion) (11%)
Class: Phosphodiesterase type 5 (PDE5) inhibitor
Central Nervous System Headache (14%) [4]
Half-life: 5 hours
Headache (10%) Leukoencephalopathy [2]
Clinically important, potentially hazardous
interactions with: alcohol, alpha blockers, Vertigo (dizziness) (14%) Neuromuscular/Skeletal
amprenavir, antihypertensives, aprepitant, Neuromuscular/Skeletal Arthralgia (15%) [2]
atazanavir, clarithromycin, diltiazem, Arthralgia (16%) Asthenia (fatigue) (39%) [26]
erythromycin, fluconazole, fosamprenavir, Asthenia (fatigue) (50%) [3] Pain in extremities (13%)
indinavir, itraconazole, ketoconazole, nefazodone, Bone or joint pain (32%) Gastrointestinal/Hepatic
nelfinavir, nitrates, ritonavir, saquinavir, strong Abdominal pain (14%)
CYP3A4 inhibitors, telithromycin, verapamil
Gastrointestinal/Hepatic
Abdominal pain (16%) Constipation (20%) [2]
Pregnancy category: C (Not indicated for use in Diarrhea (55%) [25]
women)
Colitis (2%)
Constipation (17%) Dyspepsia (10%)
Important contra-indications noted in the Nausea (32%) [10]
prescribing guidelines for: pediatric patients
Diarrhea (23%)
Nausea (22%) [2] Vomiting (24%) [6]
Note: Contra-indicated in patients using any form
of nitrates.
Vomiting (13%) Respiratory
Respiratory Cough (15%) [2]
Cough (18%) Dysphonia (>20%) [12]
Skin Dyspnea (15%) [4]
Facial flushing [2] Dyspnea (11%)
Rash (<2%) Endocrine/Metabolic Endocrine/Metabolic
ALT increased (20%) ALT increased (22%) [2]
Mucosal Appetite decreased (34%) [7]
Nasal congestion (<3%) [7] Appetite decreased (20%)
AST increased (34%) [2] AST increased [2]
Cardiovascular Creatine phosphokinase increased [3] Dehydration [2]
Flushing (3–10%) [10] Hyperamylasemia (8%) Hyperthyroidism [2]
Hypertension (<2%) Hyperbilirubinemia (6%) Hyponatremia [2]
Hyperglycemia (>10%) Hypothyroidism (19%) [8]
Central Nervous System
Thyroid dysfunction (6%) Serum creatinine increased [2]
Headache (5–12%) [9]
Weight loss (15%) Thyroid dysfunction [2]
Vertigo (dizziness) (<2%) [2]
Weight loss (25%) [3]
Neuromuscular/Skeletal Hematologic
Arthralgia (<2%) Anemia (35%) Renal
Hyperlipasemia (14%) Proteinuria (11%) [5]
Asthenia (fatigue) [2]
Back pain (<3%) [3] Lymphopenia (49%) Hematologic
Neutropenia (6%) Anemia [2]
Gastrointestinal/Hepatic
Thrombocytopenia (27%) Hemorrhage (16%)
Constipation (<2%)
Local Neutropenia [2]
Diarrhea (<2%)
Infusion-related reactions (22%) [3] Thrombotic complications (3%)
Dyspepsia (<2%) [4]
Nausea (<2%)
26 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual AZATHIOPRINE
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 27
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28 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual BASILIXIMAB
Other Skin
BACAMPICILLIN Infection [2] Acneform eruption (>10%)
Side effects (<2%) Candidiasis (3–10%)
See: www.drugeruptiondata.com/drug/id/64 Cyst (310%)
Edema (generalized) (310%)
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 29
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30 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual BENAZEPRIL
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 31
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BENZTHIAZIDE Skin
Cold extremities (2%)
BENZALKONIUM See: www.drugeruptiondata.com/drug/id/69 Dermatitis [3]
See: www.drugeruptiondata.com/drug/id/1041
Diaphoresis (<2%)
Eczema (<2%)
BENZTROPINE Edema (<2%)
Erythema (<2%)
BENZNIDAZOLE * See: www.drugeruptiondata.com/drug/id/70 Lymphadenopathy (<2%)
Pruritus (<2%)
Indications: Chagas disease (trypanosomiasis) in Purpura (<2%)
pediatric patients aged 2–12 years Rash (<2%) [3]
Class: Antibiotic, nitroimidazole BENZYDAMINE Hair
Half-life: 13 hours
Clinically important, potentially hazardous See: www.drugeruptiondata.com/drug/id/1332 Alopecia (<2%)
interactions with: disulfiram Hypertrichosis (<2%)
Pregnancy category: N/A (Can cause fetal Mucosal
harm) BENZYL ALCOHOL Epistaxis (nosebleed) (<2%)
Important contra-indications noted in the Oral ulceration (<2%)
prescribing guidelines for: nursing mothers See: www.drugeruptiondata.com/drug/id/1721 Sialorrhea (<2%)
Note: Has the potential for genotoxicity and Xerostomia (<2%)
carcinogenicity. Cardiovascular
Skin
BEPOTASTINE Angina (<2%)
Arrhythmias (<2%)
Edema [4] See: www.drugeruptiondata.com/drug/id/1731 Atrioventricular block (<2%)
Hypersensitivity [3] Bradycardia (6–8%)
Pigmentation [2] Cardiac failure (<2%)
Pruritus [5] Chest pain (2–7%)
Rash [7] BEPRIDIL Flushing (<2%)
Stevens-Johnson syndrome [2] Hypertension (<2%)
Urticaria [2] See: www.drugeruptiondata.com/drug/id/71 Hypotension (<2%)
32 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual BEVACIZUMAB
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 33
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34 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual BIVALIRUDIN
Local
Injection-site reactions (25%) BIPERIDEN BISOPROLOL
See: www.drugeruptiondata.com/drug/id/77 Trade names: Cardicor (Merck Serono), Concor
(Merck Serono), Emcor (Merck Serono), Zebeta
BIMATOPROST (Barr), Ziac (Barr)
Trade names: Latisse (Allergan), Lumigan BISACODYL Indications: Hypertension
Class: Beta adrenergic blocker, Beta blocker
(Allergan) Half-life: 912 hours
Indications: Reduction of elevated intraocular See: www.drugeruptiondata.com/drug/id/78
Clinically important, potentially hazardous
pressure in open-angle glaucoma or ocular interactions with: diltiazem, disopyramide,
hypertension, hypotrichosis of the eyelashes guanethidine, reserpine, rifampin, verapamil
Class: Prostaglandin analog BISMUTH Pregnancy category: C
Half-life: 45 minutes Important contra-indications noted in the
Clinically important, potentially hazardous Trade names: Helidac (Prometheus), Pepto- prescribing guidelines for: nursing mothers;
interactions with: none known Bismol (Procter & Gamble) pediatric patients
Pregnancy category: C Indications: As part of ‘triple therapy’ Note: Ziac is bisoprolol and hydrochlorothiazide.
Important contra-indications noted in the (antibiotics + bismuth) for eradication of H. Hydrochlorothiazide is a sulfonamide and can be
prescribing guidelines for: nursing mothers; pylori. Bismuth subgallate initiates clotting via absorbed systemically. Sulfonamides can produce
pediatric patients activation of factor XII, and is used for bleeding severe, possibly fatal, reactions such as toxic
during tonsillectomy and adenoidectomy. BIPP epidermal necrolysis and Stevens-Johnson
Skin impregnated ribbon gauze is used for packing syndrome.
Pigmentation [2] following ear surgery. Bismuth subsalicylate is in Contra-indicated in patients with cardiogenic
OTC products for gastrointestinal complaints and shock, overt cardiac failure, second or third
Hair peptic ulcer disease
Hirsutism (<5%) degree AV block, and marked sinus bradycardia.
Class: Disinfectant, Heavy metal
Hypertrichosis [2] Half-life: 2172 days
Central Nervous System Clinically important, potentially hazardous Skin
Headache (<5%) interactions with: aspirin, ciprofloxacin, Edema (3%)
demeclocycline, doxycycline, hypoglycemics, Peripheral edema (<10%)
Neuromuscular/Skeletal Rash (<10%)
Asthenia (fatigue) (<5%) lomefloxacin, lymecycline, methotrexate,
minocycline, tetracycline, warfarin Raynaud’s phenomenon (<10%)
Respiratory Pregnancy category: D (category C in first and Cardiovascular
Nasopharyngitis [2] second trimesters; category D in third trimester) Bradycardia [6]
Upper respiratory tract infection (10%) Hypotension [3]
Ocular Skin Central Nervous System
Asthenopia (<10%) Dermatitis [2] Headache [2]
Blepharitis (<10%) Hypersensitivity [2] Hyperesthesia (2%)
Cataract (<10%) Pigmentation [5] Vertigo (dizziness) [3]
Choroidal detachment [2] Pruritus (triple therapy) [2]
Conjunctival edema (<10%) Neuromuscular/Skeletal
Rash [4] Myalgia/Myopathy (<10%)
Conjunctival hemorrhage (<10%)
Conjunctival hyperemia (25–45%) [42] Mucosal Other
Conjunctivitis (<10%) Oral pigmentation [3] Adverse effects [4]
Deepening of upper lid sulcus [9] Stomatitis [4]
Eyelashes – hypertrichosis (>10%) [13] Tongue pigmentation (>10%) [3]
Xerostomia (triple therapy) (41%)
Eyelashes – pigmentation (<10%) [3]
Eyelid erythema (310%) [2] Central Nervous System
BIVALIRUDIN
Eyelid irritation (310%) Dysgeusia (taste perversion) (triple therapy) Trade name: Angiomax (The Medicines
Eyelid pain (310%) (46%) [9] Company)
Eyelid pigmentation (310%) [6] Encephalopathy [4] Indications: Angioplasty adjunct
Eyelid xerosis (310%) Pain (triple therapy) (10%) Class: Thrombin inhibitor
Eyes – adverse effects [2] Tremor [2] Half-life: 25 minutes
Foreign body sensation (<10%) Vertigo (dizziness) [2] Clinically important, potentially hazardous
Iris pigmentation (<10%) [4] Neuromuscular/Skeletal interactions with: anisindione, dicumarol,
Keratitis [2] Arthralgia [10] heparin, reteplase, streptokinase, tenecteplase,
Lacrimation (<10%) Asthenia (fatigue) [2] urokinase, warfarin
Macular edema [2] Pregnancy category: B
Ocular adverse effects [10] Gastrointestinal/Hepatic
Ocular burning (<10%) Diarrhea [5]
Ocular discharge (<10%) Nausea [4] Central Nervous System
Ocular hyperemia [4] Vomiting [2] Pain (15%)
Ocular itching (<10%) Other Neuromuscular/Skeletal
Ocular pain [2] Adverse effects (triple therapy) [52] Back pain (42%)
Ocular pigmentation (<3%) [5] Allergic reactions [2] Hematologic
Ocular pruritus (>10%) [5] Death [10] Bleeding [5]
Periorbital pigmentation (<10%) [3] Thrombosis [3]
Photophobia (<10%)
Punctate keratitis (<10%) [2] Local
Uveitis [3] Injection-site pain (8%)
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 35
BLEOMYCIN Over 100 updates per week on www.drugeruptiondata.com
36 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual BOTULINUM TOXIN (A & B)
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 37
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38 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual BRINZOLAMIDE
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40 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual BUPROPION
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 41
BUPROPION See all our books at www.crcpress.com
Skin BUTORPHANOL
Erythema (macular) (>10%)
Erythema multiforme [5] See: www.drugeruptiondata.com/drug/id/92
Erythema nodosum [3]
42 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CALCIFEDIOL
Respiratory
C1-ESTERASE CABOZANTINIB Cough (18%)
Dysphonia (20%)
INHIBITOR Trade names: Carbometyx (Exelixis), Cometriq Dyspnea (19%)
(Exelixis) Pulmonary embolism [2]
See: www.drugeruptiondata.com/drug/id/1352 Indications: Metastatic medullary thyroid cancer
(Cometriq), advanced renal cell carcinoma Endocrine/Metabolic
(Cabometyx) ALP increased (52%)
ALT increased (86%) [2]
CABAZITAXEL Class: Tyrosine kinase inhibitor
Appetite decreased (46%) [4]
Half-life: 55 hours (Cometriq); 99 hours
See: www.drugeruptiondata.com/drug/id/1701 (Cabometyx) AST increased (86%) [2]
Clinically important, potentially hazardous Dehydration (7%)
interactions with: atazanavir, boceprevir, GGT increased (27%)
carbamazepine, clarithromycin, conivaptan, Hypoalbuminemia (36%)
CABERGOLINE grapefruit juice, indinavir, itraconazole, Hypocalcemia (52%)
ketoconazole, lopinavir, nefazodone, nelfinavir, Hypokalemia (18%)
Trade name: Dostinex (Pfizer) Hypomagnesemia (19%)
phenobarbital, phenytoin, posaconazole, rifabutin,
Indications: Hyperprolactinemia, Parkinsonism Hyponatremia (10%)
rifampin, rifapentine, ritonavir, saquinavir, St
Class: Dopamine receptor agonist Hypophosphatemia (28%)
John’s wort, telithromycin, voriconazole
Half-life: 6369 hours Serum creatinine increased (58%)
Pregnancy category: D
Clinically important, potentially hazardous Weight loss (48%) [7]
Important contra-indications noted in the
interactions with: azithromycin,
levomepromazine, risperidone, zuclopenthixol
prescribing guidelines for: the elderly; nursing Renal
Pregnancy category: B
mothers; pediatric patients Proteinuria (2%)
Warning: PERFORATIONS AND FISTULAS, and Hematologic
Important contra-indications noted in the
HEMORRHAGE Anemia [2]
prescribing guidelines for: the elderly; nursing
mothers; pediatric patients Lymphopenia (53%)
Skin Neutropenia (35%) [2]
Erythema (11%) Thrombocytopenia (35%) [2]
Skin
Hand–foot syndrome (50%) [16] Thrombosis [2]
Edema [2]
Hyperkeratosis (7%) Other
Hot flashes (3%)
Jaundice (25%) Adverse effects [4]
Mucosal Rash (19%)
Xerostomia (2%) Death (6%) [5]
Toxicity [2]
Cardiovascular Xerosis (19%)
Cardiac failure [2] Hair
Hypotension [5] Alopecia (16%)
CALCIFEDIOL
Myocardial toxicity [3] Hair changes (34%) Synonym: calcidiol
Pericarditis [4] Hair pigmentation (34%) [2] Trade name: Rayaldee (Opko)
Valve regurgitation [2]
Valvulopathy [9]
Mucosal Indications: Hyperparathyroidism in stage 3 or 4
Mucosal inflammation [2] chronic kidney disease
Central Nervous System Stomatitis (51%) Class: Vitamin D analog
Dyskinesia [2] Half-life: 11 days
Headache (26%) [6]
Cardiovascular
Chest pain (9%) Clinically important, potentially hazardous
Mania [3] interactions with: anticonvulsants, atazanavir,
Hypertension (33%) [13]
Neurotoxicity [3] cholestyramine, clarithromycin, indinavir,
Hypotension (7%)
Paresthesias (5%) [2] itraconazole, ketoconazole, nefazodone,
Psychosis [3] Central Nervous System nelfinavir, phenobarbital, ritonavir, saquinavir,
Somnolence (drowsiness) (<5%) Anorexia [2] telithromycin, thiazides, voriconazole
Vertigo (dizziness) (15–17%) [6] Anxiety (9%) Pregnancy category: C
Dysgeusia (taste perversion) (34%) Important contra-indications noted in the
Neuromuscular/Skeletal
Headache (18%) prescribing guidelines for: nursing mothers;
Asthenia (fatigue) (6%) [5]
Paresthesias (7%) pediatric patients
Gastrointestinal/Hepatic Peripheral neuropathy (5%)
Abdominal pain (5%) Vertigo (dizziness) (14%)
Constipation (7–10%) Skin
Nausea (28%) [3]
Neuromuscular/Skeletal Hematoma (2%)
Arthralgia (14%)
Endocrine/Metabolic Asthenia (fatigue) (21–41%) [17] Cardiovascular
Mastodynia (2%) Muscle spasm (12%) Congestive heart failure (4%)
Pain in extremities (14%) Neuromuscular/Skeletal
Gastrointestinal/Hepatic Arthralgia (2%)
Abdominal pain (27%) Gastrointestinal/Hepatic
Constipation (27%) [2] Constipation (3%)
Diarrhea (63%) [15] Respiratory
Dyspepsia (11%) Bronchitis (3%)
Dysphagia (13%) Cough (4%)
Gastrointestinal perforation (3%) Dyspnea (4%)
Hemorrhoids (9%) Nasopharyngitis (5%)
Nausea (43%) [7]
Vomiting (24%) [4] Endocrine/Metabolic
Hyperkalemia (3%)
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 43
CALCIFEDIOL Over 100 updates per week on www.drugeruptiondata.com
44 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CAPREOMYCIN
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 45
CAPTOPRIL See all our books at www.crcpress.com
Skin Skin
Angioedema (<15%) [45] CARBAMAZEPINE AGEP [5]
Bullous pemphigoid [2] Angioedema [5]
Dermatitis [3] Trade names: Epitol (Teva), Tegretol (Novartis) Anticonvulsant hypersensitivity syndrome
DRESS syndrome [2] Indications: Epilepsy, pain or trigeminal neuralgia [19]
Erythroderma [2] Class: Anticonvulsant, Antipsychotic, CYP1A2 Bullous dermatitis [4]
Exanthems (47%) [19] inducer, CYP3A4 inducer, Mood stabilizer Dermatitis [7]
Exfoliative dermatitis (<2%) [4] Half-life: 1855 hours Diaphoresis (<10%)
Kaposi’s sarcoma [2] Clinically important, potentially hazardous DRESS syndrome [48]
Lichen planus pemphigoides [2] interactions with: abiraterone, acetaminophen, Eczema [2]
Lichenoid eruption [12] acetylcysteine, adenosine, afatinib, amitriptyline, Erythema multiforme [16]
Linear IgA bullous dermatosis [5] amlodipine, amprenavir, apixaban, apremilast, Erythroderma [12]
Lupus erythematosus [8] aprepitant, aripiprazole, artemether/lumefantrine, Exanthems (>5%) [35]
Mycosis fungoides [2] boceprevir, brigatinib, brivaracetam, Exfoliative dermatitis [24]
Pemphigus (<2%) [23] buprenorphine, cabazitaxel, cabozantinib, Facial edema [2]
Pemphigus foliaceus [2] caffeine, caspofungin, cefixime, ceritinib, charcoal, Fixed eruption [10]
Penile ulceration [2] citalopram, clarithromycin, clobazam, Hypersensitivity [71]
Photosensitivity [3] clopidogrel, clorazepate, clozapine, cobicistat/ Lichen planus [2]
Phototoxicity (<2%) elvitegravir/emtricitabine/tenofovir disoproxil, Lichenoid eruption [8]
Pigmentation [2] cobimetinib, copanlisib, crizotinib, dabigatran, Lupus erythematosus [35]
Pityriasis rosea (<2%) [6] daclatasvir, darunavir, dasabuvir/ombitasvir/ Lymphoma [2]
Pruritus (<7%) [8] paritaprevir/ritonavir, dasatinib, deflazacort,
46 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CARFILZOMIB
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 47
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48 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CASPOFUNGIN
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50 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CEFTAROLINE FOSAMIL
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52 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CELECOXIB
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54 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CETUXIMAB
Mucosal
CETIRIZINE CETRORELIX Mucositis [10]
Oral mucositis [2]
Trade name: Zyrtec (Pfizer) Trade name: Cetrotide (Merck) Stomatitis (25%) [3]
Indications: Allergic rhinitis, urticaria Indications: Inhibition of premature luteinizing Xerostomia (11%)
Class: Histamine H1 receptor antagonist hormone surges in women undergoing controlled
Half-life: 811 hours ovarian stimulation Cardiovascular
Clinically important, potentially hazardous Class: Gonadotropin-releasing hormone (GnRH) Cardiotoxicity [2]
interactions with: alcohol, CNS depressants, antagonist Flushing [2]
pilsicainide Half-life: 5 hours Thromboembolism [2]
Pregnancy category: B Clinically important, potentially hazardous Central Nervous System
Important contra-indications noted in the interactions with: none known Anorexia [2]
prescribing guidelines for: nursing mothers Pregnancy category: X Anxiety (14%)
Important contra-indications noted in the Aseptic meningitis [6]
Skin prescribing guidelines for: nursing mothers Chills (13%) [2]
Acneform eruption (<2%) Confusion (15%)
Anaphylactoid reactions/Anaphylaxis (<2%) Skin Depression (13%)
[2] Hot flashes [2] Fever (30%) [4]
Angioedema (<2%) Headache (33%)
Central Nervous System Insomnia (30%)
Bullous dermatitis (<2%) Headache [2]
Dermatitis (<2%) Pain (51%)
Diaphoresis (<2%) Peripheral neuropathy [3]
Exanthems (<2%) Rigors (13%)
Fixed eruption [6] CETUXIMAB Seizures [2]
Furunculosis (<2%) Neuromuscular/Skeletal
Hyperkeratosis (<2%) Trade name: Erbitux (Bristol-Myers Squibb) Asthenia (fatigue) (89%) [24]
Photosensitivity (<2%) Indications: Metastatic colorectal cancer, Back pain (11%)
Phototoxicity (<2%) squamous cell carcinoma of the head and neck Bone or joint pain (15%)
Pruritus (<2%) Class: Antineoplastic, Biologic, Epidermal growth
factor receptor (EGFR) inhibitor, Monoclonal Gastrointestinal/Hepatic
Purpura (<2%) Abdominal pain (59%)
Rash (<2%) antibody
Half-life: 75188 hours Constipation (46%)
Seborrhea (<2%) Diarrhea (39%) [19]
Urticaria (<2%) [9] Clinically important, potentially hazardous
interactions with: none known Dysphagia [2]
Xerosis (<2%) Hepatotoxicity [4]
Pregnancy category: C
Hair Important contra-indications noted in the Nausea [11]
Alopecia (<2%) prescribing guidelines for: nursing mothers; Vomiting (37%) [7]
Hypertrichosis (<2%) pediatric patients Respiratory
Mucosal Warning: SERIOUS INFUSION REACTIONS Cough (29%)
Sialorrhea (<2%) and CARDIOPULMONARY ARREST Dyspnea (48%) [5]
Stomatitis (<2%) Pneumonia [2]
Tongue edema (<2%) Skin Pneumonitis [3]
Tongue pigmentation (<2%) Acneform eruption (88%) [62] Pulmonary toxicity [6]
Xerostomia (6%) [2] Anaphylactoid reactions/Anaphylaxis [5] Endocrine/Metabolic
Cardiovascular Dermatitis [4] Hypokalemia [6]
Flushing (<2%) Desquamation (89%) [3] Hypomagnesemia [16]
QT prolongation [2] Erythema [3] Hyponatremia [5]
Central Nervous System Exanthems [5] Hematologic
Ageusia (taste loss) (<2%) Fissures [4] Anemia [6]
Dysgeusia (taste perversion) (<2%) Folliculitis [13] Febrile neutropenia [5]
Headache [2] Hand–foot syndrome [5] Leukopenia [9]
Hyperesthesia (<2%) Hypersensitivity [8] Neutropenia [22]
Insomnia [2] Papulopustular eruption [7] Sepsis (<4%)
Paresthesias (<2%) Peripheral edema (10%) Thrombocytopenia [5]
Parosmia (<2%) Pruritus (40%) [9] Thrombosis [3]
Somnolence (drowsiness) [5] Radiation recall dermatitis [2]
Rash (89%) [47] Ocular
Neuromuscular/Skeletal Toxic epidermal necrolysis [2] Blepharitis [3]
Asthenia (fatigue) [3] Toxicity [18] Conjunctivitis (7%) [2]
Dystonia [6] Xerosis (49%) [14] Ectropion [2]
Myalgia/Myopathy (<2%) Eyelashes – hypertrichosis [3]
Hair Trichomegaly [11]
Endocrine/Metabolic Abnormal hair growth [2]
Mastodynia (<2%) Alopecia (5%) Local
Genitourinary Hair changes [3] Application-site reactions (~3%)
Vaginitis (<2%) Hypertrichosis [3] Infusion-related reactions [7]
Infusion-site reactions (15–21%) [10]
Other Nails
Adverse effects [4] Nail changes (21%) Other
Nail disorder [2] Adverse effects [8]
Paronychia [15] Allergic reactions [3]
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CETUXIMAB Over 100 updates per week on www.drugeruptiondata.com
56 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CHLORPHENIRAMINE
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 57
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Mucosal Neuromuscular/Skeletal
Xerostomia (<10%) Asthenia (fatigue) (31%)
Cardiovascular Gastrointestinal/Hepatic
CHOLINE
Hypotension [4] Abdominal pain (19%) FENOFIBRATE
QT prolongation [4] Diarrhea (4%)
Tachycardia [2] Nausea (18%) See: www.drugeruptiondata.com/drug/id/2095
Torsades de pointes [2] Vomiting (18%)
Central Nervous System Endocrine/Metabolic
Neuroleptic malignant syndrome [7] Appetite decreased (17%) CICLESONIDE
Sedation [3]
Seizures [2] See: www.drugeruptiondata.com/drug/id/1263
Endocrine/Metabolic CHOLESTYRAMINE
Galactorrhea (<10%)
Gynecomastia (<10%) Trade name: Questran (Par) CICLOPIROX
Mastodynia (<10%) Indications: Pruritus associated with biliary
Weight gain [2] obstruction, primary hypercholesterolemia See: www.drugeruptiondata.com/drug/id/2335
Genitourinary Class: Bile acid sequestrant
Half-life: N/A
Priapism [7]
Clinically important, potentially hazardous
Otic interactions with: acarbose, acetaminophen,
Tinnitus [2] acitretin, amiodarone, aspirin, bezafibrate,
Ocular calcifediol, chloroquine, cyclopenthiazide,
Cataract [2] cyclosporine, deferasirox, digoxin, doxepin,
58 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CILOSTAZOL
Anxiety (<2%)
CIDOFOVIR CILOSTAZOL Cerebral ischemia (<2%)
Chills (<2%)
Trade name: Vistide (Gilead) Trade name: Pletal (Otsuka) Headache (27–34%) [19]
Indications: Cytomegalovirus (CMV) retinitis in Indications: Peripheral vascular disease, Hyperesthesia (2%)
patients with acquired immunodeficiency intermittent claudication Insomnia (<2%)
syndrome (AIDS) Class: Antiplatelet, Phosphodiesterase inhibitor, Neurotoxicity (<2%)
Class: Antiviral, nucleotide analog Vasodilator, peripheral Paresthesias (2%)
Half-life: ~2.6 hours Half-life: 1113 hours Syncope (<2%)
Clinically important, potentially hazardous Clinically important, potentially hazardous Vertigo (dizziness) (<10%) [4]
interactions with: amphotericin B, cobicistat/ interactions with: anagrelide, anticoagulants,
elvitegravir/emtricitabine/tenofovir alafenamide, antifungals, antiplatelet agents, clarithromycin, Neuromuscular/Skeletal
cobicistat/elvitegravir/emtricitabine/tenofovir collagenase, conivaptan, CYP2C19 inhibitors, Arthralgia (<2%)
disoproxil, tenofovir disoproxil CYP3A4 inhibitors and inducers, dasatinib, Asthenia (fatigue) (<2%)
Pregnancy category: C deferasirox, diltiazem, drotrecogin alfa, Back pain (6–7%)
Important contra-indications noted in the erythromycin, esomeprazole, fondaparinux, Bone or joint pain (<2%)
prescribing guidelines for: the elderly; nursing glucosamine, grapefruit juice, high-fat foods, Gouty tophi (<2%)
mothers; pediatric patients ibritumomab, itraconazole, ketoconazole, Myalgia/Myopathy (23%)
Warning: RENAL TOXICITY and macrolide antibiotics, NSAIDs, omeprazole, PEG- Gastrointestinal/Hepatic
NEUTROPENIA interferon, pentosan, pentoxifylline, prostacyclin Abdominal pain (4–5%)
analogues, salicylates, St John’s wort, Black stools (<2%)
Skin telithromycin, thrombolytic agents, tositumomab Cholelithiasis (gallstones) (<2%)
Acneform eruption (>10%) & iodine131, voriconazole Colitis (<2%)
Diaphoresis (<10%) Pregnancy category: C Diarrhea (12–19%) [7]
DRESS syndrome [2] Important contra-indications noted in the Dyspepsia (6%)
Pallor (<10%) prescribing guidelines for: nursing mothers; Esophagitis (<2%)
Pigmentation (>10%) pediatric patients Flatulence (2–3%)
Pruritus (<10%) [2] Note: Contra-indicated in patients with Gastritis (<2%)
Rash (27%) [2] congestive heart failure or active pathological Gastroenteritis (<2%)
Toxicity [3] bleeding. Gastrointestinal ulceration (<2%)
Ulcerations [2] Warning: CONTRA-INDICATED IN HEART Hematemesis (<2%)
Urticaria (<10%) FAILURE PATIENTS Nausea (6–7%) [4]
Peptic ulceration (<2%)
Hair Vomiting (>2%)
Alopecia (22%) [2] Skin
Ecchymoses (<2%) Respiratory
Mucosal Edema (<2%) Asthma (<2%)
Stomatitis (<10%) Facial edema (<2%) Cough (3–4%) [2]
Central Nervous System Furunculosis (<2%) Hemoptysis (<2%)
Chills (24%) Hypertrophy (<2%) Pharyngitis (7–10%)
Dysgeusia (taste perversion) (<10%) Peripheral edema (79%) Pneumonia (<2%)
Headache [4] Purpura (<2%) Rhinitis (7–12%)
Paresthesias (>10%) Rash (2%) [2] Sinusitis (<2%)
Neuromuscular/Skeletal Urticaria (<2%) Endocrine/Metabolic
Asthenia (fatigue) [2] Varicosities (<2%) Creatine phosphokinase increased (<2%)
Myalgia/Myopathy [2] Xerosis (<2%) Diabetes mellitus (<2%)
Renal Mucosal GGT increased (<2%)
Fanconi syndrome [2] Epistaxis (nosebleed) (<2%) Hyperlipidemia (<2%)
Nephrotoxicity [5] Gingival bleeding (<2%) Hyperuricemia (<2%)
Perioral abscess (<2%) Genitourinary
Ocular Rectal hemorrhage (<2%)
Intraocular inflammation [2] Albuminuria (<2%)
Tongue edema (<2%) Cystitis (<2%)
Iritis [6]
Ocular hypotension [2] Cardiovascular Urinary frequency (<2%)
Retinal detachment [3] Arrhythmias (<2%) Vaginal bleeding (<2%)
Uveitis [18] Atrial fibrillation (<2%) Vaginitis (<2%)
Vision impaired [3] Atrial flutter (<2%) Renal
Vision loss [3] Cardiac arrest (<2%) Retroperitoneal bleeding (<2%)
Cardiotoxicity [4]
Local Congestive heart failure (<2%) Hematologic
Application-site reactions (39%) [3] Extrasystoles (<2%) Anemia (<2%)
Other Hypotension (<2%) Hemorrhage (<2%)
Allergic reactions (<10%) Myocardial infarction (<2%) [4] Polycythemia (<2%)
Myocardial ischemia (<2%) Thrombosis [3]
Palpitation (5–10%) [7] Otic
Postural hypotension (<2%) Ear pain (<2%)
CILAZAPRIL Supraventricular tachycardia (<2%) Tinnitus (<2%)
See: www.drugeruptiondata.com/drug/id/1241
Tachycardia (4%) [4] Ocular
Vasodilation (<2%) Amblyopia (<2%)
Ventricular tachycardia (<2%) Blindness (<2%)
Central Nervous System Conjunctivitis (<2%)
Anorexia (<2%) Diplopia (<2%)
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CILOSTAZOL Over 100 updates per week on www.drugeruptiondata.com
Ocular hemorrhage (<2%) Renal taking corticosteroid drugs, and in patients with
Other Nephrotoxicity [3] kidney, heart or lung transplants.
Adverse effects [4] Fluoroquinolones may exacerbate muscle
Death [3] weakness in persons with myasthenia gravis.
Ciprofloxacin is chemically related to nalidixic
Infection (10–14%) CINACALCET acid.
See: www.drugeruptiondata.com/drug/id/1021 Warning: SERIOUS ADVERSE REACTIONS
INCLUDING TENDINITIS, TENDON
CIMETIDINE RUPTURE, PERIPHERAL NEUROPATHY,
CENTRIAL NERVOUS SYSTEM EFFECTS and
Trade name: Tagamet (GSK) CINNARIZINE EXACERBATION OF MYASTHENIA GRAVIS
Indications: Duodenal ulcer
Class: CYP1A2 inhibitor, CYP3A4 inhibitor, See: www.drugeruptiondata.com/drug/id/1076
Histamine H2 receptor antagonist Skin
Half-life: 2 hours Acneform eruption [3]
Clinically important, potentially hazardous AGEP [4]
interactions with: acenocoumarol, alfuzosin,
CINOXACIN Anaphylactoid reactions/Anaphylaxis [15]
aminophylline, amiodarone, amitriptyline, Angioedema [8]
See: www.drugeruptiondata.com/drug/id/154 Candidiasis [2]
anisindione, anticoagulants, buprenorphine,
butorphanol, caffeine, carmustine, citalopram, Diaphoresis [5]
clobazam, clopidogrel, clozapine, cocoa, Erythema multiforme [5]
delavirdine, dicumarol, dofetilide, duloxetine, CIPROFIBRATE Exanthems [4]
dutasteride, epirubicin, eszopiclone, fentanyl, Facial edema [2]
ferrous sulfate, floxuridine, fluorouracil, See: www.drugeruptiondata.com/drug/id/1140 Fixed eruption [13]
galantamine, gliclazide, hydromorphone, Hypersensitivity [5]
itraconazole, ketoconazole, labetalol, Jaundice [2]
levomepromazine, lidocaine, lomustine, CIPROFLOXACIN Linear IgA bullous dermatosis [2]
meptazinol, metformin, metronidazole, Photosensitivity [19]
midazolam, mizolastine, moclobemide, Trade names: Ciloxan Ophthalmic (Alcon), Phototoxicity [5]
morphine, narcotic analgesics, neratinib, Cipro (Bayer), Ciproxin (Bayer) Pruritus [11]
oxprenolol, oxtriphylline, oxycodone, Indications: Various infections caused by Purpura [4]
oxymorphone, pentazocine, phenytoin, susceptible organisms, inhalational anthrax (post Rash (<10%) [13]
pimecrolimus, posaconazole, prednisone, exposure) Serum sickness-like reaction [3]
propranolol, quinine, rilpivirine, risperidone, Class: Antibiotic, fluoroquinolone, CYP1A2 Stevens-Johnson syndrome [9]
roflumilast, sertindole, sildenafil, sufentanil, inhibitor, CYP3A4 inhibitor Toxic epidermal necrolysis [11]
tamsulosin, terbinafine, thalidomide, tolazoline, Half-life: 4 hours Toxicity [3]
warfarin, xanthines, zaleplon, zofenopril, Clinically important, potentially hazardous Urticaria [9]
zolmitriptan, zolpidem interactions with: agomelatine, aminophylline, Vasculitis [11]
Pregnancy category: B amiodarone, amitriptyline, antacids, Mucosal
Important contra-indications noted in the antineoplastics, arsenic, artemether/lumefantrine, Stomatitis [4]
prescribing guidelines for: nursing mothers; BCG vaccine, bendamustine, bepridil, bismuth, Xerostomia [3]
pediatric patients bismuth subsalicylate, bretylium, calcium salts, Cardiovascular
citalopram, clopidogrel, clozapine, Palpitation [2]
Skin corticosteroids, cyclosporine, dairy products, QT prolongation [11]
Angioedema [3] dasatinib, degarelix, didanosine, disopyramide, Torsades de pointes [8]
Erythema annulare centrifugum [2] dolasetron, duloxetine, dutasteride, eluxadoline,
erlotinib, erythromycin, flibanserin, insulin, Central Nervous System
Erythema multiforme [5] Dysgeusia (taste perversion) [3]
Exanthems [3] lanthanum, lapatinib, levofloxacin, magnesium
salts, meptazinol, methotrexate, methylxanthines, Fever [3]
Exfoliative dermatitis [2] Headache [6]
Fixed eruption [2] mifepristone, moxifloxacin, mycophenolate,
neratinib, NSAIDs, olanzapine, olaparib, opiod Mania [4]
Hypersensitivity [4] Peripheral neuropathy [2]
Lupus erythematosus [3] analgesics, oral iron, oxtriphylline, P-glycoprotein
inhibitors, pazopanib, pentoxifylline, Psychosis [5]
Pruritus [6] Seizures [5]
Pseudolymphoma [2] phenothiazines, phenytoin, pirfenidone,
probenecid, procainamide, propranolol, QT Syncope [2]
Psoriasis [6] Tremor [2]
Rash (<2%) prolonging agents, quinapril, quinidine, rasagiline,
ropinirole, ropivacaine, sevelamer, sotalol, St Vertigo (dizziness) [2]
Stevens-Johnson syndrome [3]
Toxic epidermal necrolysis [2] John’s wort, strontium ranelate, sucralfate, Neuromuscular/Skeletal
Urticaria [6] sulfonylureas, telavancin, telithromycin, tizanidine, Arthralgia [2]
Vasculitis [3] tricyclic antidepressants, typhoid vaccine, Asthenia (fatigue) [3]
venetoclax, vitamin K antagonists, voriconazole, Myalgia/Myopathy [2]
Hair vorinostat, warfarin, zinc, ziprasidone, Myasthenia gravis (exacerbation) [2]
Alopecia [4] zolmitriptan Myoclonus [4]
Central Nervous System Pregnancy category: C Rhabdomyolysis [4]
Hallucinations [3] Important contra-indications noted in the Tendinitis [4]
Neuromuscular/Skeletal prescribing guidelines for: the elderly; nursing Tendinopathy/Tendon rupture [31]
Myalgia/Myopathy [2] mothers Gastrointestinal/Hepatic
Note: Fluoroquinolones are associated with an Abdominal pain [2]
Endocrine/Metabolic increased risk of tendinitis and tendon rupture in
Gynecomastia [12] Constipation [2]
all ages. This risk is further increased in older Flatulence [2]
patients usually over 60 years of age, in patients Hepatitis [4]
60 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual CITALOPRAM
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CITALOPRAM See all our books at www.crcpress.com
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Litt’s Drug Eruption & Reaction Manual CLONAZEPAM
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Litt’s Drug Eruption & Reaction Manual CO-TRIMOXAZOLE
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Litt’s Drug Eruption & Reaction Manual COLCHICINE
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Litt’s Drug Eruption & Reaction Manual CRIZOTINIB
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Litt’s Drug Eruption & Reaction Manual CYCLOSPORINE
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Litt’s Drug Eruption & Reaction Manual CYTARABINE
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DABIGATRAN See all our books at www.crcpress.com
Endocrine/Metabolic
DABIGATRAN DABRAFENIB ALP increased (19%) [2]
ALT increased [3]
Trade name: Pradaxa (Boehringer Ingelheim) Trade name: Tafinlar (Novartis) Appetite decreased [3]
Indications: Prevention of venous Indications: Melanoma (unresectable or AST increased [3]
thromboembolic events, reduce stroke risk metastatic) in patients with BRAF V600E mutation Hyperglycemia (50%)
Class: Anticoagulant, Thrombin inhibitor Class: BRAF inhibitor, Kinase inhibitor Hyponatremia (8%) [2]
Half-life: 2.5 days Half-life: 8 hours Hypophosphatemia (37%)
Clinically important, potentially hazardous Clinically important, potentially hazardous
interactions with: amiodarone, antacids, interactions with: strong CYP3A4 or CYP2C8 Renal
anticoagulants, atorvastatin, carbamazepine, inducers or inhibitors Nephrotoxicity (<10%) [2]
clarithromycin, clopidogrel, collagenase, Pregnancy category: D Hematologic
cyclosporine, darunavir, dasatinib, deferasirox, Important contra-indications noted in the Anemia [5]
desirudin, dextran, diclofenac, dronedarone, prescribing guidelines for: nursing mothers; Leukopenia [2]
fondaparinux, heparin, ibritumomab, pediatric patients Neutropenia [4]
itraconazole, ketoconazole, ketorolac, lapatinib, Other
meloxicam, nandrolone, neratinib, NSAIDs, P- Skin Adverse effects [7]
glycoprotein inducers and inhibitors, Acneform eruption [4]
pantoprazole, pentosan, phenytoin, polysulfate Actinic keratoses [3]
sodium, prostacyclin analogues, proton pump Basal cell carcinoma [4]
inhibitors, quinidine, rifampin, rivaroxaban, Bullae (<10%)
DACARBAZINE
salicylates, St John’s wort, sulfinpyrazone, Erythema [2]
tacrolimus, telaprevir, thrombolytic agents, Synonym: DIC
Exanthems [2] Trade name: DTIC-Dome (Bayer)
ticlopidine, tipranavir, tositumomab & iodine131, Grover’s disease [4]
ulipristal, verapamil, vitamin K antagonists Indications: Malignant melanoma, carcinomas
Hand–foot syndrome (20%) [6] Class: Alkylating agent, Antineoplastic
Pregnancy category: C Hyperkeratosis (37%) [12]
Important contra-indications noted in the Half-life: 5 hours
Hypersensitivity (<10%) Clinically important, potentially hazardous
prescribing guidelines for: the elderly; nursing Keratoacanthoma (7%) [7]
mothers; pediatric patients interactions with: aldesleukin
Keratosis pilaris [4] Pregnancy category: C
Note: Contra-indicated in patients with active Lesions [2]
pathological bleeding or with a mechanical Important contra-indications noted in the
Malignant melanoma (2%) prescribing guidelines for: nursing mothers
prosthetic heart valve. Panniculitis [6]
Warning: DISCONTINUING PRADAXA IN Papillomas (27%) [4]
PATIENTS WITHOUT ADEQUATE Peripheral edema [2] Skin
CONTINUOUS ANTICOAGULATION Photosensitivity [7] Anaphylactoid reactions/Anaphylaxis
INCREASES RISK OF STROKE Pruritus [3] (<10%)
Rash (17%) [5] Hypersensitivity [2]
Skin Seborrheic keratoses [2] Photosensitivity [10]
Bruising (<10%) Squamous cell carcinoma (7%) [17] Rash (<10%) [2]
Exanthems [2] Toxicity [4] Urticaria [2]
Rash [2] Xerosis [4] Hair
Mucosal Hair Alopecia (<10%) [3]
Epistaxis (nosebleed) [2] Alopecia (22%) [7] Mucosal
Cardiovascular Hair changes [2] Stomatitis (48%)
Myocardial infarction [5] Cardiovascular Cardiovascular
Central Nervous System Chest pain [2] Flushing (<10%) [2]
Headache [2] Hypertension [3] Central Nervous System
Intracranial hemorrhage [4] Central Nervous System Dysgeusia (taste perversion) (<10%)
Subarachnoid hemorrhage [2] Chills [4] Neuromuscular/Skeletal
Gastrointestinal/Hepatic Fever (28%) [20] Asthenia (fatigue) (75%) [4]
Abdominal pain [2] Headache (32%) [7] Myalgia/Myopathy (<10%)
Dyspepsia (11%) [7] Intracranial hemorrhage [3]
Gastrointestinal/Hepatic
Esophagitis [3] Neuromuscular/Skeletal Hepatotoxicity [3]
Gastritis [2] Arthralgia (27%) [9] Nausea [3]
Gastrointestinal bleeding (6%) [10] Asthenia (fatigue) [12] Vomiting [2]
Renal Back pain (12%)
Myalgia/Myopathy (11%) [2] Respiratory
Renal failure [4] Flu-like syndrome [2]
Hematologic Gastrointestinal/Hepatic
Abdominal pain [2] Endocrine/Metabolic
Anemia (<4%) ALT increased [2]
Anticoagulation [2] Constipation (11%) [2]
Diarrhea [3] AST increased [2]
Hemorrhage [9]
Thrombosis [3] Nausea [8] Hematologic
Pancreatitis (<10%) Neutropenia [4]
Other Vomiting [6] Thrombocytopenia [2]
Adverse effects [6]
Death [6] Respiratory Local
Cough (12%) [2] Injection-site burning (>10%)
Nasopharyngitis (10%) Injection-site necrosis (>10%)
Injection-site pain (>10%)
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Litt’s Drug Eruption & Reaction Manual DALBAVANCIN
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Litt’s Drug Eruption & Reaction Manual DARATUMUMAB
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Litt’s Drug Eruption & Reaction Manual DASATINIB
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DAUNORUBICIN Over 100 updates per week on www.drugeruptiondata.com
Neuromuscular/Skeletal
DAUNORUBICIN Arthralgia (7%) DECITABINE
Asthenia (fatigue) (10%)
Synonyms: daunomycin; DNR; rubidomycin Ataxia (<5%) Synonym: 5-aza-2’-deoxycytidine
Trade name: DaunoXome (Gilead) Back pain (16%) Trade name: Dacogen (MGI Pharma)
Indications: Acute leukemias Hyperkinesia (<5%) Indications: Myelodysplastic syndromes,
Class: Antibiotic, anthracycline Hypertonia (<5%) leukemia
Half-life: 14–20 hours; 4 hours (intramuscular) Myalgia/Myopathy (7%) Class: Antineoplastic
Clinically important, potentially hazardous Half-life: ~30 minutes
interactions with: aldesleukin, gadobenate Gastrointestinal/Hepatic Clinically important, potentially hazardous
Pregnancy category: D Abdominal pain (23%) interactions with: none known
Important contra-indications noted in the Black stools (<5%) Pregnancy category: D
prescribing guidelines for: the elderly; nursing Constipation (7%) Important contra-indications noted in the
mothers; pediatric patients Diarrhea (38%) prescribing guidelines for: nursing mothers;
Warning: MYOCARDIAL TOXICITY / Dysphagia (<5%) pediatric patients
MYELOSUPPRESSION Gastritis (<5%)
Gastrointestinal bleeding (<5%)
Hemorrhoids (<5%) Skin
Skin Hepatomegaly (<5%) Bacterial infection (5%)
Angioedema [4] Nausea (54%) Candidiasis (10%)
Dermatitis [2] Tenesmus (5%) Cellulitis (12%)
Edema (11%) Vomiting (23%) Ecchymoses (22%)
Exanthems [2] Edema (18%)
Folliculitis (<5%) Respiratory Erythema (14%)
Hot flashes (<5%) Cough (28%) Facial edema (6%)
Hyperhidrosis (14%) Dyspnea (26%) Hematoma (5%)
Lymphadenopathy (<5%) Flu-like syndrome (5%) Lymphadenopathy (12%)
Neutrophilic eccrine hidradenitis [2] Hemoptysis (<5%) Pallor (23%)
Pigmentation [3] PIE syndrome (<5%) Peripheral edema (25%)
Pruritus (7%) Rhinitis (12%) Petechiae (39%)
Seborrhea (<5%) Sinusitis (8%) Pruritus (11%)
Urticaria [3] Endocrine/Metabolic Rash (19%) [2]
Xerosis (<5%) Appetite increased (<5%) Urticaria (6%)
Hair Dehydration (<5%) Mucosal
Alopecia (8%) [4] Genitourinary Gingival bleeding (8%)
Nails Dysuria (<5%) Glossodynia (5%)
Nail pigmentation [5] Nocturia (<5%) Lip ulceration (5%)
Polyuria (<5%) Mucositis [2]
Mucosal Oral candidiasis (6%)
Gingival bleeding (<5%) Hematologic
Neutropenia (15–36%) Stomatitis (12%)
Oral lesions [2] Tongue ulceration (7%)
Sialorrhea (<5%) Splenomegaly (<5%)
Stomatitis (10%) Otic Cardiovascular
Xerostomia (<5%) Ear pain (<5%) Chest pain (7%)
Hearing loss (<5%) Hypotension (6%)
Cardiovascular Pulmonary edema (6%)
Chest pain (9–14%) Tinnitus (<5%)
QT prolongation [2]
Flushing (14%) Ocular
Hypertension (<5%) Abnormal vision (5%) Central Nervous System
Myocardial toxicity [5] Conjunctivitis (<5%) Anorexia (16%) [2]
Palpitation (<5%) Ocular pain (<5%) Anxiety (11%)
Tachycardia (<5%) Confusion (12%)
Local Fever (53%) [2]
Central Nervous System Injection-site inflammation (<5%) Headache (28%)
Amnesia (<5%) Injection-site necrosis (<10%) [2] Hypoesthesia (11%)
Anorexia (23%) Injection-site ulceration (<10%) Insomnia (28%)
Anxiety (<5%) Other Pain (13%)
Cognitive impairment (<5%) Dipsia (thirst) (<5%) Rigors (22%)
Depression (10%) Hiccups (<5%) Vertigo (dizziness) (18%)
Dysgeusia (taste perversion) (<5%) Infection (40%)
Gait instability (<5%) Neuromuscular/Skeletal
Tooth decay (<5%) Arthralgia (20%)
Hallucinations (<5%)
Headache (25%) Asthenia (fatigue) (5–12%) [6]
Insomnia (6%) Back pain (17%)
Meningococcal infection (<5%) Bone or joint pain (6–19%)
Neurotoxicity (13%) Myalgia/Myopathy (5%)
Rigors (19%) Gastrointestinal/Hepatic
Seizures (<5%) Abdominal distension (5%)
Somnolence (drowsiness) (<5%) Abdominal pain (14%)
Syncope (<5%) Ascites (10%)
Tremor (<5%) Constipation (35%)
Vertigo (dizziness) (8%) Diarrhea (34%) [2]
Dyspepsia (12%)
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Litt’s Drug Eruption & Reaction Manual DEFEROXAMINE
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Litt’s Drug Eruption & Reaction Manual DESMOPRESSIN
Pneumonia (4%)
DEMECLOCYCLINE Upper respiratory tract infection (5%) DESIPRAMINE
See: www.drugeruptiondata.com/drug/id/200 Endocrine/Metabolic See: www.drugeruptiondata.com/drug/id/202
Hypercholesterolemia (7%) [2]
Hypocalcemia (2%) [34]
Hypophosphatemia [3]
DENILEUKIN Genitourinary
DESLORATADINE
See: www.drugeruptiondata.com/drug/id/201 Cystitis (6%) Trade name: Clarinex (Schering)
Hematologic Indications: Allergic rhinitis, urticaria
Anemia (3%) [2] Class: Histamine H1 receptor antagonist
DENOSUMAB Other Half-life: 27 hours
Clinically important, potentially hazardous
Adverse effects [11]
Trade names: Prolia (Amgen), Xgeva (Amgen) Infection [12] interactions with: none known
Indications: Osteoporosis (postmenopausal Pregnancy category: C
women), prevention of skeletal-related events in Important contra-indications noted in the
prescribing guidelines for: nursing mothers;
patients with bone metastases from solid tumors
Class: Bone resorption inhibitor, Monoclonal
DEOXYCHOLIC ACID pediatric patients
antibody, RANK ligand (RANKL) inhibitor Trade name: Kybella (Kythera)
Half-life: 25–28 days Indications: Improvement in the appearance of Skin
Clinically important, potentially hazardous moderate to severe convexity or fullness Urticaria [2]
interactions with: abatacept, alcohol, associated with submental fat Mucosal
azacitidine, betamethasone, cabazitaxel, Class: Cytolytic Xerostomia [5]
denileukin, docetaxel, fingolimod, gefitinib, Half-life: N/A
immuosuppressants, leflunomide, lenalidomide, Central Nervous System
Clinically important, potentially hazardous Headache [7]
oxaliplatin, pazopanib, temsirolimus, interactions with: none known
triamcinolone Somnolence (drowsiness) [6]
Pregnancy category: N/A
Pregnancy category: X Important contra-indications noted in the Neuromuscular/Skeletal
Important contra-indications noted in the prescribing guidelines for: the elderly; pediatric Asthenia (fatigue) [7]
prescribing guidelines for: nursing mothers; patients Gastrointestinal/Hepatic
pediatric patients Note: Contra-indicated in the presence of Diarrhea [2]
Note: Contra-indicated in patients with infection at the injection sites. Nausea [2]
hypocalcemia.
Other
Skin Adverse effects [6]
Skin Lymphadenopathy (<2%)
Cellulitis [9]
Dermatitis [2] Mucosal
Eczema [10] Oropharyngeal pain (3%) DESMOPRESSIN
Herpes zoster (2%) Cardiovascular
Hypersensitivity [2] Hypertension (3%) Trade names: DDAVP (Sanofi-Aventis), Minirin
Peripheral edema (5%) (Ferring), Noctiva (Serenity), Stimate (CSL
Central Nervous System Behring)
Pruritus (2%) Headache (8%)
Rash (3%) [4] Indications: Primary nocturnal enuresis, nocturia
Syncope (<2%) due to nocturnal polyuria (Noctiva)
Cardiovascular Neuromuscular/Skeletal Class: Antidiuretic hormone analog
Angina (3%) Neck pain (<2%) Half-life: 75 minutes
Atrial fibrillation (2%) Clinically important, potentially hazardous
Cardiotoxicity [2] Gastrointestinal/Hepatic
Dysphagia (2%) interactions with: amitriptyline, citalopram,
Central Nervous System Nausea (2%) demeclocycline, hydromorphone, meloxicam,
Headache [3] tapentadol
Insomnia (3%) Local Pregnancy category: B
Pain [2] Injection-site bruising (72%) [2] Important contra-indications noted in the
Vertigo (dizziness) (5%) Injection-site edema [2] prescribing guidelines for: the elderly; nursing
Injection-site erythema (27%) mothers; pediatric patients
Neuromuscular/Skeletal Injection-site hemorrhage (<2%)
Arthralgia [3] Warning: Noctiva: HYPONATREMIA
Injection-site induration (23%) [2]
Asthenia (fatigue) (2%) [2] Injection-site nodules (13%)
Back pain (35%) [6] Injection-site numbness (66%) [2] Cardiovascular
Bone or joint pain (4–8%) [3] Injection-site pain (70%) [2] Flushing (<10%)
Fractures [8] Injection-site pigmentation (<2%) Myocardial infarction [2]
Myalgia/Myopathy (3%) Injection-site pruritus (12%) Central Nervous System
Osteonecrosis (jaw) [25] Injection-site urticaria (<2%) Headache [6]
Pain in extremities (12%) [6] Seizures [5]
Other
Gastrointestinal/Hepatic Adverse effects [2] Endocrine/Metabolic
Abdominal pain (3%) Hyponatremia [11]
Flatulence (2%) SIADH [2]
Gastroesophageal reflux (2%)
Pancreatitis [2] DESFLURANE Local
Injection-site pain (<10%)
Respiratory See: www.drugeruptiondata.com/drug/id/920
Pharyngitis (2%)
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Litt’s Drug Eruption & Reaction Manual DEXRAZOXANE
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Litt’s Drug Eruption & Reaction Manual DIGOXIN
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Litt’s Drug Eruption & Reaction Manual DIPHENOXYLATE
Local
DIMETHYL FUMARATE DINUTUXIMAB Infusion-related reactions (47–60%) [2]
Synonyms: dimethyl (E) butenedioate; BG-12 Trade name: Unituxin (United Therapeutics)
Trade names: Fumaderm (Biogen Idec), Indications: High-risk neuroblastoma in
Tecfidera (Biogen Idec) combination with granulocyte-macrophage DIPHENHYDRAMINE
Indications: Relapsing forms of multiple colony-stimulating factor (GM-CSF), interleukin-2
sclerosis, psoriasis (IL-2), and isotretinoin (13-cis-retinoic acid), in Trade name: Benadryl (Pfizer)
Class: Fumaric acid ester pediatric patients who achieve at least a partial Indications: Allergic rhinitis, urticaria
Half-life: 1 hour response to prior first-line multiagent, Class: Antiemetic, Histamine H1 receptor
Clinically important, potentially hazardous multimodality therapy antagonist, Muscarinic antagonist
interactions with: none known Class: GD2-binding monoclonal antibody, Half-life: 28 hours
Pregnancy category: C Monoclonal antibody Clinically important, potentially hazardous
Important contra-indications noted in the Half-life: 10 days interactions with: alcohol, anticholinergics,
prescribing guidelines for: the elderly; nursing Clinically important, potentially hazardous chloral hydrate, CNS depressants, glutethimide,
mothers; pediatric patients interactions with: none known MAO inhibitors
Note: Fumaderm is mixed dimethyl fumarate and Pregnancy category: N/A (May cause fetal Pregnancy category: B
monoethylfumarate salts. harm) Important contra-indications noted in the
Important contra-indications noted in the prescribing guidelines for: nursing mothers
Skin prescribing guidelines for: the elderly; nursing
Contact dermatitis (from topical contact) mothers Skin
[14] Warning: SERIOUS INFUSION REACTIONS Anaphylactoid reactions/Anaphylaxis [4]
Erythema (5%) [2] AND NEUROTOXICITY Contact dermatitis [2]
Pruritus (8%) [4] Dermatitis [4]
Rash (8%) Skin Eczema [2]
Edema (17%) Fixed eruption [4]
Cardiovascular Photosensitivity [3]
Flushing (40%) [27] Urticaria (25–37%)
Pruritus [2]
Central Nervous System Mucosal Toxic epidermal necrolysis [3]
Leukoencephalopathy [6] Nasal congestion (20%) Toxicity [2]
Neuromuscular/Skeletal Cardiovascular Mucosal
Asthenia (fatigue) [3] Capillary leak syndrome (22–40%) Xerostomia (<10%)
Hypertension (14%)
Gastrointestinal/Hepatic Hypotension (60%) Cardiovascular
Abdominal pain (18%) [11] Tachycardia (19%) QT prolongation [5]
Diarrhea (14%) [10] Torsades de pointes [3]
Dyspepsia (5%) [2] Central Nervous System
Fever (55–72%) Central Nervous System
Nausea [7] Delirium [2]
Vomiting (9%) [3] Pain (61–85%) [2]
Peripheral neuropathy (13%) Sedation [2]
Endocrine/Metabolic Seizures [2]
AST increased (4%) [2] Gastrointestinal/Hepatic Somnolence (drowsiness) [7]
Diarrhea (31–43%)
Genitourinary Nausea (10%) Neuromuscular/Skeletal
Albuminuria (6%) Vomiting (33–46%) Rhabdomyolysis [5]
Urinary tract infection [2] Ocular
Respiratory
Renal Hypoxia (24%) Hallucinations, visual [2]
Proteinuria [2] Wheezing (15%) Other
Hematologic Endocrine/Metabolic Death [4]
Hemotoxicity [2] ALT increased (43–56%)
Lymphopenia (2%) [8] AST increased (16–28%)
Other Creatine phosphokinase increased (15%) DIPHENOXYLATE
Adverse effects (gastrointestinal) [19] Hyperglycemia (18%)
Infection [2] Hypertriglyceridemia (16%) Trade name: Lomotil (Pfizer)
Hypoalbuminemia (29–33%) Indications: Diarrhea
Hypocalcemia (20–27%) Class: Antimotility, Opioid agonist
Hypokalemia (26–43%) Half-life: 2.5 hours
DINOPROSTONE Hypomagnesemia (12%) Clinically important, potentially hazardous
Trade names: Cervidel (Forest), Prepidil (Pfizer) Hyponatremia (36–58%) interactions with: oxybutynin
Indications: Pregnancy termination, uterine Hypophosphatemia (20%) Pregnancy category: C
content evacuation, cervical ripening Weight gain (10%) Important contra-indications noted in the
Class: Prostaglandin Renal prescribing guidelines for: nursing mothers;
Half-life: 2.5–5 minutes Proteinuria (16%) pediatric patients
Clinically important, potentially hazardous Note: Diphenoxylate is almost always prescribed
Hematologic with atropine sulfate.
interactions with: none known Anemia (42–51%)
Pregnancy category: C Hemorrhage (17%)
Note: Dinoprostone is the naturally occurring Lymphopenia (54–62%) Mucosal
form of Prostaglandin E2 (PGE2). Neutropenia (25–39%) Xerostomia (3%)
Sepsis (18%)
Thrombocytopenia (61–66%)
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90 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual DOMPERIDONE
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Litt’s Drug Eruption & Reaction Manual DOXYCYCLINE
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DOXYCYCLINE See all our books at www.crcpress.com
Nails Respiratory
Photo-onycholysis [13] DRONEDARONE Pulmonary toxicity [9]
Mucosal Trade name: Multaq (Sanofi-Aventis) Endocrine/Metabolic
Black tongue [2] Indications: Atrial fibrillation and atrial flutter Serum creatinine increased (51%) [6]
Mucosal candidiasis [2] Class: Antiarrhythmic, Antiarrhythmic class III Renal
Central Nervous System Half-life: 13–19 hours Nephrotoxicity [2]
Anosmia [2] Clinically important, potentially hazardous Renal failure [2]
Fever [2] interactions with: amiodarone, amitriptyline, Other
Headache [4] amoxapine, antiarrhythmics, antipsychotics Adverse effects [2]
Intracranial pressure increased [2] prolonging QT interval, arsenic, atorvastatin, beta Death [2]
Paresthesias [4] blockers, bupivacaine, calcium channel blockers, Side effects [2]
Vertigo (dizziness) [3] carbamazepine, citalopram, clarithromycin,
Neuromuscular/Skeletal conivaptan, coumarins, cyclosporine, CYP3A
inducers, dabigatran, darunavir, dasabuvir/
Myalgia/Myopathy [2]
ombitasvir/paritaprevir/ritonavir, dasatinib, DROPERIDOL
Gastrointestinal/Hepatic degarelix, delavirdine, digoxin, diltiazem,
Abdominal pain [3] disopyramide, dolasetron, efavirenz, Trade names: Inapsine (Akorn), Xomolix
Diarrhea [3] erythromycin, fingolimod, grapefruit juice, (ProStrakan)
Esophagitis [3] indinavir, itraconazole, ketoconazole, lapatinib, Indications: Tranquilizer and antiemetic in
Hepatotoxicity [2] levobupivacaine, levofloxacin, levomepromazine, surgical procedures
Nausea [5] metoprolol, moxifloxacin, nefazodone, neratinib, Class: Antiemetic, Antipsychotic, Butyrophenone
Pancreatitis [3] nifedipine, ombitasvir/paritaprevir/ritonavir, Half-life: 2.3 hours
Ulcerative esophagitis [2] oxcarbazepine, pazopanib, phenindione, Clinically important, potentially hazardous
Vomiting [3] phenobarbital, phenothiazines, phenytoin, interactions with: amiodarone, amisulpride,
Endocrine/Metabolic posaconazole, prilocaine, propranolol, rifampin, amitriptyline, arsenic, atomoxetine, azithromycin,
Hypoglycemia [2] rifapentine, ritonavir, ropivacaine, rosuvastatin, chloroquine, CNS depressants, cyclobenzaprine,
saquinavir, simvastatin, sirolimus, sotalol, St John’s disopyramide, duloxetine, eszopiclone,
Genitourinary fluoxetine, fluvoxamine, hydromorphone,
wort, statins, tacrolimus, telavancin,
Vaginitis [2] hydroxychloroquine, levomepromazine,
telithromycin, tricyclic antidepressants,
Other venetoclax, verapamil, voriconazole, vorinostat, lurasidone, macrolides, metaxalone, milnacipran,
Adverse effects [6] warfarin, ziprasidone moxifloxacin, paliperidone, pentamidine,
Allergic reactions [3] Pregnancy category: X pimozide, QT prolonging agents, quinine,
Tooth pigmentation (>10%) [5] Important contra-indications noted in the ramelteon, sertraline, sotalol, sulpiride,
prescribing guidelines for: nursing mothers; tamoxifen, tapentadol, thiopental, tiagabine,
pediatric patients tricyclic antidepressants
Pregnancy category: C
DRONABINOL Warning: INCREASED RISK OF DEATH,
Important contra-indications noted in the
STROKE AND HEART FAILURE IN PATIENTS
Synonyms: tetrahydrocannabinol; THC WITH DECOMPENSATED HEART FAILURE OR prescribing guidelines for: nursing mothers;
Trade names: Marinol (AbbVie), Syndros (Insys) PERMANENT ATRIAL FIBRILLATION pediatric patients
Indications: Chemotherapy-induced nausea, Note: Contra-indicated in patients with known
anorexia associated with weight loss in patients or suspected QT prolongation.
Skin This product is not available in the European
with AIDS Anaphylactoid reactions/Anaphylaxis [2]
Class: Antiemetic, Cannabinoid market.
Dermatitis (5%) Warning: QT PROLONGATION AND
Half-life: 1924 hours Eczema (5%)
Clinically important, potentially hazardous TORSADE DE POINTES
Erythema (5%)
interactions with: disulfiram, metronidazole Pruritus (5%)
Pregnancy category: C Rash (5%) [8] Skin
Important contra-indications noted in the Anaphylactoid reactions/Anaphylaxis [3]
prescribing guidelines for: the elderly; nursing
Cardiovascular Angioedema [2]
mothers; pediatric patients
Arrhythmias [3]
Bradycardia (3%) [8] Cardiovascular
Cardiac failure (new or worsening) [9] Arrhythmias [2]
Mucosal Cardiotoxicity [3] QT prolongation [13]
Xerostomia (<10%) Congestive heart failure [2] Torsades de pointes [6]
Central Nervous System QT prolongation (28%) [10] Central Nervous System
Euphoria (<10%) Torsades de pointes [3] Akathisia [5]
Paranoia (<10%) Central Nervous System Extrapyramidal symptoms [2]
Somnolence (drowsiness) (<10%) Vertigo (dizziness) [2] Neuroleptic malignant syndrome [2]
Vertigo (dizziness) (<10%) [5] Restlessness [2]
Neuromuscular/Skeletal Sedation [2]
Gastrointestinal/Hepatic Asthenia (fatigue) (7%) [3]
Abdominal pain (<10%) Neuromuscular/Skeletal
Nausea (<10%) [2] Gastrointestinal/Hepatic Dystonia [6]
Vomiting (<10%) Abdominal pain (4%) [2]
Diarrhea (9%) [14] Other
Other Dyspepsia (2%) Death [3]
Adverse effects [4] Gastrointestinal disorder [4]
Hepatic failure [5]
Hepatotoxicity [9] DROTRECOGIN ALFA
Nausea (5%) [12]
Vomiting (2%) [6] See: www.drugeruptiondata.com/drug/id/918
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Litt’s Drug Eruption & Reaction Manual DUPILUMAB
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DURVALUMAB Over 100 updates per week on www.drugeruptiondata.com
Constipation (21%)
DURVALUMAB * Diarrhea (13%) [3] DUTASTERIDE
Nausea (16%)
Trade name: Imfinzi (AstraZeneca) Trade names: Avodart (GSK), Jalyn (GSK)
Indications: Locally advanced or metastatic Respiratory Indications: Benign prostatic hyperplasia, male
urothelial carcinoma in patients having disease Cough (10%) pattern baldness (anecdotal)
progression following platinum-containing Dyspnea (13%) Class: 5-alpha reductase inhibitor, Androgen
chemotherapy Pneumonitis (2%) antagonist
Class: Monoclonal antibody, Programmed death- Endocrine/Metabolic Half-life: 35 weeks
ligand (PD-L1) inhibitor ALP increased (4%) Clinically important, potentially hazardous
Half-life: 17 days Appetite decreased (19%) interactions with: cimetidine, ciprofloxacin,
Clinically important, potentially hazardous AST increased (2%) conivaptan, darunavir, delavirdine, diltiazem,
interactions with: none known Hypercalcemia (3%) indinavir, ketoconazole, ritonavir, telithromycin,
Pregnancy category: N/A (Can cause fetal Hyperglycemia (3%) troleandomycin, verapamil, voriconazole
harm) Hypermagnesemia (4%) Pregnancy category: X
Important contra-indications noted in the Hyperthyroidism (5–6%) Important contra-indications noted in the
prescribing guidelines for: the elderly; nursing Hyponatremia (12%) prescribing guidelines for: nursing mothers;
mothers; pediatric patients Hypothyroidism (6–10%) pediatric patients
Genitourinary Note: Jalyn is dutasteride and tamsulosin.
Skin Urinary tract infection (15%)
Peripheral edema (15%) Hematologic Endocrine/Metabolic
Rash (11%) Anemia (8%) Gynecomastia [2]
Central Nervous System Lymphopenia (11%) Libido decreased (<3%) [3]
Fever (14%) Local Genitourinary
Neuromuscular/Skeletal Infusion-related reactions (2%) Ejaculatory dysfunction [3]
Asthenia (fatigue) (39%) Erectile dysfunction [8]
Other Impotence (<5%)
Bone or joint pain (24%) Death [2] Sexual dysfunction [6]
Gastrointestinal/Hepatic Infection (30–38%)
Abdominal pain (14%) Other
Colitis (13%) Adverse effects [2]
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Litt’s Drug Eruption & Reaction Manual EFAVIRENZ
Skin
ECALLANTIDE EDARAVONE * Rash (4%)
See: www.drugeruptiondata.com/drug/id/1425 Trade name: Radicava (Mitsubishi Tanabe Mucosal
Pharma) Epistaxis (nosebleed) (5%)
Indications: Amyotrophic lateral sclerosis Gingival bleeding [2]
Oral bleeding (3%)
ECONAZOLE Class: Antioxidant
Half-life: 4–6 hours Gastrointestinal/Hepatic
See: www.drugeruptiondata.com/drug/id/1342 Clinically important, potentially hazardous Diarrhea [2]
interactions with: none known Gastrointestinal bleeding (4%)
Pregnancy category: N/A (May cause fetal Hepatotoxicity (5–8%) [2]
toxicity based on findings in animal studies )
ECULIZUMAB Important contra-indications noted in the
Genitourinary
Hematuria (2%) [2]
prescribing guidelines for: nursing mothers;
Trade name: Soliris (Alexion) pediatric patients Hematologic
Indications: Paroxysmal nocturnal Note: Radicava contains sodium bisulfite which Anemia (2–10%)
hemoglobinuria, atypical hemolytic uremic may cause allergic type reactions. Bleeding (>5%) [13]
syndrome Other
Class: Complement inhibitor, Monoclonal Adverse effects [4]
antibody Skin
Half-life: ~12 days Dermatitis (8%)
Clinically important, potentially hazardous Eczema (7%) [2]
interactions with: none known Hematoma (15%) [2] EDROPHONIUM
Pregnancy category: C Tinea (4%)
Important contra-indications noted in the Central Nervous System See: www.drugeruptiondata.com/drug/id/251
prescribing guidelines for: nursing mothers; Gait instability (13%) [2]
pediatric patients Headache (10%) [2]
Warning: SERIOUS MENINGOCOCCAL Insomnia [2] EFALIZUMAB
INFECTIONS Gastrointestinal/Hepatic
Constipation [2] See: www.drugeruptiondata.com/drug/id/1004
Skin Diarrhea [2]
Peripheral edema [2] Dysphagia [3]
Pruritus [2] Hepatotoxicity [2] EFAVIRENZ
Mucosal Respiratory
Nasal congestion [2] Hypoxia (6%) Trade names: Atripla (Gilead), Sustiva (Bristol-
Nasopharyngitis [2] Myers Squibb)
Cardiovascular Indications: HIV infection
Hypertension [2] Respiratory failure (6%) [2]
Class: Antiretroviral, CYP1A2 inhibitor, CYP3A4
Central Nervous System Genitourinary inducer, Non-nucleoside reverse transcriptase
Fever [3] Glycosuria (4%) [2] inhibitor
Headache (44%) [5] Renal Half-life: 52–76 hours
Insomnia [2] Nephrotoxicity [2] Clinically important, potentially hazardous
Meningococcal infection [4] Other interactions with: alcohol, alprazolam,
Vertigo (dizziness) [3] Adverse effects [2] amprenavir, aripiprazole, artesunate, atazanavir,
Neuromuscular/Skeletal atorvastatin, atovaquone, benzodiazepines,
Asthenia (fatigue) (12%) [4] bepridil, boceprevir, bortezomib, brentuximab
Back pain (19%) [3] vedotin, budesonide, buprenorphine, bupropion,
Pain in extremities [2]
EDOXABAN carbamazepine, carvedilol, caspofungin,
chlordiazepoxide, cisapride, citalopram,
Gastrointestinal/Hepatic Trade name: Savaysa (Daiichi Sankyo) clarithromycin, clonazepam, clopidogrel,
Abdominal pain [2] Indications: Reduce the risk of stroke and clorazepate, CNS depressants, cobimetinib,
Diarrhea [3] systemic embolism in patients with nonvalvular colchicine, conivaptan, crizotinib, cyclosporine,
Nausea [4] atrial fibrillation, treatment of deep vein CYP2B6 inhibitors and inducers, CYP2C19
Vomiting [3] thrombosis and pulmonary embolism substrates, CYP2C9 substrates, CYP3A4
Respiratory Class: Direct factor Xa inhibitor substrates and inducers, darunavir, dasabuvir/
Cough (12%) [4] Half-life: 10–14 hours ombitasvir/paritaprevir/ritonavir, dasatinib,
Nasopharyngitis (23%) [5] Clinically important, potentially hazardous deferasirox, deflazacort, diazepam,
Pharyngolaryngeal pain [2] interactions with: anticoagulants, rifampin dihydroergotamine, diltiazem, dronedarone,
Upper respiratory tract infection [2] Pregnancy category: C elbasvir & grazoprevir, enzalutamide, eplerenone,
Important contra-indications noted in the ergot, etravirine, everolimus, exemestane,
Genitourinary prescribing guidelines for: nursing mothers;
Urinary tract infection [3] fentanyl, flurazepam, fosamprenavir,
pediatric patients fosphenytoin, gefitinib, glecaprevir & pibrentasvir,
Hematologic Note: Contra-indicated in patients with active grapefruit juice, guanfacine, halofantrine,
Anemia [2] pathological bleeding. hydroxyzine, imatinib, indinavir, itraconazole,
Leukopenia [2] Warning: REDUCED EFFICACY IN ixabepilone, lapatinib, levomepromazine,
NONVALVULAR ATRIAL FIBRILLATION levonorgestrel, linagliptin, lopinavir, lorazepam,
PATIENTS WITH CRCL>95ml/min lovastatin, lurasidone, maraviroc, methadone,
ISCHEMIC EVENTS ON PREMATURE methysergide, midazolam, mifepristone,
DISCONTINUATION neratinib, nevirapine, nifedipine, nilotinib,
SPINAL/EDPIDURAL HEMATOMA nisoldipine, olaparib, ombitasvir/paritaprevir/
ritonavir, oral contraceptives, oxazepam,
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Litt’s Drug Eruption & Reaction Manual ELOTUZUMAB
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Litt’s Drug Eruption & Reaction Manual ENALAPRIL
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ENOXAPARIN
ENFUVIRTIDE ENTACAPONE
Trade names: Clexane (Sanofi-Aventis), Lovenox
Trade name: Fuzeon (Roche) (Sanofi-Aventis) Trade names: Comtan (Orion), Comtess
Indications: HIV-1 infection (in combination with Indications: Prevention of deep vein thrombosis, (Orion), Stalevo (Orion)
other antiretroviral agents) ischemic complications of unstable angina and Indications: Parkinsonism
Class: Antiretroviral, HIV cell fusion inhibitor non-Q wave myocardial infarction, treatment of Class: Catechol-O-methyl transferase inhibitor
Half-life: 3.8 hours acute ST-segment elevation myocardial infarction Half-life: 2.4 hours
Clinically important, potentially hazardous Class: Heparin, low molecular weight Clinically important, potentially hazardous
interactions with: darunavir, indinavir, tipranavir Half-life: 4.5 hours interactions with: amitriptyline, MAO
Pregnancy category: B Clinically important, potentially hazardous inhibitors, paroxetine hydrochloride, phenelzine,
Important contra-indications noted in the interactions with: ACE inhibitors, angiotensin II rasagiline, tranylcypromine, venlafaxine
prescribing guidelines for: the elderly; nursing receptor antagonists, anticoagulants, aspirin, Pregnancy category: C
mothers butabarbital, clopidogrel, danaparoid, diclofenac, Important contra-indications noted in the
dipyridamole, drotrecogin alfa, iloprost, infused prescribing guidelines for: nursing mothers;
Skin nitrates, ketorolac, NSAIDs, platelet inhibitors, pediatric patients
Folliculitis (2%) rivaroxaban, salicylates, sulfinpyrazone
Herpes simplex (4%) Pregnancy category: B
Important contra-indications noted in the Skin
Hypersensitivity [3] Diaphoresis (2%)
Papillomas (4%) prescribing guidelines for: nursing mothers;
pediatric patients Purpura (2%)
Pruritus (62%)
Note: Epidural or spinal hematomas may occur Mucosal
in patients who are anticoagulated with low Xerostomia (3%)
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Litt’s Drug Eruption & Reaction Manual EPINEPHRINE
Central Nervous System Genitourinary Upper respiratory tract infection (11%) [3]
Anxiety (2%) Hematuria (9%) Endocrine/Metabolic
Dyskinesia (25%) [3] Other ALT increased (10%)
Hyperactivity (10%) Adverse effects [4] Appetite decreased [5]
Hypokinesia (9%) Gynecomastia [2]
Parkinsonism (17%) Weight loss [3]
Somnolence (drowsiness) (2%)
Vertigo (dizziness) (8%) [2] ENZALUTAMIDE Genitourinary
Hematuria (7%)
Neuromuscular/Skeletal Trade name: Xtandi (Medivation) Pollakiuria (5%)
Asthenia (fatigue) (8%) Indications: Metastatic castration-resistant
Back pain (4%) Hematologic
prostate cancer in patients who have previously Anemia [2]
Gastrointestinal/Hepatic received docetaxel Neutropenia (15%)
Abdominal pain (8%) Class: Androgen antagonist
Constipation (6%) Half-life: 8–9 days Other
Diarrhea (10%) [3] Clinically important, potentially hazardous Adverse effects [4]
Dyspepsia (2%) interactions with: alfentanil, bosentan,
Flatulence (2%) carbamazepine, copanlisib, cyclosporine,
Nausea (14%) [3] dihydroergotamine, efavirenz, ergotamine, EPHEDRINE
Vomiting (4%) fentanyl, gemfibrozil, itraconazole, midazolam,
Respiratory midostaurin, modafinil, nafcillin, neratinib, Trade names: Rynatuss (MedPointe), Vicks
Dyspnea (3%) omeprazole, phenobarbital, phenytoin, pimozide, Vatronol (Procter & Gamble)
quinidine, rifabutin, rifampin, rifapentine, Indications: Nasal congestion, acute hypotensive
Genitourinary sirolimus, St John’s wort, tacrolimus, warfarin states, asthma
Melanuria (10%) [2] Pregnancy category: X (not indicated for use in Class: Adrenergic alpha-receptor agonist,
women) Sympathomimetic
Important contra-indications noted in the Half-life: 36 hours
ENTECAVIR prescribing guidelines for: nursing mothers; Clinically important, potentially hazardous
pediatric patients interactions with: antihypertensives,
Trade name: Baraclude (Bristol-Myers Squibb) dexamethasone, furazolidone, guanethidine,
Indications: Chronic hepatitis B virus infection Skin iobenguane, levomepromazine, MAO inhibitors,
Class: Antiviral, Guanosine nucleoside analog Hot flashes (20%) [11] methyldopa, oxprenolol, phenelzine,
Half-life: ~24 hours Peripheral edema (15%) [3] phenylpropanolamine, selegiline,
Clinically important, potentially hazardous Pruritus (4%) tranylcypromine, tricyclic antidepressants
interactions with: none known Xerosis (4%) Pregnancy category: C
Pregnancy category: C Important contra-indications noted in the
Important contra-indications noted in the Mucosal prescribing guidelines for: nursing mothers
prescribing guidelines for: nursing mothers; Epistaxis (nosebleed) (3%)
pediatric patients Cardiovascular Skin
Warning: SEVERE ACUTE EXACERBATIONS Hypertension (6%) [5] Dermatitis [5]
OF HEPATITIS B, PATIENTS CO-INFECTED Central Nervous System Diaphoresis (<10%)
WITH HIV AND HBV, and LACTIC ACIDOSIS Amnesia (>2%) Fixed eruption [6]
AND HEPATOMEGALY Anxiety (7%) Pallor (<10%)
Cognitive impairment (4%) Urticaria [2]
Skin Gait instability [3] Mucosal
Rash [2] Hallucinations (2%) Xerostomia (<10%)
Hair Headache (12%) [4]
Hypoesthesia (4%) Central Nervous System
Alopecia [2] Trembling (<10%)
Insomnia (9%)
Central Nervous System Paresthesias (7%) [2] Tremor (<10%)
Headache (2–4%) [3] Seizures [12]
Neurotoxicity [3] Spinal cord compression (7%)
Peripheral neuropathy [2] Vertigo (dizziness) (10%) [2] EPINASTINE
Neuromuscular/Skeletal Neuromuscular/Skeletal
Asthenia (fatigue) (<3%) [6] Arthralgia (21%) [4] See: www.drugeruptiondata.com/drug/id/1013
Myalgia/Myopathy [3] Asthenia (fatigue) (51%) [22]
Gastrointestinal/Hepatic Back pain (26%) [5]
Abdominal pain [2] Bone or joint pain (15%) [7] EPINEPHRINE
Diarrhea [2] Fractures (4%) [2]
Pancreatitis [3] Gastrointestinal/Hepatic Synonym: adrenaline
Constipation [3] Trade names: Adrenaclick (Amedra), Adrenalin
Respiratory
Diarrhea (22%) [9] (JHP Pharmaceuticals), Auvi-Q (Sanofi-Aventis),
Cough [2]
Nausea [4] Epipen (Mylan)
Upper respiratory tract infection [2]
Indications: Cardiac arrest, hay fever, asthma,
Endocrine/Metabolic Respiratory anaphylaxis
Acidosis [6] Bronchitis (>2%) Class: Catecholamine, Sympathomimetic
ALT increased (2–12%) [2] Laryngitis (>2%) Half-life: N/A
Creatine phosphokinase increased (<2%) Nasopharyngitis (>2%) Clinically important, potentially hazardous
Hypophosphatemia [2] Pharyngitis (>2%) interactions with: albuterol, alpha blockers,
Pneumonia (>2%) amitriptyline, amoxapine, atenolol, beta blockers,
Sinusitis (>2%)
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104 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual ERIBULIN
Neuromuscular/Skeletal
Back pain (13%) EPTIFIBATIDE ERGOTAMINE
Jaw pain (54%) [6]
Myalgia/Myopathy (44%) Trade name: Integrilin (Merck) Trade name: Wigrettes (Organon)
Indications: Acute coronary syndrome, unstable Indications: Migraine, migraine variants
Gastrointestinal/Hepatic angina Class: Ergot alkaloid
Abdominal pain (14%) Class: Antiplatelet, Glycoprotein IIb/IIIa inhibitor Half-life: 2 hours
Diarrhea [2] Half-life: 2.5 hours Clinically important, potentially hazardous
Nausea [4] Clinically important, potentially hazardous interactions with: acebutolol, almotriptan,
Respiratory interactions with: anticoagulants, antiplatelet amprenavir, azithromycin, boceprevir, ceritinib,
Alveolar hemorrhage (pulmonary) [2] agents, collagenase, dasatinib, drotrecogin alfa, chlortetracycline, crizotinib, darunavir, dasabuvir/
Dyspnea (2%) fondaparinux, glucosamine, ibritumomab, ombitasvir/paritaprevir/ritonavir, dasatinib,
Flu-like syndrome (25%) iloprost, lepirudin, NSAIDs, pentoxifylline, delavirdine, demeclocycline, doxycycline,
Pneumonia [2] salicylates, thrombolytic agents, tositumomab & eluxadoline, enzalutamide, epinephrine,
Endocrine/Metabolic iodine131 erythromycin, indinavir, itraconazole, lopinavir,
Weight loss (27%) Pregnancy category: B lymecycline, methylergonovine, mifepristone,
Important contra-indications noted in the minocycline, naratriptan, nelfinavir, nilotinib,
Hematologic prescribing guidelines for: nursing mothers; ombitasvir/paritaprevir/ritonavir, oxytetracycline,
Sepsis (25%) pediatric patients posaconazole, propyphenazone, ribociclib,
Local Note: Contra-indicated in patients with a history ritonavir, telaprevir, telithromycin, tetracycline,
Injection-site infection (21%) of bleeding diathesis, or evidence of active tigecycline, tipranavir, troleandomycin,
Injection-site pain (13%) abnormal bleeding within the previous 30 days; voriconazole, warfarin
severe hypertension not adequately controlled on Pregnancy category: X
Other
antihypertensive therapy; major surgery within Important contra-indications noted in the
Adverse effects [3]
the preceding 6 weeks; history of stroke within prescribing guidelines for: nursing mothers
30 days or any history of hemorrhagic stroke; Note: Ergotamine is excreted in breast milk and
current or planned administration of another may cause symptoms of vomiting, diarrhea, weak
EPROSARTAN parenteral GP IIb/IIIa inhibitor; or dependency on pulse and unstable blood pressure in nursing
renal dialysis. infants.
Trade name: Teveten (AbbVie)
Indications: Hypertension
Class: Angiotensin II receptor antagonist
Cardiovascular Skin
(blocker), Antihypertensive
Hypotension (7%) Toxicity [4]
Half-life: 59 hours Hematologic Cardiovascular
Clinically important, potentially hazardous Bleeding [3] Valvulopathy [3]
interactions with: none known Hemorrhage (<10%) Respiratory
Pregnancy category: D (category C in first Thrombocytopenia [16] Pleural effusion [2]
trimester; category D in second and third Thrombosis [3]
trimesters) Other
Important contra-indications noted in the
prescribing guidelines for: nursing mothers;
Death [2] ERIBULIN
pediatric patients
Warning: FETAL TOXICITY Trade name: Halaven (Eisai)
ERDOSTEINE Indications: Metastatic breast cancer in patients
who have previously received at least two
Central Nervous System See: www.drugeruptiondata.com/drug/id/1258 chemotherapeutic regimens (prior therapy should
Dysgeusia (taste perversion) [2] have included an anthracycline and a taxane in
Vertigo (dizziness) [2] either the adjuvant or metastatic setting),
Neuromuscular/Skeletal
Arthralgia (2%)
ERGOCALCIFEROL unresectable or metastatic liposarcoma in
patients who have received a prior anthracycline-
Asthenia (fatigue) (2%) See: www.drugeruptiondata.com/drug/id/264 containing regimen
Class: Antineoplastic, Microtubule inhibitor
Gastrointestinal/Hepatic
Half-life: 40 hours
Abdominal pain (2%)
Clinically important, potentially hazardous
Respiratory ERGOMETRINE interactions with: none known
Cough (4%) [3] Pregnancy category: N/A (No available data but
Pharyngitis (4%) Trade name: Ergometrine (Hameln) caused embryo-fetal toxicity in animal studies)
Rhinitis (4%) Indications: Management of the third stage of Important contra-indications noted in the
Upper respiratory tract infection (8%) [2] labor and in the treatment of postpartum prescribing guidelines for: nursing mothers;
hemorrhage pediatric patients
Other
Class: Amine alkaloid
Adverse effects [3]
Half-life: N/A
Clinically important, potentially hazardous Skin
interactions with: halothane, sympathomimetic Peripheral edema (5–10%)
agents Rash (5–10%)
Important contra-indications noted in the Hair
prescribing guidelines for: nursing mothers Alopecia (45%) [10]
Mucosal
Cardiovascular Mucosal inflammation (9%)
Myocardial infarction [4] Stomatitis (5–10%)
Myocardial ischemia [3] Xerostomia (5–10%)
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 105
ERIBULIN See all our books at www.crcpress.com
106 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual ESMOLOL
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Litt’s Drug Eruption & Reaction Manual ETHACRYNIC ACID
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ETHAMBUTOL See all our books at www.crcpress.com
phenobarbital, phenytoin, primidone, risperidone, adverse events, which can be fatal. This risk may
ETHAMBUTOL SSRIs, St John’s wort, tricyclic antidepressants, increase with duration of use.
valproic acid, zuclopenthixol
Trade name: Myambutol (Stat Trade) Pregnancy category: C
Indications: Tuberculosis Skin
Important contra-indications noted in the Exanthems [2]
Class: Antimycobacterial prescribing guidelines for: nursing mothers
Half-life: 34 hours Facial edema [2]
Note: Cases of birth defects have been reported Fixed eruption [2]
Clinically important, potentially hazardous with ethosuximide.
interactions with: cortisone, zinc Pruritus (<10%) [7]
Pregnancy category: C Rash (>10%) [5]
Important contra-indications noted in the Skin Vasculitis [2]
prescribing guidelines for: nursing mothers; Exanthems (<5%) [2] Gastrointestinal/Hepatic
pediatric patients Lupus erythematosus (>10%) [22] Abdominal pain [2]
Raynaud’s phenomenon [3] Constipation [2]
Stevens-Johnson syndrome (>10%) Dyspepsia [3]
Skin Urticaria (<5%)
Bullous dermatitis [2] Nausea [2]
Dermatitis [2] Hematologic Other
DRESS syndrome [5] Agranulocytosis [2] Adverse effects [2]
Erythema multiforme [2] Other
Exanthems (<5%) [4] Side effects (3%)
Hypersensitivity [3]
Lichenoid eruption [2]
ETOMIDATE
Lupus erythematosus [2]
Pruritus [4]
ETHOTOIN See: www.drugeruptiondata.com/drug/id/1399
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Litt’s Drug Eruption & Reaction Manual EVEROLIMUS
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Litt’s Drug Eruption & Reaction Manual EZOGABINE
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Litt’s Drug Eruption & Reaction Manual FENOPROFEN
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FENTANYL Over 100 updates per week on www.drugeruptiondata.com
Respiratory Respiratory
FENTANYL Cough [15] Dyspnea [3]
Respiratory depression [7] Local
Trade names: Actiq (Cephalon), Duragesic
(Janssen) Ocular Injection-site pain [3]
Indications: Chronic pain Miosis (>10%) Other
Class: Analgesic, opioid, Anesthetic Local Adverse effects [2]
Half-life: ~7 hours Application-site erythema [2]
Clinically important, potentially hazardous Other
interactions with: amiodarone, amprenavir,
aprepitant, atazanavir, ceritinib, cimetidine,
Adverse effects [7] FESOTERODINE
Death [7]
conivaptan, crizotinib, darunavir, dasatinib, Trade name: Toviaz (Pfizer)
delavirdine, efavirenz, eluxadoline, enzalutamide, Indications: Overactive bladder syndrome,
indinavir, itraconazole, ketoconazole, lapatinib,
lopinavir, mifepristone, nelfinavir, nevirapine, FERRIC GLUCONATE urinary incontinence, urgency and frequency
Class: Antimuscarinic, Muscarinic antagonist
nifedipine, osimertinib, ranitidine, ribociclib, Half-life: 7 hours; 4 hours (oral)
rifapentine, ritonavir, saquinavir, telithromycin, See: www.drugeruptiondata.com/drug/id/2817
Clinically important, potentially hazardous
voriconazole interactions with: alcohol, amantadine,
Pregnancy category: C anticholinergics, antidepressants, antimuscarinics,
Important contra-indications noted in the FERROUS SULFATE atazanavir, botulinum toxin (A & B),
prescribing guidelines for: nursing mothers; carbamazepine, cinacalcet, clarithromycin,
pediatric patients See: www.drugeruptiondata.com/drug/id/2677 conivaptan, CYP2D6 inhibitors, CYP3A4
Note: Contra-indicated in opioid non-tolerant inhibitors, CYP3AF inhibitors, darunavir,
patients, and for the management of acute or dasatinib, deferasirox, delavirdine, duloxetine,
postoperative pain including headache/migraines
and dental pain.
FERUMOXSIL indinavir, itraconazole, ketoconazole, nefazodone,
nelfinavir, PEG-interferon, phenobarbital,
Warning: ADDICTION, ABUSE, and MISUSE; See: www.drugeruptiondata.com/drug/id/2235 phenytoin, pramlintide, rifampin, ritonavir,
LIFE-THREATENING RESPIRATORY saquinavir, secretin, St John’s wort, telithromycin,
DEPRESSION; ACCIDENTAL EXPOSURE; terbinafine, tipranavir, tocilizumab, voriconazole
NEONATAL OPIOID WITHDRAWAL
SYNDROME; CYTOCHROME P450 3A4 FERUMOXYTOL Pregnancy category: C
Important contra-indications noted in the
INTERACTION prescribing guidelines for: nursing mothers;
EXPOSURE TO HEAT (for topical patches) Trade name: Feraheme (AMG Pharma)
Indications: Iron deficiency anemia in adults with pediatric patients
chronic kidney disease Note: Contra-indicated in patients with urinary
Skin Class: Iron supplement retention, gastric retention, or uncontrolled
Anaphylactoid reactions/Anaphylaxis [6] Half-life: 15 hours narrow-angle glaucoma.
Diaphoresis (>10%) [2] Clinically important, potentially hazardous
Edema (>10%) interactions with: none known Mucosal
Erythema (at application site) [3] Pregnancy category: C Xerostomia (19–35%) [28]
Pruritus (344%) [30] Important contra-indications noted in the
Rash [3]
Central Nervous System
prescribing guidelines for: the elderly; nursing Headache [3]
Mucosal mothers; pediatric patients
Xerostomia (>10%) [3] Note: May cause hypersensitivity reactions, Neuromuscular/Skeletal
hypotension and iron overload. Feraheme may Back pain (2%)
Cardiovascular
Bradycardia (>10%) [3]
transiently affect magnetic resonance (MRI) Gastrointestinal/Hepatic
imaging for up to 3 months following dosage. Constipation (4–6%) [16]
Flushing (310%)
Contra-indicated in patients with evidence of iron Diarrhea (<10%)
Hypotension [8]
overload or anemia not caused by iron deficiency. Dyspepsia (<2%) [2]
Tachycardia [2]
Nausea (<2%) [2]
Central Nervous System
Skin Respiratory
Agitation [2]
Anaphylactoid reactions/Anaphylaxis [3] Upper respiratory tract infection (2–3%)
Anorexia [2]
Hypersensitivity [3] Genitourinary
Confusion (>10%)
Pruritus [5] Dysuria (<2%)
Delirium [2]
Rash [2] Urinary retention [2]
Depression (>10%)
Urticaria [2] Urinary tract infection (3–4%) [3]
Hallucinations [2]
Headache (>10%) Cardiovascular Ocular
Neuroleptic malignant syndrome [2] Hypotension (3%) [3] Vision blurred [2]
Sedation [2] Central Nervous System Xerophthalmia (<4%) [2]
Serotonin syndrome [4] Headache [6]
Somnolence (drowsiness) [13] Other
Vertigo (dizziness) (3%) [3] Adverse effects [3]
Vertigo (dizziness) [12]
Neuromuscular/Skeletal
Neuromuscular/Skeletal Asthenia (fatigue) [2]
Asthenia (fatigue) (>10%) [2] Back pain [2]
Myoclonus [3]
Gastrointestinal/Hepatic
Gastrointestinal/Hepatic Abdominal pain [2]
Constipation (>10%) [11] Nausea (3%) [6]
Nausea (>10%) [31] Vomiting [2]
Vomiting (>10%) [21]
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Litt’s Drug Eruption & Reaction Manual FINGOLIMOD
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FLAVOXATE See all our books at www.crcpress.com
Ocular
FLAVOXATE Vision blurred [2] FLUCLOXACILLIN
Visual disturbances (16%) [3]
See: www.drugeruptiondata.com/drug/id/292 Trade name: Floxapen (Actavis)
Other Indications: Infections due to sensitive Gram-
Adverse effects [2] positive organisms
FLECAINIDE Class: Antibiotic, beta-lactam
Half-life: 53 minutes
Trade name: Tambocor (3M) FLIBANSERIN Clinically important, potentially hazardous
Indications: Atrial fibrillation interactions with: oral contraceptives,
Class: Antiarrhythmic, Antiarrhythmic class Ic Trade name: Addyi (Sprout) probenecid
Half-life: 12–16 hours Indications: Hypoactive sexual desire disorder in Pregnancy category: N/A
Clinically important, potentially hazardous premenopausal women Important contra-indications noted in the
interactions with: acebutolol, amiodarone, Class: Serotonin type 1A receptor agonist, prescribing guidelines for: nursing mothers
amisulpride, amitriptyline, artemether/ Serotonin type 2A receptor antagonist
lumefantrine, boceprevir, cinacalcet, clozapine, Half-life: 11 hours Skin
cobicistat/elvitegravir/emtricitabine/tenofovir Clinically important, potentially hazardous AGEP [2]
alafenamide, cobicistat/elvitegravir/emtricitabine/ interactions with: alcohol, amprenavir,
atazanavir, boceprevir, carbamazepine, Gastrointestinal/Hepatic
tenofovir disoproxil, darifenacin, delavirdine, Hepatotoxicity [21]
fosamprenavir, lopinavir, mirabegron, quinine, ciprofloxacin, clarithromycin, conivaptan, digoxin,
ritonavir, telaprevir, tipranavir diltiazem, erythromycin, fluconazole, Endocrine/Metabolic
Pregnancy category: C fosamprenavir, grapefruit juice, indinavir, Acidosis [2]
Important contra-indications noted in the itraconazole, ketoconazole, nefazodone, Renal
prescribing guidelines for: nursing mothers; nelfinavir, phenobarbital, phenytoin, Nephrotoxicity [4]
pediatric patients posaconazole, rifabutin, rifampin, rifapentine,
ritonavir, saquinavir, St John’s wort, telaprevir, Hematologic
telithromycin, verapamil Anemia [2]
Skin Pregnancy category: N/A (No data available)
Diaphoresis (<3%) Important contra-indications noted in the
Edema (4%)
Psoriasis [2]
prescribing guidelines for: the elderly; nursing FLUCONAZOLE
mothers; pediatric patients
Rash (<3%) Warning: HYPOTENSION AND SYNCOPE IN Trade name: Diflucan (Pfizer)
Cardiovascular CERTAIN SETTINGS Indications: Candidiasis
Arrhythmias [7] Class: Antibiotic, triazole, Antifungal, azole,
Atrial fibrillation [3] Mucosal CYP3A4 inhibitor
Atrial flutter [2] Xerostomia (2%) Half-life: 2530 hours
Atrioventricular block [2] Clinically important, potentially hazardous
Bradycardia [4] Central Nervous System interactions with: alprazolam, amphotericin B,
Brugada syndrome [4] Anxiety (2%) anisindione, anticoagulants, atorvastatin, avanafil,
Bundle branch block [2] Insomnia (5%) [2] betamethasone, bosentan, celecoxib, citalopram,
Cardiotoxicity [3] Sedation [2] clobazam, clopidogrel, deflazacort, dicumarol,
Chest pain (5%) Somnolence (drowsiness) (11%) [9] eluxadoline, eplerenone, erythromycin,
Congestive heart failure [2] Vertigo (dizziness) (2%) [9] flibanserin, irbesartan, ivacaftor, lesinurad,
Extrasystoles [2] Neuromuscular/Skeletal methadone, midazolam, mifepristone,
Flushing (<3%) Asthenia (fatigue) (9%) [5] naldemedine, neratinib, nevirapine, olaparib,
Hypotension [2] Gastrointestinal/Hepatic ospemifene, pantoprazole, phenobarbital,
Palpitation (6%) Abdominal pain (2%) phenytoin, pimecrolimus, propranolol,
QT prolongation [7] Constipation (2%) quetiapine, ramelteon, rifapentine, rilpivirine,
Supraventricular tachycardia [2] Nausea (10%) [6] ruxolitinib, simeprevir, sonidegib, sulfonylureas,
Tachycardia [2] temsirolimus, terbinafine, tipranavir, tofacitinib,
Torsades de pointes [4] trabectedin, triamcinolone, venetoclax,
Central Nervous System vinblastine, vincristine, warfarin, zidovudine
Headache (10%) [4]
FLORBETAPIR F18 Pregnancy category: D (fluconazole is
Hyperesthesia (<10%) pregnancy category C for vaginal candidiasis)
See: www.drugeruptiondata.com/drug/id/2897 Important contra-indications noted in the
Neurotoxicity [3]
Seizures [2] prescribing guidelines for: the elderly; nursing
Syncope [2] mothers
Tremor (5%) FLOXURIDINE
Vertigo (dizziness) (19%) [5] Skin
See: www.drugeruptiondata.com/drug/id/960 AGEP [3]
Neuromuscular/Skeletal
Asthenia (fatigue) (5–8%) Erythema multiforme [3]
Exfoliative dermatitis [2]
Gastrointestinal/Hepatic Fixed eruption [10]
Abdominal pain (3%) Hypersensitivity (<4%)
Constipation (4%) Rash (2%) [4]
Diarrhea (<3%) [2] Stevens-Johnson syndrome [6]
Nausea (9%) [3] Toxic epidermal necrolysis [4]
Respiratory Hair
Dyspnea (10%) Alopecia [4]
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Litt’s Drug Eruption & Reaction Manual FLUORIDES
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Litt’s Drug Eruption & Reaction Manual FLUTICASONE FUROATE
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Litt’s Drug Eruption & Reaction Manual FUROSEMIDE
Pregnancy category: C telithromycin, tipranavir, triazolam, vardenafil, methyldopa, minoxidil, moxisylyte, moxonidine,
Important contra-indications noted in the warfarin nitrates, nitroprusside, NSAIDs, pentoxifylline,
prescribing guidelines for: nursing mothers; Pregnancy category: C phosphodiesterase 5 inhibitors, potassium salts,
pediatric patients Important contra-indications noted in the prostacyclin analogues, rituximab, sirolimus,
Note: Dulera is formoterol and mometasone; prescribing guidelines for: the elderly; nursing spironolactone, sulfonylureas, temsirolimus,
Symbicort is formoterol and budesonide. mothers; pediatric patients tizanidine, tolvaptan, triamterene, trimethoprim
Warning: ASTHMA-RELATED DEATH Note: Fosamprenavir is a sulfonamide and can be Pregnancy category: D (category C in first
absorbed systemically. Sulfonamides can produce trimester; category D in second and third
Skin severe, possibly fatal, reactions such as toxic trimesters)
Pruritus (2%) epidermal necrolysis and Stevens-Johnson Important contra-indications noted in the
syndrome. prescribing guidelines for: nursing mothers
Mucosal Fosamprenavir is a prodrug of amprenavir (see Warning: USE IN PREGNANCY
Xerostomia (<3%) [3] separate entry).
Cardiovascular Skin
Chest pain (2%) Skin Angioedema [3]
Central Nervous System Hypersensitivity [2] Respiratory
Anxiety (2%) Pruritus (7%) Cough [3]
Fever (2%) Rash (~19%) [5]
Headache [8] Central Nervous System
Insomnia (2%)
Tremor (2%) [6]
Depression (8%)
Headache (19%)
FOSPHENYTOIN
Vertigo (dizziness) (2–3%) [2] Paresthesias (oral) (2%) See: www.drugeruptiondata.com/drug/id/311
Neuromuscular/Skeletal Neuromuscular/Skeletal
Back pain (4%) Asthenia (fatigue) (10%)
Cramps (2%)
Leg cramps (2%) Gastrointestinal/Hepatic FROVATRIPTAN
Abdominal pain (5%)
Gastrointestinal/Hepatic Diarrhea [2] See: www.drugeruptiondata.com/drug/id/856
Diarrhea (5%) [2] Hepatotoxicity [2]
Nausea (5%) Vomiting [2]
Vomiting (2%)
Respiratory
Respiratory FULVESTRANT
Bronchitis [2]
Asthma (exacerbation) [3] Cough [2] See: www.drugeruptiondata.com/drug/id/905
Bronchitis (5%) Nasopharyngitis [3]
Cough [5] Rhinitis [2]
Dysphonia [2]
Dyspnea (2%) [2]
Upper respiratory tract infection [2] FURAZOLIDONE
Nasopharyngitis [7] Other
Pharyngitis (4%) [2] Adverse effects [3] See: www.drugeruptiondata.com/drug/id/312
Pneumonia [2]
Rhinitis [2]
Upper respiratory tract infection (7%) [3] FOSCARNET FUROSEMIDE
Genitourinary
See: www.drugeruptiondata.com/drug/id/308 Trade name: Lasix (Sanofi-Aventis)
Urinary tract infection [2]
Indications: Edema
Other Class: Diuretic, loop
Adverse effects [2] Half-life: ~2 hours
Death [2] FOSFOMYCIN Clinically important, potentially hazardous
Infection (17%) interactions with: acemetacin, aliskiren,
See: www.drugeruptiondata.com/drug/id/309
amikacin, amyl nitrite, celecoxib, diclofenac,
digoxin, flurbiprofen, gentamicin, hyaluronic acid,
FOSAMPRENAVIR FOSINOPRIL
hydrocortisone, kanamycin, mivacurium,
neomycin, piroxicam, probenecid, streptomycin,
Trade name: Lexiva (ViiV) tobramycin, tolmetin
Indications: HIV infections (in combination with Trade name: Monopril (Bristol-Myers Squibb) Pregnancy category: C
other antiretrovirals) Indications: Hypertension, heart failure Important contra-indications noted in the
Class: Antiretroviral, HIV-1 protease inhibitor Class: Angiotensin-converting enzyme (ACE) prescribing guidelines for: the elderly; nursing
Half-life: 7.7 hours inhibitor, Antihypertensive, Vasodilator mothers; pediatric patients
Clinically important, potentially hazardous Half-life: 12 hours Note: Furosemide is a sulfonamide and can be
interactions with: amiodarone, atorvastatin, Clinically important, potentially hazardous absorbed systemically. Sulfonamides can produce
avanafil, bepridil, carbamazepine, darifenacin, interactions with: alcohol, aldesleukin, severe, possibly fatal, reactions such as toxic
delavirdine, dihydroergotamine, efavirenz, allopurinol, alpha blockers, alprostadil, amifostine, epidermal necrolysis and Stevens-Johnson
etravirine, flecainide, flibanserin, itraconazole, amiloride, angiotensin II receptor blocking agents, syndrome.
ketoconazole, lidocaine, lopinavir, lovastatin, antacids, antidiabetics, antihypertensives,
midazolam, mifepristone, nevirapine, olaparib, antipsychotics, anxiolytics and hypnotics,
azathioprine, baclofen, beta blockers, calcium Skin
phenobarbital, phenytoin, pimozide, AGEP [2]
posaconazole, propafenone, quinidine, quinine, channel blockers, clonidine, corticosteroids,
cyclosporine, diazoxide, diuretics, estrogens, Anaphylactoid reactions/Anaphylaxis [2]
rifabutin, rifampin, rilpivirine, ritonavir, Bullous dermatitis [16]
rivaroxaban, rosuvastatin, sildenafil, simeprevir, general anesthetics, gold & gold compounds,
heparins, hydralazine, hypotensives, insulin, Bullous pemphigoid [11]
simvastatin, St John’s wort, tadalafil, telaprevir, Erythema multiforme [3]
levodopa, lithium, MAO inhibitors, metformin,
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Litt’s Drug Eruption & Reaction Manual GATIFLOXACIN
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GEFITINIB See all our books at www.crcpress.com
Endocrine/Metabolic Cardiovascular
GEFITINIB ALT increased [7] Arrhythmias [3]
Appetite decreased [2] Atrial fibrillation [4]
Trade name: Iressa (AstraZeneca) AST increased [6] Capillary leak syndrome [9]
Indications: Advanced non-small cell lung cancer Dehydration [2] Cardiotoxicity [3]
Class: Antineoplastic, Biologic, Epidermal growth Weight loss (3–5%) Hypertension [3]
factor receptor (EGFR) inhibitor, Tyrosine kinase Hypotension [2]
inhibitor Genitourinary
Cystitis [2] Myocardial infarction [3]
Half-life: 48 hours Thromboembolism [2]
Clinically important, potentially hazardous Renal Venous thromboembolism [4]
interactions with: antifungals, BCG vaccine, Nephrotoxicity [2]
boceprevir, carbamazepine, cardiac glycosides, Central Nervous System
Hematologic Anorexia [11]
clozapine, conivaptan, CYP3A4 inhibitors and Anemia [4]
inducers, dasatinib, deferasirox, denosumab, Fever (41%) [13]
Neutropenia [6] Leukoencephalopathy [4]
echinacea, efavirenz, grapefruit juice, Thrombocytopenia [3]
itraconazole, leflunomide, natalizumab, Neurotoxicity [10]
phenobarbital, phenytoin, pimecrolimus, Ocular Pain [2]
ranitidine, rifampin, rifapentine, sipuleucel-T, St Amblyopia (2%) Paresthesias (10%) [2]
John’s wort, tacrolimus, topotecan, trastuzumab, Blepharitis [2] Peripheral neuropathy [5]
vaccines, vitamin K antagonists, voriconazole, Conjunctivitis [2] Somnolence (drowsiness) (11%)
warfarin Other Neuromuscular/Skeletal
Pregnancy category: D Adverse effects [11] Asthenia (fatigue) (18%) [44]
Important contra-indications noted in the Death [8] Myalgia/Myopathy (>10%) [6]
prescribing guidelines for: nursing mothers; Gastrointestinal/Hepatic
pediatric patients Abdominal pain [2]
GEMCITABINE Cholangitis [2]
Skin Constipation [3]
Acneform eruption (25–33%) [32] Trade name: Gemzar (Lilly) Diarrhea (19%) [25]
Desquamation (39%) [2] Indications: Pancreatic carcinoma as a single Gastrointestinal bleeding [2]
Exanthems [3] agent, ovarian cancer (with carboplatin), breast Hepatic disorder [2]
Folliculitis [4] cancer (with paclitaxel), non-small cell lung cancer Hepatotoxicity [11]
Hand–foot syndrome [2] (with cisplatin) Nausea (69%) [25]
Papulopustular eruption [3] Class: Antimetabolite, Antineoplastic Vomiting (69%) [20]
Peripheral edema (2%) Half-life: 42–94 minutes for short infusions; 4–11 Respiratory
Pruritus (8–9%) [5] hours for longer infusions Dyspnea (10–23%) [2]
Rash (43–54%) [63] Clinically important, potentially hazardous Flu-like syndrome (19%) [2]
Seborrhea [2] interactions with: aldesleukin Pneumonitis [5]
Toxicity [10] Pregnancy category: D Pulmonary toxicity [11]
Ulcerations [2] Important contra-indications noted in the
Xerosis (13–26%) [12] prescribing guidelines for: nursing mothers; Endocrine/Metabolic
pediatric patients ALT increased [6]
Hair Appetite decreased [2]
Alopecia [6] AST increased [6]
Hypertrichosis [2] Skin Dehydration [2]
Nails Acneform eruption [3] Hypomagnesemia [7]
Nail changes (17%) Bullous dermatitis [2] Hyponatremia [2]
Paronychia (6%) [13] Cellulitis [5]
Dermatitis [6] Genitourinary
Pyogenic granuloma [2] Hematuria (30%)
Eczema (13%)
Mucosal Edema (13%) [4] Renal
Mucositis [4] Exanthems [2] Nephrotoxicity [5]
Stomatitis [7] Hand–foot syndrome [19] Renal failure [2]
Cardiovascular Hypersensitivity [3] Hematologic
Hypertension [2] Livedo reticularis [2] Anemia (70%) [38]
Central Nervous System Necrosis [2] Febrile neutropenia [17]
Anorexia (7–10%) [2] Peripheral edema (20%) [4] Hemolytic uremic syndrome [32]
Petechiae (16%) Hemotoxicity [6]
Neuromuscular/Skeletal Pruritus (13%) [2]
Asthenia (fatigue) [11] Leukocytopenia [3]
Radiation recall dermatitis (<74%) [17] Leukopenia (62%) [24]
Gastrointestinal/Hepatic Rash (30%) [35] Myelosuppression [7]
Abdominal pain [3] Raynaud’s phenomenon [3] Myelotoxicity [3]
Diarrhea (48–67%) [37] Thrombocytopenic purpura [6] Neutropenia (61%) [87]
Gastrointestinal perforation [2] Toxic epidermal necrolysis [3] Thrombocytopenia (30%) [63]
Hepatotoxicity [26] Toxicity [5] Thrombosis [3]
Nausea (13–18%) [9] Vasculitis [3] Thrombotic microangiopathy [4]
Vomiting (9–12%) [5] Hair Local
Respiratory Alopecia (15%) [15] Injection-site reactions (4%)
Dyspnea (2%) Mucosal
Pneumonia [2] Other
Mucositis [7] Adverse effects [9]
Pneumonitis [4] Stomatitis (11%) [13]
Pulmonary toxicity [16] Allergic reactions (4%)
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Litt’s Drug Eruption & Reaction Manual GLATIRAMER
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Litt’s Drug Eruption & Reaction Manual GREPAFLOXACIN
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Litt’s Drug Eruption & Reaction Manual HEPATITIS A VACCINE
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Litt’s Drug Eruption & Reaction Manual HYDROCHLOROTHIAZIDE
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Litt’s Drug Eruption & Reaction Manual HYDROXYZINE
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Litt’s Drug Eruption & Reaction Manual IBUPROFEN
Cytopenia [3]
IBANDRONATE IBRUTINIB Febrile neutropenia [3]
Hemorrhage [2]
Synonym: ibandronic acid Trade name: Imbruvica (Pharmacyclics) Lymphocytosis [2]
Trade names: Bondronat (Roche), Boniva Indications: Mantle cell lymphoma Neutropenia [15]
(Roche) Class: Bruton’s tyrosine kinase (BTK) inhibitor Sepsis [2]
Indications: Postmenopausal osteoporosis Half-life: 4–6 hours Thrombocytopenia [13]
Class: Bisphosphonate Clinically important, potentially hazardous
Half-life: 37–157 hours interactions with: carbamazepine, Other
Clinically important, potentially hazardous clarithromycin, grapefruit juice, itraconazole, Adverse effects [2]
interactions with: alcohol, aminoglycosides, ketoconazole, phenytoin, posaconazole, rifampin, Infection [7]
antacids, calcium salts, food, magnesium salts, St John’s wort, strong or moderate CYP3A
NSAIDs, oral iron inhibitors or inducers, telithromycin, voriconazole
Pregnancy category: C Pregnancy category: D IBUPROFEN
Important contra-indications noted in the Important contra-indications noted in the
prescribing guidelines for: nursing mothers; prescribing guidelines for: nursing mothers; Trade names: Advil (Wyeth), Motrin (McNeil),
pediatric patients pediatric patients Vicoprofen (AbbVie)
Indications: Arthritis, pain
Skin Skin Class: Non-steroidal anti-inflammatory (NSAID)
Rash (<2%) Cellulitis [3] Half-life: 24 hours
Ecchymoses (30%) [4] Clinically important, potentially hazardous
Cardiovascular interactions with: aspirin, ciprofibrate, diuretics,
Hypertension (6–7%) Panniculitis [2]
Peripheral edema (35%) [3] methotrexate, methyl salicylate, NSAIDs,
Central Nervous System Petechiae (11%) oxycodone hydrochloride, salicylates, tacrine,
Fever (~9%) [4] Rash (25%) [5] tacrolimus, urokinase, voriconazole
Headache (3–7%) Toxicity (14%) [3] Pregnancy category: D (category C prior to 30
Vertigo (dizziness) (<4%) Tumor lysis syndrome [2] weeks gestation; category D starting at 30 weeks
gestation)
Neuromuscular/Skeletal Mucosal Note: NSAIDs may cause an increased risk of
Arthralgia (3–6%) [2] Epistaxis (nosebleed) (11%) serious cardiovascular and gastrointestinal
Asthenia (fatigue) (4%) [3] Stomatitis (17%) adverse events, which can be fatal. This risk may
Back pain (4–14%)
Cardiovascular increase with duration of use.
Bone or joint pain [3]
Cramps (2%) Atrial fibrillation [10]
Joint disorder (4%) Hypertension [4] Skin
Myalgia/Myopathy (<6%) Hypotension [2] AGEP [5]
Osteonecrosis [13] Central Nervous System Anaphylactoid reactions/Anaphylaxis [5]
Pain in extremities (<8%) Fever (18%) [5] Angioedema [8]
Headache (13%) [2] Bullous dermatitis [3]
Gastrointestinal/Hepatic
Peripheral neuropathy [2] Bullous pemphigoid [2]
Abdominal pain (5–8%)
Vertigo (dizziness) (14%) Dermatitis [5]
Constipation (3–4%)
Neuromuscular/Skeletal DRESS syndrome [4]
Diarrhea (4–7%) [2]
Erythema multiforme [11]
Dyspepsia (6–12%) [4] Arthralgia (11%) [3]
Erythema nodosum (<5%)
Gastritis (2%) Asthenia (fatigue) (14–41%) [19]
Exanthems [9]
Gastrointestinal disorder [3] Bone or joint pain (37%)
Fixed eruption [15]
Nausea (5%) [4] Muscle spasm (14%) [2]
Hypersensitivity [5]
Vomiting (3%) [4] Gastrointestinal/Hepatic Lupus erythematosus [5]
Respiratory Abdominal pain (24%) Nicolau syndrome [2]
Bronchitis (3–10%) Constipation (25%) Peripheral edema [2]
Flu-like syndrome (<4%) [7] Diarrhea (51%) [23] Photosensitivity [6]
Nasopharyngitis (4%) Dyspepsia (11%) Pruritus (<5%) [5]
Pharyngitis (3%) Hepatotoxicity [2] Psoriasis (palms) [2]
Pneumonia (6%) Nausea (31%) [14] Rash (>10%) [2]
Upper respiratory tract infection (2–34%) Vomiting (24%) [3] Stevens-Johnson syndrome [10]
Endocrine/Metabolic Respiratory Toxic epidermal necrolysis [8]
Hypercholesterolemia (5%) Cough (19%) [3] Urticaria (>10%) [10]
Hypocalcemia [3] Dyspnea (27%) Vasculitis [8]
Hypophosphatemia [2] Pneumonia (14%) [7] Vesiculobullous eruption [2]
Genitourinary Sinusitis (13%) [2] Hair
Urinary tract infection (2–6%) Upper respiratory tract infection (34%) [6] Alopecia [2]
Other Endocrine/Metabolic Cardiovascular
Adverse effects [5] Appetite decreased (21%) Cardiotoxicity [2]
Allergic reactions (3%) Dehydration (12%) [2] Hypertension [4]
Infection (4%) Hyperuricemia (15%)
Hypokalemia [2]
Central Nervous System
Tooth disorder (4%) Aseptic meningitis [16]
Genitourinary Headache [3]
Urinary tract infection (14%) [2]
Neuromuscular/Skeletal
IBRITUMOMAB Hematologic Arthralgia [2]
Anemia [11] Back pain [2]
See: www.drugeruptiondata.com/drug/id/906 Bleeding [11]
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Litt’s Drug Eruption & Reaction Manual IMATINIB
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Litt’s Drug Eruption & Reaction Manual INDACATEROL
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Upper respiratory tract infection [3] delavirdine, diazepam, didanosine, dienogest, Gingivitis (<2%)
Other digoxin, dihydroergotamine, dronedarone, Cardiovascular
Adverse effects [6] dutasteride, efavirenz, enfuvirtide, eplerenone, Flushing (<2%)
ergot derivatives, ergotamine, estazolam,
estrogens, etravirine, everolimus, felodipine, Central Nervous System
fentanyl, fesoterodine, flibanserin, flurazepam, Anorexia (3%)
INDAPAMIDE fluticasone propionate, food, fusidic acid, Dysesthesia (<2%)
grapefruit juice, guanfacine, H2-antagonists, Dysgeusia (taste perversion) (3%)
Trade name: Lozol (Sanofi-Aventis) halazepam, halofantrine, HMG-CoA reductase Fever (2%)
Indications: Edema inhibitors, itraconazole, ixabepilone, Headache (5%)
Class: Diuretic, thiazide ketoconazole, lapatinib, lidocaine, lomitapide, Hyperesthesia (<2%)
Half-life: 1418 hours lopinavir, lovastatin, maraviroc, meperidine, Paresthesias (<2%)
Clinically important, potentially hazardous methylergonovine, methylprednisolone, Somnolence (drowsiness) (2%)
interactions with: digoxin, lithium, zinc methysergide, midazolam, midostaurin, Vertigo (dizziness) (3%)
Pregnancy category: B mifepristone, mometasone, nefazodone, Neuromuscular/Skeletal
Important contra-indications noted in the nelfinavir, neratinib, nevirapine, nicardipine, Asthenia (fatigue) (2%)
prescribing guidelines for: the elderly; nursing nifedipine, nilotinib, nisoldipine, olaparib, P- Back pain (8%)
mothers; pediatric patients glycoprotein inhibitors and inducers, paclitaxel, Myalgia/Myopathy with lovastatin or
Note: Indapamide is a sulfonamide and can be palbociclib, pantoprazole, paricalcitol, pazopanib, simvastatin (<2%)
absorbed systemically. Sulfonamides can produce PEG-interferon, phenobarbital, phenytoin,
severe, possibly fatal, reactions such as toxic Gastrointestinal/Hepatic
pimavanserin, pimecrolimus, pimozide, ponatinib, Abdominal pain (17%) [2]
epidermal necrolysis and Stevens-Johnson prasugrel, protease inhibitors, proton pump
syndrome. Diarrhea (3%)
inhibitors, quazepam, quinidine, quinine, Dyspepsia (2%)
ranolazine, ribociclib, rifabutin, rifampin, Nausea (12%)
Skin rifapentine, rilpivirine, rivaroxaban, romidepsin, Vomiting (8%)
Angioedema [3] rosuvastatin, ruxolitinib, salmeterol, saxagliptin,
Erythema multiforme [2] sildenafil, silodosin, simeprevir, simvastatin, Respiratory
Pemphigus foliaceus [2] sirolimus, solifenacin, sorafenib, St John’s wort, Cough (2%)
Peripheral edema (<5%) [2] sunitinib, tacrolimus, tadalafil, tamsulosin, Endocrine/Metabolic
Pruritus (<5%) [2] telithromycin, temsirolimus, tenofovir disoproxil, ALT increased (5%)
Rash (<5%) [4] theophylline, ticagrelor, tolvaptan, trazodone, Appetite increased (2%)
Toxic epidermal necrolysis [3] triazolam, tricyclic antidepressants, valproic acid, AST increased (4%)
Urticaria (<5%) vardenafil, vemurafenib, venetoclax, venlafaxine, Creatine phosphokinase increased [2]
Vasculitis (<5%) vorapaxar, zidovudine Diabetes mellitus [2]
Mucosal Pregnancy category: C Gynecomastia [4]
Xerostomia (<5%) [2] Important contra-indications noted in the Porphyria (acute) [2]
prescribing guidelines for: nursing mothers;
Cardiovascular Genitourinary
pediatric patients
Flushing (<5%) Crystalluria [2]
Note: Protease inhibitors cause dyslipidemia
QT prolongation [5] Dysuria (2%)
which includes elevated triglycerides and
Central Nervous System cholesterol and redistribution of body fat centrally Renal
Paresthesias (<5%) to produce the so-called ‘protease paunch’, Nephrolithiasis (9%) [4]
Vertigo (dizziness) [2] breast enlargement, facial atrophy, and ‘buffalo Nephrotoxicity [13]
hump’. Ocular
Endocrine/Metabolic
Hypokalemia [2] Eyelid edema (<2%)
Hyponatremia [2] Skin Other
Bromhidrosis (<2%) Bruxism (<2%)
Dermatitis (<2%)
Diaphoresis (<2%)
INDINAVIR Folliculitis (<2%)
Herpes simplex (<2%) INDOMETHACIN
Trade name: Crixivan (Merck)
Indications: HIV infection
Herpes zoster (<2%)
Synonym: indometacin
Class: Antiretroviral, CYP3A4 inhibitor, HIV-1
Jaundice (2%)
Indications: Arthritis
protease inhibitor
Lipodystrophy [8]
Class: Non-steroidal anti-inflammatory (NSAID)
Half-life: ~1.8 hours
Lipomatosis [2]
Half-life: 4.5 hours
Clinically important, potentially hazardous
Pruritus [2]
Clinically important, potentially hazardous
interactions with: abiraterone, alfuzosin,
Rash [2]
interactions with: aldesleukin, aspirin, atenolol,
almotriptan, alosetron, alprazolam, amiodarone,
Seborrhea (<2%)
cyclopenthiazide, diflunisal, diuretics,
amprenavir, antacids, antiarrhythmics, antifungal
Stevens-Johnson syndrome [2]
methotrexate, NSAIDs, prednisolone,
agents, artemether/lumefantrine, astemizole,
Xerosis [2]
prednisone, sermorelin, tiludronate, torsemide,
atazanavir, atorvastatin, atovaquone, atovaquone/ Hair triamterene, urokinase
proguanil, avanafil, bepridil, bortezomib, Alopecia [5] Pregnancy category: C
bosentan, brigatinib, brinzolamide, cabazitaxel, Nails Important contra-indications noted in the
cabozantinib, calcifediol, calcium channel Onychocryptosis [2] prescribing guidelines for: nursing mothers;
blockers, carbamazepine, chlordiazepoxide, Paronychia [5] pediatric patients
ciclesonide, cisapride, clarithromycin, Pyogenic granuloma [3] Note: NSAIDs may cause an increased risk of
clonazepam, clorazepate, colchicine, conivaptan, serious cardiovascular and gastrointestinal
copanlisib, corticosteroids, crizotinib, Mucosal adverse events, which can be fatal. This risk may
cyclosporine, CYP3A4 inducers and substrates, Aphthous stomatitis (<2%)
increase with duration of use.
darifenacin, darunavir, dasatinib, deferasirox, Cheilitis [4]
142 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual INFLIXIMAB
Warning: RISK OF SERIOUS severe heart failure (New York Heart Association Paresthesias (<4%) [2]
CARDIOVASCULAR AND Functional Class III/IV). Peripheral neuropathy [7]
GASTROINTESTINAL EVENTS Warning: SERIOUS INFECTIONS and Seizures [2]
MALIGNANCY Vertigo (dizziness) [3]
Skin Neuromuscular/Skeletal
Angioedema [2] Skin Arthralgia (<8%) [15]
Bullous dermatitis [2] Abscess [4] Asthenia (fatigue) (9%) [4]
Dermatitis [5] Acneform eruption [6] Back pain (8%)
Dermatitis herpetiformis (exacerbation) [2] AGEP [2] Myalgia/Myopathy (5%) [7]
Edema (39%) Anaphylactoid reactions/Anaphylaxis [10] Polymyositis [2]
Exanthems (<5%) [7] Angioedema [2] Gastrointestinal/Hepatic
Fixed eruption [2] Candidiasis (5%) [4] Abdominal pain (12%) [3]
Pruritus (<10%) [3] Cellulitis [5] Crohn’s disease (26%)
Psoriasis [7] Dermatitis [4] Diarrhea (12%)
Purpura [5] Eczema [5] Dyspepsia (10%)
Rash (>10%) Edema [3] Hepatitis [11]
Toxic epidermal necrolysis [6] Erythema multiforme [2] Hepatotoxicity [16]
Urticaria [7] Exanthems [4] Nausea (21%) [3]
Vasculitis [5] Folliculitis [2] Pancreatitis [2]
Mucosal Hand–foot syndrome [2]
Herpes [2] Respiratory
Oral lesions (<7%) [2] Bronchitis (10%)
Oral ulceration [4] Herpes simplex [4]
Herpes zoster [11] Cough (12%) [3]
Central Nervous System Hypersensitivity [11] Dyspnea (6%) [3]
Psychosis [3] Leukocytoclastic vasculitis [2] Pharyngitis (12%)
Gastrointestinal/Hepatic Lichen planus [2] Pneumonia [12]
Gastrointestinal bleeding [2] Lichenoid eruption [3] Pulmonary toxicity [6]
Gastrointestinal perforation [3] Lupus erythematosus [35] Rhinitis (8%)
Gastrointestinal ulceration [3] Lupus syndrome [11] Sinusitis (14%) [4]
Pancreatitis [2] Lymphoma [9] Tuberculosis [13]
Malignancies [2] Upper respiratory tract infection (32%) [6]
Otic
Tinnitus [2] Molluscum contagiosum [2] Endocrine/Metabolic
Neoplasms [2] ALT increased [2]
Ocular Nevi [2]
Periorbital edema [2] Genitourinary
Palmar–plantar pustulosis [3] Cystitis [2]
Other Pityriasis lichenoides chronica [2] Urinary tract infection (8%) [2]
Adverse effects [8] Pruritus (7%) [8]
Pseudolymphoma [2] Renal
Psoriasis [56] Nephrotoxicity [2]
Pustules [5] Hematologic
INDORAMIN Rash (10%) [13] Neutropenia [5]
Sarcoidosis [5] Sepsis [2]
See: www.drugeruptiondata.com/drug/id/1341
Serum sickness [2] Thrombocytopenia [5]
Serum sickness-like reaction (<3%) [5]
Ocular
Toxic epidermal necrolysis [2]
INFLIXIMAB Toxicity [2]
Optic neuritis [3]
Uveitis [2]
Urticaria [6]
Trade names: Inflectra (Celltrion) ((Remsima)), Vasculitis [18] Local
Remicade (Centocor), Renflexis (Samsung Vitiligo [4] Application-site reactions (mild) (<4%) [6]
Bioepsis) Infusion-related reactions [20]
Indications: Crohn’s disease, ulcerative colitis,
Hair Infusion-site reactions (20%) [12]
Alopecia [6]
rheumatoid arthritis, ankylosing spondylitis, Injection-site reactions (6%) [9]
psoriatic arthritis, plaque psoriasis
Alopecia areata [3]
Other
Class: Cytokine inhibitor, Disease-modifying Cardiovascular
Adverse effects [43]
antirheumatic drug (DMARD), Monoclonal Cardiotoxicity [2]
Allergic reactions [8]
antibody, TNF inhibitor Chest pain [4]
Death [13]
Half-life: 8–10 days Flushing [2]
Infection (36%) [58]
Clinically important, potentially hazardous Hypertension (7%) [3]
Nocardiosis [3]
interactions with: abatacept, anakinra, live Palpitation [2]
Side effects [2]
vaccines, methotrexate, tocilizumab Pericarditis [2]
Systemic reactions [2]
Pregnancy category: B Tachycardia [2]
Important contra-indications noted in the Central Nervous System
prescribing guidelines for: the elderly; nursing Aseptic meningitis [2]
mothers Chills (59%) [2]
Note: TNF inhibitors should be used in patients Demyelination [3]
with heart failure only after consideration of other Fever (7%) [10]
treatment options. Headache (18%) [11]
Contra-indicated in patients with a personal or Leukoencephalopathy [2]
family history of multiple sclerosis or Neurotoxicity [8]
demyelinating disease. TNF inhibitors should not Pain (8%) [3]
be administered to patients with moderate to
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Cardiovascular
INFLUENZA VACCINE INGENOL MEBUTATE Hypotension [2]
Veno-occlusive disease (23%) [4]
Trade names: Afluria (Seqirus), Agrippal Trade name: Picato (Leo Pharma)
(Chiron), Comvax (Merck), Fluad (Novartis), Indications: Actinic keratosis Central Nervous System
Fluarix (GSK), FluMist (Medimmune) (Wyeth), Class: Cell death inducer Chills (11%)
Flurix (GSK), Fluviral (Shire), Inflexal V (Berna Half-life: N/A Fever (32%) [4]
Biotech), Invivac (Solvay), Vaxigrip (Sanofi- Clinically important, potentially hazardous Headache (28%) [2]
Aventis) interactions with: none known Neuromuscular/Skeletal
Indications: Influenza prevention Pregnancy category: C Asthenia (fatigue) (35%) [2]
Class: Vaccine Important contra-indications noted in the Gastrointestinal/Hepatic
Half-life: N/A prescribing guidelines for: pediatric patients Abdominal distension (6%)
Clinically important, potentially hazardous Abdominal pain (23%)
interactions with: aminophylline, Skin Ascites (4%)
carbamazepine, cyclosporine, mercaptopurine, Crusting [4] Constipation (16%)
phenobarbital, phenytoin, prednisone, vincristine, Erythema [4] Diarrhea (17%)
warfarin Flaking [4] Hepatotoxicity (14%) [3]
Pregnancy category: C Scaling [3] Nausea (31%) [4]
Important contra-indications noted in the Vomiting (15%)
prescribing guidelines for: pediatric patients Central Nervous System
Note: Inactivated influenza vaccine should not be Headache (2%) [4] Respiratory
given to persons with anaphylactic Respiratory Pneumonia [2]
hypersensitivity to eggs or other components of Nasopharyngitis (2%) [2] Endocrine/Metabolic
the vaccine. For current data on influenza in the Ocular ALP increased (13%)
USA consult the Centers for Disease Control and Eyelid edema [2] ALT increased (>10%) [2]
Protection website (www.cdc.gov/flu). Periorbital edema (3%) [2] Appetite decreased (12%)
AST increased (>10%) [3]
Local GGT increased (21%)
Skin Application-site erythema [2]
Anaphylactoid reactions/Anaphylaxis (rare) Hyperbilirubinemia (21%) [5]
Application-site infection (3%) [2] Hyperuricemia (4%)
[3] Application-site pain (2–15%) [6]
Henoch–Schönlein purpura [2] Application-site pruritus (8%) [4] Hematologic
Hypersensitivity [2] Application-site reactions [3] Anemia (36%)
Linear IgA bullous dermatosis [2] Febrile neutropenia (26%) [2]
Purpura [2] Hemorrhage (33%)
Rash [3] Hyperlipasemia (9%)
Serum sickness-like reaction [2] INOSITOL Leukopenia (35%) [3]
Vasculitis [10] Lymphopenia (18%) [4]
See: www.drugeruptiondata.com/drug/id/1376 Myelosuppression (>10%)
Central Nervous System
Fever [13] Neutropenia (49%) [9]
Guillain–Barré syndrome [11] Pancytopenia (2%)
Headache [9] INOTUZUMAB Thrombocytopenia (51%) [9]
Seizures [3] Local
OZOGAMICIN * Infusion-related reactions (2%)
Neuromuscular/Skeletal
Arthralgia [2] Trade name: Besponsa (Wyeth) Other
Asthenia (fatigue) [7] Indications: Relapsed or refractory B-cell Infection (48%) [2]
Myalgia/Myopathy [11] precursor acute lymphoblastic leukemia
Polymyositis [4] Class: Antibody drug conjugate (ADC), CD22-
Gastrointestinal/Hepatic directed antibody-drug conjugate
Half-life: 12 days
INSULIN
Abdominal pain [2]
Clinically important, potentially hazardous See: www.drugeruptiondata.com/drug/id/361
Respiratory interactions with: none known
Asthma [2]
Pregnancy category: N/A (Can cause fetal
Cough [2]
harm)
Hematologic Important contra-indications noted in the INSULIN ASPART
Thrombocytopenia [2] prescribing guidelines for: nursing mothers;
pediatric patients Trade names: NovoLog (Novo Nordisk),
Ocular NovoRapid (Novo Nordisk), Ryzodeg (Novo
Oculorespiratory syndrome [15] Warning: HEPATOTOXICITY, INCLUDING
HEPATIC VENOOCCLUSIVE DISEASE (ALSO Nordisk)
Optic neuritis [2] Indications: Diabetes mellitus
KNOWN AS SINUSOIDAL OBSTRUCTION
Local SYNDROME) and INCREASED RISK OF Class: Hormone, polypeptide
Injection-site edema [4] POSTHEMATOPOIETIC STEM CELL Half-life: 81 minutes
Injection-site erythema [7] TRANSPLANT NONRELAPSE MORTALITY Clinically important, potentially hazardous
Injection-site induration [5] interactions with: ACE inhibitors, alcohol,
Injection-site inflammation [3] atypical antipsychotics, beta blockers, clonidine,
Injection-site pain (2028%) [15] Skin corticosteroids, danazol, disopyramide, diuretics,
Injection-site reactions [3] Hypersensitivity (2%) epinephrine, estrogens, fibrates, fluoxetine,
Tumor lysis syndrome (2%) isoniazid, isoniazid, lithium salts, MAO inhibitors,
Other
Adverse effects [7] Mucosal niacin, octreotide, oral contraceptives,
Side effects [4] Stomatitis (13%) pentamidine, phenothiazine derivatives,
Systemic reactions (injection site) [5] pramlintide, propoxyphene, salbutamol,
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Litt’s Drug Eruption & Reaction Manual INSULIN GLARGINE
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INSULIN GLARGINE See all our books at www.crcpress.com
Ocular Cardiovascular
Cataract (18%) INTERFERON ALFA Cardiotoxicity [2]
Retinopathy [2] Hypertension [3]
Synonyms: IFN; INF Hypotension [2]
Local Trade names: Infergen (Intermune), Intron A
Injection-site pain (3%) (Schering), Rebetron (Schering), Roferon-A Central Nervous System
Injection-site reactions [4] (Roche) Ageusia (taste loss) [2]
Other Indications: Chronic hepatitis C virus infection, Anorexia [4]
Adverse effects [5] hairy cell leukemia Anosmia [4]
Infection (9–14%) Class: Biologic, Immunomodulator, Interferon Anxiety [2]
Half-life: 2 hours Chills [4]
Clinically important, potentially hazardous Depression (515%) [24]
Dysgeusia (taste perversion) [K] (25%) [2]
INSULIN GLULISINE interactions with: aldesleukin, amitriptyline,
captopril, gemfibrozil, metaxalone, methadone, Fever (37%) [6]
ribavirin, telbivudine, theophylline, theophylline Headache (54%) [5]
Trade name: Apidra (Sanofi-Aventis) Insomnia (19%)
Indications: Diabetes derivatives, zafirlukast, zidovudine
Pregnancy category: C (pregnancy category Irritability [2]
Class: Insulin analog Neurotoxicity [4]
Half-life: 13–42 minutes will be X when used in combination with
ribavirin) Paresthesias 8% [L] (12%)
Clinically important, potentially hazardous Parkinsonism [3]
interactions with: ACE inhibitors, albuterol, Important contra-indications noted in the
prescribing guidelines for: nursing mothers; Restless legs syndrome [2]
alcohol, anitpsychotics, beta blockers, clonidine, Rigors (35%)
clozapine, corticosteroids, danazol, disopyramide, pediatric patients
Note: Many of the adverse reactions depend on Seizures [2]
diuretics, epinephrine, fibrates, fluoxetine, Suicidal ideation [6]
glucagon, guanethidine, isoniazid, lithium, MAO the nature of the disease being treated. Either
hairy cell leukemia [L] or AIDS-related Kaposi’s Tremor [2]
inhibitors, niacin, oral antidiabetic agents, oral Vertigo (dizziness) (16%) [2]
contraceptives, pentamidine, pentoxifylline, sarcoma [K].
phenothiazine derivatives, pramlintide, Neuromuscular/Skeletal
propoxyphene, propranolol, protease inhibitors, Skin Arthralgia (28%) [4]
reserpine, salicylates, somatostatin analogs, Angioedema [3] Asthenia (fatigue) (56%) [11]
somatropin, sulfonamide antibiotics, terbutaline, Bullous dermatitis [4] Back pain (9%)
thyroid hormones Dermatitis (6%) Myalgia/Myopathy 69% [L] 71% [K] [10]
Pregnancy category: C Eczema [6] Myasthenia gravis [11]
Important contra-indications noted in the Edema [L] (11%) [2] Rhabdomyolysis [3]
prescribing guidelines for: nursing mothers; Erythema [2] Gastrointestinal/Hepatic
pediatric patients Exanthems [3] Abdominal pain (15%)
Note: Various forms of insulin are available - see Herpes simplex [2] Constipation [2]
other insulin profiles for reaction details. Kaposi’s sarcoma [2] Diarrhea (24%) [5]
Lichen planus [8] Nausea (24%) [7]
Skin Linear IgA bullous dermatosis [3] Pancreatitis [7]
Peripheral edema (8%) Livedo reticularis [2] Vomiting [5]
Lupus erythematosus [17] Respiratory
Cardiovascular Lupus syndrome [2]
Hypertension (4%) Cough [2]
Necrosis [6] Dyspnea (13%) [2]
Central Nervous System Pemphigus [2] Flu-like syndrome (>10%) [10]
Headache (7%) Photosensitivity [2] Pulmonary hypertension [2]
Neuromuscular/Skeletal Pigmentation [3]
Pruritus 13% [L] 5–7% [K] (13%) [4] Endocrine/Metabolic
Arthralgia (6%) ALT increased [2]
Psoriasis [22]
Respiratory Purpura [2] AST increased [2]
Influenza (4–6%) Rash 44% [L] 11% [K] [5] Hyperglycemia [2]
Nasopharyngitis (8–11%) Raynaud’s phenomenon [11] Hyperthyroidism [3]
Upper respiratory tract infection (7–11%) Sarcoidosis [47] Thyroid dysfunction [3]
Endocrine/Metabolic Seborrheic dermatitis [2] Thyroiditis [2]
Hypoglycemia (6–7%) [3] Sjögren’s syndrome [4] Weight loss (16%) [5]
Thrombocytopenic purpura [2] Genitourinary
Local
Toxicity [4] Impotence [2]
Injection-site reactions (10%) [2]
Urticaria [K] (<3%) [3] Renal
Vasculitis [7] Nephrotoxicity [3]
Vitiligo [9] Proteinuria [2]
Hair Hematologic
Alopecia (23%) [16] Anemia (11%) [7]
Hair pigmentation [3] Febrile neutropenia [2]
Hypertrichosis [3] Hemolytic uremic syndrome [6]
Straight hair [2] Leukopenia [5]
Mucosal Lymphopenia (14%)
Aphthous stomatitis [2] Neutropenia (21%) [5]
Oral lichen planus [7] Thrombocytopenia [7]
Stomatitis (<10%) Otic
Xerostomia (>10%) [4] Tinnitus [4]
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Litt’s Drug Eruption & Reaction Manual IPILIMUMAB
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Litt’s Drug Eruption & Reaction Manual ISONIAZID
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Litt’s Drug Eruption & Reaction Manual IVABRADINE
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Litt’s Drug Eruption & Reaction Manual IXEKIZUMAB
Ocular Pregnancy category: N/A (Insufficient evidence Upper respiratory tract infection (14%) [9]
Conjunctivitis (6%) to inform drug-associated risk) Hematologic
Vision blurred (6%) Important contra-indications noted in the Neutropenia (11%) [3]
Xerophthalmia (5%) prescribing guidelines for: pediatric patients Thrombocytopenia (3%)
Other Otic
Adverse effects [4] Skin Ear infection (2%)
Hypersensitivity [4]
Peripheral edema [2] Local
Urticaria [2] Injection-site erythema [2]
IXEKIZUMAB Injection-site reactions (17%) [7]
Central Nervous System
Trade name: Taltz (Lilly) Headache [7] Other
Indications: Plaque psoriasis Infection [3]
Gastrointestinal/Hepatic
Class: Interleukin-17A (IL-17A) antagonist, Crohn’s disease [2]
Monoclonal antibody Nausea (2%)
Half-life: 13 days
Clinically important, potentially hazardous Respiratory
interactions with: live vaccines Nasopharyngitis [9]
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Litt’s Drug Eruption & Reaction Manual KETOPROFEN
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Litt’s Drug Eruption & Reaction Manual LAMOTRIGINE
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Litt’s Drug Eruption & Reaction Manual LEFLUNOMIDE
Pregnancy category: D
Important contra-indications noted in the LATANOPROST LEDIPASVIR &
prescribing guidelines for: nursing mothers;
pediatric patients Trade name: Xalatan (Pfizer) SOFOSBUVIR
Note: Lapitinib is used in conjunction with Indications: Reduction of elevated intraocular
pressure in open angle glaucoma or ocular Trade name: Harvoni (Gilead)
capecitabine.
hypertension Indications: Hepatitis C
Warning: HEPATOXICITY
Class: Prostaglandin analog Class: Hepatitis C virus NS5A inhibitor
Half-life: 17 minutes (ledipasvir), Hepatitis C virus nucleotide analog
Skin Clinically important, potentially hazardous NS5B polymerase inhibitor (sofosbuvir)
Acneform eruption (90%) [4] interactions with: thimerosal Half-life: 47 hours (ledipasvir); <27 hours
Depigmentation (21%) Pregnancy category: C (sofosbuvir)
Hand–foot syndrome (53%) [9] Important contra-indications noted in the Clinically important, potentially hazardous
Inflammation (15%) prescribing guidelines for: nursing mothers; interactions with: amiodarone, carbamazepine,
Pruritus [3] pediatric patients cobicistat/elvitegravir/emtricitabine/tenofovir
Rash (28%) [26] disoproxil, oxcarbazepine, phenobarbital,
Toxicity [6] phenytoin, rifabutin, rifampin, rifapentine,
Xerosis (10%) Skin ritonavir, rosuvastatin, simeprevir, St John’s wort,
Pigmentation [2] tenofovir disoproxil
Hair Pruritus [2]
Alopecia [2] Pregnancy category: N/A (Insufficient evidence
Rash (<10%) to inform drug-associated risk; contra-indicated in
Nails Cardiovascular pregnancy when given with ribavirin )
Paronychia [3] Angina (<10%) Important contra-indications noted in the
Mucosal Chest pain (<10%) prescribing guidelines for: nursing mothers;
Mucosal inflammation (15%) Central Nervous System pediatric patients
Mucositis [2] Headache [3] Note: See also separate entry for sofosbuvir.
Stomatitis (14%) Vertigo (dizziness) [2]
Central Nervous System Neuromuscular/Skeletal Skin
Anorexia (24%) [2] Arthralgia (<10%) Pruritus [6]
Insomnia (10%) Back pain (<10%) Rash [5]
Neuromuscular/Skeletal Myalgia/Myopathy (<10%) Cardiovascular
Asthenia (fatigue) (12%) [19] Respiratory Bradycardia [3]
Back pain (11%) Flu-like syndrome (<10%) Central Nervous System
Bone or joint pain [2] Upper respiratory tract infection (<10%) Headache (11–17%) [32]
Pain in extremities (12%)
Ocular Insomnia (3–6%) [11]
Gastrointestinal/Hepatic Conjunctival hyperemia [19] Irritability [5]
Abdominal pain (15%) Deepening of upper lid sulcus [5] Vertigo (dizziness) [3]
Diarrhea (65%) [44] Eyelashes – hypertrichosis [15] Neuromuscular/Skeletal
Dyspepsia (11%) Eyelashes – pigmentation [9] Arthralgia [3]
Hepatotoxicity [11] Eyelid edema (<4%) Asthenia (fatigue) (7–18%) [33]
Nausea (44%) [9] Eyelid erythema (<4%) Muscle spasm [2]
Vomiting (26%) [7] Eyelid pain (<10%) Myalgia/Myopathy [3]
Respiratory Eyelid pigmentation [4] Gastrointestinal/Hepatic
Dyspnea (12%) [2] Eyelid pruritus (2%) Diarrhea (3–7%) [12]
Endocrine/Metabolic Foreign body sensation [5] Hepatotoxicity [3]
ALT increased (37%) [5] Iris pigmentation [7] Nausea (6–9%) [20]
AST increased (49%) [4] Keratitis [3]
Macular edema [7] Respiratory
Hyperbilirubinemia [3]
Ocular adverse effects [7] Cough [3]
Hematologic Ocular hyperemia [4] Dyspnea [3]
Anemia [5] Ocular itching [8] Nasopharyngitis [2]
Febrile neutropenia [2] Ocular pigmentation (5%) [12] Upper respiratory tract infection [6]
Leukopenia [4] Periorbitopathy [2] Renal
Lymphopenia [2] Uveitis [5] Nephrotoxicity [3]
Neutropenia [8] Vision blurred [3]
Hematologic
Otic Xerophthalmia (<10%)
Anemia [7]
Tinnitus (14%) Other
Other
Other Allergic reactions (<10%)
Adverse effects [5]
Adverse effects [11]
Infection [2]
Death [2]
LARONIDASE LEFLUNOMIDE
See: www.drugeruptiondata.com/drug/id/391
See: www.drugeruptiondata.com/drug/id/996
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Litt’s Drug Eruption & Reaction Manual LEUCOVORIN
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Other
LEUPROLIDE LEVETIRACETAM Adverse effects [8]
Death [2]
Trade names: Eligard (Sanofi-Aventis), Lupron Trade names: Elepsia XR (Sun Pharma), Keppra Infection (1326%) [7]
(TAP), Lupron Depot-Ped (AbbVie), Viadur (UCB)
(Bayer) Indications: Partial onset seizures
Indications: Prostate carcinoma, endometriosis Class: Anticonvulsant
Class: Gonadotropin-releasing hormone (GnRH) Half-life: 7 hours LEVOBETAXOLOL
agonist Clinically important, potentially hazardous
Half-life: 34 hours interactions with: carbamazepine, See: www.drugeruptiondata.com/drug/id/767
Clinically important, potentially hazardous eslicarbazepine
interactions with: none known Pregnancy category: C
Pregnancy category: X Important contra-indications noted in the LEVOBUNOLOL
Important contra-indications noted in the prescribing guidelines for: nursing mothers
prescribing guidelines for: nursing mothers See: www.drugeruptiondata.com/drug/id/397
Skin
Skin DRESS syndrome [7]
Anaphylactoid reactions/Anaphylaxis [3] Erythema [2] LEVOBUPIVACAINE
Dermatitis (5%) Erythema multiforme [2]
Dermatitis herpetiformis [2] Rash [5] See: www.drugeruptiondata.com/drug/id/922
Ecchymoses (<5%) Stevens-Johnson syndrome [3]
Edema (<10%) Toxic epidermal necrolysis [2]
Granulomas [2]
Hot flashes (12%) [6]
Urticaria [2] LEVOCETIRIZINE
Central Nervous System
Peripheral edema (412%) Aggression [7] Trade name: Xyzal (UCB Pharma)
Pigmentation (<5%) Agitation [5] Indications: Allergic rhinitis, chronic idiopathic
Pruritus (<5%) Anorexia [2] urticaria
Rash (<10%) Behavioral disturbances [4] Class: Histamine H1 receptor antagonist
Vasculitis [2] Compulsions [2] Half-life: 6–10 hours
Xerosis (<5%) Depression [8] Clinically important, potentially hazardous
Hair Encephalopathy [4] interactions with: none known
Alopecia (<5%) Fever [2] Pregnancy category: B
Cardiovascular Headache (25%) [12] Important contra-indications noted in the
Flushing (61%) [2] Irritability [9] prescribing guidelines for: the elderly; nursing
Thrombophlebitis (2%) Nervousness [2] mothers; pediatric patients
Neurotoxicity [3]
Central Nervous System Paresthesias (2%)
Dysgeusia (taste perversion) (<5%) Skin
Psychosis [3] Fixed eruption [3]
Paresthesias (<5%) Seizures [4]
Neuromuscular/Skeletal Sleep related disorder [2] Mucosal
Myalgia/Myopathy [2] Somnolence (drowsiness) [17] Xerostomia (2–3%)
Endocrine/Metabolic Suicidal ideation [4] Central Nervous System
Gynecomastia (7%) Vertigo (dizziness) (918%) [20] Headache [2]
Mastodynia (7%) Neuromuscular/Skeletal Sedation [2]
Asthenia (fatigue) (<22%) [20] Somnolence (drowsiness) (5–6%)
Ocular
Diplopia [2] Osteoporosis [2] Neuromuscular/Skeletal
Rhabdomyolysis [3] Asthenia (fatigue) (<4%)
Local
Injection-site granuloma [6] Gastrointestinal/Hepatic Gastrointestinal/Hepatic
Injection-site inflammation (2%) Abdominal pain [2] Hepatotoxicity [2]
Injection-site pain [2] Diarrhea [2] Respiratory
Injection-site reactions (24%) Hepatotoxicity [3] Nasopharyngitis (4–6%)
Nausea [4] Pharyngitis (<2%)
Vomiting [4]
LEVALBUTEROL Respiratory
Influenza [2] LEVODOPA
See: www.drugeruptiondata.com/drug/id/876 Nasopharyngitis [5]
Endocrine/Metabolic Synonyms: L-dopa; carbidopa
Creatine phosphokinase increased [3] Trade names: Duopa (Abbvie), Rytary (Impax),
LEVAMISOLE Libido decreased [2] Sinemet (Bristol-Myers Squibb), Stalevo (Orion)
Weight gain [4] Indications: Parkinsonism
See: www.drugeruptiondata.com/drug/id/395 Genitourinary Class: Dopamine precursor
Sexual dysfunction [2] Half-life: 13 hours
Clinically important, potentially hazardous
Renal interactions with: ACE inhibitors, acebutolol,
Nephrotoxicity [2] alfuzosin, alpha blockers, amisulpride, ampicillin,
Hematologic angiotensin II receptor antagonists, anti-
Hemotoxicity [2] hypertensives, antimuscarinics, antipsychotics,
Pancytopenia [2] baclofen, benzodiazepines, beta blockers,
Thrombocytopenia [2] bupropion, calcium channel blockers, captopril,
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Litt’s Drug Eruption & Reaction Manual LEVOMEPROMAZINE
chloramphenicol, cholestyramine, cilazapril, Back pain [2] Radiation recall dermatitis [2]
clobazam, clonidine, darifenacin, diazoxide, Gastrointestinal/Hepatic Rash (2%) [2]
diuretics, dopamine D2 receptor antagonists, Abdominal pain [2] Stevens-Johnson syndrome [2]
enalapril, erythromycin, fosinopril, hydralazine, Constipation [4] Toxic epidermal necrolysis [5]
irbesartan, iron salts, isoniazid, levomepromazine, Diarrhea [2] Vasculitis [3]
linezolid, lisinopril, MAO inhibitors, memantine, Hepatotoxicity [2] Cardiovascular
methyldopa, metoclopramide, minoxidil, Nausea [9] Myocardial infarction [2]
moclobemide, moxonidine, nitrates, olanzapine, Vomiting [4] Palpitation [2]
olmesartan, oral iron, oxybutynin, paliperidone, QT prolongation [5]
papaverine, pericyazine, phenelzine, phenytoin, Endocrine/Metabolic
Weight loss [2] Torsades de pointes [6]
probenecid, pyridoxine, quetiapine, quinapril,
ramipril, rifampin, risperidone, sapropterin, Ocular Central Nervous System
selegiline, sodium nitroprusside, sulpiride, Hallucinations, visual [2] Anorexia [2]
tetrabenazine, tiotropium, trandolapril, Ocular adverse effects [2] Delirium [5]
tranylcypromine, tricyclic antidepressants, Depression [2]
Other Dysgeusia (taste perversion) [2]
trospium, volatile liquid general anesthetics, Adverse effects [2]
ziprasidone, zuclopenthixol, zuclopenthixol Headache (6%) [6]
Hiccups [2] Insomnia (4%) [3]
acetate, zuclopenthixol decanoate, zuclopenthixol
dihydrochloride Peripheral neuropathy [3]
Pregnancy category: C Psychosis [2]
Important contra-indications noted in the LEVOFLOXACIN Seizures [9]
prescribing guidelines for: nursing mothers; Vertigo (dizziness) [6]
pediatric patients Trade names: Iquix (Santen), Levaquin (Ortho- Neuromuscular/Skeletal
Note: Levodopa is always used in conjuntion with McNeil), Quixin (Johnson & Johnson), Tavanic Arthralgia [4]
carbidopa. Stalevo is levodopa, carbidopa and (Sanofi-Aventis) Myalgia/Myopathy [4]
entacapone. Contra-indicated in patients with Indications: Various infections caused by Myasthenia gravis (exacerbation) [3]
narrow-angle glaucoma or those with a history of susceptible organisms, inhalational anthrax (post Rhabdomyolysis [4]
melanoma. exposure) Tendinitis [2]
Class: Antibiotic, fluoroquinolone Tendinopathy/Tendon rupture [35]
Half-life: 68 hours
Skin Clinically important, potentially hazardous Gastrointestinal/Hepatic
Chromhidrosis (<10%) interactions with: alfuzosin, aminophylline, Abdominal pain [3]
Edema [2] amiodarone, antacids, antidiabetics, arsenic, Constipation (3%)
Exanthems [2] artemether/lumefantrine, BCG vaccine, Diarrhea (5%) [4]
Lupus erythematosus [2] chloroquine, ciprofloxacin, corticosteroids, Hepatotoxicity [4]
Melanoma [28] cyclosporine, didanosine, dronedarone, Nausea (7%) [6]
Rash [3] gadobutrol, insulin, lanthanum, mycophenolate, Vomiting [3]
Hair nilotinib, NSAIDs, oral iron, oral typhoid vaccine, Endocrine/Metabolic
Hair pigmentation [2] phenindione, pimozide, probenecid, QT ALT increased [3]
Nails prolonging agents, quinine, strontium ranelate, AST increased [3]
Nail growth [2] sucralfate, sulfonylureas, tetrabenazine, Hypoglycemia [3]
thioridazine, vitamin K antagonists, warfarin, zinc, Genitourinary
Mucosal ziprasidone, zolmitriptan
Xerostomia (<10%) [2] Vaginitis (2%)
Pregnancy category: C
Cardiovascular Important contra-indications noted in the Renal
Hypotension [2] prescribing guidelines for: the elderly; nursing Nephrotoxicity [5]
Orthostatic hypotension [4] mothers Hematologic
Central Nervous System Note: Fluoroquinolones are associated with an Thrombocytopenia [5]
Agitation [2] increased risk of tendinitis and tendon rupture in Other
Anosmia [2] all ages. This risk is further increased in older
Adverse effects [13]
Anxiety [2] patients usually over 60 years of age, in patients
Death [5]
Confusion [3] taking corticosteroid drugs, and in patients with
Side effects [2]
Delusions [2] kidney, heart or lung transplants.
Depression [3] Fluoroquinolones may exacerbate muscle
Dyskinesia [44] weakness in persons with myasthenia gravis.
Gait instability [3] Warning: SERIOUS ADVERSE REACTIONS LEVOLEUCOVORIN
Hallucinations [12] INCLUDING TENDINITIS, TENDON
RUPTURE, PERIPHERAL NEUROPATHY, See: www.drugeruptiondata.com/drug/id/1297
Insomnia [6]
Narcolepsy [2] CENTRIAL NERVOUS SYSTEM EFFECTS and
Neuroleptic malignant syndrome [7] EXACERBATION OF MYASTHENIA GRAVIS
Neurotoxicity [3] LEVOMEPROMAZINE
Psychosis [6] Skin
Restless legs syndrome [5] Anaphylactoid reactions/Anaphylaxis [6] See: www.drugeruptiondata.com/drug/id/2175
Somnolence (drowsiness) [5] Erythema [2]
Suicidal ideation [2] Erythema nodosum (<3%)
Tardive dyskinesia [2] Exanthems [2]
Vertigo (dizziness) [4] Hypersensitivity [5]
Neuromuscular/Skeletal Photosensitivity [3]
Arthralgia [2] Phototoxicity [5]
Asthenia (fatigue) [2] Pruritus (2%) [3]
Purpura [2]
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164 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual LINEZOLID
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LINEZOLID See all our books at www.crcpress.com
serotonin/norepinephrine reuptake inhibitors, Allergic reactions (4%) Upper respiratory tract infection (10%) [3]
sertraline, sibutramine, SSRIs, tapentadol, Death [2] Endocrine/Metabolic
tetrabenazine, tetrahydrozoline, tramadol, Appetite decreased [6]
trazodone, tricyclic antidepressants, Hypoglycemia [10]
trimipramine, tryptophan, venlafaxine
Pregnancy category: C
LIOTHYRONINE Weight loss [6]
Important contra-indications noted in the Genitourinary
Synonym: T3 sodium Urinary tract infection (6%)
prescribing guidelines for: nursing mothers Trade names: Cytomel (Pfizer), Triostat (Par)
Indications: Hypothyroidism Local
Skin Class: Thyroid hormone, synthetic Injection-site reactions (2%) [3]
Cellulitis [2] Half-life: 1649 hours Other
Edema (2%) Clinically important, potentially hazardous Adverse effects [13]
Fungal dermatitis (2%) interactions with: anticoagulants, dicumarol, Malignant neoplasms (11%)
Pruritus [2] warfarin
Rash (<7%) [3] Pregnancy category: A
Mucosal LISDEXAMFETAMINE
Black tongue [2] Skin
Central Nervous System Urticaria [3] Trade name: Vyvanse (Shire)
Dysgeusia (taste perversion) (<2%) Indications: Attention-deficit hyperactivity
Fever (2–14%) disorder (ADHD)
Headache (<11%) [4] LIRAGLUTIDE Class: CNS stimulant, Dextroamphetamine
prodrug
Insomnia (3%)
Neurotoxicity [5] Trade names: Saxenda (Novo Nordisk), Victoza Half-life: 1 hour
Peripheral neuropathy [12] (Novo Nordisk), Xultophy (Novo Nordisk) Clinically important, potentially hazardous
Seizures (3%) Indications: To improve glycemic control in interactions with: acetazolamide, ammonium
Serotonin syndrome [27] adults with Type II diabetes mellitus (Victoza), chloride, analgesics, antacids, antihistamines,
Vertigo (dizziness) (2%) adjunct to diet and exercise for chronic weight antihypertensives, antipsychotics, atomoxetine,
management (Saxenda) cannabinoids, carbonic anhydrase inhibitors,
Gastrointestinal/Hepatic chlorpromazine, epinephrine, ethosuximide,
Abdominal pain (<2%) Class: Glucagon-like peptide-1 (GLP-1) receptor
agonist haloperidol, iobenguane, lithium, MAO inhibitors,
Constipation (2%) [2] meperidine, methenamine, phenobarbital,
Diarrhea (3–11%) [9] Half-life: 13 hours
Clinically important, potentially hazardous phenytoin, propoxyphene, sympathomimetics,
Gastrointestinal bleeding (2%) tricyclic antidepressants, urinary alkalinizing
Gastrointestinal disorder [2] interactions with: acetaminophen, atorvastatin,
digoxin, griseofulvin, lisinopril, warfarin agents
Loose stools (<2%) Pregnancy category: C
Nausea (3–10%) [9] Pregnancy category: C
Important contra-indications noted in the Important contra-indications noted in the
Vomiting (<10%) [4] prescribing guidelines for: nursing mothers;
prescribing guidelines for: nursing mothers;
Respiratory pediatric patients pediatric patients
Apnea (2%) Note: Contra-indicated in patients with a Warning: ABUSE AND DEPENDENCE
Cough (<2%) personal or family history of medullary thyroid
Dyspnea (3%) carcinoma or in patients with multiple endocrine Skin
Pneumonia (3%) neoplasia syndrome Type 2. Xultophy is liraglutide Hyperhidrosis (3%)
Upper respiratory tract infection (4%) and insulin degludec. Rash (3%)
Endocrine/Metabolic Warning: RISK OF THYROID C-CELL TUMORS Mucosal
Acidosis [5] Xerostomia (4–26%) [20]
ALP increased (<4%) Cardiovascular
ALT increased (2–10%) Cardiovascular
Cardiotoxicity [2] Hypertension (3%)
AST increased (2–5%) Hypertension (3%)
Hypoglycemia [2] Tachycardia [3]
Hypokalemia (3%) Central Nervous System Central Nervous System
Hyponatremia [2] Headache (~5%) [7] Agitation (3%)
Vertigo (dizziness) (6%) [2] Anorexia (5%) [3]
Genitourinary
Candidal vaginitis (<2%) Neuromuscular/Skeletal Anxiety [8]
Asthenia (fatigue) [3] Fever (2%)
Renal Back pain (5%) [3] Headache [29]
Nephrotoxicity [2] Insomnia (13–23%) [28]
Gastrointestinal/Hepatic
Hematologic Abdominal pain [3] Irritability (10%) [19]
Anemia (<6%) [6] Cholelithiasis (gallstones) [3] Restlessness (3%)
Leukopenia [2] Constipation (10%) [12] Somnolence (drowsiness) (2%) [2]
Myelosuppression [7] Diarrhea (17%) [31] Tic disorder (2%) [2]
Pancytopenia [4] Dyspepsia [3] Vertigo (dizziness) (5%) [6]
Sepsis (8%) Gastrointestinal disorder [3] Neuromuscular/Skeletal
Thrombocytopenia (<5%) [19] Nausea (28%) [61] Asthenia (fatigue) [3]
Ocular Pancreatitis [10] Back pain [2]
Optic neuropathy [14] Vomiting (11%) [30] Muscle spasm [2]
Local Respiratory Gastrointestinal/Hepatic
Injection-site reactions (3%) Influenza (7%) Abdominal pain (12%) [12]
Other Nasopharyngitis (5%) [6] Constipation [2]
Adverse effects (4%) [15] Sinusitis (6%) Diarrhea (7%)
166 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual LITHIUM
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LITHIUM Over 100 updates per week on www.drugeruptiondata.com
Hypothyroidism [3]
Thyrotoxicosis [2] LOMITAPIDE LOPERAMIDE
Weight gain [3]
Trade name: Juxtapid (Aegerion) Trade names: Imodium (McNeil), Maalox
Genitourinary Indications: Homozygous familial (Novartis)
Polyuria [2] hypercholesterolemia Indications: Diarrhea
Priapism [5] Class: Lipid regulator Class: Opiate agonist
Renal Half-life: 39.7 hours Half-life: 914 hours
Nephrogenic diabetes insipidus [2] Clinically important, potentially hazardous Clinically important, potentially hazardous
Nephrotoxicity [13] interactions with: bile acid sequestrants, interactions with: St John’s wort
Other boceprevir, clarithromycin, conivaptan, grapefruit Pregnancy category: B
Adverse effects [5] juice, indinavir, itraconazole, ketoconazole, Important contra-indications noted in the
Side effects (2333%) [4] lopinavir, lovastatin, mibefradil, nefazodone, prescribing guidelines for: nursing mothers;
Teratogenicity [3] nelfinavir, oral contraceptives, P-glycoprotein pediatric patients
substrates, posaconazole, ritonavir, saquinavir,
simvastatin, strong or moderate CYP3A4 Cardiovascular
inhibitors, telaprevir, telithromycin, voriconazole,
LIXISENATIDE warfarin
Torsades de pointes [2]
Pregnancy category: X Gastrointestinal/Hepatic
Trade names: Adlyxin (Sanofi-Aventis), Lyxumia Important contra-indications noted in the Abdominal pain [2]
(Sanofi-Aventis), Soliqua (Sanofi-Aventis) prescribing guidelines for: nursing mothers; Constipation [3]
Indications: To improve glycemic control in pediatric patients Nausea [2]
adults with Type II diabetes mellitus Warning: RISK OF HEPATOTOXICITY
Class: Glucagon-like peptide-1 (GLP-1) receptor
agonist
Half-life: 3 hours Mucosal LOPINAVIR
Clinically important, potentially hazardous Nasal congestion (10%)
Trade name: Kaletra (AbbVie)
interactions with: none known Cardiovascular Indications: HIV-1 infected children above the
Pregnancy category: N/A (Use during Angina (10%) age of 2 years and adults, in combination with
pregnancy only if the potential benefit justifies the Chest pain (24%) other antiretroviral agents
potential risk to the fetus) Palpitation (10%) Class: Antiretroviral, HIV-1 protease inhibitor
Important contra-indications noted in the Central Nervous System Half-life: 5–6 hours
prescribing guidelines for: nursing mothers; Fever (10%) Clinically important, potentially hazardous
pediatric patients Headache (10%) interactions with: abacavir, alfuzosin,
Note: Soliqua is lixisenatide and insulin glargine. Vertigo (dizziness) (10%) amiodarone, amprenavir, aripiprazole,
Neuromuscular/Skeletal artemether/lumefantrine, atazanavir, atorvastatin,
Central Nervous System Asthenia (fatigue) (17%) atovaquone, bepridil, bosentan, brigatinib,
Headache (9%) [2] Back pain (14%) bupropion, cabozantinib, carbamazepine,
Vertigo (dizziness) (7%) [2] chlorpheniramine, cisapride, clarithromycin,
Gastrointestinal/Hepatic colchicine, copanlisib, cyclosporine, darifenacin,
Gastrointestinal/Hepatic Abdominal pain (21–34%)
Abdominal distension (2%) darunavir, dasatinib, delavirdine, dexamethasone,
Constipation (21%) didanosine, digoxin, disulfiram, efavirenz, elbasvir
Abdominal pain (2%) Defecation (urgency) (10%)
Constipation (3%) & grazoprevir, eltrombopag, eluxadoline,
Diarrhea (79%) [3] ergotamine, estradiol, felodipine, fentanyl,
Diarrhea (8%) [9] Dyspepsia (38%) [3]
Dyspepsia (3%) flecainide, fluticasone propionate, fosamprenavir,
Flatulence (21%) glecaprevir & pibrentasvir, indinavir, itraconazole,
Nausea (25%) [21] Gastroenteritis (14%)
Vomiting (10%) [20] ketoconazole, lidocaine, lidocaine, lomitapide,
Gastroesophageal reflux (10%) lovastatin, maraviroc, methadone,
Endocrine/Metabolic Hepatotoxicity [5] methylergonovine, metronidazole, midazolam,
Hypoglycemia (3%) [7] Nausea (65%) [2] midostaurin, mifepristone, nelfinavir, neratinib,
Local Tenesmus (10%) nevirapine, nicardipine, nifedipine, nilotinib,
Injection-site reactions (4%) [2] Vomiting (34%) [3] olaparib, ombitasvir/paritaprevir/ritonavir,
Other Respiratory palbociclib, phenobarbital, phenytoin, pimozide,
Adverse effects [3] Influenza (21%) pitavastatin, ponatinib, primidone, quinidine,
Allergic reactions [2] Nasopharyngitis (17%) ranolazine, ribociclib, rifabutin, rifampin,
Pharyngolaryngeal pain (14%) rilpivirine, rivaroxaban, rosuvastatin, ruxolitinib,
Endocrine/Metabolic salmeterol, saquinavir, sildenafil, simeprevir,
simvastatin, sirolimus, sofosbuvir/velpatasvir/
LODOXAMIDE ALT increased (17%) [3]
Weight loss (24%) voxilaprevir, St John’s wort, tacrolimus, tadalafil,
telithromycin, tenofovir disoproxil, tipranavir,
See: www.drugeruptiondata.com/drug/id/1207 Other tolterodine, trazodone, triazolam, vardenafil,
Adverse effects [5] venetoclax, vinblastine, vincristine, voriconazole,
warfarin, zidovudine
LOMEFLOXACIN Pregnancy category: C
LOMUSTINE Important contra-indications noted in the
See: www.drugeruptiondata.com/drug/id/407 prescribing guidelines for: nursing mothers
See: www.drugeruptiondata.com/drug/id/408 Note: Kaletra is lopinavir and ritonavir.
Skin
Acneform eruption (<10%)
Lipodystrophy (<10%)
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Litt’s Drug Eruption & Reaction Manual LORCASERIN
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170 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual LYMECYCLINE
Other Mucosal
LUMACAFTOR/ Adverse effects [2] Sialorrhea (2%)
IVACAFTOR Central Nervous System
Agitation (5%)
Trade name: Orkambi (Vertex) LUMIRACOXIB Akathisia (13%) [19]
Indications: Cystic fibrosis in patients aged 12 Anxiety (5%)
years and older who are homozygous for the See: www.drugeruptiondata.com/drug/id/1245 Extrapyramidal symptoms [2]
F508del mutation in the CFTR gene Insomnia (10%) [2]
Class: CFTR potentiator, CYP3A4 inducer Parkinsonism (10%) [5]
Half-life: 26 hours
Clinically important, potentially hazardous
LURASIDONE Restlessness (2%) [2]
Sedation [8]
interactions with: rifampin, St John’s wort Trade name: Latuda (Sunovion) Somnolence (drowsiness) (17%) [13]
Pregnancy category: B Indications: Schizophrenia, depressive epidodes Vertigo (dizziness) (4%) [3]
Important contra-indications noted in the associated with bipolar I disorder Neuromuscular/Skeletal
prescribing guidelines for: nursing mothers; Class: Antipsychotic Dystonia (5%)
pediatric patients Half-life: 18 hours
Note: See also separate profile for ivacaftor. Gastrointestinal/Hepatic
Clinically important, potentially hazardous Dyspepsia (6%)
interactions with: alcohol, amphetamines, CNS Nausea (10%) [11]
Skin depressants, dasabuvir/ombitasvir/paritaprevir/ Vomiting (8%) [3]
Rash (7%) [2] ritonavir, dasatinib, deferasirox, diltiazem,
disopyramide, dopamine, dopamine agonists, Endocrine/Metabolic
Mucosal Hyperprolactinemia [2]
droperidol, efavirenz, epinephrine, hydroxyzine,
Rhinorrhea (6%) Weight gain (5%) [3]
ketoconazole, levomepromazine, lithium, MAO
Neuromuscular/Skeletal inhibitors, methylphenidate, metoclopramide, Other
Asthenia (fatigue) (9%) ombitasvir/paritaprevir/ritonavir, pimozide, Adverse effects [3]
Gastrointestinal/Hepatic procainamide, quinagolide, quinidine, rifampin,
Diarrhea (12%) strong CYP3A4 inducers or inhibitors,
tetrabenazine, tocilizumab
Flatulence (7%)
Nausea (13%) Pregnancy category: B
LUTROPIN ALFA
Important contra-indications noted in the
Respiratory See: www.drugeruptiondata.com/drug/id/1148
prescribing guidelines for: the elderly; nursing
Dyspnea (13%) [3]
mothers; pediatric patients
Influenza (5%)
Warning: INCREASED MORTALITY IN
Nasopharyngitis (13%)
Upper respiratory tract infection (10%)
ELDERLY PATIENTS WITH DEMENTIA- LYMECYCLINE
RELATED PSYCHOSIS
Endocrine/Metabolic See: www.drugeruptiondata.com/drug/id/1359
Creatine phosphokinase increased (7%)
Menstrual irregularities (10%)
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172 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual MEFENAMIC ACID
Gastrointestinal/Hepatic
MEASLES, MUMPS & Abdominal pain [4] MEDROXY-
RUBELLA (MMR) VIRUS PROGESTERONE
VACCINE MEBEVERINE Trade names: Depo-Provera (Pfizer), Lunelle
(Pfizer), Premphase (Wyeth), Prempro (Wyeth),
Trade name: M-M-R II (Merck) See: www.drugeruptiondata.com/drug/id/1418 Provera (Pfizer)
Indications: Protection against measles Indications: Secondary amenorrhea, renal or
(rubeola), mumps and rubella (German measles) endometrial carcinoma
Class: Vaccine
Half-life: N/A
MECAMYLAMINE Class: Progestogen
Half-life: 30 days
Clinically important, potentially hazardous See: www.drugeruptiondata.com/drug/id/965 Clinically important, potentially hazardous
interactions with: none known interactions with: acitretin, dofetilide
Pregnancy category: C Pregnancy category: X
Important contra-indications noted in the
prescribing guidelines for: nursing mothers; MECASERMIN Skin
pediatric patients
Note: Contra-indicated for pregnant females; See: www.drugeruptiondata.com/drug/id/1089 Acneform eruption (<5%)
patients who have had anaphylactic or
Chloasma (<10%)
anaphylactoid reactions to neomycin; febrile
Diaphoresis (<31%)
Edema (>10%)
respiratory illness or other active febrile infection; MECHLORETHAMINE Melasma (<10%)
patients receiving immunosuppressive therapy or
with blood dyscrasias, leukemia, lymphomas of
Pruritus (<10%)
Synonyms: mustine; nitrogen mustard
any type, or other malignant neoplasms affecting
Rash (<5%)
Indications: Hodgkin’s disease, mycosis
the bone marrow or lymphatic systems; primary fungoides Hair
and acquired immunodeficiency states, or Class: Alkylating agent Alopecia (<5%)
individuals with a family history of congenital or Half-life: <1 minute Cardiovascular
hereditary immunodeficiency, until the immune Clinically important, potentially hazardous Flushing (12%)
competence of the potential vaccine recipient is interactions with: aldesleukin, vaccines Thrombophlebitis (<10%)
demonstrated. Pregnancy category: D
Neuromuscular/Skeletal
Osteoporosis [2]
Skin Skin
Henoch–Schönlein purpura [2] Endocrine/Metabolic
Anaphylactoid reactions/Anaphylaxis
Rash [4] Amenorrhea [3]
(<10%) [4]
Galactorrhea [2]
Central Nervous System Bullous dermatitis [3]
Mastodynia (<5%)
Fever [7] Dermatitis [26]
Weight gain [3]
Seizures [3] Herpes zoster (>10%)
Hypersensitivity (<10%) Genitourinary
Neuromuscular/Skeletal Pigmentation [8] Vaginitis (<5%)
Asthenia (fatigue) [2] Pruritus [2] Local
Gastrointestinal/Hepatic Squamous cell carcinoma [3] Injection-site pain (>10%)
Vomiting [2] Urticaria [3]
Local Hair
Injection-site erythema [2]
Injection-site pain [2]
Alopecia (<10%) MEFENAMIC ACID
Central Nervous System
Injection-site reactions [3] Dysgeusia (taste perversion) (<10%) Trade name: Ponstel (First Horizon)
Other Indications: Pain, dysmenorrhea
Local
Adverse effects [5] Class: Non-steroidal anti-inflammatory (NSAID)
Injection-site extravasation (<10%)
Infection [2] Half-life: 3.5 hours
Injection-site thrombophlebitis (<10%) [2]
Clinically important, potentially hazardous
interactions with: methotrexate
Pregnancy category: C
MEBENDAZOLE MECLIZINE Important contra-indications noted in the
prescribing guidelines for: nursing mothers;
Trade name: Vermox (Janssen) See: www.drugeruptiondata.com/drug/id/421 pediatric patients
Indications: Parasitic worm infestations
Note: NSAIDs may cause an increased risk of
Class: Anthelmintic, Antibiotic, imidazole
serious cardiovascular and gastrointestinal
Half-life: 112 hours
Clinically important, potentially hazardous MECLOFENAMATE adverse events, which can be fatal. This risk may
increase with duration of use.
interactions with: aminophylline
See: www.drugeruptiondata.com/drug/id/422 Warning: CARDIOVASCULAR AND
Pregnancy category: C
GASTROINTESTINAL RISK
Skin
Stevens-Johnson syndrome [2]
Skin
Anaphylactoid reactions/Anaphylaxis [2]
Hair Erythema multiforme [2]
Alopecia [3] Fixed eruption [12]
Central Nervous System Pruritus (<10%)
Headache [2] Rash (>10%)
Vertigo (dizziness) [2] Toxic epidermal necrolysis [2]
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MEFENAMIC ACID See all our books at www.crcpress.com
MELOXICAM Cardiovascular
Trade name: Lariam (Roche) Angina (<2%)
Indications: Malaria Arrhythmias (<2%)
Class: Antimalarial, Antiprotozoal Trade name: Mobic (Boehringer Ingelheim)
Indications: Osteoarthritis Cardiac failure (<2%)
Half-life: 2122 days Hypertension (<2%)
Clinically important, potentially hazardous Class: COX-2 inhibitor, Non-steroidal anti-
inflammatory (NSAID) Hypotension (<2%)
interactions with: acebutolol, artemether/ Myocardial infarction (<2%)
lumefantrine, ethosuximide, halofantrine, Half-life: 1520 hours
Clinically important, potentially hazardous Palpitation (<2%)
ketoconazole, lacosamide, moxifloxacin, Tachycardia (<2%)
oxcarbazepine, quinine, tiagabine, typhoid interactions with: ACE inhibitors, adrenergic
vaccine, vigabatrin neurone blockers, alcohol, aliskiren, alpha Central Nervous System
Pregnancy category: C blockers, angiotensin II receptor antagonists, Abnormal dreams (<2%)
Important contra-indications noted in the anticoagulants, antidepressants, antiplatelet Anxiety (<2%)
prescribing guidelines for: nursing mothers agents, aspirin, baclofen, beta blockers, bile acid Confusion (<2%)
Warning: NEUROPSYCHIATRIC ADVERSE sequestrants, calcium channel blockers, cardiac Depression (<2%)
REACTIONS glycosides, cholestyramine, clonidine, clopidogrel, Dysgeusia (taste perversion) (<2%)
collagenase, conivaptan, corticosteroids, Fever (<2%)
coumarins, cyclosporine, dabigatran, dasatinib, Headache (2–6%) [2]
Skin desmopressin, diazoxide, digoxin, diuretics, Insomnia (<4%)
Anaphylactoid reactions/Anaphylaxis [2] drotrecogin alfa, eplerenone, erlotinib, Nervousness (<2%)
Erythema [2] glucosamine, haloperidol, heparins, hydralazine, Pain (4%)
Exanthems (30%) ibritumomab, iloprost, ketorolac, lithium, Paresthesias (<2%)
Pruritus (410%) [2] methotrexate, methyldopa, mifamurtide, Seizures (<2%)
Psoriasis [2] minoxidil, moxonidine, nitrates, nitroprusside, Somnolence (drowsiness) (<2%)
Rash (<10%) NSAIDs, pemetrexed, penicillamine, pentosan, Syncope (<2%)
Stevens-Johnson syndrome [2] pentoxifylline, phenindione, pralatrexate, Tremor (<2%)
Toxic epidermal necrolysis [2] prasugrel, probenecid, prostacyclin analogues, Vertigo (dizziness) (<3%)
Vasculitis [3] quinolones, ritonavir, serotonin/norepinephrine Neuromuscular/Skeletal
Cardiovascular reuptake inhibitors, SSRIs, sulfonylureas, Arthralgia (<5%)
Palpitation [3] tacrolimus, thrombolytic agents, tositumomab & Asthenia (fatigue) [2]
Tachycardia [2] iodine131, treprostinil, vancomycin, venlafaxine, Back pain (<3%)
Central Nervous System vitamin K antagonists, voriconazole, zidovudine Bone or joint pain (2%)
Abnormal dreams [3] Pregnancy category: C (category D from 30
weeks gestation) Gastrointestinal/Hepatic
Aggression [2] Abdominal pain (2–5%) [2]
Amnesia [2] Important contra-indications noted in the
prescribing guidelines for: the elderly; nursing Black stools (<2%)
Anorexia [2] Colitis (<2%)
Anxiety [5] mothers
Note: NSAIDs may cause an increased risk of Constipation (<3%) [2]
Chills (<10%) Diarrhea (2–6%) [2]
Confusion [2] serious cardiovascular and gastrointestinal
adverse events, which can be fatal. This risk may Dyspepsia (4–10%) [2]
Delusions [2] Eructation (belching) (<2%)
Depression [7] increase with duration of use.
Warning: CARDIOVASCULAR AND Esophagitis (<2%)
Fever (<10%) [2] Flatulence (<3%)
Hallucinations [3] GASTROINTESTINAL RISKS
Gastritis (<2%)
Headache (<10%) [5] Gastroesophageal reflux (<2%)
Insomnia [3] Skin Gastrointestinal bleeding [2]
Mania [4] Anaphylactoid reactions/Anaphylaxis (<2%) Gastrointestinal perforation (<2%) [2]
Neurotoxicity [8] Angioedema (<2%) [3] Gastrointestinal ulceration (<2%) [3]
Psychosis [8] Bullous dermatitis (<2%) Hematemesis (<2%)
Seizures [6] Edema (25%) Hepatitis (<2%)
Sleep disturbances [2] Erythema [2] Hepatotoxicity [6]
Suicidal ideation [2] Erythema multiforme (<2%) Nausea (3–7%) [4]
Vertigo (dizziness) (<10%) [20] Exanthems (<2%) Pancreatitis (<2%)
Neuromuscular/Skeletal Facial edema (<2%) Vomiting (<3%)
Arthralgia [2] Hematoma [3]
Hot flashes (<2%) Respiratory
Asthenia (fatigue) (<10%) [2] Asthma (<2%)
Myalgia/Myopathy (<10%) [2] Hyperhidrosis (<2%)
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Litt’s Drug Eruption & Reaction Manual MENINGOCOCCAL GROUP B VACCINE
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Litt’s Drug Eruption & Reaction Manual METAXALONE
MEROPENEM
Trade name: Meronem (AstraZeneca)
MESALAMINE MESNA
Indications: Aerobic and anaerobic infections, Synonyms: 5-aminosalicylic acid; 5-ASA; See: www.drugeruptiondata.com/drug/id/435
febrile neutropenia fisalamine; mesalazine
Class: Antibiotic, carbapenem, Thienamycin Trade names: Asacol (Procter & Gamble),
Half-life: 46 hours
Clinically important, potentially hazardous
Canasa (Aptalis), Lialda (Shire), Pentasa (Shire),
Rowasa (Solvay)
MESORIDAZINE
interactions with: oral contraceptives, Indications: Ulcerative colitis
probenecid, valproic acid See: www.drugeruptiondata.com/drug/id/436
Class: Aminosalicylate
Pregnancy category: B Half-life: 0.51.5 hours
Clinically important, potentially hazardous
Skin interactions with: azathioprine, NSAIDs, METAMIZOLE
AGEP [2] pantoprazole
Hypersensitivity [3] Pregnancy category: B See: www.drugeruptiondata.com/drug/id/1131
Rash (2%) [6] Important contra-indications noted in the
Central Nervous System prescribing guidelines for: the elderly; nursing
Headache (2%) mothers METAXALONE
Seizures [7]
Skin Trade name: Skelaxin (Elan)
Gastrointestinal/Hepatic Indications: Muscle spasm
Diarrhea [4] Diaphoresis (3%)
Exanthems [3] Class: Central muscle relaxant
Hepatotoxicity [3] Half-life: 4–14 hours
Nausea [2] Hypersensitivity [8]
Lupus erythematosus [2] Clinically important, potentially hazardous
Vomiting [2] interactions with: alcohol, barbiturates,
Photosensitivity [3]
Endocrine/Metabolic Psoriasis [2] conivaptan, droperidol, interferon alfa,
ALT increased [3] Rash (3%) [6] levomepromazine, St John’s wort, tricyclic
AST increased [3] antidepressants
Hair Pregnancy category: B
Local Alopecia [6] Important contra-indications noted in the
Injection-site pain [3]
Cardiovascular prescribing guidelines for: nursing mothers;
Other Cardiotoxicity [2] pediatric patients
Adverse effects [14] Myocarditis [6] Note: Contra-indicated in patients with known
Death [2] Pericarditis [5] tendency to drug-induced, hemolytic, or other
Central Nervous System anemias, or significantly impaired renal or hepatic
Fever (<6%) [6] function.
MEROPENEM & Headache (2–25%) [5]
Pain (14%) Cardiovascular
VABORBACTAM * Vertigo (dizziness) (2–8%) Tachycardia [2]
Trade name: Vabomere (Rempex) Neuromuscular/Skeletal Central Nervous System
Indications: Complicated urinary tract infections Myalgia/Myopathy (3%) Agitation [2]
caused by susceptible bacteria Gastrointestinal/Hepatic Serotonin syndrome [2]
Class: Antibiotic, carbapenem (meropenem), Abdominal pain (<18%) [6] Somnolence (drowsiness) [3]
Beta-lactamase inhibitor (vaborbactam) Colitis (ulcerative / exacerbation) [3] Vertigo (dizziness) [3]
Half-life: 1–2 hours Diarrhea (2–8%) [4] Gastrointestinal/Hepatic
Clinically important, potentially hazardous Eructation (belching) (16%) Nausea [2]
interactions with: probenecid, valproic acid Flatulence (<6%) [2] Vomiting [2]
Pregnancy category: N/A (Potential risk to Nausea (3–13%) [3]
fetus based on animal studies) Pancreatitis [20]
Important contra-indications noted in the Vomiting (<5%) [2]
prescribing guidelines for: pediatric patients
Respiratory
Note: See also separate entry for meropenem.
Eosinophilic pneumonia [4]
Pharyngitis (11%)
Skin Pneumonia [5]
Hypersensitivity (2%) Pneumonitis [2]
Central Nervous System Pulmonary toxicity [9]
Fever (2%) Renal
Headache (9%) Nephrotoxicity [6]
Gastrointestinal/Hepatic Hematologic
Diarrhea (3%) Anemia [2]
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METFORMIN See all our books at www.crcpress.com
178 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual METHOTREXATE
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METHOTREXATE Over 100 updates per week on www.drugeruptiondata.com
METHYL SALICYLATE
METHOXSALEN METHYLNALTREXONE
See: www.drugeruptiondata.com/drug/id/2055
Trade name: Oxsoralen (Valeant) See: www.drugeruptiondata.com/drug/id/2907
Indications: Psoriasis, vitiligo
Class: CYP1A2 inhibitor, Psoralen, Repigmenting METHYLDOPA
agent METHYLPHENIDATE
Half-life: 1.1 hours Trade name: Aldoclor (Merck)
Clinically important, potentially hazardous Indications: Hypertension Trade names: Concerta (Janssen), Metadate CD
interactions with: caffeine, chloroquine, Class: Adrenergic alpha-receptor agonist (Celltech), Methylin (Mallinckrodt), Ritalin
cyclosporine, fluoroquinolones, phenothiazines, Half-life: 1.7 hours (Novartis)
sulfonamides Clinically important, potentially hazardous Indications: Attention deficit disorder,
Pregnancy category: C interactions with: acebutolol, alfuzosin, narcolepsy
Important contra-indications noted in the bromocriptine, captopril, cilazapril, Class: Amphetamine
prescribing guidelines for: pediatric patients cyclopenthiazide, diclofenac, enalapril, ephedrine, Half-life: 24 hours
Note: Potential hazards of long-term therapy fosinopril, irbesartan, levodopa, Clinically important, potentially hazardous
include the possibilities of carcinogenicity and levomepromazine, linezolid, lisinopril, meloxicam, interactions with: amitriptyline, benazepril,
cataractogenicity. olmesartan, quinapril, ramipril, risperidone, bupropion, captopril, citalopram, clevidipine,
rotigotine, trandolapril, triamcinolone, cyclosporine, enalapril, escitalopram, irbesartan,
Skin zuclopenthixol linezolid, lisinopril, lurasidone, MAO inhibitors,
Anaphylactoid reactions/Anaphylaxis [2] Pregnancy category: B olmesartan, paliperidone, pantoprazole,
Basal cell carcinoma [3] Important contra-indications noted in the paroxetine hydrochloride, phenylbutazone,
Bullous dermatitis (with UVA) [4] prescribing guidelines for: nursing mothers pimozide, quinapril, safinamide, ziprasidone
Burning (<10%) [3] Note: Aldoril is methyldopa and Pregnancy category: C
Carcinoma [5] hydrochlorothiazide. Hydrochlorothiazide is a Important contra-indications noted in the
Dermatitis [4] sulfonamide and can be absorbed systemically. prescribing guidelines for: the elderly; nursing
Edema (<10%) Sulfonamides can produce severe, possibly fatal, mothers
Ephelides (<10%) [5] reactions such as toxic epidermal necrolysis and Warning: ABUSE AND DEPENDENCE
Erythema (<10%) Stevens-Johnson syndrome.
Exanthems [2]
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Litt’s Drug Eruption & Reaction Manual METHYSERGIDE
Endocrine/Metabolic
Hyperglycemia [4] Skin
Lupus erythematosus [2]
Ocular Peripheral edema (<10%)
Cataract [3] Rash (<10%)
Glaucoma [2] Scleroderma [4]
Other Hair
Adverse effects [7] Alopecia [4]
Allergic reactions [3]
Death [2] Cardiovascular
Valvulopathy [3]
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METIPRANOLOL See all our books at www.crcpress.com
Otic
METIPRANOLOL METRONIDAZOLE Hearing loss [2]
See: www.drugeruptiondata.com/drug/id/998 Trade names: Flagyl (Pfizer), Metrocream Ocular
(Galderma), MetroGel (Galderma), Metrolotion Vision loss [2]
(Galderma), Noritate (Dermik), Vandazole Other
METOCLOPRAMIDE (Upsher-Smith)
Indications: Various infections caused by
Adverse effects [12]
Death [3]
See: www.drugeruptiondata.com/drug/id/456 susceptible organisms, rosacea Infection (fungal) (12%)
Class: Antibacterial, Antibiotic, nitroimidazole
Half-life: 612 hours
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Litt’s Drug Eruption & Reaction Manual MIDOSTAURIN
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184 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual MINOXIDIL
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MIRABEGRON See all our books at www.crcpress.com
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Litt’s Drug Eruption & Reaction Manual MORPHINE
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Litt’s Drug Eruption & Reaction Manual MYCOPHENOLATE
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 189
NABILONE See all our books at www.crcpress.com
Vomiting (3–9%)
NABILONE Endocrine/Metabolic
NALBUPHINE
Trade name: Cesamet (Valeant) Pseudoporphyria [8] Trade name: Nubain (Endo)
Indications: Nausea and vomiting Renal Indications: Moderate to severe pain
Class: Antiemetic, Cannabinoid Nephrotoxicity [2] Class: Opiate agonist
Half-life: 2 hours Otic Half-life: 5 hours
Clinically important, potentially hazardous Tinnitus (<10%) Clinically important, potentially hazardous
interactions with: CNS depressants interactions with: CNS depressants, diazepam,
Pregnancy category: C Other hydrocodone, hydromorphone, oxymorphone,
Adverse effects [6] pentobarbital, promethazine, tapentadol
Mucosal Pregnancy category: B
Xerostomia [6] Note: Nalbuphine contains sulfites.
Cardiovascular
NADOLOL
Hypotension [8] Skin
Trade name: Corzide (Monarch) Clammy skin (9%)
Central Nervous System Indications: Hypertension, angina pectoris Diaphoresis (9%)
Dyskinesia [3] Class: Adrenergic beta-receptor antagonist,
Somnolence (drowsiness) [2] Antiarrhythmic class II Mucosal
Vertigo (dizziness) [15] Half-life: 1024 hours Xerostomia (4%)
Neuromuscular/Skeletal Clinically important, potentially hazardous Central Nervous System
Asthenia (fatigue) [5] interactions with: clonidine, epinephrine, Vertigo (dizziness) (5%)
verapamil Local
Pregnancy category: C Injection-site pain [4]
Important contra-indications noted in the
NABUMETONE prescribing guidelines for: nursing mothers;
pediatric patients
Trade name: Relafen (GSK) Note: Corzide is nadolol and NALDEMEDINE *
Indications: Arthritis bendroflumethiazide. Cutaneous side effects of
Class: Non-steroidal anti-inflammatory (NSAID) beta-receptor blockers are clinically Trade name: Symproic (Shionogi)
Half-life: 22.530 hours polymorphous. They apparently appear after Indications: Opioid-induced constipation in adult
Clinically important, potentially hazardous several months of continuous therapy. Contra- patients with chronic non-cancer pain
interactions with: methotrexate indicated in patients with bronchial asthma, sinus Class: Opioid antagonist
Pregnancy category: C bradycardia and greater than first degree Half-life: 11 hours
Important contra-indications noted in the conduction block, cardiogenic shock, and overt Clinically important, potentially hazardous
prescribing guidelines for: nursing mothers; cardiac failure. interactions with: amiodarone, aprepitant,
pediatric patients atazanavir, captopril, carbamazepine,
Note: NSAIDs may cause an increased risk of clarithromycin, cyclosporine, diltiazem,
serious cardiovascular and gastrointestinal Skin erythromycin, fluconazole, itraconazole,
adverse events, which can be fatal. This risk may Edema (<5%) ketoconazole, moderate or strong CYP3A
increase with duration of use. Psoriasis [4] inhibitors, other opioid antagonists, P-gp
Warning: CARDIOVASCULAR AND Raynaud’s phenomenon (2%) [2] inhibitors, phenytoin, quercetin, quinidine,
GASTROINTESTINAL RISKS Cardiovascular rifampin, ritonavir, saquinavir, St John’s wort,
Bradycardia (2%) strong CYP3A inducers, verapamil
Skin Central Nervous System Pregnancy category: N/A (Potential for opioid
Diaphoresis (<3%) Hypoesthesia (fingers and toes) (>5%) withdrawal in fetus)
Edema (39%) Paresthesias (>5%) Important contra-indications noted in the
Erythema [2] Vertigo (dizziness) (2%) prescribing guidelines for: nursing mothers;
Hypersensitivity [3] pediatric patients
Neuromuscular/Skeletal Note: Contra-indicated in patients with known
Photosensitivity [2] Asthenia (fatigue) (2%)
Pruritus (39%) [2] or suspected gastrointestinal obstruction. Opioid
Rash (39%) [4] Other withdrawal symptoms have occurred in patients
Adverse effects [4] treated with naldemedine.
Mucosal
Stomatitis (<3%)
Xerostomia (<3%) Skin
Central Nervous System
NAFARELIN Hypersensitivity (<2%)
Rash (<2%)
Headache (3–9%) [2] See: www.drugeruptiondata.com/drug/id/484
Insomnia (3–9%) Gastrointestinal/Hepatic
Nervousness (3–9%) Abdominal pain (8–11%)
Somnolence (drowsiness) (3–9%) Diarrhea (7%) [2]
Vertigo (dizziness) (3–9%) NAFCILLIN Gastroenteritis (2–3%)
Nausea (4–6%)
Gastrointestinal/Hepatic See: www.drugeruptiondata.com/drug/id/485 Vomiting (3%)
Abdominal pain (12%) [5]
Constipation (3–9%) Respiratory
Diarrhea (14%) [5] Bronchospasm (<2%)
Dyspepsia (13%) [4] Other
Flatulence (3–9%) Adverse effects [3]
Gastrointestinal ulceration [3]
Hepatotoxicity [2]
Nausea (3–9%) [2]
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Litt’s Drug Eruption & Reaction Manual NAPROXEN
Skin Neuromuscular/Skeletal
Diaphoresis (<10%) Arthralgia (>10%) Skin
Pruritus [2] Asthenia (fatigue) [3] Anaphylactoid reactions/Anaphylaxis [2]
Rash (<10%) Gastrointestinal/Hepatic Angioedema [5]
Bullous dermatitis [5]
Mucosal Constipation [5]
Diaphoresis (<3%) [3]
Xerostomia [2] Hepatotoxicity [5]
DRESS syndrome [4]
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Litt’s Drug Eruption & Reaction Manual NEPAFENAC
Gastrointestinal/Hepatic
methylergonovine, methysergide, midazolam, NEOSTIGMINE
midostaurin, mifepristone, neratinib, olaparib,
Diarrhea (16%) [2] omeprazole, oral contraceptives, oxazepam, Trade name: Prostigmin (Valeant)
Dysphagia (3%) paclitaxel, palbociclib, pantoprazole, pazopanib, Indications: Myasthenia gravis
Vomiting (29%) phenytoin, pimozide, ponatinib, primidone, Class: Acetylcholinesterase inhibitor,
Respiratory progestogens, quazepam, quinidine, quinine, Cholinesterase inhibitor, Parasympathomimetic
Hemoptysis (10%) ranolazine, rifabutin, rifampin, rilpivirine, ritonavir, Half-life: 52 minutes
Pulmonary embolism (5%) rivaroxaban, romidepsin, rosuvastatin, ruxolitinib, Clinically important, potentially hazardous
Pulmonary toxicity [2] saquinavir, sildenafil, simeprevir, simvastatin, interactions with: aminoglycosides,
solifenacin, St John’s wort, sunitinib, tacrolimus, antiarrhythmics, anticholinergics, chloroquine,
Endocrine/Metabolic
tadalafil, telithromycin, temazepam, temsirolimus, clindamycin, hydroxychloroquine, kanamycin,
Hypocalcemia (45%)
ticagrelor, tolterodine, tolvaptan, triazolam, lithium, local and general anesthetics, neomycin,
Hypokalemia (28%)
vardenafil, vemurafenib, vorapaxar non-depolarising muscle relaxants, polymixins,
Hypomagnesemia (83%) [8]
Pregnancy category: B propafenone, propranolol, streptomycin,
Hypophosphatemia (31%)
Important contra-indications noted in the succinylcholine
Weight loss (13%)
prescribing guidelines for: nursing mothers Pregnancy category: C (Anticholinesterase
Hematologic Note: Protease inhibitors cause dyslipidemia drugs may cause uterine irritability and induce
Anemia [2] which includes elevated triglycerides and premature labor when given intravenously to
Febrile neutropenia [2] cholesterol and redistribution of body fat centrally pregnant women near term)
Neutropenia [4] to produce the so-called ‘protease paunch’, Important contra-indications noted in the
Thrombocytopenia [3] breast enlargement, facial atrophy, and ‘buffalo prescribing guidelines for: nursing mothers;
Ocular hump’. pediatric patients
Conjunctivitis (7%) Note: Neostigmine bromide is given orally;
Local Skin neostigmine methylsulfate is given parenterally.
Infusion-related reactions (2%) [2] Rash (<10%) [4] Contra-indicated in patients with a previous
history of reaction to bromides, or those with
Other Gastrointestinal/Hepatic
peritonitis or mechanical obstruction of the
Adverse effects [2] Diarrhea [3]
intestinal or urinary tract.
Death [2] Hepatotoxicity [3]
Genitourinary
Skin
Urolithiasis [2]
Anaphylactoid reactions/Anaphylaxis [3]
NEDOCROMIL Hematologic
Cardiovascular
Lymphopenia [2]
See: www.drugeruptiondata.com/drug/id/966 Atrioventricular block [3]
Bradycardia [3]
Cardiac arrest [3]
NEOMYCIN Tachycardia [2]
NEFAZODONE Central Nervous System
Trade names: Maxitrol (Falcon), Neosporin
See: www.drugeruptiondata.com/drug/id/491 Anxiety [2]
(Monarch)
Sedation [2]
Indications: Various infections caused by
susceptible organisms Gastrointestinal/Hepatic
NELARABINE Class: Antibiotic, aminoglycoside Abdominal pain [3]
Diarrhea [2]
Half-life: 3 hours
See: www.drugeruptiondata.com/drug/id/1121 Clinically important, potentially hazardous Nausea [14]
interactions with: acarbose, aldesleukin, Vomiting [12]
aminoglycosides, atracurium, bacitracin, Respiratory
bumetanide, doxacurium, ethacrynic acid,
NELFINAVIR furosemide, methoxyflurane, neostigmine,
Bronchospasm [3]
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NERATINIB See all our books at www.crcpress.com
Hematologic Skin
NERATINIB * Anemia [2] Angioedema [2]
Leukopenia [2] DRESS syndrome [12]
Trade name: Nerlynx (Puma) Neutropenia [3] Exanthems [6]
Indications: Early stage HER2-overexpressed/ Hypersensitivity [15]
amplified breast cancer, to follow adjuvant Lipodystrophy [2]
trastuzumab-based therapy
Class: Kinase inhibitor NESIRITIDE Rash (<48%) [31]
Stevens-Johnson syndrome [34]
Half-life: 7–17 hours Toxic epidermal necrolysis [16]
Clinically important, potentially hazardous See: www.drugeruptiondata.com/drug/id/852
Toxicity [3]
interactions with: aprepitant, boceprevir,
bosentan, carbamazepine, cimetidine, Mucosal
ciprofloxacin, clarithromycin, clotrimazole, NETUPITANT & Gingivitis (<3%)
Ulcerative stomatitis (4%)
cobicistat, conivaptan, crizotinib, cyclosporine,
dabigatran, dasabuvir/ombitasvir/paritaprevir/ PALONOSETRON Central Nervous System
ritonavir, digoxin, diltiazem, dronedarone, Fever [2]
efavirenz, enzalutamide, erythromycin, etravirine, Synonym: NEPA Paresthesias (2%)
fexofenadine, fluconazole, fluvoxamine, grapefruit Trade name: Akynzeo (Helsinn) Peripheral neuropathy [2]
juice, H2-receptor antagonists, idelalisib, imatinib, Indications: Acute and delayed nausea and
vomiting associated with cancer chemotherapy Neuromuscular/Skeletal
indinavir, itraconazole, ketoconazole, Myalgia/Myopathy (<10%)
lansoprazole, lopinavir, mitotane, modafinil, Class: Neurokinin 1 receptor antagonist
nefazodone, nelfinavir, ombitasvir/paritaprevir/ (netupitant), Serotonin type 3 receptor antagonist Gastrointestinal/Hepatic
ritonavir, phenytoin, posaconazole, rifampin, (palonosetron) Hepatic failure [2]
ritonavir, saquinavir, St John’s wort, strong or Half-life: 40 hours Hepatotoxicity [30]
moderate CYP3A4 inhibitors or inducers, Clinically important, potentially hazardous Endocrine/Metabolic
tipranavir, tofisopam, troleandomycin, verapamil, interactions with: rifampin Acidosis [2]
voriconazole Pregnancy category: C
Important contra-indications noted in the Other
Pregnancy category: N/A (Can cause fetal
prescribing guidelines for: nursing mothers; Adverse effects [7]
harm)
pediatric patients Death [3]
Important contra-indications noted in the
prescribing guidelines for: nursing mothers;
pediatric patients Skin
Erythema (3%) NIACIN
Skin Central Nervous System Synonyms: nicotinic acid; vitamin B3
Fissures (2%) Headache (9%) [7] Trade names: Advicor (Kos), Niacor (Upsher-
Rash (18%)
Neuromuscular/Skeletal Smith), Niaspan (Merck), Simcor (AbbVie), Slo-
Xerosis (6%) Niacin (Upsher-Smith)
Asthenia (fatigue) (4–8%)
Nails Indications: Hyperlipidemia
Gastrointestinal/Hepatic
Nail disorder (8%) Class: Vitamin
Constipation (3%) [6]
Mucosal Dyspepsia (4%) [2] Half-life: 45 minutes
Epistaxis (nosebleed) (5%) Clinically important, potentially hazardous
Other interactions with: antihypertensives,
Stomatitis (14%)
Adverse effects [2] atorvastatin, bile acid sequestrants, insulin aspart,
Xerostomia (3%)
Hiccups [2] insulin degludec, insulin detemir, insulin glargine,
Cardiovascular insulin glulisine, pitavastatin, rosuvastatin,
Cardiotoxicity [2] selenium
Central Nervous System NEVIRAPINE Pregnancy category: C (Where niacin is co-
Anorexia [4] administered with a statin, refer to the pregnancy
Peripheral neuropathy [2] Trade name: Viramune (Boehringer Ingelheim) category for the statin)
Neuromuscular/Skeletal Indications: HIV infection Important contra-indications noted in the
Asthenia (fatigue) (27%) [4] Class: Antiretroviral, CYP3A4 inducer, Non- prescribing guidelines for: nursing mothers;
Muscle spasm (11%) nucleoside reverse transcriptase inhibitor pediatric patients
Half-life: 45 hours Note: Contra-indicated in patients with active
Gastrointestinal/Hepatic Clinically important, potentially hazardous liver or peptic ulcer disease, or arterial bleeding.
Abdominal distension (5%) interactions with: amiodarone, amprenavir, Simcor is niacin and simvastatin.
Abdominal pain (36%) atazanavir, carbamazepine, caspofungin,
Diarrhea (95%) [13] clarithromycin, clonazepam, cyclosporine,
Dyspepsia (10%) Skin
diltiazem, disopyramide, efavirenz, ethosuximide, Acanthosis nigricans (8%) [14]
Hepatotoxicity (<2%) etravirine, fentanyl, fluconazole, fosamprenavir,
Nausea (43%) [8] Exanthems (<3%)
indinavir, itraconazole, ketoconazole, Pruritus (<5%) [9]
Vomiting (26%) [5] levonorgestrel, lidocaine, lopinavir, midazolam, Rash [5]
Endocrine/Metabolic nifedipine, rifampin, rilpivirine, simeprevir, St
ALT increased (9%) John’s wort, verapamil Cardiovascular
Appetite decreased (12%) Pregnancy category: B Flushing (<30%) [31]
AST increased (7%) Important contra-indications noted in the Central Nervous System
Dehydration (4%) prescribing guidelines for: nursing mothers Paresthesias (<10%) [2]
Weight loss (5%) Warning: LIFE-THREATENING (INCLUDING Neuromuscular/Skeletal
Genitourinary FATAL) HEPATOTOXICITY and SKIN Myalgia/Myopathy [5]
Urinary tract infection (5%) REACTIONS
Gastrointestinal/Hepatic
Hepatotoxicity [3]
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Litt’s Drug Eruption & Reaction Manual NIFEDIPINE
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Litt’s Drug Eruption & Reaction Manual NITROFURAZONE
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Litt’s Drug Eruption & Reaction Manual NYSTATIN
Skin
Pregnancy category: D Central Nervous System
Important contra-indications noted in the Headache (50%)
Exanthems [2]
prescribing guidelines for: pediatric patients Neuromuscular/Skeletal
Fixed eruption [3]
Warning: SUICIDALITY AND Back pain (41%)
Phototoxicity [4]
ANTIDEPRESSANT DRUGS Scoliosis (5%)
Toxic epidermal necrolysis [2]
Nails Gastrointestinal/Hepatic
Skin Constipation (30%)
Photo-onycholysis [2]
Diaphoresis (<10%)
Neuromuscular/Skeletal Photosensitivity [2] Respiratory
Rhabdomyolysis [2] Bronchitis (>5%)
Mucosal Upper respiratory tract infection (39%)
Tendinopathy/Tendon rupture [4]
Xerostomia (>10%) [9]
Other Otic
Central Nervous System Ear infection (5%)
Adverse effects [2]
Dysgeusia (taste perversion) (>10%)
Parkinsonism (<10%)
Vertigo (dizziness) [2]
NORTRIPTYLINE Other
NYSTATIN
Adverse effects [2] Trade names: Mycology-II (Bristol-Myers
Trade names: Aventyl (Ranbaxy), Pamelor
(Mallinckrodt) Squibb), Mycostatin (Bristol-Myers Squibb)
Indications: Depression Indications: Candidiasis
Class: Antidepressant, tricyclic NUSINERSEN * Class: Antifungal
Half-life: 2831 hours Half-life: ~2–3 hours
Clinically important, potentially hazardous Trade name: Spinraza (Biogen) Clinically important, potentially hazardous
interactions with: amprenavir, arbutamine, Indications: Spinal muscular atrophy interactions with: none known
clonidine, cobicistat/elvitegravir/emtricitabine/ Class: Survival motor neuron-2 (SMN2)-directed Pregnancy category: C
tenofovir alafenamide, cobicistat/elvitegravir/ antisense oligonucleotide Important contra-indications noted in the
emtricitabine/tenofovir disoproxil, epinephrine, Half-life: 63–87 days (in plasma) prescribing guidelines for: nursing mothers
fluoxetine, formoterol, guanethidine, Clinically important, potentially hazardous
isocarboxazid, linezolid, MAO inhibitors, interactions with: none known Skin
phenelzine, quinolones, sparfloxacin, Pregnancy category: N/A (No data available) AGEP [5]
tranylcypromine Important contra-indications noted in the Dermatitis [12]
prescribing guidelines for: nursing mothers Eczema [2]
Fixed eruption [2]
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OBETICHOLIC ACID Over 100 updates per week on www.drugeruptiondata.com
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Litt’s Drug Eruption & Reaction Manual OFLOXACIN
Vertigo (dizziness) [2] Central Nervous System kidney, heart or lung transplants.
Neuromuscular/Skeletal Chills (8%) Fluoroquinolones may exacerbate muscle
Arthralgia (5–15%) Fever (20%) [2] weakness in persons with myasthenia gravis.
Asthenia (fatigue) [4] Headache (6%) Warning: SERIOUS ADVERSE REACTIONS
Myalgia/Myopathy (5–15%) [2] Insomnia (7%) INCLUDING TENDINITIS, TENDON
Peripheral neuropathy [2] RUPTURE, PERIPHERAL NEUROPATHY,
Gastrointestinal/Hepatic CENTRIAL NERVOUS SYSTEM EFFECTS and
Abdominal pain (5–61%) [4] Neuromuscular/Skeletal
Asthenia (fatigue) (15%) [4] EXACERBATION OF MYASTHENIA GRAVIS
Diarrhea (34–58%) [4]
Flatulence (38%) Back pain (8%)
Hepatotoxicity [3] Gastrointestinal/Hepatic Skin
Loose stools [2] Diarrhea (18%) [2] Anaphylactoid reactions/Anaphylaxis [4]
Nausea (5–61%) [6] Nausea (11%) [3] Angioedema [3]
Pancreatitis [2] Exanthems [3]
Respiratory Fixed eruption [4]
Vomiting (4–21%) Bronchitis (11%) Hypersensitivity [2]
Respiratory Cough (19%) Photosensitivity [8]
Cough (5–15%) Dyspnea (14%) Phototoxicity [3]
Pharyngitis (5–15%) Nasopharyngitis (8%) Pruritus (<3%) [5]
Rhinitis (5–15%) Pneumonia (23%) Pruritus ani et vulvae (<3%)
Sinusitis (5–15%) Pulmonary toxicity [3] Rash (<10%) [5]
Endocrine/Metabolic Upper respiratory tract infection (11%) Stevens-Johnson syndrome [4]
Galactorrhea (<4%) Hematologic Toxic epidermal necrolysis [3]
Gynecomastia (<4%) Anemia (16%) [4] Urticaria [3]
Hyperglycemia [6] Hemolysis [2] Vasculitis [4]
Hypothyroidism (12%) Hemolytic anemia [2] Nails
Genitourinary Leukopenia [2] Photo-onycholysis [2]
Vaginitis (<4%) Lymphopenia [2]
Neutropenia (>10%) [11] Mucosal
Hematologic Sepsis (8%) Oral mucosal eruption [3]
Anemia (15%) Thrombocytopenia [5] Xerostomia (<3%)
Neutropenia [2] Cardiovascular
Thrombocytopenia [3] Local
Infusion-related reactions [10] QT prolongation [3]
Otic Infusion-site reactions [2] Central Nervous System
Ear pain (5–15%) Dysgeusia (taste perversion) (<3%) [2]
Other
Local Adverse effects [2] Hallucinations [2]
Injection-site granuloma [2] Infection (70%) [10] Headache [3]
Injection-site pain (8%) [2] Insomnia [2]
Peripheral neuropathy [2]
Psychosis [2]
OFATUMUMAB OFLOXACIN Seizures [2]
Vertigo (dizziness) [3]
Trade names: Floxin (Ortho-McNeil), Ocuflox
Trade name: Arzerra (Novartis) (Allergan), Taravid (Sanofi-Aventis) Neuromuscular/Skeletal
Indications: Chronic lymphocytic leukemia Indications: Various infections caused by Arthralgia [2]
Class: CD20-directed cytolytic monoclonal susceptible organisms Arthropathy [2]
antibody, Monoclonal antibody Class: Antibiotic, fluoroquinolone Asthenia (fatigue) [2]
Half-life: 14 days Half-life: 48 hours Myalgia/Myopathy [2]
Clinically important, potentially hazardous Clinically important, potentially hazardous Rhabdomyolysis [2]
interactions with: live vaccines interactions with: aminophylline, amiodarone, Tendinopathy/Tendon rupture [7]
Pregnancy category: N/A (May cause fetal B- antacids, arsenic, artemether/lumefantrine, BCG Gastrointestinal/Hepatic
cell depletion) vaccine, bendamustine, bepridil, bretylium, Abdominal pain [3]
Important contra-indications noted in the calcium salts, clozapine, corticosteroids, Diarrhea [2]
prescribing guidelines for: nursing mothers; cyclosporine, CYP1A2 substrates, didanosine, Nausea [4]
pediatric patients disopyramide, erythromycin, insulin, lanthanum, Vomiting [2]
Warning: HEPATITIS B VIRUS REACTIVATION magnesiuim salts, mycophenolate, NSAIDs, oral
AND PROGRESSIVE MULTIFOCAL Genitourinary
iron, oral typhoid vaccine, oxtriphylline, Vaginitis (<10%)
LEUKOENCEPHALOPATHY phenothiazines, probenecid, procainamide,
quinapril, quinidine, sevelamer, sotalol, St John’s Local
Skin wort, strontium ranelate, sucralfate, Injection-site pain (<10%)
Herpes (6%) sulfonylureas, tricyclic antidepressants, vitamin K Other
Hyperhidrosis (5%) antagonists, warfarin, zinc, zolmitriptan Adverse effects [10]
Peripheral edema (9%) Pregnancy category: C Death [2]
Rash (14%) [2] Important contra-indications noted in the Side effects [2]
Toxicity [3] prescribing guidelines for: the elderly; nursing
Urticaria (8%) mothers; pediatric patients
Cardiovascular Note: Fluoroquinolones are associated with an
Angina [2] increased risk of tendinitis and tendon rupture in
Hypertension (5%) all ages. This risk is further increased in older
Hypotension (5%) patients usually over 60 years of age, in patients
Tachycardia (5%) taking corticosteroid drugs, and in patients with
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OLANZAPINE See all our books at www.crcpress.com
Sedation [17]
OLANZAPINE Seizures [8] OLAPARIB
Serotonin syndrome [2]
Trade names: Symbyax (Lilly), Zyprexa (Lilly), Somnolence (drowsiness) (20–39%) [11] Trade name: Lynparza (AstraZeneca)
Zyprexa Relprevv (Lilly) Suicidal ideation [2] Indications: BRCA-mutated ovarian cancer
Indications: Schizophrenia, bipolar I disorder Tardive dyskinesia [5] Class: Poly (ADP-ribose) polymerase (PARP)
Class: Antipsychotic, Muscarinic antagonist Tremor (<10%) [5] inhibitor
Half-life: 2154 hours Twitching (2%) Half-life: 7–17 hours
Clinically important, potentially hazardous Vertigo (dizziness) [5] Clinically important, potentially hazardous
interactions with: alcohol, antihypertensive interactions with: amprenavir, aprepitant,
agents, carbamazepine, ciprofloxacin, CNS acting Neuromuscular/Skeletal atazanavir, boceprevir, bosentan, carbamazepine,
drugs, diazepam, dopamine agonists, eszopiclone, Asthenia (fatigue) (8–20%) [4] ciprofloxacin, clarithromycin, crizotinib,
fluoxetine, fluvoxamine, insulin degludec, insulin Back pain (<10%) darunavir, diltiazem, efavirenz, erythromycin,
detemir, insulin glargine, levodopa, lithium, Dystonia [6] etravirine, fluconazole, fosamprenavir, grapefruit
tetrabenazine, valproic acid Myalgia/Myopathy [2] juice, imatinib, indinavir, itraconazole,
Pregnancy category: C Rhabdomyolysis [9] ketoconazole, lopinavir, modafinil, nafcillin,
Important contra-indications noted in the Gastrointestinal/Hepatic nefazodone, nelfinavir, phenytoin, posaconazole,
prescribing guidelines for: the elderly; nursing Abdominal pain (<10%) rifampin, ritonavir, saquinavir, St John’s wort,
mothers; pediatric patients Constipation (9–11%) [2] strong and moderate CYP3A inhibitors,
Note: Can cause DRESS and other serious skin Diarrhea (<10%) [2] telaprevir, telithromycin, verapamil, voriconazole
reactions. Dyspepsia (7–11%) Pregnancy category: D
Symbyax is olanzapine and fluoxetine; Zypraxa Flatulence (<10%) Important contra-indications noted in the
Relprevv is olanzapine pamoate. Hepatotoxicity [4] prescribing guidelines for: nursing mothers;
Warning: INCREASED MORTALITY IN Nausea (<10%) pediatric patients
ELDERLY PATIENTS WITH DEMENTIA- Pancreatitis [7]
RELATED PSYCHOSIS Vomiting (<10%) Skin
POST-INJECTION DELIRIUM/SEDATION SYN- Respiratory Eczema (<10%)
DROME (Zyprexa Relprevv) Cough (<10%) Hot flashes (<10%)
Nasopharyngitis [2] Peripheral edema (10–20%)
Skin Pharyngitis (<10%) Pruritus (<10%)
Angioedema [2] Pneumonia [2] Rash (25%) [2]
Edema [3] Pulmonary embolism [3] Xerosis (<10%)
Hypersensitivity [2] Rhinitis (<10%) Hair
Peripheral edema (<10%) [5] Sinusitis (<10%) Alopecia [2]
Psoriasis [2] Endocrine/Metabolic Mucosal
Purpura (<10%) Appetite increased [2] Stomatitis (<10%)
Rash (>2%) [2] Diabetes mellitus [7]
Vesiculobullous eruption (2%) Diabetic ketoacidosis [2] Cardiovascular
Xanthomas [2] Galactorrhea [2] Hypertension (<10%) [2]
Glucose dysregulation [3] Venous thromboembolism (<10%)
Hair
Alopecia [3] Gynecomastia [2] Central Nervous System
Hypercholesterolemia [2] Anxiety (<10%)
Mucosal Hyperglycemia [6] Depression (<10%)
Epistaxis (nosebleed) (<10%) Hyperprolactinemia [2] Dysgeusia (taste perversion) (21%) [2]
Sialorrhea [4] Metabolic syndrome [11] Fever (<10%)
Xerostomia (13%) [11] Weight gain (5–40%) [60] Headache (25%) [4]
Cardiovascular Genitourinary Insomnia (<10%)
Hypertension (<10%) Priapism [19] Peripheral neuropathy (<10%) [2]
Hypotension (<10%) [4] Sexual dysfunction [2] Neuromuscular/Skeletal
Orthostatic hypotension [2] Urinary incontinence (<10%) Arthralgia (21–32%)
QT prolongation [6] Urinary tract infection (<10%) Asthenia (fatigue) (66–68%) [18]
Tachycardia (<10%) Back pain (25%)
Torsades de pointes [3] Hematologic
Agranulocytosis [2] Myalgia/Myopathy (22–25%)
Venous thromboembolism [4]
Dyslipidemia [4] Gastrointestinal/Hepatic
Central Nervous System Eosinophilia [2] Abdominal pain (43–47%) [3]
Akathisia (<10%) [7] Neutropenia [4] Constipation (10–20%) [2]
Amnesia [2] Pancytopenia [2] Diarrhea (28–31%) [8]
Compulsions [2] Dyspepsia (25%) [3]
Confusion [2] Ocular
Amblyopia (<10%) Gastric obstruction [2]
Delirium [6] Nausea (64–75%) [14]
Extrapyramidal symptoms [3] Oculogyric crisis [2]
Vision blurred [2] Vomiting (32–43%) [10]
Fever [2]
Hallucinations [2] Other Respiratory
Headache (17%) [3] Adverse effects [9] Cough (21%) [2]
Insomnia (12%) [3] Death [7] Dyspnea (10–20%)
Neuroleptic malignant syndrome [35] Nasopharyngitis (26–43%)
Parkinsonism (<10%) [6] Pharyngitis (43%)
Psychosis [2] Pulmonary embolism (<10%)
Restless legs syndrome [7] Upper respiratory tract infection (26–43%)
Restlessness [2]
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Litt’s Drug Eruption & Reaction Manual OLOPATADINE
Endocrine/Metabolic Hematologic
ALT increased [2] Lymphopenia (77%) OLODATEROL
Appetite decreased (22–25%) [4] Neutropenia (65%) [2]
Creatine phosphokinase increased (26–30%) Prothrombin time increased (33%) Trade names: Stiolto Respimat (Boehringer
Hyperglycemia (<10%) Thrombocytopenia (63%) Ingelheim), Striverdi Respimat (Boehringer
Hypomagnesemia (<10%) Ingelheim)
Ocular Indications: Chronic obstructive pulmonary
Genitourinary Xerophthalmia (11%) disease including chronic bronchitis and
Dysuria (<10%) Local emphysema
Urinary incontinence (<10%) Infusion-related reactions (13%) Class: Beta-2 adrenergic agonist
Urinary tract infection (10–20%) Half-life: 8 hours
Hematologic Clinically important, potentially hazardous
Anemia (25–34%) [17]
Febrile neutropenia [2]
OLMESARTAN interactions with: adrenergics, beta blockers,
diuretics, MAO inhibitors, QT interval prolonging
Leukopenia (<10%) [3] Trade names: Benicar (Sankyo), Olmetec agents, steroids, tricyclic antidepressants,
Lymphopenia (56%) (Daiichi Sankyo) xanthine derivatives
Myelodysplastic syndrome [2] Indications: Hypertension Pregnancy category: C
Myeloid leukemia [2] Class: Angiotensin II receptor antagonist Important contra-indications noted in the
Neutropenia (25–32%) [12] (blocker), Antihypertensive prescribing guidelines for: nursing mothers;
Thrombocytopenia (26–30%) [8] Half-life: ~13 hours pediatric patients
Other Clinically important, potentially hazardous Note: Stiolto Respimat is olodaterol and
Adverse effects [5] interactions with: ACE inhibitors, adrenergic tiotropium.
Death [3] neurone blockers, aldesleukin, aliskiren, Warning: ASTHMA-RELATED DEATH
alprostadil, amifostine, antihypertensives,
antipsychotics, anxiolytics and hypnotics, Skin
OLARATUMAB baclofen, beta blockers, calcium channel blockers, Rash (2%)
clonidine, colesevelam, corticosteroids, Cardiovascular
Trade name: Lartruvo (Lilly) cyclosporine, diazoxide, diuretics, eltrombopag, Hypertension [2]
Indications: Treatment of adult patients with soft eplerenone, estrogens, general anesthetics,
heparins, hydralazine, levodopa, lithium, MAO Central Nervous System
tissue sarcoma (with doxorubicin) with a Fever (>2%)
histologic subtype for which an anthracycline- inhibitors, methyldopa, methylphenidate,
minoxidil, moxisylyte, moxonidine, nitrates, Headache [3]
containing regimen is appropriate and which is Vertigo (dizziness) (2%) [2]
not amenable to curative treatment with nitroprusside, NSAIDs, pentoxifylline,
radiotherapy or surgery phosphodiesterase 5 inhibitors, potassium salts, Neuromuscular/Skeletal
Class: Monoclonal antibody, Platelet-derived quinine, rituximab, tacrolimus, tizanidine, Arthralgia (2%) [2]
growth factor receptor alpha blocking antibody tolvaptan, trimethoprim Back pain (4%) [4]
Half-life: ~11 days Pregnancy category: D (category C in first Gastrointestinal/Hepatic
Clinically important, potentially hazardous trimester; category D in second and third Constipation (>2%)
interactions with: none known trimesters) Diarrhea (3%) [3]
Pregnancy category: N/A (Can cause fetal Important contra-indications noted in the
prescribing guidelines for: nursing mothers; Respiratory
harm) Bronchitis (5%) [4]
Important contra-indications noted in the pediatric patients
Note: Contra-indicated in patients with diabetes. COPD [2]
prescribing guidelines for: the elderly; nursing Cough (4%) [3]
mothers; pediatric patients Warning: FETAL TOXICITY
Dyspnea [3]
Note: See separate entry for doxorubicin. Nasopharyngitis (11%) [4]
Skin Pneumonia (>2%) [3]
Hair Angioedema [3] Upper respiratory tract infection (8%) [4]
Alopecia (52%) Edema [2]
Peripheral edema [2] Genitourinary
Mucosal Urinary tract infection (3%) [3]
Mucositis (53%) [2] Cardiovascular
Hypotension [2]
Central Nervous System
Anxiety (11%) Central Nervous System OLOPATADINE
Headache (20%) Vertigo (dizziness) (3%) [8]
Neurotoxicity (22%) Neuromuscular/Skeletal Trade names: Pataday (Alcon), Patanol (Alcon)
Neuromuscular/Skeletal Asthenia (fatigue) [2] Indications: Pruritus due to allergic
Asthenia (fatigue) (64%) Gastrointestinal/Hepatic conjunctivitis, rhinitis
Bone or joint pain (64%) Diarrhea [4] Class: Histamine H1 receptor antagonist
Enteropathy [20] Half-life: 3 hours
Gastrointestinal/Hepatic Clinically important, potentially hazardous
Abdominal pain (23%) Gastrointestinal disorder [6]
interactions with: none known
Diarrhea (34%) [3] Respiratory Pregnancy category: C
Nausea (73%) [2] Upper respiratory tract infection [2] Important contra-indications noted in the
Vomiting (45%) [2] Endocrine/Metabolic prescribing guidelines for: nursing mothers;
Endocrine/Metabolic Hyperkalemia [3] pediatric patients
ALP increased (16%) Other
Appetite decreased (31%) Adverse effects [6] Central Nervous System
Hyperglycemia (52%) Headache (7%) [2]
Hypokalemia (21%)
Hypomagnesemia (16%) Ocular
Eyelid burning (<5%)
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OLOPATADINE Over 100 updates per week on www.drugeruptiondata.com
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Litt’s Drug Eruption & Reaction Manual ONDANSETRON
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Litt’s Drug Eruption & Reaction Manual OSPEMIFENE
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Litt’s Drug Eruption & Reaction Manual OXYBUTYNIN
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Litt’s Drug Eruption & Reaction Manual OXYTOCIN
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Litt’s Drug Eruption & Reaction Manual PALONOSETRON
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Litt’s Drug Eruption & Reaction Manual PAPAVERINE
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Litt’s Drug Eruption & Reaction Manual PEGAPTANIB
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Litt’s Drug Eruption & Reaction Manual PENBUTOLOL
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PENCICLOVIR Over 100 updates per week on www.drugeruptiondata.com
Nails
PENCICLOVIR Nail pigmentation [4] PENICILLIN V
See: www.drugeruptiondata.com/drug/id/1178 Mucosal Trade name: V-cillin K (Lilly)
Aphthous stomatitis [2] Indications: Cellulitis, endocarditis, erysipelas,
Mucosal lesions (pemphigus-like) [2] oral infections, otitis media, rheumatic fever,
Oral ulceration [5]
PENICILLAMINE Stomatitis [6]
scarlet fever, tonsillitis
Class: Antibiotic, penicillin
Trade name: Depen (MedPointe) Central Nervous System Half-life: 4 hours
Indications: Wilson’s disease, rheumatoid Ageusia (taste loss) (12%) [2] Clinically important, potentially hazardous
arthritis Dysgeusia (taste perversion) (metallic taste) interactions with: estrogens, methotrexate,
Class: Antidote, Chelator, Disease-modifying [8] minocycline, neomycin, phenindione, probenecid,
antirheumatic drug (DMARD) Hypogeusia (2533%) [2] sulfinpyrazone, warfarin
Half-life: 1.73.2 hours Neuromuscular/Skeletal Pregnancy category: B
Clinically important, potentially hazardous Dystonia [4]
interactions with: aluminum, antacids, ascorbic Myasthenia gravis [73] Skin
acid, bone marrow suppressants, chloroquine, Polymyositis [8] Anaphylactoid reactions/Anaphylaxis [2]
clozapine, cytotoxic agents, diclofenac, ferrous Respiratory DRESS syndrome [2]
sulfate, food, gold & gold compounds, Pulmonary toxicity [2] Hypersensitivity [3]
hydroxychloroquine, iron, magnesium, Serum sickness [2]
meloxicam, primaquine, probenecid, sodium Endocrine/Metabolic Serum sickness-like reaction [2]
picosulfate Gynecomastia [5] Urticaria [3]
Pregnancy category: D Renal Central Nervous System
Important contra-indications noted in the Glomerulonephritis [3] Fever [3]
prescribing guidelines for: nursing mothers; Nephrotoxicity [5]
pediatric patients Proteinuria [2] Neuromuscular/Skeletal
Note: As an antidote, it is difficult to differentiate Arthralgia [2]
Hematologic
side effects due to the drug from those due to the
Hemotoxicity [2] Gastrointestinal/Hepatic
effects of the poison. Diarrhea [2]
Other
Adverse effects [2]
Skin
Bullous dermatitis [3] PENTAGASTRIN
Bullous pemphigoid [6]
Cicatricial pemphigoid [2] PENICILLIN G See: www.drugeruptiondata.com/drug/id/538
Cutis laxa [13]
Dermatitis [4] Trade name: Crystapen (Britannia)
Dermatomyositis [14] Indications: Anthrax, cellulitis, endocarditis,
Edema of lip (<10%) infections, otitis media, rheumatic fever, PENTAMIDINE
Ehlers–Danlos syndrome [2] respiratory infections, septicemia
Class: Antibiotic, penicillin Trade names: NebuPent (Astellas), Pentacarinat
Elastosis perforans serpiginosa [43] (Sanofi-Aventis), Pentam 300 (Astellas)
Epidermolysis bullosa [4] Half-life: 4 hours
Clinically important, potentially hazardous Indications: Pneumocystis jiroveci infection,
Epidermolysis bullosa acquisita [2] trypanosomiasis, leishmaniasis
Erythema multiforme (<5%) interactions with: estrogens, methotrexate,
minocycline, phenindione, probenecid, Class: Antiprotozoal
Exanthems [8] Half-life: 9.1–13.2 hours (intramuscular); 6.5
Fragility [2] sulfinpyrazone, warfarin
Pregnancy category: B hours (intravenous)
Hypersensitivity [3] Clinically important, potentially hazardous
Lichen planus [4] Important contra-indications noted in the
prescribing guidelines for: nursing mothers interactions with: adefovir, aminoglycosides,
Lichenoid eruption [7] amiodarone, amisulpride, amitriptyline,
Lupus erythematosus [43] amphotericin B, cisplatin, droperidol,
Morphea [2] Skin erythromycin, foscarnet, insulin aspart, insulin
Pemphigus [75] Anaphylactoid reactions/Anaphylaxis [5] degludec, insulin detemir, insulin glargine, insulin
Pemphigus erythematodes (SenearUsher) Dermatitis [2] glulisine, ivabradine, levomepromazine,
[10] Hypersensitivity [4] moxifloxacin, phenothiazines, saquinavir,
Pemphigus foliaceus [16] Jarisch–Herxheimer reaction [21] sparfloxacin, sulpiride, tricyclic antidepressants,
Pemphigus herpetiformis [3] Nicolau syndrome [2] trifluoperazine, vancomycin
Pemphigus vulgaris [2] Rash [4] Pregnancy category: C
Peripheral edema (<10%) Serum sickness-like reaction [2] Important contra-indications noted in the
Pruritus (4450%) [2] prescribing guidelines for: nursing mothers;
Central Nervous System
Pseudoxanthoma elasticum [16] pediatric patients
Hoigne’s syndrome [16]
Psoriasis [4] Note: The rate of adverse side effects is
Seizures [2]
Purpura [5] increased in patients with AIDS.
Rash (4450%) [6] Gastrointestinal/Hepatic
Scleroderma [7] Hepatotoxicity [2]
Toxic epidermal necrolysis [2] Genitourinary Skin
Urticaria (4450%) [2] Exanthems (<15%) [10]
Cystitis [3]
Vasculitis [7] Pruritus [2]
Renal Rash (<47%) [4]
Hair Nephrotoxicity [2] Toxic epidermal necrolysis [3]
Alopecia [3] Urticaria [3]
Hirsutism [2]
Hematologic
Thrombosis [2]
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Litt’s Drug Eruption & Reaction Manual PERICYAZINE
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Litt’s Drug Eruption & Reaction Manual PHENYTOIN
Pregnancy category: C
PHENOXY-BENZAMINE Important contra-indications noted in the PHENYTOIN
prescribing guidelines for: nursing mothers
See: www.drugeruptiondata.com/drug/id/554 Synonyms: diphenylhydantoin; DPH; phenytoin
sodium
Cardiovascular Trade name: Dilantin (Pfizer)
Flushing (<10%) [2]
PHENSUXIMIDE Central Nervous System
Indications: Grand mal seizures
Class: Antiarrhythmic class Ib, Anticonvulsant,
See: www.drugeruptiondata.com/drug/id/555 Headache [2] Antiepileptic, hydantoin, CYP3A4 inducer
Genitourinary Half-life: 742 hours (dose dependent)
Priapism [4] Clinically important, potentially hazardous
interactions with: abacavir, abiraterone,
PHENTERMINE acitretin, afatinib, amiodarone, amitriptyline,
amlodipine, amprenavir, apixaban, apremilast,
Trade names: Adipex-P (Teva), Ionamin PHENYLBUTAZONE aprepitant, artemether/lumefantrine,
(Celltech), Lomaira (Avanthi), Qsymia (Vivus) beclomethasone, boceprevir, brigatinib,
Indications: Obesity See: www.drugeruptiondata.com/drug/id/1257 brivaracetam, buprenorphine, cabazitaxel,
Class: Amphetamine cabozantinib, caffeine, calcium, capecitabine,
Half-life: 1924 hours caspofungin, cefazolin, ceritinib, chloramphenicol,
Clinically important, potentially hazardous
interactions with: fluoxetine, fluvoxamine,
PHENYLEPHRINE cimetidine, ciprofloxacin, citalopram, clobazam,
clorazepate, cobicistat/elvitegravir/emtricitabine/
MAO inhibitors, paroxetine hydrochloride, Trade names: Rynatan (MedPointe), Tussi-12D tenofovir disoproxil, cobimetinib, colesevelam,
phenelzine, sertraline, tranylcypromine (MedPointe) copanlisib, crizotinib, cyclosporine, cyproterone,
Pregnancy category: X Indications: Nasal congestion, glaucoma, dabigatran, daclatasvir, darunavir, dasabuvir/
Important contra-indications noted in the hypotension ombitasvir/paritaprevir/ritonavir, dasatinib,
prescribing guidelines for: the elderly; nursing Class: Adrenergic alpha-receptor agonist, deferasirox, deflazacort, delavirdine,
mothers; pediatric patients Sympathomimetic dexamethasone, diazoxide, disulfiram, dopamine,
Note: Qsymia is phentermine and topiramate. Half-life: 2.5 hours doxycycline, dronedarone, efavirenz, elbasvir &
Clinically important, potentially hazardous grazoprevir, eliglustat, emtricitabine/rilpivirine/
Mucosal interactions with: epinephrine, furazolidone, tenofovir alafenamide, enzalutamide, erlotinib,
Xerostomia [6] iobenguane, MAO inhibitors, oxprenolol, eslicarbazepine, ethosuximide, etravirine,
Cardiovascular phenelzine, tranylcypromine everolimus, ezogabine, fesoterodine, flibanserin,
Cardiotoxicity [3] Pregnancy category: C floxuridine, fluconazole, flunisolide, fluoxetine,
Hypertension [11] Important contra-indications noted in the fosamprenavir, gefitinib, gold & gold compounds,
Palpitation [3] prescribing guidelines for: nursing mothers; hydrocortisone, ibrutinib, idelalisib, imatinib,
Tachycardia [4] pediatric patients indinavir, influenza vaccine, isoniazid, isotretinoin,
Valvulopathy [17] isradipine, itraconazole, ixabepilone, ixazomib,
Skin lacosamide, lapatinib, ledipasvir & sofosbuvir,
Central Nervous System leflunomide, levodopa, levomepromazine,
Anxiety [2] Dermatitis [16]
Hypersensitivity [2] levonorgestrel, lisdexamfetamine, lomustine,
Cognitive impairment [4] lopinavir, meperidine, metformin, methsuximide,
Depression [3] Stinging (from nasal or ophthalmic
preparations) (<10%) methylprednisolone, metronidazole, midazolam,
Dysgeusia (taste perversion) [4] midostaurin, mifepristone, mivacurium,
Headache [2] Cardiovascular naldemedine, nelfinavir, neratinib, nifedipine,
Insomnia [7] Bradycardia [3] nilotinib, nilutamide, nintedanib, olaparib,
Paresthesias [6] Hypertension [2] ombitasvir/paritaprevir/ritonavir, omeprazole,
Vertigo (dizziness) [4] Ocular ondansetron, osimertinib, oxcarbazepine,
Gastrointestinal/Hepatic Blepharoconjunctivitis [4] oxtriphylline, palbociclib, paroxetine
Constipation [5] Periorbital dermatitis [4] hydrochloride, pemetrexed, perampanel,
Endocrine/Metabolic Other phenylbutazone, pimavanserin, piracetam,
Adverse effects [2] ponatinib, posaconazole, prednisolone,
Acidosis [3]
prednisone, propranolol, regorafenib, rifapentine,
Renal rilpivirine, riociguat, risperidone, ritonavir,
Nephrotoxicity [2] rivaroxaban, roflumilast, romidepsin, saquinavir,
Other PHENYL- simeprevir, sofosbuvir, sofosbuvir & velpatasvir,
Death [4] sofosbuvir/velpatasvir/voxilaprevir, solifenacin,
Teratogenicity [2]
PROPANOLAMINE sonidegib, sorafenib, St John’s wort, sucralfate,
sunitinib, tegafur/gimeracil/oteracil, telaprevir,
See: www.drugeruptiondata.com/drug/id/872
telithromycin, temsirolimus, teniposide, tenofovir
alafenamide, thalidomide, tiagabine, ticagrelor,
PHENTOLAMINE ticlopidine, tinidazole, tipranavir, tizanidine,
tolvaptan, triamcinolone, trimethoprim, ulipristal,
Trade name: Regitine (Novartis)
uracil/tegafur, valbenazine, vandetanib,
Indications: Hypertensive episodes in
vemurafenib, venetoclax, vigabatrin, vorapaxar,
pheochromocytoma
voriconazole, vortioxetine, zidovudine,
Class: Adrenergic alpha-receptor antagonist
zuclopenthixol
Half-life: 19 minutes
Pregnancy category: D
Clinically important, potentially hazardous
Note: Aromatic antiepileptic drugs, phenytoin,
interactions with: none known
phenobarbital, carbamazepine and primidone, are
a frequent cause of severe cutaneous adverse
reactions. A strong genetic association between
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 223
PHENYTOIN Over 100 updates per week on www.drugeruptiondata.com
HLA-B*1502 and phenytoin-induced Stevens- Myasthenia gravis [2] Ocular burning (<10%)
Johnson syndrome and toxic epidermal necrolysis Osteoporosis [2] Ocular stinging (>10%)
has been shown in Han Chinese patients. Rhabdomyolysis [6]
Children whose mothers receive phenytoin Gastrointestinal/Hepatic
during pregnancy are born with fetal hydantoin
syndrome. The main features of this syndrome
Hepatotoxicity [10] PHYTONADIONE
are mental and growth retardation, unusual facies, Respiratory
Cough [2] Synonym: vitamin K1
digital and nail hypoplasia, and coarse scalp hair. Trade names: Mephyton (Valeant), Vitamin K
Occasionally neonatal acne will be present. Ocular (AbbVie)
Hallucinations, visual [2] Indications: Coagulation disorders
Skin Local Class: Vitamin
Acne keloid [2] Injection-site extravasation [2] Half-life: 24 hours
Acneform eruption [8] Injection-site necrosis [2] Clinically important, potentially hazardous
AGEP [5] Other interactions with: cholestyramine, orlistat,
Angioedema [2] Adverse effects [3] warfarin
Anticonvulsant hypersensitivity syndrome Death [4] Pregnancy category: C
[10] Hiccups [2] Important contra-indications noted in the
Coarse facies [4] Teratogenicity [3] prescribing guidelines for: nursing mothers;
Dermatomyositis [2] pediatric patients
DRESS syndrome [32]
Erythema multiforme [11] Skin
Erythroderma [9] PHYSOSTIGMINE Anaphylactoid reactions/Anaphylaxis [4]
Exanthems (671%) [22] Dermatitis [9]
Exfoliative dermatitis [15] Synonym: eserine
Indications: Miotic in glaucoma treatment, Eczema [2]
Fixed eruption [5] Nicolau syndrome [2]
Hypersensitivity [47] reverses toxic CNS effects caused by
anticholinergic drugs Scleroderma [12]
Kaposi’s varicelliform eruption [2] Urticaria [4]
Linear IgA bullous dermatosis [8] Class: Cholinesterase inhibitor
Lupus erythematosus [19] Half-life: 1540 minutes Local
Lymphoma [6] Clinically important, potentially hazardous Injection-site eczematous eruption [10]
Mycosis fungoides [7] interactions with: bethanechol, corticosteroids, Injection-site erythema [2]
Pemphigus [2] galantamine, methacholine, succinylcholine Injection-site induration [15]
Pigmentation [4] Pregnancy category: C Other
Pruritus [5] Important contra-indications noted in the Allergic reactions [2]
Pseudolymphoma [31] prescribing guidelines for: nursing mothers
Purple glove syndrome [10] Note: Antilirium is a derivative of the Calabar
Purpura [4] bean, and its active moiety, physostigmine, is also
Pustules [3] known as eserine. Physostigmine is used to PILOCARPINE
Rash (<10%) [13] reverse the effect upon the nervous system
caused by clinical or toxic dosages of drugs and Trade names: Ocusert Pilo (Akorn), Pilopine
Reticular hyperplasia [2] (Alcon), Salagen (MGI)
Serum sickness-like reaction [2] herbs capable of producing the anticholinergic
syndrome. Some of the drugs responsible are: Indications: Glaucoma, miosis induction,
Stevens-Johnson syndrome (14%) [58] xerostomia
Toxic epidermal necrolysis (2%) [65] amitriptyline, amoxapine, atropine, benztropine,
biperiden, clidinium, cyclobenzaprine, Class: Miotic, Muscarinic cholinergic agonist
Urticaria [5] Half-life: N/A
Vasculitis (2%) [11] desipramine, doxepin, hyoscyamine, imipramine,
lorazepam, maprotiline, nortriptyline, Clinically important, potentially hazardous
Hair protriptyline, propantheline, scopolamine, interactions with: acebutolol, galantamine
Alopecia [3] trimipramine. Some herbals that can elicit the Pregnancy category: C
Hirsutism [8] anticholinergic syndrome are black henbane, Important contra-indications noted in the
Nails deadly nightshade, Devil’s apple, Jimson weed, prescribing guidelines for: nursing mothers;
Nail changes [2] Loco seeds or weeds, Matrimony vine, night pediatric patients
Nail hypoplasia [3] blooming jessamine, stinkweed.
Mucosal Skin
Gingival hyperplasia/hypertrophy (>10%) Skin Burning (<10%)
[57] Diaphoresis (>10%) Dermatitis [4]
Mucocutaneous eruption [2] Erythema (<10%) Diaphoresis [5]
Edema (4%)
Cardiovascular Mucosal Hyperhidrosis [2]
Bradycardia [2] Sialorrhea (>10%) Hypersensitivity (<10%)
Polyarteritis nodosa [2] Cardiovascular Stinging (<10%)
Central Nervous System Atrial fibrillation [2] Central Nervous System
Ageusia (taste loss) [2] Bradycardia [3] Dysgeusia (taste perversion) (2%)
Fetal hydantoin syndrome [8] Central Nervous System Headache [2]
Hallucinations [2] Seizures (<10%) [4]
Neurotoxicity [2] Ocular
Twitching (<10%) Cataract [2]
Paresthesias [2]
Restless legs syndrome [2] Gastrointestinal/Hepatic
Nausea [4]
Neuromuscular/Skeletal Vomiting [3]
Digital malformations [4]
Myalgia/Myopathy [2] Ocular
Epiphora (>10%)
224 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual PIPECURONIUM
Rosacea [5]
PIMAVANSERIN Tinea [3] PIOGLITAZONE
Trade name: Nuplazid (Acadia) Cardiovascular Trade name: Actos (Takeda)
Indications: Hallucinations and delusions Cardiac arrest [2] Indications: Type II diabetes
associated with Parkinson’s disease psychosis Respiratory Class: Antidiabetic, CYP3A4 inducer,
Class: Antipsychotic Upper respiratory tract infection (19%) Thiazolidinedione
Half-life: 57 hours Local Half-life: 37 hours
Clinically important, potentially hazardous Application-site burning (826%) Clinically important, potentially hazardous
interactions with: amiodarone, carbamazepine, Application-site reactions (2%) interactions with: alcohol, conivaptan,
chlorpromazine, clarithromycin, disopyramide, corticosteroids, CYP2C8 inhibitors and inducers,
drugs known to prolong the QT interval, Other dapagliflozin, deferasirox, gemfibrozil, insulin,
gatifloxacin, indinavir, itraconazole, ketoconazole, Infection (5%) [2] pegvisomant, pregabalin, rifampin, saxagliptin,
moxifloxacin, phenytoin, procainamide, quinidine, somatropin, teriflunomide, trimethoprim
rifampin, sotalol, St John’s wort, strong CYP3A4 Pregnancy category: C
inhibitors and inducers, thioridazine, ziprasidone PIMOZIDE Important contra-indications noted in the
Pregnancy category: N/A (No data available) prescribing guidelines for: nursing mothers;
Important contra-indications noted in the Trade name: Orap (Teva) pediatric patients
prescribing guidelines for: the elderly; nursing Indications: Tourette’s syndrome, schizophrenia Note: Contra-indicated in patients with
mothers; pediatric patients Class: Antipsychotic established NYHA Class III or IV heart failure.
Warning: INCREASED MORTALITY IN Half-life: 50 hours Warning: CONGESTIVE HEART FAILURE
ELDERLY PATIENTS WITH DEMENTIA- Clinically important, potentially hazardous
RELATED PSYCHOSIS interactions with: amitriptyline, amoxapine, Skin
amphetamines, amprenavir, aprepitant, arsenic, Edema (411%) [29]
Skin artemether/lumefantrine, astemizole, atazanavir, Peripheral edema [12]
Peripheral edema (7%) [2] azithromycin, azole antifungals, boceprevir,
ceritinib, citalopram, clarithromycin, crizotinib, Cardiovascular
Central Nervous System darunavir, dasabuvir/ombitasvir/paritaprevir/ Cardiac failure (<10%) [14]
Confusion (6%) ritonavir, dasatinib, degarelix, delavirdine, Cardiomyopathy [3]
Gait instability (2%) [3] dirithromycin, dolasetron, droperidol, efavirenz, Cardiotoxicity [2]
Hallucinations (5%) [2] eluxadoline, enzalutamide, erythromycin, Myocardial infarction [3]
Gastrointestinal/Hepatic fluoxetine, fosamprenavir, grapefruit juice, Central Nervous System
Constipation (4%) imatinib, indinavir, itraconazole, ketoconazole, Headache (9%) [4]
Nausea (7%) lapatinib, levofloxacin, levomepromazine, Stroke [2]
Genitourinary lopinavir, lurasidone, methylphenidate, Neuromuscular/Skeletal
Urinary tract infection [2] mifepristone, moxifloxacin, nefazodone, Asthenia (fatigue) (4%)
nelfinavir, nilotinib, ombitasvir/paritaprevir/ Bone loss [4]
ritonavir, paroxetine hydrochloride, pazopanib, Fractures [10]
pemoline, phenothiazines, posaconazole,
PIMECROLIMUS protease inhibitors, quinidine, quinine, ribociclib,
Myalgia/Myopathy (5%)
ritonavir, saquinavir, sertraline, sotalol, Gastrointestinal/Hepatic
Trade name: Elidel (Valeant) sparfloxacin, sulpiride, telaprevir, telavancin, Diarrhea [4]
Indications: Second-line therapy for the short- telithromycin, thioridazine, tipranavir, tricyclic Hepatotoxicity [8]
term and non-continuous chronic treatment of antidepressants, trifluoperazine, troleandomycin, Nausea [3]
mild to moderate atopic dermatitis vandetanib, voriconazole, vorinostat, zileuton, Vomiting [2]
Class: Immunomodulator, Macrolactam ziprasidone Respiratory
Half-life: N/A Pregnancy category: C Nasopharyngitis [3]
Clinically important, potentially hazardous Important contra-indications noted in the Pharyngitis (5%)
interactions with: abatacept, alcohol, alefacept, prescribing guidelines for: nursing mothers; Sinusitis (6%)
aprepitant, azacitidine, betamethasone, pediatric patients Upper respiratory tract infection (13%)
cabazitaxel, calcium channel blockers, cimetidine,
conivaptan, CYP3A4 inhibitors, darunavir, Endocrine/Metabolic
delavirdine, denileukin, docetaxel, efavirenz, Skin Hypoglycemia [10]
erythromycin, fingolimod, fluconazole, gefitinib, Facial edema (<10%) Weight gain [19]
immunosuppressants, indinavir, itraconazole, Rash (8%) Genitourinary
ketoconazole, lapatinib, leflunomide, Mucosal Bladder cancer [7]
lenalidomide, oxaliplatin, pazopanib, pemetrexed, Sialorrhea (14%) Hematologic
telithromycin, temsirolimus, triamcinolone, Xerostomia (>10%) [3]
Anemia (<2%) [2]
voriconazole Cardiovascular Pancytopenia [2]
Pregnancy category: C QT prolongation [4]
Important contra-indications noted in the Ocular
prescribing guidelines for: nursing mothers; Neuromuscular/Skeletal Macular edema [2]
pediatric patients Myalgia/Myopathy (3%) Other
Warning: LONG-TERM SAFETY OF TOPICAL Endocrine/Metabolic Adverse effects [4]
CALCINEURIN INHIBITORS HAS NOT BEEN Gynecomastia (>10%) Death [3]
ESTABLISHED. Tooth disorder (5%)
Skin PINDOLOL
Burning [4] PIPECURONIUM
Dermatitis [2] See: www.drugeruptiondata.com/drug/id/563
Peripheral edema [3] See: www.drugeruptiondata.com/drug/id/949
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226 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual POMALIDOMIDE
See: www.drugeruptiondata.com/drug/id/568
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POMALIDOMIDE Over 100 updates per week on www.drugeruptiondata.com
Mucosal Neuromuscular/Skeletal
Epistaxis (nosebleed) (15%) PORFIMER Arthralgia (11%)
Cardiovascular Asthenia (fatigue) (3–17%) [2]
See: www.drugeruptiondata.com/drug/id/1177 Back pain (10%)
Chest pain (22%)
Venous thromboembolism [8] Bone or joint pain (16%)
Myalgia/Myopathy (16%)
Central Nervous System POSACONAZOLE
Anxiety (11%) Gastrointestinal/Hepatic
Chills (9%) Abdominal pain (5–27%) [3]
Trade name: Noxafil (Schering) Constipation (21%)
Confusion (10%) Indications: Aspergillus and Candida infection
Fever (19%) [3] Diarrhea (10–42%) [6]
prophylaxis in immunocompromised patients Dyspepsia (10%)
Headache (13%) Class: Antibiotic, triazole, Antifungal, azole
Insomnia (7%) Flatulence [2]
Half-life: 35 hours Hepatitis (<5%)
Neurotoxicity (18%) [3] Clinically important, potentially hazardous
Pain (6%) Hepatomegaly (<5%)
interactions with: alprazolam, atazanavir, Hepatotoxicity (<5%) [6]
Peripheral neuropathy (10%) [2] atorvastatin, boceprevir, brigatinib, cabozantinib,
Tremor (9%) [2] Nausea (9–38%) [11]
calcium channel blockers, cimetidine, copanlisib, Vomiting (7–29%) [5]
Vertigo (dizziness) (20%) cyclosporine, digoxin, dihydroergotamine,
Neuromuscular/Skeletal diltiazem, dronedarone, efavirenz, ergotamine, Respiratory
Arthralgia (16%) esomeprazole, everolimus, felodipine, flibanserin, Cough (3–25%)
Asthenia (fatigue) (12–55%) [10] fosamprenavir, HMG-CoA reductase inhibitors, Dyspnea (<20%)
Back pain (32%) [3] ibrutinib, lapatinib, lomitapide, lovastatin, Pharyngitis (12%)
Bone or joint pain (11–12%) [2] metoclopramide, midazolam, midostaurin, Pneumonia (3–10%)
Muscle spasm (19%) mifepristone, neratinib, nicardipine, nifedipine, Pulmonary embolism (<5%)
Myalgia/Myopathy [2] olaparib, omeprazole, palbociclib, pantoprazole, Upper respiratory tract infection (7%)
Pain in extremities (5%) phenytoin, pimozide, ponatinib, quinidine, Endocrine/Metabolic
Gastrointestinal/Hepatic regorafenib, rifabutin, rilpivirine, ritonavir, Adrenal insufficiency (<5%)
Constipation (36%) [2] rivaroxaban, ruxolitinib, simeprevir, simvastatin, ALP increased (3–13%)
Diarrhea (34%) [2] sirolimus, sonidegib, tacrolimus, telaprevir, ALT increased (3–11%) [2]
Nausea (36%) temsirolimus, triazolam, venetoclax, verapamil, AST increased (6–17%) [2]
Vomiting (14%) vinblastine, vincristine, vorapaxar Dehydration (<11%)
Pregnancy category: C Hyperbilirubinemia [2]
Respiratory Important contra-indications noted in the Hyperglycemia (11%)
Cough (14%) prescribing guidelines for: nursing mothers; Hypocalcemia (9%)
Dyspnea (34%) [5] pediatric patients Hypokalemia (30%)
Pneumonia (23%) [7] Hypomagnesemia (18%)
Upper respiratory tract infection (32%) Weight loss (<14%)
Skin
Endocrine/Metabolic Edema (9%) Genitourinary
Appetite decreased (22%) Herpes (14%) Vaginal bleeding (10%)
Dehydration [2] Herpes simplex (3–15%)
Hypercalcemia (21%) Renal
Hyperhidrosis (2–10%) Renal failure (<5%)
Hyperglycemia (12%) [2] Jaundice (<5%)
Hypocalcemia (6%) Peripheral edema (15%) Hematologic
Hypokalemia (10%) Petechiae (11%) Anemia (2–25%)
Hyponatremia (10%) Pruritus (11%) Febrile neutropenia (20%)
Serum creatinine increased (15%) Rash (3–19%) [3] Hemolytic uremic syndrome (<5%)
Weight loss (14%) Thrombocytopenic purpura (<5%) Neutropenia (4–23%)
Genitourinary Thrombocytopenia (29%)
Mucosal
Urinary tract infection (8%) Epistaxis (nosebleed) (14%) Ocular
Renal Mucositis (17%) Vision blurred (~2%)
Renal failure (15%) Oral candidiasis (<12%) Other
Hematologic Cardiovascular Adverse effects [11]
Anemia (38%) [13] Hypertension (18%) Allergic reactions (<5%)
Febrile neutropenia [2] Hypotension (14%) Infection (18%)
Leukopenia (11%) [3] QT prolongation [3]
Lymphopenia (4%) [2] Tachycardia (12%)
Myelosuppression [4] Torsades de pointes (<5%) POTASSIUM IODIDE
Neutropenia (52%) [22] Central Nervous System
Sepsis [2] Anorexia (2–19%) Synonyms: KI; Lugol’s solution
Thrombocytopenia (25%) [14] Anxiety (9%) Trade name: SSKI (Upsher-Smith)
Other Dysgeusia (taste perversion) (~2%) Indications: Hyperthyroidism, erythema
Death [3] Fever (6–45%) nodosum, sporotrichosis
Infection [9] Headache (8–28%) [6] Class: Antihyperthyroid, Antimycobacterial
Insomnia (<17%) Half-life: N/A
Neurotoxicity [2] Clinically important, potentially hazardous
Paresthesias (<5%) interactions with: ACE inhibitors, potassium-
PONATINIB Rigors (<20%) sparing diuretics, spironolactone, triamterene
See: www.drugeruptiondata.com/drug/id/3145
Tremor (~2%)
Vertigo (dizziness) (11%) [3]
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Litt’s Drug Eruption & Reaction Manual PRASUGREL
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230 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual PRILOCAINE
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PRILOCAINE Over 100 updates per week on www.drugeruptiondata.com
Seizures [2]
Hematologic
PROCAINAMIDE PROCHLORPERAZINE
Methemoglobinemia [11] Trade names: Procan (Pfizer), Procanbid (Pfizer) Trade name: Compazine (GSK)
Other Indications: Ventricular arrhythmias Indications: Psychotic disorders, control of
Adverse effects [2] Class: Antiarrhythmic, Antiarrhythmic class Ia severe nausea and vomiting
Half-life: 2.54.5 hours Class: Antiemetic, Antipsychotic, Muscarinic
Clinically important, potentially hazardous antagonist, Phenothiazine
PRIMAQUINE interactions with: abarelix, amiodarone,
amisulpride, arsenic, artemether/lumefantrine,
Half-life: 23 hours
Clinically important, potentially hazardous
See: www.drugeruptiondata.com/drug/id/576 asenapine, astemizole, ciprofloxacin, enoxacin, interactions with: antihistamines, arsenic,
ethoxzolamide, gatifloxacin, glycopyrrolate, chlorpheniramine, dofetilide, pericyazine,
glycopyrronium, imidapril, lomefloxacin, piperazine, quinine, quinolones, sparfloxacin
lurasidone, metformin, mivacurium, moxifloxacin, Pregnancy category: C
PRIMIDONE nilotinib, norfloxacin, ofloxacin, pimavanserin, Important contra-indications noted in the
quinine, quinolones, ribociclib, rocuronium, prescribing guidelines for: the elderly; nursing
See: www.drugeruptiondata.com/drug/id/577 sotalol, sparfloxacin, tetrabenazine, trimethoprim, mothers; pediatric patients
trospium, vandetanib, zofenopril
Pregnancy category: C Skin
PRISTINAMYCIN Important contra-indications noted in the Anaphylactoid reactions/Anaphylaxis
prescribing guidelines for: nursing mothers; (<10%)
See: www.drugeruptiondata.com/drug/id/1311 pediatric patients Fixed eruption [3]
Photosensitivity (<10%) [3]
Skin Pruritus (<10%)
PROBENECID Dermatitis (6%) Rash (<10%)
Exanthems (<8%) [5] Toxic epidermal necrolysis [2]
Indications: Gouty arthritis Hypersensitivity [2] Mucosal
Class: Uricosuric Lupus erythematosus (>10%) [175] Xerostomia (>10%)
Half-life: 612 hours (dose-dependent) Purpura [3]
Clinically important, potentially hazardous Urticaria (<5%) Central Nervous System
interactions with: acemetacin, acetaminophen, Vasculitis [5] Akathisia [14]
amphotericin B, ampicillin/sulbactam, Extrapyramidal symptoms [3]
Mucosal Neuroleptic malignant syndrome [3]
benzodiazepines, captopril, cefazolin, cefditoren, Oral mucosal eruption (2%)
cefixime, ceftaroline fosamil, ceftazidime & Parkinsonism [4]
avibactam, ceftriaxone, ciprofloxacin, Cardiovascular Neuromuscular/Skeletal
deferiprone, doripenem, ertapenem, Hypotension [2] Dystonia [6]
flucloxacillin, furosemide, gemifloxacin, QT prolongation [4]
Torsades de pointes [3] Endocrine/Metabolic
glibenclamide, ketoprofen, ketorolac, levodopa,
Gynecomastia (<10%)
levofloxacin, meloxicam, meropenem & Central Nervous System
vaborbactam, methotrexate, moxifloxacin, Dysgeusia (taste perversion) (34%)
norfloxacin, NSAIDs, ofloxacin, pemetrexed, Psychosis [2]
penicillamine, penicillin G, penicillin V, salicylates,
Neuromuscular/Skeletal
PROCYCLIDINE
sulfamethoxazole, sulfonamides, torsemide,
Myalgia/Myopathy [2] See: www.drugeruptiondata.com/drug/id/582
zidovudine
Myasthenia gravis [3]
Pregnancy category: C
Important contra-indications noted in the Gastrointestinal/Hepatic
prescribing guidelines for: nursing mothers; Hepatotoxicity [3]
Nausea [3]
PROGESTINS
pediatric patients
Respiratory Trade names: Aygestin (Barr), Megace (Bristol-
Skin Pulmonary toxicity [2] Myers Squibb), Micronor (Ortho), Ovrette
Pruritus (<10%) Hematologic (Wyeth), Provera (Pfizer)
Rash (<10%) Agranulocytosis [4] Indications: Prevention of pregnancy
Urticaria (<5%) Neutropenia [3] Class: Progestogen
Pancytopenia [2] Half-life: N/A
Mucosal Clinically important, potentially hazardous
Gingivitis (<10%) Pure red cell aplasia [3]
interactions with: acitretin, aprepitant,
Cardiovascular dofetilide, rosuvastatin, voriconazole
Flushing (<10%)
Renal
PROCARBAZINE Skin
Nephrotoxicity [3] See: www.drugeruptiondata.com/drug/id/580 Acneform eruption [3]
Hematologic Dermatitis [4]
Thrombocytopenia [2] Diaphoresis (31%)
Erythema multiforme [2]
Urticaria [2]
Cardiovascular
Flushing (12%)
Endocrine/Metabolic
Amenorrhea [2]
232 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual PROPRANOLOL
Mucosal Respiratory
PROMAZINE Oral lesions (>5%) Apnea [4]
Xerostomia (2%) Cough [2]
See: www.drugeruptiondata.com/drug/id/584 Hypoxia [7]
Cardiovascular
Bradycardia [3] Respiratory depression [2]
Brugada syndrome [7] Endocrine/Metabolic
PROMETHAZINE Cardiotoxicity [3] Acidosis [2]
Congestive heart failure [2] Renal
Trade name: Phenergan (Wyeth) Hypotension [3]
Indications: Allergic rhinitis, urticaria Green urine [8]
Class: Histamine H1 receptor antagonist Central Nervous System Local
Half-life: 1014 hours Dysgeusia (taste perversion) (323%) Infusion-related reactions [3]
Clinically important, potentially hazardous Seizures [3] Injection-site pain (>10%) [35]
interactions with: antihistamines, arsenic, Syncope [2]
Other
chlorpheniramine, dofetilide, nalbuphine, Gastrointestinal/Hepatic Adverse effects [4]
piperazine, quinolones, sparfloxacin, zaleplon Hepatotoxicity [8] Death [8]
Pregnancy category: C Local Hiccups [3]
Important contra-indications noted in the Injection-site pain (2890%) [4]
prescribing guidelines for: the elderly; nursing
mothers; pediatric patients
Note: Not for intra-arterial or subcutaneous PROPOXYPHENE
injection and contra-indicated in comatose states. PROPANTHELINE
Warning: RESPIRATORY DEPRESSION and See: www.drugeruptiondata.com/drug/id/589
SEVERE TISSUE INJURY, INCLUDING See: www.drugeruptiondata.com/drug/id/587
GANGRENE
PROPRANOLOL
Skin PROPOFOL
Dermatitis [3] Trade names: Hemangeol (Pierre Fabre), Inderal
Erythema multiforme [2] Trade name: Diprivan (AstraZeneca) (Wyeth)
Lupus erythematosus [2] Indications: Induction and maintenance of Indications: Hypertension, angina pectoris, atrial
Photosensitivity [12] anesthesia fibrillation, myocardial infarction, migraine,
Purpura [2] Class: Anesthetic, general tremor, infantile hemangioma
Toxic epidermal necrolysis [2] Half-life: initial: 40 minutes; terminal: 3 days Class: Antiarrhythmic, Antiarrhythmic class II,
Urticaria [3] Clinically important, potentially hazardous Beta adrenergic blocker, Beta blocker
interactions with: zinc Half-life: 26 hours
Mucosal Pregnancy category: B Clinically important, potentially hazardous
Xerostomia (<10%) [2] Important contra-indications noted in the interactions with: alcohol, aluminum hydroxide,
Cardiovascular prescribing guidelines for: nursing mothers; aminophylline, amiodarone, barbiturates,
QT prolongation [2] pediatric patients bupivacaine, chlorpromazine, cholestyramine,
Central Nervous System cimetidine, ciprofloxacin, clonidine, colestipol,
Neuroleptic malignant syndrome [2] Skin delavirdine, diazepam, dronedarone, epinephrine,
Seizures [2] Anaphylactoid reactions/Anaphylaxis ethanol, fluconazole, fluoxetine, fluvoxamine,
Somnolence (drowsiness) [3] (<10%) [8] haloperidol, imipramine, insulin, insulin detemir,
Angioedema [2] insulin glargine, insulin glulisine, isoniazid,
Exanthems (6%) [2] levothyroxine, lidocaine, neostigmine, nicardipine,
nifedipine, nilutamide, nisoldipine, oxtriphylline,
PROPAFENONE Rash (5%)
Urticaria [2] paroxetine hydrochloride, phenobarbital,
phenytoin, propafenone, pyridostigmine,
Trade name: Rythmol (Reliant) Hair quinidine, rifampin, ritonavir, rizatriptan, sodium
Indications: Ventricular arrhythmias Hair pigmentation [3] iodide I-131, teniposide, terbutaline, tolbutamide,
Class: Antiarrhythmic, Antiarrhythmic class Ic Cardiovascular verapamil, warfarin, zileuton, zolmitriptan
Half-life: 1032 hours Bradycardia [14] Pregnancy category: C
Clinically important, potentially hazardous Brugada syndrome [2] Important contra-indications noted in the
interactions with: amitriptyline, boceprevir, Cardiac failure [2] prescribing guidelines for: nursing mothers;
carvedilol, clozapine, cobicistat/elvitegravir/ Hypotension [17] pediatric patients
emtricitabine/tenofovir alafenamide, cobicistat/ Tachycardia [2] Note: Cutaneous side effects of beta-receptor
elvitegravir/emtricitabine/tenofovir disoproxil, blockers are clinically polymorphous. They
delavirdine, digoxin, efavirenz, fosamprenavir, Central Nervous System
Amnesia [10] apparently appear after several months of
grapefruit juice, mirabegron, neostigmine, continuous therapy.
paroxetine hydrochloride, propranolol, Hallucinations [3]
pyridostigmine, rifapentine, ritonavir, telaprevir, Seizures [8]
tipranavir Twitching (<10%) Skin
Pregnancy category: C Neuromuscular/Skeletal Acneform eruption [2]
Important contra-indications noted in the Ataxia [2] Angioedema [2]
prescribing guidelines for: nursing mothers; Rhabdomyolysis [9] Cold extremities [6]
pediatric patients Dermatitis [2]
Gastrointestinal/Hepatic Eczema [2]
Nausea [3] Exanthems [4]
Skin Pancreatitis [7] Lichenoid eruption [3]
Lupus erythematosus [3] Vomiting [4] Lupus erythematosus [2]
Psoriasis [2] Necrosis [3]
Rash (<3%)
Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC 233
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234 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual PYRIMETHAMINE
Skin
Anaphylactoid reactions/Anaphylaxis [2] PYRIDOSTIGMINE PYRIMETHAMINE
Basal cell carcinoma [3]
Bullous pemphigoid (with UVA) [13] Trade names: Mestinon (Valeant), Regonol Trade names: Daraprim (GSK), Fansidar (Roche)
Burning (<10%) [3] (Novartis) Indications: Malaria
Dermatitis [11] Indications: Myasthenia gravis Class: Antimalarial, Antiprotozoal
Eczema [2] Class: Acetylcholinesterase inhibitor Half-life: 8095 hours
Edema (<10%) Half-life: ~2 hours Clinically important, potentially hazardous
Ephelides (<10%) [5] Clinically important, potentially hazardous interactions with: dapsone, pemetrexed,
Erythema [2] interactions with: aminoglycosides, bacitracin, trimethoprim, zidovudine
Herpes simplex [2] clindamycin, colistin, edrophonium, polymyxin B, Pregnancy category: C
Herpes zoster [2] propafenone, propranolol, quinidine, tetracyclines Important contra-indications noted in the
Hypomelanosis (<10%) Pregnancy category: B prescribing guidelines for: the elderly; nursing
Lupus erythematosus [5] Important contra-indications noted in the mothers
Melanoma [3] prescribing guidelines for: nursing mothers; Note: Fansidar is pyrimethamine and sulfadoxine.
Photosensitivity [14] pediatric patients Sulfadoxine is a sulfonamide and can be absorbed
Phototoxicity [14] systemically. Sulfonamides can produce severe,
Pigmentation [9] Central Nervous System possibly fatal, reactions such as toxic epidermal
Porokeratosis (actinic) [3] Neurotoxicity [3] necrolysis and Stevens-Johnson syndrome.
Pruritus (>10%) [4] Parkinsonism [2]
Rash (<10%) Gastrointestinal/Hepatic Skin
Squamous cell carcinoma [4] Abdominal pain [5] Angioedema [2]
Tumors (for the most part malignant) [18] Diarrhea [2] Bullous dermatitis [2]
Vesiculation [2] Nausea [3] DRESS syndrome [2]
Vitiligo [2] Erythema multiforme [4]
Other Exanthems [3]
Hair Adverse effects [2]
Hypertrichosis [4] Exfoliative dermatitis [2]
Side effects [2] Fixed eruption [3]
Nails Hypersensitivity (>10%)
Nail pigmentation [4] Lichenoid eruption [2]
Photo-onycholysis [3] PYRIDOXINE Photosensitivity (>10%) [3]
Mucosal Pigmentation [5]
Cheilitis (<10%) See: www.drugeruptiondata.com/drug/id/598 Pruritus [2]
Central Nervous System Stevens-Johnson syndrome (<10%) [25]
Pain [3] Toxic epidermal necrolysis [15]
PYRILAMINE Central Nervous System
Vertigo (dizziness) [2]
PYRAZINAMIDE See: www.drugeruptiondata.com/drug/id/599 Neuromuscular/Skeletal
Asthenia (fatigue) [2]
See: www.drugeruptiondata.com/drug/id/597 Gastrointestinal/Hepatic
Diarrhea [2]
Nausea [2]
Vomiting [2]
Other
Adverse effects [2]
Death [4]
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QUAZEPAM Over 100 updates per week on www.drugeruptiondata.com
236 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual QUINUPRISTIN/DALFOPRISTIN
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RABEPRAZOLE See all our books at www.crcpress.com
238 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual RANIBIZUMAB
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RANIBIZUMAB Over 100 updates per week on www.drugeruptiondata.com
240 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual RIBAVIRIN
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242 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual RILUZOLE
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RIMANTADINE Over 100 updates per week on www.drugeruptiondata.com
Skin
RIMANTADINE Ecchymoses (4%) RISPERIDONE
Peripheral edema (8%)
See: www.drugeruptiondata.com/drug/id/623 Pruritus (3%) Trade names: Risperdal (Ortho-McNeil)
Rash (8%) (Janssen), Risperdal Consta (Ortho-McNeil)
(Janssen)
Cardiovascular
RIMONABANT Chest pain (5%)
Indications: Schizophrenia, bipolar mania,
irritability associated with autistic disorder
Hypertension (11%) Class: Antipsychotic, Mood stabilizer
See: www.drugeruptiondata.com/drug/id/1236
Central Nervous System Half-life: 330 hours
Depression (7%) Clinically important, potentially hazardous
Fever [2] interactions with: ACE inhibitors, alcohol, alpha
RIOCIGUAT Headache (10%) [3] blockers, amantadine, angiotensin II receptor
Insomnia (5%) antagonists, anxiolytics and hypnotics,
Trade name: Adempas (Bayer) Pain (14%) apomorphine, artemether/lumefantrine,
Indications: Pulmonary hypertension Paresthesias (2%) barbiturates, bromocriptine, cabergoline, calcium
Class: Soluble guanylate cyclase (sGC) stimulator Vertigo (dizziness) (7%) channel blockers, carbamazepine, cimetidine,
Half-life: 7–12 hours citalopram, clozapine, cobicistat/elvitegravir/
Clinically important, potentially hazardous Neuromuscular/Skeletal
Arthralgia (10–24%) [6] emtricitabine/tenofovir alafenamide, cobicistat/
interactions with: antacids, carbamazepine, elvitegravir/emtricitabine/tenofovir disoproxil,
dipyridamole, nitrates or nitric oxide donors, Asthenia (fatigue) (5%)
Back pain (28%) [4] ethosuximide, fluoxetine, general anesthetics,
nitroprusside, phenobarbital, phenytoin, rifampin, histamine, levodopa, memantine, methyldopa,
sildenafil, St John’s wort, tadalafil, theophylline, Bone or joint pain (7%) [5]
Fractures (9%) [9] metoclopramide, opioid analgesics,
vardenafil oxcarbazepine, paliperidone, paroxetine
Pregnancy category: X Myalgia/Myopathy (7%) [3]
Neck pain (5%) [3] hydrochloride, pergolide, phenytoin,
Important contra-indications noted in the pramipexole, primidone, ranitidine, ritonavir,
prescribing guidelines for: nursing mothers; Osteonecrosis [5]
Tendinopathy/Tendon rupture (3%) ropinirole, rotigotine, sodium oxybate,
pediatric patients sympathomimetics, tetrabenazine, tramadol,
Warning: EMBRYO-FETAL TOXICITY Gastrointestinal/Hepatic tricyclics, valproic acid
Abdominal pain (12%) [3] Pregnancy category: C
Skin Constipation (13%) [3] Important contra-indications noted in the
Peripheral edema [2] Diarrhea (11%) [4] prescribing guidelines for: nursing mothers;
Dyspepsia (11%) [2] pediatric patients
Cardiovascular Esophagitis [2]
Hypotension (10%) [6] Note: Safety and effectiveness have not been
Gastrointestinal disorder [3] established for pediatric patients with
Central Nervous System Hepatotoxicity [6] schizophrenia <13 years of age, for bipolar mania
Headache (27%) [3] Nausea (11%) [2] <10 years of age, and for autistic disorder <5
Syncope [2] Respiratory years of age. [C] = in children.
Vertigo (dizziness) (20%) Bronchitis (10%) Warning: INCREASED MORTALITY IN
Gastrointestinal/Hepatic Cough (6%) ELDERLY PATIENTS WITH DEMENTIA-
Constipation (5%) Flu-like syndrome (11%) [2] RELATED PSYCHOSIS
Diarrhea (12%) Influenza [3]
Dyspepsia (21%) [2] Nasopharyngitis [3] Skin
Gastroesophageal reflux (5%) Pharyngitis (6%) Angioedema [6]
Nausea (14%) Rhinitis (6%) Edema [3]
Vomiting (10%) Sinusitis (9%) Peripheral edema (16%) [4]
Hematologic Genitourinary Photosensitivity (<10%) [2]
Anemia (7%) Urinary tract infection (11%) Rash [C] (11%) (2–4%)
Bleeding (2%) [2] Ocular Seborrhea (2%)
Other Cataract (7%) Urticaria [2]
Adverse effects [5] Ocular adverse effects [3] Xerosis (2%)
Scleritis [2] Hair
Other Alopecia [2]
RISEDRONATE Adverse effects [5] Mucosal
Allergic reactions (4%) Sialopenia (5%)
Trade names: Actonel (Procter & Gamble), Infection (31%) [2] Sialorrhea [C] (22%) (<3%) [11]
Atelvia (Warner Chilcott) Tooth disorder (2%) Xerostomia [C] (13%) (4%) [7]
Indications: Paget’s disease of bone, Cardiovascular
osteoporosis Bradycardia [2]
Class: Bisphosphonate Cardiotoxicity [2]
Half-life: terminal: 220 hours Hypotension [2]
Clinically important, potentially hazardous QT prolongation [4]
interactions with: antacids, calcium Tachycardia [C] (7%) (<5%)
supplements, iron preparations, laxatives, Venous thromboembolism [6]
magnesium-based supplements Ventricular arrhythmia [2]
Pregnancy category: C
Important contra-indications noted in the Central Nervous System
prescribing guidelines for: nursing mothers; Agitation [2]
pediatric patients Akathisia [C] (16%) (5–9%) [18]
Anorexia [C] (8%) (2%)
244 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual RITONAVIR
Anxiety [C] (16%) (2–16%) [5] Ocular darifenacin, dasatinib, deferasirox, delavirdine,
Catatonia [2] Abnormal vision [C] (4–7%) (<3%) diazepam, diclofenac, dihydroergotamine,
Compulsions [3] Vision blurred [3] docetaxel, dronedarone, dutasteride, efavirenz,
Depression (14%) [7] Local eletriptan, eluxadoline, ergot alkaloids,
Extrapyramidal symptoms [16] Injection-site pain [2] ergotamine, erlotinib, estazolam, estradiol,
Fever [C] (20%) (<2%) eszopiclone, etravirine, everolimus, ezetimibe,
Headache [9] Other fentanyl, fesoterodine, flecainide, flibanserin,
Insomnia [9] Adverse effects [11] flurazepam, fluticasone propionate, glecaprevir &
Neuroleptic malignant syndrome [25] Death [3] pibrentasvir, halazepam, indacaterol,
Neurotoxicity [2] Tooth disorder (<3%) isavuconazonium sulfate, itraconazole, ivabradine,
Parkinsonism [C] (2–16%) (12–20%) [7] ixabepilone, ketoconazole, lapatinib, ledipasvir &
Psychosis [3] sofosbuvir, levomepromazine, levothyroxine,
Rabbit syndrome [3] RITODRINE lomitapide, macitentan, maraviroc, meloxicam,
Restless legs syndrome [2] meperidine, meptazinol, methylergonovine,
Schizophrenia [2] Indications: Preterm labor methysergide, midazolam, midostaurin,
Sedation [4] Class: Beta-2 adrenergic agonist, Tocolytic mifepristone, naldemedine, nelfinavir, neratinib,
Seizures [3] Half-life: 1.312 hours nifedipine, nilotinib, olaparib, oral contraceptives,
Serotonin syndrome [3] Clinically important, potentially hazardous osimertinib, paclitaxel, palbociclib, paroxetine
Somnolence (drowsiness) [C] (12–67%) (5– interactions with: glycopyrrolate hydrochloride, pazopanib, phenytoin, pimozide,
14%) [16] Pregnancy category: B piroxicam, pitavastatin, ponatinib, posaconazole,
Stuttering [2] propafenone, propoxyphene, propranolol,
Suicidal ideation [3] Skin quazepam, quinidine, quinine, ranolazine,
Tardive dyskinesia [5] ribociclib, rifabutin, rifampin, rifapentine,
Anaphylactoid reactions/Anaphylaxis (<3%)
Tremor [C] (10–12%) (6%) [6] rilpivirine, rimonabant, risperidone, rivaroxaban,
Diaphoresis (<14%)
Vertigo (dizziness) [C] (7–16%) (4–10%) [5] romidepsin, rosuvastatin, ruxolitinib, saquinavir,
Erythema (1015%) [2]
Neuromuscular/Skeletal sildenafil, silodosin, simeprevir, simvastatin,
Pustules [2]
Arthralgia (2–3%) sofosbuvir, sofosbuvir/velpatasvir/voxilaprevir,
Rash (<3%)
Asthenia (fatigue) [C] (18–42%) (<3%) [4] solifenacin, St John’s wort, sunitinib, tadalafil,
Toxic epidermal necrolysis [2]
Back pain (2–3%) telaprevir, telithromycin, temsirolimus, tenofovir
Vasculitis [2]
Dystonia [C] (9–18%) (5–11%) [4] disoproxil, ticagrelor, tolvaptan, trabectedin,
Cardiovascular triazolam, ulipristal, vardenafil, vemurafenib,
Pisa syndrome [3]
Chest pain [2] venetoclax, vorapaxar, voriconazole, zolpidem,
Rhabdomyolysis [7]
Myocardial ischemia [2] zuclopenthixol
Gastrointestinal/Hepatic Pulmonary edema [3] Pregnancy category: B
Abdominal pain [C] (15–18%) (3–4%) Central Nervous System Important contra-indications noted in the
Constipation [C] (21%) (8–9%) [4] prescribing guidelines for: nursing mothers
Chills (310%)
Diarrhea [C] (7%) (73%) Note: Protease inhibitors cause dyslipidemia
Tremor (>10%)
Dyspepsia [C] (5–16%) (4–10%) which includes elevated triglycerides and
Dysphagia [2] Neuromuscular/Skeletal
cholesterol and redistribution of body fat centrally
Nausea [C] (8–16%) (4–9%) [4] Rhabdomyolysis [4]
to produce the so-called ‘protease paunch’,
Pancreatitis [2] Gastrointestinal/Hepatic breast enlargement, facial atrophy, and ‘buffalo
Vomiting [C] (10–25%) Hepatotoxicity [3] hump’. Kaletra is ritonavir and lopinavir. See also
Respiratory Endocrine/Metabolic separate entry for ombitasvir/paritaprevir/
Cough [C] (34%) (3%) Hypokalemia [2] ritonavir.
Dyspnea [C] (2–5%) (2%) Warning: DRUG-DRUG INTERACTIONS
Ocular LEADING TO POTENTIALLY SERIOUS AND/
Pneumonia [2]
Glaucoma [2] OR LIFE THREATENING REACTIONS
Pulmonary embolism [3]
Rhinitis [C] (13–36%) (7–11%) Other
Upper respiratory tract infection [C] (34%) Adverse effects [2] Skin
(2–3%) Acneform eruption (4%)
Endocrine/Metabolic Bullous dermatitis (<2%)
Amenorrhea [6] RITONAVIR Dermatitis (<2%)
Appetite decreased [2] Diaphoresis (<10%)
Appetite increased [C] (49%) [3] Trade names: Kaletra (AbbVie), Norvir (AbbVie) Ecchymoses (<2%)
Diabetes mellitus [2] Indications: HIV infection Eczema (<2%)
Galactorrhea (<10%) [14] Class: Antiretroviral, CYP3A4 inhibitor, HIV-1 Edema (6%)
Gynecomastia (<10%) [6] protease inhibitor Exanthems (<2%) [2]
Hyperprolactinemia [22] Half-life: 35 hours Facial edema (8%)
Metabolic syndrome [5] Clinically important, potentially hazardous Folliculitis (<2%)
Weight gain [C] (5%) [33] interactions with: abiraterone, afatinib, Hypersensitivity (8%)
alfentanil, alfuzosin, alprazolam, amiodarone, Jaundice [3]
Genitourinary
amitriptyline, amprenavir, aprepitant, astemizole, Lipodystrophy [4]
Priapism (<10%) [27]
atazanavir, atorvastatin, atovaquone, atovaquone/ Peripheral edema (6%)
Sexual dysfunction [3]
proguanil, avanafil, azithromycin, bepridil, Photosensitivity (<2%)
Urinary incontinence [C] (5–22%) (2%)
boceprevir, bosentan, brigatinib, buprenorphine, Pruritus (12%)
Urinary tract infection (3%)
bupropion, buspirone, cabazitaxel, cabozantinib, Psoriasis (<2%)
Renal calcifediol, carbamazepine, ceritinib, Rash (27%) [12]
Enuresis [4] chlordiazepoxide, ciclesonide, citalopram, Seborrhea (<2%)
Hematologic clozapine, cobicistat/elvitegravir/emtricitabine/ Toxicity [2]
Neutropenia [2] tenofovir disoproxil, colchicine, conivaptan, Urticaria (8%)
copanlisib, crizotinib, cyclosporine, cyproterone,
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RITONAVIR See all our books at www.crcpress.com
246 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual ROFECOXIB
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ROFLUMILAST Over 100 updates per week on www.drugeruptiondata.com
Mucosal
ROFLUMILAST ROLAPITANT Stomatitis (6–10%)
Trade names: Daliresp (Takeda), Daxas (Takeda) Trade name: Varubi (Tesaro) Cardiovascular
Indications: To reduce the risk of COPD Indications: Delayed nausea and vomiting from Hypotension (7–23%)
exacerbations in patients with severe COPD chemotherapy, in combination with Supraventricular arrhythmias (>2%)
associated with chronic bronchitis and a history of dexamethasone and a 5HT3-receptor antagonist Tachycardia (10%)
exacerbations Class: Antiemetic, Neurokinin 1 receptor Ventricular arrhythmia (>2%)
Class: Anti-inflammatory, Phosphodiesterase antagonist Central Nervous System
inhibitor, Phosphodiesterase type 4 (PDE4) Half-life: ~7 days Anorexia (23–54%) [5]
inhibitor Clinically important, potentially hazardous Chills (11–17%)
Half-life: 17 hours interactions with: thioridazine Dysgeusia (taste perversion) (15–40%)
Clinically important, potentially hazardous Pregnancy category: N/A (No data available) Fever (20–47%)
interactions with: aminophylline, Important contra-indications noted in the Headache (15–34%)
carbamazepine, cimetidine, denileukin, efavirenz, prescribing guidelines for: nursing mothers; Neuromuscular/Skeletal
enoxacin, erythromycin, fingolimod, fluvoxamine, pediatric patients Asthenia (fatigue) (53–77%) [10]
ketoconazole, oral contraceptives, pazopanib,
phenobarbital, phenytoin, rifampin Gastrointestinal/Hepatic
Mucosal Abdominal pain (13–14%)
Pregnancy category: C Stomatitis (4%)
Important contra-indications noted in the Constipation (12–40%)
prescribing guidelines for: nursing mothers; Central Nervous System Diarrhea (20–36%)
pediatric patients Headache [5] Nausea (56–86%) [9]
Note: Contra-indicated in patients with Vertigo (dizziness) (6%) Vomiting (34–52%) [5]
moderate to severe liver impairment (Child-Pugh Neuromuscular/Skeletal Respiratory
B or C class). Asthenia (fatigue) [5] Cough (18–21%)
Gastrointestinal/Hepatic Dyspnea (13–21%)
Cardiovascular Abdominal pain (3%) Endocrine/Metabolic
Cardiotoxicity [2] Constipation [6] ALT increased (3–22%)
Hypertension [3] Dyspepsia (4%) [3] AST increased (3–28%)
Central Nervous System Endocrine/Metabolic Hyperglycemia (2–51%)
Anorexia [2] Appetite decreased (9%) Hypermagnesemia (27%)
Anxiety (<2%) [2] Hyperuricemia (33%)
Genitourinary Hypoalbuminemia (3–48%)
Depression (<2%) Urinary tract infection (4%)
Headache (4%) [21] Hypocalcemia (4–52%)
Insomnia (2%) [6] Hematologic Hypokalemia (6–20%)
Neurotoxicity [3] Anemia (3%) Hypomagnesemia (22–28%)
Suicidal ideation [2] Neutropenia (7–9%) [2] Hyponatremia (<20%)
Tremor (<2%) Other Hypophosphatemia (27%)
Vertigo (dizziness) [3] Hiccups (5%) [3] Weight loss (10–15%)
Neuromuscular/Skeletal Hematologic
Back pain (3%) [4] Anemia (19–72%) [3]
Muscle spasm (<2%) ROMIDEPSIN Leukopenia (4–55%) [2]
Lymphopenia (4–57%) [2]
Gastrointestinal/Hepatic Neutropenia (11–66%) [5]
Abdominal pain (<2%) [2] Trade name: Istodax (Celgene)
Indications: Cutaneous T-cell lymphoma (CTCL) Sepsis (>2%)
Diarrhea (10%) [25] Thrombocytopenia (17–72%) [8]
Dyspepsia (<2%) Class: Histone deacetylase (HDAC) inhibitor
Gastritis (<2%) Half-life: 3 hours Other
Nausea (5%) [24] Clinically important, potentially hazardous Adverse effects [2]
Vomiting (<2%) [2] interactions with: atazanavir, carbamazepine, Infection (46–54%) [2]
clarithromycin, conivaptan, coumadin derivatives,
Respiratory CYP3A4 inhibitors and inducers, darunavir,
Bronchitis [3]
COPD [3]
delavirdine, dexamethasone, efavirenz, indinavir,
itraconazole, ketoconazole, nefazodone,
ROMIPLOSTIM
Dyspnea [3] nelfinavir, oxcarbazepine, phenobarbital,
Influenza (3%) [3] See: www.drugeruptiondata.com/drug/id/1305
phenytoin, rifabutin, rifampin, rifapentine,
Nasopharyngitis [4] ritonavir, saquinavir, St John’s wort, telithromycin,
Pneumonia [3] voriconazole, warfarin
Rhinitis (<2%) Pregnancy category: D ROPINIROLE
Sinusitis (<2%) Important contra-indications noted in the
Upper respiratory tract infection [4] prescribing guidelines for: nursing mothers; Trade name: Requip (GSK)
Endocrine/Metabolic pediatric patients Indications: Parkinsonism
Appetite decreased (2%) [4] Class: Dopamine receptor agonist
Weight loss (8%) [24] Half-life: ~6 hours
Skin Clinically important, potentially hazardous
Genitourinary Dermatitis (4–27%) interactions with: ciprofloxacin, estradiol,
Urinary tract infection (<2%) Edema (>2%) levomepromazine, norfloxacin, risperidone,
Other Exfoliative dermatitis (4–27%) warfarin, zuclopenthixol
Adverse effects [6] Peripheral edema (6–10%)
Pruritus (7–31%)
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Litt’s Drug Eruption & Reaction Manual ROSUVASTATIN
Pregnancy category: C
Important contra-indications noted in the ROPIVACAINE ROSUVASTATIN
prescribing guidelines for: nursing mothers;
pediatric patients See: www.drugeruptiondata.com/drug/id/1771 Trade name: Crestor (AstraZeneca)
Indications: Hypercholesterolemia, mixed
dyslipidemia
Skin
Diaphoresis (3–6%) ROSIGLITAZONE Class: HMG-CoA reductase inhibitor, Statin
Half-life: ~19 hours
Herpes simplex (5%) Clinically important, potentially hazardous
Hyperhidrosis (3%) Trade names: Avandamet (GSK), Avandaryl
(GSK), Avandia (GSK) interactions with: alcohol, amiodarone,
Peripheral edema (2–7%) [2] antacids, atazanavir, ciprofibrate, colchicine,
Rash [2] Indications: Type II diabetes
Class: Antidiabetic, Thiazolidinedione conivaptan, coumarins, cyclosporine, daptomycin,
Mucosal Half-life: 3–4 hours darunavir, dronedarone, elbasvir & grazoprevir,
Xerostomia (5%) Clinically important, potentially hazardous eltrombopag, eluxadoline, erythromycin,
Cardiovascular interactions with: CYP2C8 inhibitors and ethinylestradiol, fenofibrate, fibrates,
Cardiotoxicity [2] inducers, gemfibrozil, grapefruit juice, paclitaxel, fosamprenavir, fusidic acid, gemfibrozil, indinavir,
Chest pain (4%) rifampin, teriflunomide ledipasvir & sofosbuvir, lopinavir, nelfinavir, niacin,
Flushing (3%) Pregnancy category: C niacinamide, phenindione, progestins, protease
Hypotension [2] Important contra-indications noted in the inhibitors, ritonavir, safinamide, saquinavir,
Orthostatic hypotension [4] prescribing guidelines for: nursing mothers sofosbuvir/velpatasvir/voxilaprevir, tipranavir,
Note: Thiazolidinediones, including rosiglitazone, trabectedin, vitamin K antagonists, warfarin
Central Nervous System Pregnancy category: X
Amnesia (3%) cause or exacerbate congestive heart failure in
some patients. Important contra-indications noted in the
Dyskinesia [9] prescribing guidelines for: nursing mothers
Hallucinations (<5%) [7] Contra-indicated in patients with established
Headache (6%) [5] NYHA Class III or IV heart failure. Avandaryl is
Hyperesthesia (4%) rosiglitazone and glimepiride; Avandamet is Skin
Impulse control disorder [3] rosiglitazone and metformin. Peripheral edema (>2%)
Insomnia [2] Warning: CONGESTIVE HEART FAILURE Rash (>2%)
Pain (3–8%) Central Nervous System
Paresthesias (5%) Skin Depression (>2%)
Psychosis [5] Edema (5%) [12] Headache (6%)
Sleep related disorder [2] Peripheral edema [11] Pain (>2%)
Somnolence (drowsiness) (11–40%) [13] Cardiovascular Paresthesias (>2%)
Syncope (<12%) [3] Cardiac failure [13] Vertigo (dizziness) (4%) [3]
Tremor (6%) Congestive heart failure [2] Neuromuscular/Skeletal
Vertigo (dizziness) (6–40%) [16] Myocardial infarction [9] Arthralgia (>2%)
Yawning (3%) Myocardial ischemia [3] Asthenia (fatigue) (3%) [2]
Neuromuscular/Skeletal Central Nervous System Back pain (3%)
Arthralgia (4%) Headache (6%) Myalgia/Myopathy (3%) [18]
Asthenia (fatigue) (8–11%) [4] Stroke [2] Rhabdomyolysis [16]
Back pain [2] Gastrointestinal/Hepatic
Myalgia/Myopathy (3%) Neuromuscular/Skeletal
Arthralgia (5%) Abdominal pain (>2%)
Gastrointestinal/Hepatic Back pain (4%) Constipation (2%)
Abdominal pain (3–7%) [2] Fractures [5] Hepatitis [2]
Constipation [2] Hepatotoxicity [5]
Diarrhea (5%) Gastrointestinal/Hepatic Nausea (3%)
Dyspepsia (4–10%) [3] Hepatotoxicity [9]
Nausea [2] Respiratory
Nausea (40–60%) [18] Cough (>2%)
Vomiting (11%) [3] Respiratory Flu-like syndrome (2%)
Respiratory Dyspnea [2] Rhinitis (2%)
Cough (3%) Nasopharyngitis (6%) Sinusitis (2%)
Dyspnea (3%) Respiratory tract infection (10%)
Endocrine/Metabolic
Flu-like syndrome (3%) Endocrine/Metabolic Creatine phosphokinase increased [2]
Pharyngitis (6–9%) Weight gain [4] Diabetes mellitus [3]
Rhinitis (4%) Genitourinary
Sinusitis (4%) Renal
Bladder disorder [2] Nephrotoxicity [4]
Genitourinary Hematologic Renal failure [3]
Impotence (3%) Anemia [2]
Urinary tract infection (5%) Other
Ocular Adverse effects [8]
Ocular Macular edema [8]
Abnormal vision (6%) Proptosis [2]
Xerophthalmia (2%)
Other
Other Adverse effects [3]
Adverse effects [5] Death [6]
Infection (viral) (11%)
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250 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual SAQUINAVIR
Renal
SACCHARIN Nephrotoxicity [3] SALMETEROL
Renal failure (5%)
Indications: Sugar substitute See: www.drugeruptiondata.com/drug/id/635
Class: Sweetening agent Other
Half-life: N/A Adverse effects [2]
Clinically important, potentially hazardous
interactions with: none known
SALSALATE
Pregnancy category: N/A SAFINAMIDE * Trade name: Mono-Gesic (Schwarz)
Note: Saccharin is a sulfonamide and can be Indications: Arthritis
absorbed systemically. Sulfonamides can produce Trade name: Xadago (Newron) Class: Non-steroidal anti-inflammatory (NSAID),
severe, possibly fatal, reactions such as toxic Indications: Adjunctive treatment to levodopa/ Salicylate
epidermal necrolysis and Stevens-Johnson carbidopa in patients with Parkinson’s disease Half-life: 78 hours
syndrome. experiencing ’off’ episodes Clinically important, potentially hazardous
Class: Monoamine oxidase B inhibitor interactions with: dichlorphenamide,
Skin Half-life: 20–26 hours methotrexate
Dermatitis [3] Clinically important, potentially hazardous Pregnancy category: C
Exanthems [2] interactions with: cyclobenzaprine, Important contra-indications noted in the
Photosensitivity [3] dextromethorphan, dopaminergic antagonists, prescribing guidelines for: nursing mothers;
Pruritus [3] imatinib, irinotecan, isoniazid, lapatinib, linezolid, pediatric patients
Urticaria [5] meperidine, methadone, methylphenidate, Note: NSAIDs may cause an increased risk of
metoclopramide, mitoxantrone, other MAO serious cardiovascular and gastrointestinal
inhibitors, propoxyphene, rosuvastatin, adverse events, which can be fatal. This risk may
serotonergic drugs, St John’s wort, sulfasalazine,
SACUBITRIL/ sympathomimetics, topotecan, tramadol, tricyclic
increase with duration of use.
or tetracyclic antidepressants
VALSARTAN Pregnancy category: C Skin
Important contra-indications noted in the Anaphylactoid reactions/Anaphylaxis
Trade name: Entresto (Novartis) (<10%)
prescribing guidelines for: nursing mothers;
Indications: To reduce risk of cardiovascular Rash (<10%)
pediatric patients
death and hospitalization for heart failure in
chronic heart failure
Class: Angiotensin receptor neprilysin inhibitor Skin
(ARNI) Peripheral edema [2] SAPROPTERIN
Half-life: <12 hours Cardiovascular See: www.drugeruptiondata.com/drug/id/1271
Clinically important, potentially hazardous Hypertension [3]
interactions with: ACE inhibitors, aliskiren, Orthostatic hypotension (2%)
lithium, NSAIDs, potassium-sparing diuretics
Pregnancy category: N/A (Can cause fetal Central Nervous System
Anxiety (2%)
SAQUINAVIR
harm)
Important contra-indications noted in the Dyskinesia (17–21%) [5] Trade name: Invirase (Roche)
prescribing guidelines for: nursing mothers; Fever [3] Indications: Advanced HIV infection
pediatric patients Gait instability (4–6%) [2] Class: Antiretroviral, CYP3A4 inhibitor, HIV-1
Note: Contra-indicated in patients with a history Headache [3] protease inhibitor
of angioedema related to previous therapy with Insomnia (<4%) [2] Half-life: 12 hours
angiotensin-converting enzyme inhibitor or Parkinsonism (exacerbation) [2] Clinically important, potentially hazardous
angiotensin II receptor blocker. See also separate Tremor [2] interactions with: abiraterone, afatinib,
profile for valsartan. Vertigo (dizziness) [2] alprazolam, amitriptyline, amprenavir, astemizole,
Warning: FETAL TOXICITY Neuromuscular/Skeletal atazanavir, atorvastatin, avanafil, brigatinib,
Asthenia (fatigue) [2] cabazitaxel, cabozantinib, calcifediol, clindamycin,
Back pain [3] clozapine, copanlisib, crizotinib, darifenacin,
Skin
Gastrointestinal/Hepatic darunavir, dasatinib, delavirdine,
Angioedema (<2%) [2]
Abdominal pain [2] dihydroergotamine, dronedarone, efavirenz,
Peripheral edema [2]
Constipation [2] elbasvir & grazoprevir, eluxadoline, eplerenone,
Cardiovascular ergot derivatives, everolimus, fentanyl,
Hypotension (18%) [4] Dyspepsia (<2%)
Nausea (3–6%) [2] fesoterodine, flibanserin, fluticasone propionate,
Orthostatic hypotension (2%) itraconazole, ixabepilone, ketoconazole, lapatinib,
Vomiting [2]
Central Nervous System levomepromazine, lomitapide, lopinavir,
Gait instability (2%) Respiratory maraviroc, methysergide, midazolam,
Vertigo (dizziness) (6%) [2] Cough (2%) [2] midostaurin, mifepristone, naldemedine,
Nasopharyngitis [2] nelfinavir, neratinib, olaparib, omeprazole,
Neuromuscular/Skeletal
Endocrine/Metabolic paclitaxel, palbociclib, pantoprazole, pazopanib,
Arthralgia [2]
ALT increased (3–7%) pentamidine, phenytoin, pimozide, ponatinib,
Gastrointestinal/Hepatic AST increased (6–7%) quinine, ribociclib, rifampin, rilpivirine, ritonavir,
Constipation [2] Weight loss [2] rivaroxaban, romidepsin, rosuvastatin, ruxolitinib,
Respiratory sildenafil, simeprevir, simvastatin, solifenacin,
Ocular
Cough (9%) [4] sonidegib, St John’s wort, sunitinib, tadalafil,
Cataract [3]
Nasopharyngitis [2] telithromycin, temsirolimus, ticagrelor, tipranavir,
Vision blurred [2]
tolvaptan, vardenafil, vemurafenib, vorapaxar,
Endocrine/Metabolic voriconazole
Hyperkalemia (12%) [4]
Serum creatinine increased [2]
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Litt’s Drug Eruption & Reaction Manual SERTRALINE
Neuromuscular/Skeletal
Central Nervous System
Dysgeusia (taste perversion) (3%)
SELEGILINE Arthralgia (11%)
Headache (4%) [3] Jaw pain (26%) [5]
Synonyms: deprenyl; L-deprenyl Myalgia/Myopathy (16%)
Gastrointestinal/Hepatic Trade names: Eldepryl (Somerset), Emsam Pain in extremities (17%)
Abdominal pain (2%) (Mylan Specialty), Zelapar (Valeant)
Diarrhea (3%) Indications: Parkinsonism Gastrointestinal/Hepatic
Nausea [3] Class: Antidepressant, Monoamine oxidase B Diarrhea (42%) [3]
inhibitor Nausea (33%) [5]
Genitourinary Vomiting (18%)
Half-life: 9 minutes
Vulvovaginal candidiasis (10%)
Vulvovaginal pruritus (2%)
Clinically important, potentially hazardous Endocrine/Metabolic
interactions with: amitriptyline, carbidopa, Appetite decreased (6%)
citalopram, doxepin, ephedra, ephedrine, Hematologic
escitalopram, fluoxetine, fluvoxamine, levodopa, Anemia (8%)
SECOBARBITAL meperidine, methadone, moclobemide,
naratriptan, nefazodone, oral contraceptives,
See: www.drugeruptiondata.com/drug/id/640 oxcarbazepine, paroxetine hydrochloride,
propoxyphene, sertraline, tramadol, valbenazine, SERMORELIN
venlafaxine
See: www.drugeruptiondata.com/drug/id/961
SECRETIN Pregnancy category: C
Important contra-indications noted in the
See: www.drugeruptiondata.com/drug/id/641 prescribing guidelines for: nursing mothers;
pediatric patients SERTACONAZOLE
Warning: SUICIDALITY IN CHILDREN AND
ADOLESCENTS See: www.drugeruptiondata.com/drug/id/1023
SECUKINUMAB
Trade name: Cosentyx (Novartis) Mucosal
Indications: Plaque psoriasis, psoriatic arthritis, Xerostomia (>10%) [2] SERTINDOLE
ankylosing spondylitis Cardiovascular
Class: Interleukin-17A (IL-17A) antagonist, Hypertension [2] See: www.drugeruptiondata.com/drug/id/2455
Monoclonal antibody
Half-life: 22–31 days
Central Nervous System
Hallucinations [2]
Clinically important, potentially hazardous
interactions with: live vaccines
Headache [2] SERTRALINE
Pregnancy category: B
Serotonin syndrome [2]
Trade name: Zoloft (Pfizer)
Important contra-indications noted in the Gastrointestinal/Hepatic Indications: Depression, panic disorders,
prescribing guidelines for: nursing mothers; Nausea [2] obsessive compulsive disorders
pediatric patients Local Class: Antidepressant, Selective serotonin
Note: Use with caution in patients with Application-site reactions [5] reuptake inhibitor (SSRI)
inflammatory bowel disease. Half-life: 2426 hours
Other
Bruxism (<10%) Clinically important, potentially hazardous
Skin interactions with: amphetamines, astemizole,
Candidiasis [4] clarithromycin, clozapine, darunavir,
Neoplasms [2] dextroamphetamine, diethylpropion, droperidol,
Pruritus [3] SELENIUM efavirenz, erythromycin, isocarboxazid, linezolid,
Psoriasis (exacerbation) [2] MAO inhibitors, mazindol, methamphetamine,
See: www.drugeruptiondata.com/drug/id/915 metoclopramide, phendimetrazine, phenelzine,
Cardiovascular
phentermine, phenylpropanolamine, pimozide,
Hypertension [2]
pseudoephedrine, selegiline, sibutramine, St
Central Nervous System
Headache [13]
SELEXIPAG John’s wort, sumatriptan, sympathomimetics,
tranylcypromine, trazodone, troleandomycin,
Neuromuscular/Skeletal Trade name: Uptravi (Actelion) zolmitriptan
Arthralgia [3] Indications: Pulmonary arterial hypertension Pregnancy category: C
Class: Prostacyclin receptor agonist
Gastrointestinal/Hepatic
Half-life: <3 hours Skin
Diarrhea (3–4%) [4]
Clinically important, potentially hazardous Angioedema [3]
Respiratory interactions with: gemfibrozil, strong CYP2C8 Diaphoresis (8%) [6]
Nasopharyngitis (11–12%) [19] inhibitors Rash (<10%)
Upper respiratory tract infection (3%) [12] Pregnancy category: N/A (No data available) Stevens-Johnson syndrome [2]
Hematologic Important contra-indications noted in the
prescribing guidelines for: nursing mothers Hair
Neutropenia [4]
Alopecia [3]
Local
Skin Mucosal
Injection-site reactions [3]
Rash (11%) Xerostomia (16%) [7]
Other
Cardiovascular Cardiovascular
Adverse effects [5]
Flushing (12%) Chest pain (<10%)
Infection (29%) [12]
Flushing (2%)
Central Nervous System Palpitation (<10%)
Headache (65%) [7] QT prolongation [3]
Torsades de pointes [2]
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254 Litt’s Drug Eruption & Reaction Manual B 2018 by Taylor & Francis Group, LLC
Litt’s Drug Eruption & Reaction Manual SIMVASTATIN
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Litt’s Drug Eruption & Reaction Manual SOFOSBUVIR & VELPATASVIR
Endocrine/Metabolic Hematologic
Creatine phosphokinase increased [2] SODIUM OXYBATE Anemia (6–21%) [32]
Hypoglycemia [10] Lymphopenia [2]
Weight gain [3] See: www.drugeruptiondata.com/drug/id/919 Neutropenia (<17%) [5]
Weight loss [2] Other
Renal Adverse effects [8]
Renal failure [2] SODIUM PICOSULFATE Infection [2]
Other See: www.drugeruptiondata.com/drug/id/2988
Adverse effects [7]
Cancer [3] SOFOSBUVIR &
SODIUM THIOSULFATE VELPATASVIR
SITAXENTAN See: www.drugeruptiondata.com/drug/id/2807 Trade name: Epclusa (Gilead)
Indications: Hepatitis C
See: www.drugeruptiondata.com/drug/id/1222
Class: Direct-acting antiviral, Hepatitis C virus
SOFOSBUVIR NS5A inhibitor (velpatasvir), Hepatitis C virus
nucleotide analog NS5B polymerase inhibitor
SMALLPOX VACCINE Trade name: Sovaldi (Gilead) (sofosbuvir)
Indications: Hepatitis C Half-life: <27 hours (sofosbuvir); 15 hours
Trade name: Dryvax (Wyeth) Class: Direct-acting antiviral, Hepatitis C virus (velpatasvir)
Indications: Prevention of smallpox (variola) nucleotide analog NS5B polymerase inhibitor Clinically important, potentially hazardous
Class: Vaccine Half-life: <27 hours interactions with: amiodarone, carbamazepine,
Half-life: ~5 years Clinically important, potentially hazardous efavirenz, omeprazole, oxcarbazepine,
Clinically important, potentially hazardous interactions with: carbamazepine, phenobarbital, phenytoin, rifabutin, rifampin,
interactions with: corticosteroids oxcarbazepine, phenobarbital, phenytoin, rifapentine, St John’s wort, topotecan
Pregnancy category: C rifabutin, rifampin, rifapentine, ritonavir, St John’s Pregnancy category: N/A (Insufficient evidence
wort, tipranavir to inform drug-associated risk; contra-indicated in
Skin Pregnancy category: N/A (May cause fetal pregnancy when given with ribavirin)
Basal cell carcinoma [4] harm) Important contra-indications noted in the
Bullous dermatitis [2] Important contra-indications noted in the prescribing guidelines for: nursing mothers;
Carcinoma [2] prescribing guidelines for: nursing mothers; pediatric patients
Dermatitis [2] pediatric patients Note: See also separate entry for sofosbuvir.
Eczema vaccinatum [13] Note: Used in combination with daclatasvir,
Erythema multiforme [8] ledipasvir, ribavirin, velpatasvir or with PEG- Skin
Exanthems [7] interferon and ribavirin (see separate entries). Rash (2%)
Folliculitis [2] Central Nervous System
Herpes simplex [2] Skin Headache (22%) [13]
Herpes zoster [2] Pruritus (11–27%) [11] Insomnia (5%) [6]
Melanoma [2] Rash (8–18%) [9]
Photosensitivity [2] Neuromuscular/Skeletal
Purpura [11] Cardiovascular Arthralgia [2]
Rash [3] Bradyarrhythmia [2] Asthenia (fatigue) (5–15%) [13]
Scar [2] Bradycardia [2]
Gastrointestinal/Hepatic
Stevens-Johnson syndrome [3] Central Nervous System Hepatotoxicity (2–6%)
Toxic epidermal necrolysis [5] Chills (2–18%) [2] Nausea (9%) [11]
Tumors [3] Fever (4–18%) [3]
Respiratory
Urticaria [5] Headache (24–44%) [48]
Nasopharyngitis [4]
Vaccinia [25] Insomnia (15–29%) [19]
Vaccinia gangrenosum [3] Irritability (10–16%) [5] Endocrine/Metabolic
Vaccinia necrosum [6] Vertigo (dizziness) [3] Creatine phosphokinase increased (<2%)
Central Nervous System Neuromuscular/Skeletal Hematologic
Headache [2] Arthralgia [2] Anemia [3]
Asthenia (fatigue) (30–59%) [47] Thrombocytopenia [2]
Other
Allergic reactions [2] Back pain [2]
Death [8] Myalgia/Myopathy (6–16%) [4]
Gastrointestinal/Hepatic
Diarrhea (9–17%) [6]
SODIUM IODIDE I-131 Nausea (13–34%) [35]
Vomiting [2]
See: www.drugeruptiondata.com/drug/id/2657 Respiratory
Cough [4]
Flu-like syndrome (3–18%) [3]
SODIUM NITRITE Nasopharyngitis [2]
Upper respiratory tract infection [4]
See: www.drugeruptiondata.com/drug/id/2797 Endocrine/Metabolic
Appetite decreased (6–18%)
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Cardiovascular Endocrine/Metabolic
SOFOSBUVIR/ QT prolongation [3] ALT increased (19%)
Appetite decreased (30%)
VELPATASVIR/ Central Nervous System
AST increased (19%)
Vertigo (dizziness) (2%) [3]
VOXILAPREVIR * Neuromuscular/Skeletal
Creatine phosphokinase increased (61%) [7]
Hyperbilirubinemia [2]
Asthenia (fatigue) (<2%) Hyperglycemia (51%)
Trade name: Vosevi (Gilead)
Indications: Chronic HCV infection Gastrointestinal/Hepatic Weight loss (30%) [3]
Class: Direct-acting antiviral, Hepatitis C virus Abdominal pain (2%) Hematologic
NS3/4A protease inhibitor (voxilaprevir), Constipation [11] Anemia (32%)
Hepatitis C virus NS5A inhibitor (velpatasvir), Ocular Lymphopenia (28%)
Hepatitis C virus nucleotide analog NS5B Vision blurred (45%) [5]
polymerase inhibitor (sofosbuvir) Xerophthalmia (2%)
Half-life: <29 hours (sofosbuvir); 17 hours
(velpatasvir); 33 hours (voxilaprevir)
Other SORAFENIB
Adverse effects [5]
Clinically important, potentially hazardous
Trade name: Nexavar (Bayer)
interactions with: amiodarone, atazanavir,
Indications: Advanced renal cell carcinoma
carbamazepine, cyclosporine, efavirenz, lopinavir,
Class: Antineoplastic, Epidermal growth factor
oxcarbazepine, phenobarbital, phenytoin, SOMATROPIN receptor (EGFR) inhibitor, Tyrosine kinase
pitavastatin, rifabutin, rifampin, rifapentine,
See: www.drugeruptiondata.com/drug/id/1035 inhibitor
ritonavir, rosuvastatin, St John’s wort, tipranavir
Half-life: 2548 hours
Pregnancy category: N/A (Insufficient evidence
Clinically important, potentially hazardous
to inform drug-associated risk)
interactions with: bevacizumab,
Important contra-indications noted in the SONIDEGIB carbamazepine, clozapine, conivaptan, coumarins,
prescribing guidelines for: nursing mothers;
CYP3A4 inducers, darunavir, delavirdine,
pediatric patients Trade name: Odomzo (Novartis) dexamethasone, digoxin, docetaxel, doxorubicin,
Note: See also separate entries for sofosbuvir Indications: Basal cell carcinoma efavirenz, indinavir, irinotecan, neomycin,
and sofosbuvir & velpatasvir. Class: Hedgehog (Hh) signaling pathway inhibitor oxcarbazepine, phenobarbital, phenytoin,
Warning: RISK OF HEPATITIS B VIRUS Half-life: 28 days rifabutin, rifampin, rifapentine, St John’s wort,
REACTIVATION IN PATIENTS COINFECTED Clinically important, potentially hazardous telithromycin, voriconazole, warfarin
WITH HCV AND HBV interactions with: atazanavir, carbamazepine, Pregnancy category: D
diltiazem, efavirenz, fluconazole, itraconazole, Important contra-indications noted in the
Skin ketoconazole, modafinil, nefazodone, prescribing guidelines for: nursing mothers;
Rash (<2%) phenobarbital, phenytoin, posaconazole, rifabutin, pediatric patients
rifampin, saquinavir, St John’s wort, telithromycin, Note: In combination with carboplatin and
Central Nervous System
voriconazole paclitaxel, Nexavar is contra-indicated in patients
Headache (21–23%) [6]
Pregnancy category: N/A (Can cause fetal with squamous cell lung cancer.
Insomnia (3–6%)
harm)
Neuromuscular/Skeletal Important contra-indications noted in the
Asthenia (fatigue) (6–19%) [7] prescribing guidelines for: nursing mothers; Skin
pediatric patients Acneform eruption (<10%) [6]
Gastrointestinal/Hepatic Actinic keratoses [4]
Diarrhea (13–14%) [6] Note: Patients should not donate blood or blood
products while receiving sonidegib and for at least AGEP [2]
Nausea (10–13%) [6] Desquamation (19–40%) [9]
20 months after the last dose.
Endocrine/Metabolic Warning: EMBRYO-FETAL TOXICITY Eczema [2]
Hyperbilirubinemia (4–13%) Edema [3]
Hematologic Erythema (>10%) [4]
Skin Erythema multiforme [11]
Hyperlipasemia (2–3%) Pruritus (10%) Exanthems [3]
Hair Exfoliative dermatitis (<10%)
Alopecia (53%) [6] Facial erythema [3]
SOLIFENACIN Central Nervous System Folliculitis [3]
Anorexia [2] Hand–foot syndrome (21–30%) [113]
Trade name: Vesicare (Astellas) Hyperkeratosis [4]
Indications: Overactive bladder Dysgeusia (taste perversion) (46%) [6]
Hypersensitivity [2]
Class: Antimuscarinic, Muscarinic antagonist Headache (15%)
Keratoacanthoma [4]
Half-life: 4568 hours Pain (14%)
Keratosis pilaris [2]
Clinically important, potentially hazardous Vertigo (dizziness) [2]
Milia [2]
interactions with: atazanavir, carbamazepine, Neuromuscular/Skeletal Nevi [3]
clarithromycin, indinavir, itraconazole, Asthenia (fatigue) (41%) [5] Palmar–plantar toxicity [2]
ketoconazole, nefazodone, nelfinavir, Bone or joint pain (32%) Pigmentation [2]
phenobarbital, phenytoin, rifabutin, rifampin, Muscle spasm (54%) [6] Pruritus (14–19%) [10]
rifapentine, ritonavir, saquinavir, St John’s wort, Myalgia/Myopathy (19%) [5] Psoriasis [2]
troleandomycin, voriconazole Radiation recall dermatitis [3]
Gastrointestinal/Hepatic
Pregnancy category: C Rash (19–40%) [51]
Abdominal pain (18%)
Important contra-indications noted in the Recall reaction [2]
Diarrhea (32%)
prescribing guidelines for: nursing mothers; Seborrheic dermatitis [2]
Hepatotoxicity [2]
pediatric patients Squamous cell carcinoma [8]
Nausea (39%) [4]
Vomiting (11%) [3] Stevens-Johnson syndrome [2]
Mucosal Toxicity [16]
Xerostomia (1127%) [21] Xerosis (10–11%) [6]
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Neuromuscular/Skeletal Mucosal
Asthenia (fatigue) [2] SUCCINYLCHOLINE Xerostomia [2]
Gastrointestinal/Hepatic Synonym: suxamethonium Gastrointestinal/Hepatic
Abdominal pain [2] Trade name: Anectine (Sabex) Constipation (2%)
Nausea [2] Indications: Skeletal muscle relaxation during
Vomiting [2] general anesthesia
Renal Class: Cholinesterase inhibitor, Depolarizing SUCRALOSE
Nephrotoxicity [2] muscle relaxant
Hematologic Half-life: N/A Trade name: Splenda (McNeil)
Neutropenia [2] Clinically important, potentially hazardous Indications: Weight reduction
interactions with: amikacin, aminoglycosides, Class: Sweetening agent
Local donepezil, galantamine, gentamicin, Half-life: 25 hours
Injection-site pain (<10%) hydromorphone, kanamycin, levomepromazine, Clinically important, potentially hazardous
neomycin, neostigmine, paromomycin, interactions with: none known
physostigmine, pipecuronium, pralidoxime, Pregnancy category: N/A
STRONTIUM quinine, streptomycin, tapentadol, thalidomide,
tobramycin, vancomycin, vecuronium Central Nervous System
RANELATE Pregnancy category: C Migraine [3]
Important contra-indications noted in the
See: www.drugeruptiondata.com/drug/id/1386 prescribing guidelines for: the elderly; nursing
mothers
Warning: RISK OF CARDIAC ARREST FROM SUFENTANIL
SUCCIMER HYPERKALEMIC RHABDOMYOLYSIS
See: www.drugeruptiondata.com/drug/id/660
Synonym: DMSA Skin
Trade name: Chemet (Sanofi-Aventis) Anaphylactoid reactions/Anaphylaxis [13]
Indications: Heavy metal poisoning
Mucosal
SUGAMMADEX
Class: Chelator
Sialorrhea (<10%) Trade name: Bridion (Organon)
Half-life: 2 days
Clinically important, potentially hazardous Cardiovascular Indications: Reversal of neuromuscular blockade
interactions with: other chelating agents Bradycardia [2] induced by rocuronium bromide and vecuronium
Pregnancy category: C Central Nervous System bromide in adults undergoing surgery
Important contra-indications noted in the Malignant hyperthermia [7] Class: Cyclodextrin, Selective relaxant binding
prescribing guidelines for: nursing mothers; Paralysis [3] agent
pediatric patients Twitching [4] Half-life: ~2 hours
Clinically important, potentially hazardous
Neuromuscular/Skeletal interactions with: toremifene
Skin Myalgia/Myopathy [11] Pregnancy category: N/A (No data available)
Candidiasis (16%) Rhabdomyolysis [26] Important contra-indications noted in the
Exanthems (11%)
Pruritus (11%)
Endocrine/Metabolic prescribing guidelines for: the elderly; nursing
Hyperkalemia [8] mothers; pediatric patients
Rash (<11%) [2]
Mucosal Other
Death [3] Skin
Mucocutaneous eruption (11%)
Anaphylactoid reactions/Anaphylaxis [8]
Central Nervous System Erythema (<2%)
Chills (16%) Hypersensitivity [7]
Dysgeusia (taste perversion) (metallic) SUCRALFATE Pruritus (2–3%)
(21%)
Trade name: Carafate (Aptalis) Mucosal
Fever (16%)
Indications: Duodenal ulcer Oropharyngeal pain (3–5%)
Headache (16%)
Class: Chelator Xerostomia (<2%) [2]
Pain (3%)
Half-life: N/A Cardiovascular
Paresthesias (13%)
Clinically important, potentially hazardous Bradycardia (<5%)
Neuromuscular/Skeletal interactions with: anagrelide, chlortetracycline, QT prolongation (<6%) [2]
Back pain (16%) ciprofloxacin, clorazepate, demeclocycline, Tachycardia (2–5%)
Gastrointestinal/Hepatic doxycycline, gemifloxacin, ketoconazole,
lansoprazole, levofloxacin, lomefloxacin, Central Nervous System
Abdominal pain (16%)
lymecycline, minocycline, moxifloxacin, Anxiety (<3%)
Respiratory Chills (3–7%)
norfloxacin, ofloxacin, oxtriphylline,
Flu-like syndrome (16%) Depression (<2%)
oxytetracycline, paricalcitol, phenytoin,
sparfloxacin, tetracycline, tigecycline, Dysgeusia (taste perversion) [3]
voriconazole Fever (5–9%)
Pregnancy category: B Headache (5–10%) [2]
Important contra-indications noted in the Hypoesthesia (<3%)
prescribing guidelines for: the elderly; nursing Insomnia (2–5%)
mothers; pediatric patients Pain (36–52%)
Note: Sucralfate use can lead to symptoms of Restlessness (<2%)
aluminum toxicity. Somnolence (drowsiness) [2]
Vertigo (dizziness) (3–6%)
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Litt’s Drug Eruption & Reaction Manual TARTRAZINE
Tumors [3]
Vasculitis [5] TAMSULOSIN TAPENTADOL
Xerosis (7%)
Trade names: Flomax (Boehringer Ingelheim), Trade names: Nucynta (Janssen), Nucynta ER
Hair Jalyn (GSK) (Janssen), Palexia (Grunenthal)
Alopecia [7] Indications: Benign prostatic hypertrophy Indications: Immediate release formulation:
Hirsutism [2] Class: Adrenergic alpha-receptor antagonist moderate to severe acute pain, extended release
Mucosal Half-life: 913 hours formulation: moderate to severe chronic pain and
Stomatitis [2] Clinically important, potentially hazardous neuropathic pain associated with diabetic
Xerostomia (7%) [2] interactions with: alpha adrenergic blockers, peripheral neuropathy when a continuous
Cardiovascular cimetidine, conivaptan, darunavir, delavirdine, analgesic is needed for an extended period of
Flushing (>10%) [9] erythromycin, indinavir, ketoconazole, paroxetine time
Myocardial ischemia [2] hydrochloride, phosphodiesterase 5 inhibitors, Class: Analgesic, opioid
QT prolongation [3] tadalafil, telithromycin, terbinafine, vardenafil, Half-life: 5 hours
Thromboembolism [6] voriconazole, warfarin Clinically important, potentially hazardous
Thrombophlebitis [3] Pregnancy category: B (not indicated for use in interactions with: alcohol, alvimopan,
Venous thromboembolism [6] women; Jalyn is pregnancy category X) amphetamines, anesthestics, anitemetics,
Important contra-indications noted in the anticholinergics, buprenorphine, butorphanol,
Central Nervous System prescribing guidelines for: nursing mothers; CNS depressants, desmopressin, droperidol,
Depression [5] pediatric patients hypnotics, linezolid, MAO inhibitors, mirtazapine,
Headache [3] Note: Jalyn is tamsulosin and dutasteride. nalbuphine, PEG-interferon, pegvisomant,
Insomnia [4] pentazocine, phenothiazines, sedatives,
Mood changes [3] sibutramine, SNRIs, SSRIs, St John’s wort,
Parkinsonism [2] Mucosal
Xerostomia [4] succinylcholine, thiazide diuretics, tramadol,
Stroke [4] tranquilizers, trazodone, tricyclic antidepressants,
Vertigo (dizziness) [3] Cardiovascular triptans
Neuromuscular/Skeletal Chest pain (4%) Pregnancy category: C
Asthenia (fatigue) [5] Hypotension (6–19%) [3] Important contra-indications noted in the
Bone or joint pain [3] Postural hypotension [3] prescribing guidelines for: the elderly; nursing
Fractures [2] Central Nervous System mothers; pediatric patients
Leg cramps [2] Headache (19–21%) [6] Note: Contra-indicated in patients with impaired
Myalgia/Myopathy [4] Insomnia (<2%) pulmonary function or paralytic ileus. Should not
Gastrointestinal/Hepatic Somnolence (drowsiness) (3–4%) be used in patients currently using or within 14
Hepatic steatosis [2] Vertigo (dizziness) (15–17%) [16] days of using a monoamine oxidase inhibitor.
Hepatotoxicity [10] Neuromuscular/Skeletal Warning: For extended release oral tablets:
Nausea [4] Asthenia (fatigue) (8–9%) [2] ABUSE POTENTIAL, LIFE-THREATENING
Pancreatitis [4] Back pain (7–8%) RESPIRATORY DEPRESSION, ACCIDENTAL
Vomiting [3] EXPOSURE, and INTERACTION WITH
Gastrointestinal/Hepatic ALCOHOL
Respiratory Constipation [2]
Pulmonary embolism [7] Diarrhea (4–6%)
Nausea (3–4%) Mucosal
Endocrine/Metabolic Xerostomia [4]
ALP increased [2] Respiratory
Amenorrhea [8] Cough (3–5%) Central Nervous System
Galactorrhea (<10%) Pharyngitis (5–6%) Headache [4]
Hypercholesterolemia [2] Rhinitis (13–18%) [2] Neurotoxicity [2]
Hypertriglyceridemia [7] Sinusitis (2–4%) Somnolence (drowsiness) [8]
Libido decreased [4] Vertigo (dizziness) (4%) [9]
Endocrine/Metabolic
Weight gain [4] Libido decreased (<2%) Neuromuscular/Skeletal
Genitourinary Asthenia (fatigue) [3]
Genitourinary
Dyspareunia [4] Ejaculatory dysfunction (8–18%) [9] Gastrointestinal/Hepatic
Endometrial cancer [5] Erectile dysfunction [2] Constipation [15]
Ovarian hyperstimulation syndrome [2] Priapism [4] Diarrhea [2]
Sexual dysfunction [2] Urinary retention [3] Gastrointestinal disorder [2]
Vaginal bleeding [4] Nausea (4%) [21]
Vaginal discharge [5] Ocular Vomiting (3%) [14]
Vaginal dryness [5] Floppy iris syndrome [34]
Vision blurred (<2%) Other
Hematologic Adverse effects [4]
Hemolytic uremic syndrome [2] Other
Thrombosis [9] Adverse effects [3]
Infection (9–11%)
Ocular Tooth disorder (<2%) TARTRAZINE
Cataract [9]
Keratopathy [4] Class: Food additive
Macular edema [2] Half-life: N/A
Maculopathy [5] Clinically important, potentially hazardous
Ocular adverse effects [5] interactions with: none known
Ocular toxicity [5] Note: Tartrazine intolerance has been estimated
Retinopathy [5] to affect between 0.01% and 0.1% of the
Vision impaired [3] population. Adverse reactions are most common
in people who are sensitive to aspirin.
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Litt’s Drug Eruption & Reaction Manual TENOFOVIR ALAFENAMIDE
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Hepatotoxicity [3]
TENOFOVIR Nausea (8%) [10] TERBINAFINE
Pancreatitis [5]
DISOPROXIL Vomiting (4–5%) [5] Trade name: Lamisil (Novartis)
Indications: Fungal infections of the skin and nails
Trade names: Atripla (Gilead), Complera Respiratory Class: Antifungal
(Gilead), Truvada (Gilead), Viread (Gilead) Nasopharyngitis [3] Half-life: ~36 hours
Indications: HIV infection in combination with at Pneumonia (2–5%) Clinically important, potentially hazardous
least two other antiretroviral agents Upper respiratory tract infection [2] interactions with: amitriptyline, amphotericin B,
Class: Antiretroviral, Nucleoside analog reverse Endocrine/Metabolic atomoxetine, caffeine, carbamazepine,
transcriptase inhibitor Acidosis [3] cimetidine, codeine, conivaptan, cyclosporine,
Half-life: 12–18 hours ALT increased [3] CYP2D6 substrates, desipramine, estrogens,
Clinically important, potentially hazardous Creatine phosphokinase increased [3] fesoterodine, fluconazole, nebivolol,
interactions with: acyclovir, adefovir, atazanavir, Hypokalemia [2] progestogens, rifampin, rifapentine, saxagliptin,
cidofovir, cobicistat/elvitegravir/emtricitabine/ Hypophosphatemia [3] tamoxifen, tamsulosin, tetrabenazine,
tenofovir disoproxil, darunavir, didanosine, Weight loss (2%) thioridazine, tramadol, tricyclic antidepressants
ganciclovir, high-fat foods, indinavir, ledipasvir & Pregnancy category: B
Renal
sofosbuvir, lopinavir, protease inhibitors, ritonavir, Important contra-indications noted in the
Fanconi syndrome [25]
telaprevir, tipranavir, trospium, valacyclovir, prescribing guidelines for: nursing mothers;
Nephrotoxicity [41]
valganciclovir pediatric patients
Proteinuria [4]
Pregnancy category: B
Renal failure [10]
Important contra-indications noted in the
prescribing guidelines for: nursing mothers;
Renal tubular necrosis [2] Skin
pediatric patients Other AGEP [24]
Note: Atripla is tenofovir disoproxil, efavirenz Adverse effects [11] Baboon syndrome (SDRIFE) [2]
and emtricitabine; Complera is tenofovir
Dermatitis (<10%)
disoproxil, emtricitabine and rilpivirine; Truvada is
Eczema [2]
Erythema multiforme [9]
tenofovir disoproxil and emtricitabine. See also
separate profile for tenofovir disoproxil in
TENOXICAM Erythroderma [2]
combination with cobicistat, elvitegravir and
Exanthems [5]
See: www.drugeruptiondata.com/drug/id/1346 Fixed eruption [3]
emtricitabine.
Warning: LACTIC ACIDOSIS/SEVERE
Hypersensitivity [3]
HEPATOMEGALY WITH STEATOSIS and POST
Lichenoid eruption [2]
TREATMENT EXACERBATION OF HEPATITIS TERAZOSIN Lupus erythematosus [30]
Pityriasis rosea [2]
Trade name: Hytrin (AbbVie) Pruritus (3%) [6]
Skin Indications: Hypertension, benign prostatic Psoriasis [14]
Diaphoresis (3%) hypertrophy Pustules [3]
Lichenoid eruption [2] Class: Adrenergic alpha-receptor antagonist Rash (6%) [3]
Rash (5–18%) [4] Half-life: 12 hours Stevens-Johnson syndrome [2]
Stevens-Johnson syndrome [2] Clinically important, potentially hazardous Toxic epidermal necrolysis [3]
Cardiovascular interactions with: vardenafil Urticaria [7]
Chest pain (3%) Pregnancy category: C Hair
Central Nervous System Alopecia (<10%)
Abnormal dreams [3] Skin Nails
Anorexia (3%) Edema (<10%) Onychocryptosis [2]
Anxiety (6%) [2] Lichenoid eruption [2]
Depression (4–11%) Peripheral edema (6%) Central Nervous System
Fever (2–8%) Ageusia (taste loss) [17]
Mucosal Dysgeusia (taste perversion) (3%) [8]
Headache (5–14%) [10] Xerostomia (<10%)
Insomnia (3–5%) [2] Headache (13%)
Neurotoxicity (3%) [6]
Cardiovascular Gastrointestinal/Hepatic
Pain (7–13%) Postural hypotension [2] Abdominal pain (2%)
Peripheral neuropathy (<3%) Central Nervous System Diarrhea (6%)
Somnolence (drowsiness) [2] Paresthesias (3%) Dyspepsia (4%)
Vertigo (dizziness) (<3%) [4] Vertigo (dizziness) [3] Flatulence (2%)
Neuromuscular/Skeletal Genitourinary Hepatotoxicity [11]
Arthralgia (5%) Priapism [2] Nausea (3%)
Asthenia (fatigue) (6–7%) [6] Ocular Other
Back pain (3–9%) Floppy iris syndrome [2] Adverse effects [3]
Bone or joint pain [4] Allergic reactions (<10%)
Fractures [2] Side effects (3%)
Myalgia/Myopathy (3%) [2]
Osteomalacia [5]
Gastrointestinal/Hepatic
Abdominal pain (4–7%) [2]
Diarrhea (11%) [7]
Dyspepsia (3–4%)
Flatulence (3%)
Hepatic failure [2]
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Litt’s Drug Eruption & Reaction Manual TERIPARATIDE
Skin
TERBUTALINE Acneform eruption (<3%) TERIPARATIDE
Burning (2–3%)
Trade names: Brethine (aaiPharma), Bricanyl Herpes (oral) (2–4%) Trade name: Forteo (Lilly)
(AstraZeneca) Pruritus (3–4%) Indications: Osteoporosis in postmenopausal
Indications: Bronchospasm women and men at increased risk of fractures
Class: Beta-2 adrenergic agonist, Bronchodilator, Hair Class: Parathyroid hormone analog
Tocolytic Alopecia (10–13%) [14] Half-life: 1 hour
Half-life: 1116 hours Cardiovascular Clinically important, potentially hazardous
Clinically important, potentially hazardous Hypertension (4%) [3] interactions with: alcohol, digoxin
interactions with: alpha blockers, atomoxetine, Palpitation (2–3%) Pregnancy category: C
beta blockers, betahistine, cannabinoids, Central Nervous System Important contra-indications noted in the
epinephrine, insulin aspart, insulin degludec, Anxiety (3–4%) prescribing guidelines for: nursing mothers;
insulin detemir, insulin glargine, insulin glulisine, Carpal tunnel syndrome (<3%) pediatric patients
iobenguane, loop diuretics, MAO inhibitors, Headache (19–22%) [4] Warning: POTENTIAL RISK OF
propranolol, sotalol, sympathomimetics, tricyclic Paresthesias (9–10%) [3] OSTEOSARCOMA
antidepressants, yohimbine Peripheral neuropathy (<2%) [2]
Pregnancy category: C Skin
Important contra-indications noted in the Neuromuscular/Skeletal
Asthenia (fatigue) [2] Diaphoresis (2%)
prescribing guidelines for: nursing mothers; Herpes zoster (3%)
pediatric patients Back pain (<3%) [2]
Bone or joint pain (4–5%) Rash (5%)
Warning: PROLONGED TOCOLYSIS
Myalgia/Myopathy (3–4%) Cardiovascular
Gastrointestinal/Hepatic Angina (3%)
Skin Hypertension (7%)
Diaphoresis (<10%) Abdominal distension (<2%)
Abdominal pain (5–6%) Central Nervous System
Mucosal Diarrhea (15–18%) [11] Anxiety (4%)
Xerostomia (<10%) Gastroenteritis (2–4%) Depression (4%)
Cardiovascular Hepatotoxicity [4] Dysgeusia (taste perversion) (<2%)
Arrhythmias [2] Nausea (9–14%) [9] Headache (8%) [8]
Central Nervous System Respiratory Insomnia (4–5%)
Dysgeusia (taste perversion) (<10%) Bronchitis (5–8%) Pain (21%)
Tremor [2] Influenza (9–12%) [2] Paresthesias (<2%)
Nasopharyngitis [2] Syncope (3%)
Gastrointestinal/Hepatic Vertigo (dizziness) (4–8%) [7]
Nausea [2] Sinusitis (4–6%)
Upper respiratory tract infection (9%) Neuromuscular/Skeletal
Other Arthralgia (10%) [3]
Side effects [2] Endocrine/Metabolic
ALT increased (12–14%) [11] Asthenia (fatigue) (9%)
AST increased (2–3%) Bone tumor [2]
GGT increased (3–5%) Leg cramps (3%) [4]
TERCONAZOLE Hypophosphatemia (mild) (18%) Myalgia/Myopathy [2]
Weight loss (2–3%) Neck pain (3%)
See: www.drugeruptiondata.com/drug/id/679 Pain in extremities [3]
Genitourinary
Cystitis (2–4%) Gastrointestinal/Hepatic
Constipation (5%)
TERFENADINE Renal
Renal failure [2]
Diarrhea (5%)
Dyspepsia (5%)
See: www.drugeruptiondata.com/drug/id/680 Hematologic Gastritis (2–7%)
Immunosupression (10–15%) Nausea (9–14%) [8]
Leukopenia (<2%) [2] Vomiting (3%)
TERIFLUNOMIDE Lymphopenia [2]
Neutropenia (2–4%) [4]
Respiratory
Cough (6%)
Trade name: Aubagio (Sanofi-Aventis) Ocular Dyspnea (4–6%)
Indications: Relapsing forms of multiple sclerosis Conjunctivitis (<3%) Pharyngitis (6%)
Class: Pyrimidine synthesis inhibitor Vision blurred (3%) Pneumonia (4–6%)
Half-life: N/A
Other Rhinitis (10%)
Clinically important, potentially hazardous Endocrine/Metabolic
Adverse effects [4]
interactions with: alosetron, caffeine, Hypercalcemia [6]
Allergic reactions (2–3%)
duloxetine, ethinylestradiol, leflunomide, live
Infection [5] Local
vaccines, oral contraceptives, paclitaxel,
Side effects [2] Injection-site pain (<2%)
pioglitazone, repaglinide, rosiglitazone,
Toothache (4%)
theophylline, tizanidine, warfarin Other
Pregnancy category: X Adverse effects [4]
Important contra-indications noted in the Tooth disorder (2%)
prescribing guidelines for: the elderly; nursing
mothers; pediatric patients
Warning: HEPATOTOXICITY and RISK OF
TERATOGENICITY
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Litt’s Drug Eruption & Reaction Manual THIOGUANINE
Genitourinary Mucosal
Vaginitis [3] Oral candidiasis (4–11%) THALLIUM
Other Xerostomia (8%) [9]
Indications: For diagnostic use in myocardial
Adverse effects [4] Cardiovascular perfusion imaging
Tooth pigmentation (commonly in under 8- Bradycardia [5] Class: Radioactive element
year-olds) (>10%) [12] Cardiotoxicity [2] Half-life: 73.1 hours
Hypotension (16%) Clinically important, potentially hazardous
Thromboembolism [2] interactions with: none known
TETRAZEPAM Venous thromboembolism [5] Pregnancy category: C
Central Nervous System
See: www.drugeruptiondata.com/drug/id/2015 Agitation (9–26%) Hair
Fever (19–23%) [2] Alopecia [11]
Hyperesthesia [2]
Nails
THALIDOMIDE Insomnia (9%)
Neurotoxicity (22%) [24] Leukonychia (Mees’ lines) [2]
Trade name: Thalomid (Celgene) Paresthesias (6–16%) [8] Cardiovascular
Indications: Graft-versus-host reactions, Parkinsonism [2] Tachycardia [3]
recalcitrant aphthous stomatitis Peripheral neuropathy [26] Central Nervous System
Class: Immunosuppressant, TNF modulator Somnolence (drowsiness) (36%) [13] Encephalopathy [5]
Half-life: 5–7 hours Tremor (4–26%) [6] Peripheral neuropathy [5]
Clinically important, potentially hazardous Vertigo (dizziness) (4–20%) [16]
Gastrointestinal/Hepatic
interactions with: alcohol, amiodarone, Neuromuscular/Skeletal Abdominal pain [5]
antihistamines, antipsychotics, bortezomib, Arthralgia (13%)
calcium channel blockers, carbamazepine, Asthenia (fatigue) (79%) [16] Other
cimetidine, cisplatin, CNS depressants, digoxin, Myalgia/Myopathy (7%) Death [2]
disulfiram, docetaxel, famotidine, griseofulvin, Gastrointestinal/Hepatic
lithium, metronidazole, modafinil, opioids, Abdominal pain (3%)
paclitaxel, penicillins, phenytoin, rifabutin, Constipation [13] THIABENDAZOLE
rifampin, St John’s wort, succinylcholine, Diarrhea (4–19%)
vincristine Flatulence (8%) Synonym: tiabendazole
Pregnancy category: X Hepatotoxicity [4] Indications: Various infections caused by
Important contra-indications noted in the Pancreatitis [2] susceptible helminths
prescribing guidelines for: nursing mothers; Class: Anthelmintic, Antibiotic, imidazole
pediatric patients Respiratory Half-life: 1.2 hours
Note: Thalidomide is a potent teratogen, an Dyspnea (42%) Clinically important, potentially hazardous
agent that causes congenital malformations and Pharyngitis (4–8%) interactions with: none known
developmental abnormalities if introduced during Pneumonia [2] Pregnancy category: C
gestation. Some of these teratogenic side effects Rhinitis (4%)
of thalidomide include fetal limb growth Sinusitis (3–8%)
Skin
retardation (arms, legs, hands, feet), ingrown Endocrine/Metabolic Dermatitis [3]
genitalia, absence of lung, partial/total loss of Amenorrhea [6] Erythema multiforme [3]
hearing or sight, malformed digestive tract, heart, Gynecomastia [2] Exanthems (>5%) [4]
kidney, and stillborn infant. Weight gain (22%) Fixed eruption [2]
Warning: FETAL RISK AND VENOUS Weight loss (23%) Rash (<10%)
THROMBOEMBOLIC EVENTS
Genitourinary Sjögren’s syndrome [3]
Erectile dysfunction [2] Stevens-Johnson syndrome (<10%)
Skin Impotence (38%) Toxic epidermal necrolysis [2]
Bullous dermatitis (5%) Leukorrhea (17–35%) Urticaria (<5%)
Dermatitis [2] Hematologic Central Nervous System
Diaphoresis (13%) Anemia (6–13%) [4] Vertigo (dizziness) [3]
Edema (57%) [11] Neutropenia (31%) [9]
Erythema [2] Gastrointestinal/Hepatic
Thrombocytopenia [6] Abdominal pain [2]
Erythema nodosum [2] Thrombosis [13]
Erythroderma [2] Nausea [2]
Exanthems [2] Other
Exfoliative dermatitis [4] Adverse effects [8]
Facial erythema (<5%) [2] Death [2] THIAMINE
Hypersensitivity [3] Infection (6–8%) [6]
Peripheral edema (3–8%) [4] Teratogenicity [6] See: www.drugeruptiondata.com/drug/id/686
Pruritus (3–8%) [3] Toothache (4%)
Psoriasis [2]
Purpura [2]
Rash (1150%) [24]
THIMEROSAL
Stevens-Johnson syndrome [2]
See: www.drugeruptiondata.com/drug/id/848
Toxic epidermal necrolysis [4]
Urticaria (3%) [2]
Vasculitis [2]
Xerosis (21%) [5] THIOGUANINE
See: www.drugeruptiondata.com/drug/id/687
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Litt’s Drug Eruption & Reaction Manual TOLTERODINE
Cardiovascular Other
Cardiotoxicity [3] TOFACITINIB Adverse effects [8]
Hypertension (6%) [3] Infection (20–22%) [11]
Trade name: Xeljanz (Pfizer)
Central Nervous System Indications: Rheumatoid arthritis
Headache (7%) [7] Class: Janus kinase (JAK) inhibitor
Neurotoxicity [2] Half-life: ~3 hours TOLAZAMIDE
Vertigo (dizziness) (3%) Clinically important, potentially hazardous
Neuromuscular/Skeletal interactions with: azathioprine, biologic See: www.drugeruptiondata.com/drug/id/701
Arthralgia [4] disease-modifying antirheumatics, cyclosporine,
Fractures [2] CYP3A4 inhibitors, fluconazole, ketoconazole,
Gastrointestinal/Hepatic live vaccines, potent immunosuppressives, TOLAZOLINE
Abdominal pain (2%) rifampin, strong CYP inducers, strong CYP2C19
Diarrhea [2] inhibitors, tacrolimus See: www.drugeruptiondata.com/drug/id/702
Gastroenteritis [6] Pregnancy category: C
Gastrointestinal bleeding [3] Important contra-indications noted in the
Gastrointestinal perforation [8] prescribing guidelines for: the elderly; nursing
mothers; pediatric patients
TOLBUTAMIDE
Gastrointestinal ulceration (<2%)
Hepatotoxicity [15] Warning: SERIOUS INFECTIONS AND See: www.drugeruptiondata.com/drug/id/703
Nausea [3] MALIGNANCY
Pancreatitis [2]
Respiratory Skin TOLCAPONE
Bronchitis (3%) [6] Erythema (<2%)
Cough (<2%) Herpes zoster [5] See: www.drugeruptiondata.com/drug/id/704
Dyspnea (<2%) Peripheral edema (<2%)
Influenza [3] Pruritus (<2%)
Rash (<2%) [3]
Nasopharyngitis (7%) [7]
Pharyngitis [3] Mucosal
TOLMETIN
Pneumonia [12] Nasal congestion (<2%) See: www.drugeruptiondata.com/drug/id/705
Pneumothorax [2] Cardiovascular
Pulmonary toxicity [5] Hypertension (2%)
Upper respiratory tract infection (7%) [10]
Endocrine/Metabolic
Central Nervous System TOLTERODINE
Fever (<2%)
ALT increased (6%) [10] Headache (3–4%) [10] Trade name: Detrol (Pharmacia & Upjohn)
AST increased [4] Insomnia (<2%) Indications: Urinary incontinence
Hypercholesterolemia [4] Paresthesias (<2%) Class: Muscarinic antagonist
Hyperlipidemia [5] Half-life: 24 hours
Hypertriglyceridemia [2] Neuromuscular/Skeletal
Arthralgia (<2%) Clinically important, potentially hazardous
Hypothyroidism (<2%) interactions with: itraconazole, ketoconazole,
Weight gain (<2%) Bone or joint pain (<2%)
Tendinitis (<2%) lopinavir, nelfinavir, sotalol, voriconazole, warfarin
Genitourinary Pregnancy category: C
Urinary tract infection [3] Gastrointestinal/Hepatic Important contra-indications noted in the
Abdominal pain (<2%) [2] prescribing guidelines for: nursing mothers;
Renal Diarrhea (3–4%) [8] pediatric patients
Nephrolithiasis (<2%) Dyspepsia (<2%) [2]
Pyelonephritis [3] Gastritis (<2%)
Hematologic Nausea (<2%) [3] Skin
Vomiting (<2%) Erythema (2%)
Hemotoxicity [2]
Rash (2%)
Leukopenia (<2%) [5] Respiratory
Lymphopenia [2] Bronchitis [3] Mucosal
Neutropenia [19] Cough (<2%) Xerostomia (35%) [38]
Sepsis [2] Dyspnea (<2%) Cardiovascular
Ocular Influenza [2] Chest pain (2%)
Conjunctivitis (<2%) Nasopharyngitis (3–4%) [8] Central Nervous System
Local Tuberculosis [3] Headache (7%) [4]
Infusion-related reactions [3] Upper respiratory tract infection (4–5%) [8] Somnolence (drowsiness) (3%)
Infusion-site reactions [2] Endocrine/Metabolic Vertigo (dizziness) (5%) [4]
Other ALT increased [2] Neuromuscular/Skeletal
Adverse effects [11] AST increased [2] Arthralgia (2%)
Death [5] Creatine phosphokinase increased [2] Asthenia (fatigue) (4%)
Infection [39] Dehydration (<2%)
Gastrointestinal/Hepatic
Genitourinary Abdominal pain (5%) [2]
Urinary tract infection (2%) [5] Constipation (7%) [13]
Hematologic Diarrhea (4%)
Anemia (<2%) Dyspepsia (4%)
Neutropenia [3] Respiratory
Flu-like syndrome (3%)
Upper respiratory tract infection (6%)
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Litt’s Drug Eruption & Reaction Manual TRAMETINIB
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Litt’s Drug Eruption & Reaction Manual TREPROSTINIL
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Litt’s Drug Eruption & Reaction Manual TYPHOID VACCINE
Endocrine/Metabolic Skin
Appetite decreased (39%) DRESS syndrome [2] TRIPELENNAMINE
Genitourinary Fixed eruption [6]
Pruritus (<10%) See: www.drugeruptiondata.com/drug/id/728
Urinary tract infection (4%)
Rash (37%)
Hematologic Stevens-Johnson syndrome [5]
Anemia (77%) [7]
Febrile neutropenia [3]
Toxic epidermal necrolysis [3] TRIPROLIDINE
Granulocytopenia [3] Central Nervous System
Aseptic meningitis [3] See: www.drugeruptiondata.com/drug/id/729
Leukopenia [7]
Neutropenia (67%) [9] Neuromuscular/Skeletal
Thrombocytopenia (42%) [3] Rhabdomyolysis [3]
Other Gastrointestinal/Hepatic
TRIPTORELIN
Infection (27%) Hepatotoxicity [2] See: www.drugeruptiondata.com/drug/id/814
Endocrine/Metabolic
Hyperkalemia [3]
TRIHEXYPHENIDYL Hyponatremia [2] TROGLITAZONE
Hematologic
See: www.drugeruptiondata.com/drug/id/720 Anemia [2] See: www.drugeruptiondata.com/drug/id/1861
Thrombocytopenia [2]
TRIMEPRAZINE TROLEANDOMYCIN
See: www.drugeruptiondata.com/drug/id/721
TRIMETREXATE
See: www.drugeruptiondata.com/drug/id/731
See: www.drugeruptiondata.com/drug/id/725
TRIMETHADIONE TROSPIUM
See: www.drugeruptiondata.com/drug/id/722
TRIMIPRAMINE
See: www.drugeruptiondata.com/drug/id/1173
Trade name: Surmontil (Odyssey)
Indications: Major depression
TRIMETHOBENZAMIDE Class: Antidepressant, tricyclic TROVAFLOXACIN
Half-life: 2026 hours
See: www.drugeruptiondata.com/drug/id/723 Clinically important, potentially hazardous See: www.drugeruptiondata.com/drug/id/732
interactions with: amprenavir, arbutamine,
bupropion, clonidine, epinephrine, formoterol,
TRIMETHOPRIM guanethidine, isocarboxazid, linezolid, MAO
inhibitors, phenelzine, quinolones, sparfloxacin, TRYPTOPHAN
Trade names: Bactrim (Women First), Septra tranylcypromine, venlafaxine
Pregnancy category: C See: www.drugeruptiondata.com/drug/id/798
(Monarch)
Indications: Various urinary tract infections Important contra-indications noted in the
caused by susceptible organisms, acute otitis prescribing guidelines for: pediatric patients
media in children, acute and chronic bronchitis Warning: SUICIDALITY AND TYPHOID VACCINE
Class: Antibiotic ANTIDEPRESSANT DRUGS
Half-life: 810 hours Trade names: Typherix (GSK), Typhim Vi (Sanofi
Clinically important, potentially hazardous Skin Pasteur), Vivotif (Berna Biotech)
interactions with: ACE inhibitors, amantadine, Indications: Immunization against typhoid fever
Diaphoresis (<10%)
angiotensin II receptor antagonists, antidiabetics, Class: Vaccine
Mucosal Half-life: N/A
azathioprine, benazepril, captopril, carvedilol, Xerostomia (>10%) [2]
cilazapril, conivaptan, coumarins, cyclosporine, Clinically important, potentially hazardous
CYP2C8 substrates, CYP2C9 inhibitors, CYP3A4 Cardiovascular interactions with: alcohol, antibiotics,
inducers, dapsone, deferasirox, digoxin, QT prolongation [2] antimalarials, atovaquone/proguanil, azathioprine,
dofetilide, enalapril, eplerenone, fosinopril, belimumab, cefixime, ceftaroline fosamil,
Central Nervous System
irbesartan, lamivudine, leucovorin, ceftobiprole, chloroquine, ciprofloxacin,
Dysgeusia (taste perversion) (>10%)
levoleucovorin, lisinopril, memantine, corticosteroids, daptomycin, fingolimod,
Parkinsonism (<10%)
mercaptopurine, metformin, methotrexate, gemifloxacin, hydroxychloroquine,
Seizures [4]
olmesartan, oral typhoid vaccine, PEG-interferon, immunosuppressants, interferon gamma,
phenytoin, pioglitazone, pralatrexate, leflunomide, mefloquine, mercaptopurine,
procainamide, pyrimethamine, quinapril, ramipril, sulfonamides, telavancin, tigecycline, tinidazole,
repaglinide, rifampin, sulfonylureas, trandolapril
TRIOXSALEN tocilizumab, ustekinumab
Pregnancy category: C Pregnancy category: C
See: www.drugeruptiondata.com/drug/id/727 Important contra-indications noted in the
Important contra-indications noted in the
prescribing guidelines for: nursing mothers prescribing guidelines for: nursing mothers;
Note: Although trimethoprim has been known to pediatric patients
elicit occasional adverse reactions by itself, it is Note: Vivotif is a live oral vaccine.
most commonly used in conjunction with
sulfamethoxazole (co-trimoxazole - see separate Skin
entry). Anaphylactoid reactions/Anaphylaxis [2]
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Litt’s Drug Eruption & Reaction Manual USTEKINUMAB
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Litt’s Drug Eruption & Reaction Manual VANDETANIB
Vomiting [2] Warning: FETAL TOXICITY Red man syndrome (<14%) [50]
Respiratory Red neck syndrome [2]
Pleural effusion [3] Skin Stevens-Johnson syndrome [10]
Pneumonitis [2] Angioedema (>2%) [9] Toxic epidermal necrolysis [10]
Edema [5] Urticaria [8]
Endocrine/Metabolic Vasculitis [2]
Acute intermittent porphyria [2] Peripheral edema [3]
Appetite increased [2] Photosensitivity [2] Cardiovascular
Hyperammonemia [13] Pruritus (>2%) Cardiac arrest [2]
Hyponatremia [2] Pseudolymphoma [2] Extravasation [2]
Metabolic syndrome [3] Rash (>2%) Flushing (<10%)
Porphyria [2] Mucosal Hypotension [3]
SIADH [6] Aphthous stomatitis (<10%) Phlebitis (1423%) [6]
Weight gain [23] Xerostomia (>10%) Central Nervous System
Genitourinary Cardiovascular Chills (>10%) [2]
Vaginitis (<5%) Hypotension [2] Dysgeusia (taste perversion) (>10%)
Fever [7]
Renal Central Nervous System Headache [4]
Enuresis [2] Dysgeusia (taste perversion) (>10%) Vertigo (dizziness) [2]
Fanconi syndrome [4] Headache [7]
Paresthesias (>2%) Gastrointestinal/Hepatic
Hematologic Constipation [3]
Bone marrow suppression [4] Vertigo (dizziness) [9]
Diarrhea [7]
Coagulopathy [2] Neuromuscular/Skeletal Gastrointestinal disorder [2]
Eosinophilia [2] Arthralgia (<10%) Nausea [11]
Hemotoxicity [3] Myalgia/Myopathy (1029%) Vomiting [5]
Neutropenia [3] Gastrointestinal/Hepatic
Thrombocytopenia [4] Endocrine/Metabolic
Enteropathy [2] ALT increased [2]
Otic Respiratory AST increased [2]
Hearing loss [2] Cough [2] Renal
Ocular Nasopharyngitis [3] Nephrotoxicity [32]
Ocular adverse effects [2] Upper respiratory tract infection [2] Renal failure [3]
Other Endocrine/Metabolic Hematologic
Adverse effects [8] Hyperkalemia [3] Anemia [2]
Allergic reactions (<5%) Other Eosinophilia [3]
Congenital malformations [4] Adverse effects [5] Leukopenia [2]
Death [8] Allergic reactions (>2%) Neutropenia [7]
Teratogenicity [31] Thrombocytopenia [16]
Otic
VALRUBICIN VANCOMYCIN Ototoxicity [5]
Tinnitus [2]
Trade name: Vancocin (Lilly) Local
See: www.drugeruptiondata.com/drug/id/964 Indications: Various infections caused by Infusion-related reactions [2]
susceptible organisms
Class: Antibiotic, glycopeptide Other
VALSARTAN Half-life: 511 hours Adverse effects [5]
Allergic reactions (<5%) [5]
Clinically important, potentially hazardous
Trade names: Byvalson (Forest), Diovan interactions with: meloxicam, metformin, Death [5]
(Novartis), Diovan HCT (Novartis), Exforge pentamidine, rocuronium, succinylcholine,
(Novartis), Valturna (Novartis) teicoplanin, trospium
Indications: Hypertension Pregnancy category: C VANDETANIB
Class: Angiotensin II receptor antagonist
(blocker), Antihypertensive Skin Trade name: Caprelsa (AstraZeneca)
Half-life: 9 hours Abscess [2] Indications: Medullary thyroid cancer
Clinically important, potentially hazardous AGEP [8] Class: Tyrosine kinase inhibitor
interactions with: none known Anaphylactoid reactions/Anaphylaxis [14] Half-life: 19 days
Pregnancy category: D Angioedema [3] Clinically important, potentially hazardous
Important contra-indications noted in the Bullous dermatitis [5] interactions with: amiodarone, amoxapine,
prescribing guidelines for: nursing mothers; Cellulitis [3] antiarrhythmics, arsenic, carbamazepine,
pediatric patients DRESS syndrome [18] chloroquine, clarithromycin, CYP3A4 inducers,
Note: Byvalson is valsartan and nebivolol; Erythema multiforme [5] dexamethasone, disopyramide, dofetilide,
Exforge is valsartan and amlodipine; Valturna is Exanthems [16] dolasetron, efavirenz, granisetron, haloperidol,
valsartan and aliskiren; Diovan HCT is valsartan Exfoliative dermatitis [4] methadone, moxifloxacin, pazopanib,
and hydrochlorothiazide. Hydrochlorothiazide is Fixed eruption [2] phenobarbital, phenytoin, pimozide,
a sulfonamide and can be absorbed systemically. Hypersensitivity [8] procainamide, QT prolonging agents, rifabutin,
Sulfonamides can produce severe, possibly fatal, Leukocytoclastic vasculitis [4] rifampin, rifapentine, sotalol, St John’s wort,
reactions such as toxic epidermal necrolysis and Linear IgA bullous dermatosis [50] telavancin
Stevens-Johnson syndrome. Lupus erythematosus [2]
See also separate profile for Sacubitril/Valsartan. Pruritus [12]
Rash [19]
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Litt’s Drug Eruption & Reaction Manual VEMURAFENIB
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Nevi [6]
Panniculitis [9] VENETOCLAX VENLAFAXINE
Papillomas (21%)
Papular lesions (5%) Trade name: Venclexta (AbbVie) Trade names: Effexor (Wyeth), Effexor XL
Peripheral edema (17%) Indications: Chronic lymphocytic leukemia in (Wyeth)
Photosensitivity (33%) [27] patients with 17p deletion, as detected by an FDA Indications: Major depressive disorder
Pruritus (23%) [10] approved test, who have received at least one Class: Antidepressant, Serotonin-norepinephrine
Radiation recall dermatitis [2] prior therapy reuptake inhibitor
Rash (37%) [23] Class: BCL-2 inhibitor Half-life: 37 hours
Squamous cell carcinoma (24%) [35] Half-life: 26 hours Clinically important, potentially hazardous
Stevens-Johnson syndrome [4] Clinically important, potentially hazardous interactions with: 5HT1 agonists, artemether/
Sunburn (10%) interactions with: amiodarone, azithromycin, lumefantrine, aspirin, atomoxetine, clozapine,
Toxic epidermal necrolysis [5] bosentan, captopril, carbamazepine, carvedilol, desvenlafaxine, dexibuprofen, diclofenac,
Toxicity [10] ciprofloxacin, clarithromycin, conivaptan, duloxetine, entacapone, haloperidol, indinavir,
Vasculitis [2] cyclosporine, digoxin, diltiazem, dronedarone, isocarboxazid, ketoconazole, linezolid, lithium,
Verruca vulgaris [2] efavirenz, erythromycin, etravirine, everolimus, MAO inhibitors, meloxicam, metoclopramide,
Verrucous lesions [3] felodipine, fluconazole, grapefruit juice, indinavir, metoprolol, mirtazapine, moclobemide,
Vitiligo [2] itraconazole, ketoconazole, live vaccines, naratriptan, NSAIDs, phenelzine, selegiline,
Warts [2] lopinavir, modafinil, nafcillin, phenytoin, sibutramine, SNRIs, SSRIs, St John’s wort,
Xerosis [5] posaconazole, quercetin, quinidine, ranolazine, sumatriptan, tramadol, tranylcypromine,
rifampin, ritonavir, sirolimus, St John’s wort, stong trazodone, trimipramine, triptans, voriconazole,
Hair or moderate P-gp inhibitors or substrates, strong warfarin
Alopecia (45%) [18] or moderate CYP3A inducers or inhibitors, Pregnancy category: C
Hair changes [2] telaprevir, ticagrelor, verapamil, voriconazole Important contra-indications noted in the
Nails Pregnancy category: N/A (May cause fetal prescribing guidelines for: the elderly; nursing
Paronychia [3] harm) mothers; pediatric patients
Pyogenic granuloma [2] Important contra-indications noted in the Warning: SUICIDALITY AND
Mucosal prescribing guidelines for: nursing mothers; ANTIDEPRESSANT DRUGS
Gingival hyperplasia/hypertrophy [2] pediatric patients
Note: Concomitant use of strong CYP3A Skin
Cardiovascular inhibitors during initiation and ramp-up phase is
QT prolongation [2] Diaphoresis [7]
contra-indicated. Ecchymoses [2]
Central Nervous System Hyperhidrosis [2]
Dysgeusia (taste perversion) (14%) Skin Pruritus (<10%)
Fever (19%) [5] Peripheral edema (11%) Rash (3%)
Headache (23%) [2] Tumor lysis syndrome (6%) [7]
Paralysis [2] Hair
Central Nervous System Alopecia [2]
Neuromuscular/Skeletal Fever (16%) [3]
Arthralgia (53%) [19] Mucosal
Headache (15%) [2] Xerostomia (22%) [10]
Asthenia (fatigue) (38%) [18]
Back pain (8%) Neuromuscular/Skeletal Cardiovascular
Bone or joint pain (8%) Asthenia (fatigue) (21%) [3] Cardiac failure [2]
Myalgia/Myopathy (8–13%) [2] Back pain (10%) Cardiomyopathy [3]
Pain in extremities (18%) Gastrointestinal/Hepatic Hypertension [7]
Gastrointestinal/Hepatic Constipation (14%) Myocardial infarction [2]
Constipation (12%) Diarrhea (35%) [5] Orthostatic hypotension [2]
Diarrhea (28%) [7] Nausea (33%) [6] Preeclampsia [2]
Hepatotoxicity [4] Vomiting (15%) QT prolongation [6]
Nausea (35%) [8] Respiratory Tachycardia [2]
Vomiting (18%) [3] Cough (13%) Central Nervous System
Respiratory Pneumonia (8%) [3] Akathisia [2]
Cough (8%) Upper respiratory tract infection (22%) [3] Delirium [2]
Endocrine/Metabolic Dysgeusia (taste perversion) (2%)
Endocrine/Metabolic Headache [8]
ALT increased [5] Hyperkalemia (20%)
Hyperphosphatemia (15%) Insomnia [5]
Appetite decreased (18%) [2] Mania [10]
AST increased [5] Hyperuricemia (6%)
Hypocalcemia (9%) Paresthesias (3%)
GGT increased [2] Psychosis [3]
Hypokalemia (12%)
Ocular Restless legs syndrome [3]
Chorioretinopathy [2] Hematologic Seizures [7]
Uveitis [3] Anemia (29%) [5] Serotonin syndrome [22]
Vision blurred [2] Febrile neutropenia [3] Somnolence (drowsiness) [9]
Neutropenia (45%) [7] Tremor (<10%) [3]
Other Thrombocytopenia (22%) [5]
Adverse effects [11] Vertigo (dizziness) [10]
Other Yawning [2]
Death [3] Neuromuscular/Skeletal
Asthenia (fatigue) [5]
Dystonia [2]
Rhabdomyolysis [3]
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Litt’s Drug Eruption & Reaction Manual VIGABATRIN
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Litt’s Drug Eruption & Reaction Manual VITAMIN A
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Litt’s Drug Eruption & Reaction Manual VORICONAZOLE
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Litt’s Drug Eruption & Reaction Manual XYLOMETAZOLINE
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Litt’s Drug Eruption & Reaction Manual ZIDOVUDINE
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Litt’s Drug Eruption & Reaction Manual ZOLPIDEM
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DESCRIPTIONS OF IMPORTANT REACTIONS
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DESCRIPTIONS OF IMPORTANT REACTIONS Litt’s Drug Eruption & Reaction Manual
Baboon syndrome (SDRIFE) extremities, especially over the dorsa of the hands and extensor aspects of
Baboon syndrome or symmetric drug-related intertriginous and flexural the forearms. Lesions tend to spread peripherally and may involve the palms
exanthema (SDRIFE) is an unusual presentation of a drug eruption with a and trunk as well as the mucous membranes of the mouth and genitalia.
characteristic intertriginous distribution pattern. Several drugs have been Central healing and overlapping lesions often lead to arciform, annular and
implicated, notably mercury, nickel, heparin, aminophylline, pseudoephe- gyrate patterns. Lesions appear over the course of a week or 10 days and
drine, terbinafine, IVIG, various antibiotics (amoxicillin, ampicillin), and food resolve over the next two weeks.
additives. The following drugs have been most often associated with erythema
Originally described as a type of systemic contact dermatitis characterized multiforme: allopurinol, barbiturates, carbamazepine, estrogens/progestins,
by a pruritic exanthems involving the buttocks and major flexures – groins gold, lamotrigine, NSAIDs, penicillamine, phenytoin, sulfonamides, tetra-
and axillae, some investigators believe that this entity is a form of recall cycline, tolbutamide and valproic acid.
phenomenon. In children, it is important in the differential diagnosis of viral
exanthems. Erythema nodosum
Erythema nodosum is a cutaneous reaction pattern characterized by
Black tongue (lingua villosa nigra) erythematous, tender or painful subcutaneous nodules commonly distrib-
Black hairy tongue (BHT) represents a benign hyperplasia of the filiform uted over the anterior aspect of the lower legs, and occasionally elsewhere.
papillae of the anterior two-thirds of the tongue. More common in young women, erythema nodosum is often associated
These papillary elongations, usually associated with black, brown, or with increased estrogen levels as occurs during pregnancy and with the
yellow pigmentation attributed to the overgrowth of pigment-producing ingestion of oral contraceptives. It is also an occasional manifestation of
bacteria, may be as long as 2 cm. streptococcal infection, sarcoidosis, secondary syphilis, tuberculosis, certain
Occurring only in adults, BHT has been associated with the administration deep fungal infections, Hodgkin’s disease, leukemia, ulcerative colitis, and
of oral antibiotics, poor dental hygiene, and excessive smoking. radiation therapy and is often preceded by fever, fatigue, arthralgia, vomiting,
and diarrhea.
Bullous dermatitis The incidence of erythema nodosum due to drugs is low and it is
Bullous and vesicular drug eruptions are diseases in which blisters and impossible to distinguish clinically between erythema nodosum due to drugs
vesicles occur as a complication of the administration of drugs. Blisters are a and that caused by other factors.
well-known manifestation of cutaneous reactions to drugs. Some of the drugs that are known to occasion erythema nodosum are:
In many types of drug reactions, bullae and vesicles may be found in antibiotics, estrogens, amiodarone, gold, NSAIDs, oral contraceptives,
addition to other manifestations. Bullae are usually noted in: erythema sulfonamides, and opiates.
multiforme; Stevens–Johnson syndrome; toxic epidermal necrolysis; fixed
eruptions when very intense; urticaria; vasculitis; porphyria cutanea tarda; Exanthems
and phototoxic reactions (from furosemide and nalidixic acid). Tense, thick- Exanthems, commonly resembling viral rashes, represent the most common
walled bullae can be seen in bromoderma and iododerma as well as in type of cutaneous drug eruption. Described as maculopapular or morbilli-
barbiturate overdosage. form eruptions, these flat, barely raised, erythematous patches, from one to
Common drugs that cause bullous eruptions and bullous pemphigoid are: several millimeters in diameter, are usually bilateral and symmetrical. They
nadalol, penicillamine, piroxicam, psoralens, rifampin, clonidine, furosemide, commonly begin on the head and neck or upper torso and progress
diclofenac, mefenamic acid, and bleomycin. downward to the limbs. They may present or develop into confluent areas
and may be accompanied by pruritus and a mild fever.
DRESS syndrome
The DRESS syndrome is an acronym for Drug Rash with Eosinophilia and The exanthems caused by drugs can be classified as:
Systemic Symptoms. It is also known as the Drug-Induced Pseudolymphoma
and Drug Hypersensitivity Syndrome. l Morbilliform eruptions: fingernail-sized erythematous patches
The symptoms of DRESS syndrome usually begin 1 to 8 weeks after l Scarlatiniform eruptions: punctate, pinpoint, or pinhead-sized lesions in
exposure to the offending drug. Common causes include carbamazepine, erythematous areas that have a tendency to coalesce. Circumoral pallor
phenobarbital, phenytoin, terbinafine, and valproic acid. and the subsequent appearance of scaling may also be noted.
Erythema multiforme
Maculopapular drug eruptions usually fade with desquamation and,
Erythema multiforme is a relatively common, acute, self-limited, inflamma- occasionally, postinflammatory hyperpigmentation, in about 2 weeks. They
tory reaction pattern that is often associated with a preceding herpes invariably recur on rechallenge.
simplex or mycoplasma infection. Other causes are associated with Exanthems often have a sudden onset during the first 2 weeks of
connective tissue disease, physical agents, X-ray therapy, pregnancy and administration, except in cases of semisynthetic penicillin administration,
internal malignancies, to mention a few. In 50% of the cases, no cause can be when the exanthems frequently develop after the first 2 weeks following the
found. In a recent prospective study of erythema multiforme, only 10% initial dose.
were drug related.
The eruption rapidly occurs over a period of 12 to 24 hours. In about half The drugs most commonly associated with exanthems are: amoxicillin,
the cases there are prodromal symptoms of an upper respiratory infection ampicillin, bleomycin, captopril, carbamazepine, chlorpromazine, co-trimox-
accompanied by fever, malaise, and varying degrees of muscular and joint azole, gold, nalidixic acid, naproxen, phenytoin, penicillamine, and piroxicam.
pains.
Clinically, bluish-red, well-demarcated, macular, papular, or urticarial
lesions, as well as the classical ‘iris’ or ‘target lesions’, sometimes with central
vesicles, bullae, or purpura, are distributed preferentially over the distal
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needles’ or of a limb being ‘asleep’. It is a symptom of partial damage to a Patients with a true photoallergy (the interaction of drug, light and the
peripheral nerve, as occurs from a head or spinal injury, lack of blood supply immune system), a less common form of drug-induced photosensitivity, are
to a nerve, or in many cases medications. often sensitive to UVB radiation, the so-called ‘burning rays’ at 290–320 nm.
Paresthesias can affect various parts of the body; hands, fingers, and feet Photoallergic reactions, unlike phototoxic responses, represent an immu-
are common sites but all areas are possibilities. nologic change and require a latent period of from 24 to 48 hours during
Scores of generic drugs have been reported to occasion paresthesias which sensitization occurs. They are not dose-related.
including alprazolam, allopurinol, buspirone, celecoxib, ciprofloxacin, If the photosensitizer acts internally, it is a photodrug reaction; if it acts
cyclosporine, enalapril, glipizine and many others. externally, it is photocontact dermatitis.
Drugs that are likely to cause phototoxic reactions are: amiodarone,
Pemphigus vulgaris nalidixic acid, various NSAIDs, phenothiazines (especially chlorpromazine),
Pemphigus vulgaris (PV) is a rare, serious, acute or chronic, blistering disease and tetracyclines (particularly demeclocycline).
involving the skin and mucous membranes. Photoallergic reactions may occur as a result of exposure to systemically-
Characterized by thin-walled, easily ruptured, flaccid bullae that are seen administered drugs such as griseofulvin, NSAIDs, phenothiazines, quinidine,
to arise on normal or erythematous skin and over mucous membranes, the sulfonamides, sulfonylureas, and thiazide diuretics as well as to external
lesions of PV appear initially in the mouth (in about 60% of the cases) and agents such as para-aminobenzoic acid (found in sunscreens), bithionol (used
then spread, after weeks or months, to involve the axillae and groin, scalp, in soaps and cosmetics), paraphenylenediamine, and others.
face and neck. The lesions may become generalized.
Because of their fragile roofs, the bullae rupture leaving painful erosions Pigmentation
and crusts may develop principally over the scalp. Drug-induced pigmentation on the skin, hair, nails, and mucous membranes
is a result of either melanin synthesis, increased lipofuscin synthesis, or post-
Peyronie’s disease inflammatory pigmentation.
First described in 1743 by the French surgeon, Francois de la Peyronie, Color changes, which can be localized or widespread, can also be a result
Peyronie’s disease is a rare, benign connective tissue disorder involving the of a deposition of bile pigments (jaundice), exogenous metal compounds, and
growth of fibrous plaques in the soft tissue of the penis. Beginning as a direct deposition of elements such as carotene or quinacrine.
localized inflammation, it often develops into a hardened scar. Affecting as Post-inflammatory pigmentation can follow a variety of drug-induced
many as 1% of men, it may cause deformity, pain, cord-like lesions, or inflammatory cutaneous reactions; fixed eruptions are known to leave a
abnormal curvature of the penis when erect. residual pigmentation that can persist for months.
It has been associated with several drugs, including all the adrenergic The following is a partial list of those drugs that can cause various
blocking agents (beta-blockers), methotrexate, colchicine and others. pigmentary changes: anticonvulsants, antimalarials, cytostatics, hormones,
metals, tetracyclines, phenothiazine tranquilizers, psoralens and amiodarone.
Photosensitivity
Pityriasis rosea-like eruption
A photosensitive reaction is a chemically induced change in the skin that
makes an individual unusually sensitive to electromagnetic radiation (light). Pityriasis rosea, commonly mistaken for ringworm, is a unique disorder that
On absorbing light of a specific wavelength, an oral, injected or topical drug usually begins as a single, large, round or oval pinkish patch known as the
may be chemically altered to produce a reaction ranging from macules and ‘mother’ or ‘herald’ patch. The most common sites for this solitary lesion
papules, vesicles and bullae, edema, urticaria, or an acute eczematous are the chest, the back, or the abdomen. This is followed in about 2 weeks
reaction. by a blossoming of small, flat, round or oval, scaly patches of similar color,
Any eruption that is prominent on the face, the dorsa of the hands, the ‘V’ each with a central collarette scale, usually distributed in a Christmas tree
of the neck, and the presternal area should suggest an adverse reaction to pattern over the trunk and, to a lesser degree, the extremities. This eruption
light. The distribution is the key to the diagnosis. seldom itches and usually limits itself to areas from the neck to the knees.
Initially the eruption, which consists of erythema, edema, blisters, While the etiology of idiopathic pityriasis rosea is unknown, various
weeping and desquamation, involves the forehead, rims of the ears, the medications have been reported to give rise to this disorder. These include:
nose, the malar eminences and cheeks, the sides and back of the neck, the barbiturates, beta-blockers, bismuth, captopril, clonidine, gold, griseofulvin,
extensor surfaces of the forearms and the dorsa of the hands. These isotretinoin, labetalol, meprobamate, metronidazole, penicillin, and
reactions commonly spare the shaded areas: those under the chin, under the tripelennamine.
nose, behind the ears and inside the fold of the upper eyelids. There is In drug-induced pityriasis rosea, the ‘herald patch’ is usually absent, and
usually a sharp cut-off at the site of jewelry and at clothing margins. All light- the eruption will often not follow the classic pattern.
exposed areas need not be affected equally.
There are two main types of photosensitive reactions: the phototoxic and Pruritus
the photoallergic reaction. Generalized itching, without any visible signs, is one of the least common
Phototoxic reactions, the most common type of drug-induced photo- adverse reactions to drugs. More frequently than not, drug-induced itching –
sensitivity, resemble an exaggerated sunburn and occur within 5 to 20 hours moderate or severe – is fairly generalized.
after the skin has been exposed to a photosensitizing substance and light of For most drugs it is not known in what way they elicit pruritus; some
the proper wavelength and intensity. It is not a form of allergy – prior drugs can cause itching directly or indirectly through cholestasis. Pruritus
sensitization is not required – and, theoretically, could occur in anyone given may develop by different pathogenetic mechanisms: allergic, pseudoallergic
enough drug and light. Phototoxic reactions are dose-dependent both for (histamine release), neurogenic, by vasodilatation, cholestatic effect, and
drug and sunlight. Patients with phototoxicity reactions are commonly others.
sensitive to ultraviolet A (UVA radiation), the so-called ‘tanning rays’ at 320– A partial list of those drugs that can cause pruritus are as follows: aspirin,
400 nm. Phototoxic reactions may cause onycholysis, as the nailbed is NSAIDs, penicillins, sulfonamides, chloroquine, ACE-inhibitors, amiodarone,
particularly susceptible because of its lack of melanin protection. nicotinic acid derivatives, lithium, bleomycin, tamoxifen, interferons, gold,
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bacterial or viral infection and can develop after radiation therapy or with a variety of small, palpable purpuric lesions most frequently distributed
vaccinations. over the lower extremities: urticaria-like lesions, small ulcerations, and
In the drug-induced form of TEN, a morbilliform eruption accompanied occasional hemorrhagic vesicles and pustules. The basic process involves an
by large red, tender areas of the skin will develop shortly after the drug has immunologically mediated response to antigens that result in vessel wall
been administered. This progresses rapidly to blistering, and a widespread damage.
exfoliation of the epidermis develops dramatically over a very short period Beginning as small macules and papules, they ultimately eventuate into
accompanied by high fever. The hairy parts of the body are usually spared. purpuric lesions and, in the more severe cases, into hemorrhagic blisters and
The mucous membranes and eyes are often involved. frank ulcerations. A polymorphonuclear infiltrate and fibrinoid changes in the
The clinical picture resembles an extensive second-degree burn; the small dermal vessels characterize the vasculitic reaction.
patient is acutely ill. Fatigue, vomiting, diarrhea and angina are prodromal Drugs that are commonly associated with vasculitis are: ACE-inhibitors,
symptoms. In a few hours the condition becomes grave. amiodarone, ampicillin, cimetidine, coumadin, furosemide, hydantoins,
TEN is a medical emergency and unless the offending agent is hydralazine, NSAIDs, pyrazolons, quinidine, sulfonamides, thiazides, and
discontinued immediately, the outcome may be fatal in the course of a thiouracils.
few days.
Drugs that are the most common cause of TEN are: allopurinol, Vertigo
ampicillin, amoxicillin, carbamazepine, NSAIDs, phenobarbital, pentamidine, Vertigo, a specific type of dizziness, is a feeling of unsteadiness. It is the
phenytoin (diphenylhydantoin), pyrazolons, and sulfonamides. sensation of spinning or swaying while actually remaining stationary with
respect to the surroundings. It is a result of either motion sickness, a viral
Urticaria infection of the organs of balance, low blood sugar, or medications. It is a
Urticaria induced by drugs is, after exanthems, the second most common symptom of multiple sclerosis, carbon monoxide poisoning, and Meniere’s
type of drug reaction. Urticaria, or hives, is a vascular reaction of the skin disease.
characterized by pruritic, erythematous wheals. These welts – or wheals – Vertigo is one of the most common health problems in adults. According
caused by localized edema, can vary in size from one millimeter in diameter to the National Institutes of Health, about 40% of people in the United
to large palm-sized swellings, favor the covered areas (trunk, buttocks, States experience vertigo at least once during their lifetime. Prevalence is
chest), and are, more often than not, generalized. Urticaria usually develops higher in women and increases with age.
within 36 hours following the administration of the responsible drug. Classes of drugs that have been reported to trigger vertigo include,
Individual lesions rarely persist for more than 24 hours. aminoglycoside antibiotics, antihypertensives, diuretics, vasodilators, phe-
Urticaria may be the only symptom of drug sensitivity, or it may be a nothiazines, tranquilizers, antidepressants, anticonvulsants, hypnotics,
concomitant or followed by the manifestations of serum sickness. Urticaria analgesics, alcohol, caffeine, and tobacco.
may be accompanied by angioedema of the lips or eyelids. It may, on rare
occasions, progress to anaphylactoid reactions or to anaphylaxis. Xerostomia
The following are the most common causes of drug-induced urticaria: Xerostomia is a dryness of the oral cavity that makes speaking, chewing and
antibiotics, notably penicillin (more commonly following parenteral admin- swallowing difficult. Some people also experience changes in taste and
istration than by ingestion), barbiturates, captopril, levamisole, NSAIDs, salivary gland enlargement. Lack of saliva may predispose one to oral
quinine, rifampin, sulfonamides, thiopental, and vancomycin. infection, such as candidiasis, and increase the risk of dental caries.
Resulting from a partial or complete absence of saliva production,
Vasculitis xerostomia can be caused by more than 400 generic drugs.
Drug-induced cutaneous necrotizing vasculitis, a clinicopathologic process
characterized by inflammation and necrosis of blood vessels, often presents
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MAIN CLASSES OF DRUGS
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* Note that acetaminophen (Paracetamol; Tylenol) is not on this list; unlike other common analgesics such as aspirin and ibuprofen, it has no anti-
inflammatory properties, and so it is not a member of the class of drugs known as non-steroidal anti-inflammatory drugs. Acetaminophen relieves
pain in mild arthritis but has no effect on the underlying inflammation, redness and swelling of the joint. It belongs to a class of drugs called analgesics
(pain relievers) and antipyretics (fever reducers) and is thought to relieve pain by elevating the pain threshold (that is, by requiring a greater amount
of pain to develop before it is felt). It reduces fever through its action on the heat-regulating center of the brain; specifically, it tells the center to
lower the body’s temperature when the temperature is elevated.
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CLASS REACTIONS*
ACE INHIBITORS
B C E F L P Q R T Z =
SKIN
B Benazepril; C Captopril; E Enalapril; F Fosinopril; L Lisinopril; P Perindopril; Q Quinapril; R Ramipril; T Trandolapril; Z Zofenopril
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ACE INHIBITORS CLASS REACTIONS
B C E F L P Q R T Z =
Pemphigus foliaceus [1] [2] [2] [1] [2] [1] [1] [1] [1] ü
Peripheral edema [3] [2] [1] [3] [3] ü
Photosensitivity • [3] [2] • • [2] [2] ü
Pityriasis rosea [6] [2]
HAIR
MUCOSAL
Glossitis [3] •
Sialorrhea [1] •
Xerostomia [1] • • • • • • • ü
B Benazepril; C Captopril; E Enalapril; F Fosinopril; L Lisinopril; P Perindopril; Q Quinapril; R Ramipril; T Trandolapril; Z Zofenopril
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CLASS REACTIONS ANTIARRHYTHMICS
ANTIARRHYTHMICS
A Di Dr F I L Pn Pf Pr Q S =
SKIN
Exanthems [5] [1] [1] [1] [2] [5] [1] [4] [6] ü
(<5%) (8%) (17%)
Exfoliative dermatitis [1] • [2] [1] [5]
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ANTIARRHYTHMICS CLASS REACTIONS
A Di Dr F I L Pn Pf Pr Q S =
Raynaud’s [3] • ?
phenomenon (59%)
HAIR
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CLASS REACTIONS ANTIBIOTICS, MACROLIDE
ANTIBIOTICS, MACROLIDE
A C E =
SKIN
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ANTICONVULSANTS CLASS REACTIONS
ANTICONVULSANTS
B C G La Le O Phb Phy Ti To V Z =
SKIN
Hyperhidrosis [1] •
B Brivaracetam; C Carbamazepine; G Gabapentin; La Lamotrigine; Le Levetiracetam; O Oxcarbazepine; Phb Phenobarbital; Phy Phenytoin;
Ti Tiagabine; To Topiramate; V Valproic Acid; Z Zonisamide
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CLASS REACTIONS ANTICONVULSANTS
B C G La Le O Phb Phy Ti To V Z =
Neoplasms [1] •
Pruritus [7] [1] [3] [1] [1] [5] • [3] [1] [1] ü
(>5%) (2–6%)
Pseudolymphoma [17] [1] [1] [31] [2] ?
Psoriasis [1] [1] •
Rash [30] [2] [53] [5] [11] [4] [13] [2] [3] [7] [6] ü
(12%) (12–22%) (9%) (17%) (5%) (6%) (>5%) (7%)
Scleroderma [1] [1]
Stevens-Johnson [98] [2] [49] [3] [10] [21] [58] [11] [3] ü
syndrome (68%) (30%) (15%) (68%)
Toxic epidermal [88] [51] [2] [4] [26] [65] [7] [1] ü
necrolysis (68%) (13%) (13%) (68%)
B Brivaracetam; C Carbamazepine; G Gabapentin; La Lamotrigine; Le Levetiracetam; O Oxcarbazepine; Phb Phenobarbital; Phy Phenytoin;
Ti Tiagabine; To Topiramate; V Valproic Acid; Z Zonisamide
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ANTICONVULSANTS CLASS REACTIONS
B C G La Le O Phb Phy Ti To V Z =
HAIR
NAILS
MUCOSAL
Epistaxis • •
Gingivitis • • • • • • ü
Glossitis • (<5%) •
Halitosis • [1]
Sialorrhea • • [1]
(4–5%)
Stomatitis • • • (<5%) •
Ulcerative stomatitis • •
B Brivaracetam; C Carbamazepine; G Gabapentin; La Lamotrigine; Le Levetiracetam; O Oxcarbazepine; Phb Phenobarbital; Phy Phenytoin;
Ti Tiagabine; To Topiramate; V Valproic Acid; Z Zonisamide
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CLASS REACTIONS ANTIDEPRESSANTS, TRICYCLIC
ANTIDEPRESSANTS, TRICYCLIC
Ami Amo C I N T =
SKIN
MUCOSAL
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ANTIHISTAMINES (H1) CLASS REACTIONS
ANTIHISTAMINES (H1)
Ce Chl Des Dy Fex H Lev Lor O P =
SKIN
Diaphoresis • •
Edema • •
HAIR
Alopecia • •
MUCOSAL
Sialorrhea • •
Stomatitis • •
Ce Cetirizine; Chl Chlorpheniramine; Des Desloratadine; Dy Diphenhydramine; Fex Fexofenadine; H Hydroxyzine; Lev Levocetirizine;
Lor Loratadine; O Olopatadine; P Promethazine
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CLASS REACTIONS ANTIMALARIALS
ANTIMALARIALS
Amo A/L Art A/P C H M P Quc Qud Qun S =
SKIN
Exanthems [1] [3] [4] [1] [3] [3] [6] [3] [1] ü
(<5%) (<5%) (30%) (80%) (17%) (<5%)
Exfoliative dermatitis [4] [3] [1] [2] [3] [5] [2] [3] ü
(8%)
Fixed eruption [1] • • [3] [3] [2] [12] [2] ü
Hypersensitivity [1] [1] [1] [1] (>10%)
Amo Amodiaquine; A/L Artemether/Lumefantrine; Art Artesunate; A/P Atovaquone/Proguanil; C Chloroquine; H Hydroxychloroquine; M Mefloquine;
P Pyrimethamine; Quc Quinacrine; Qud Quinidine; Qun Quinine; S Sulfadoxine
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ANTIMALARIALS CLASS REACTIONS
Urticaria [1] [2] [1] [1] [4] [2] [1] [1] [1] [2] ü
Vasculitis [1] [3] [5] [5]
HAIR
MUCOSAL
Glossitis • •
Amo Amodiaquine; A/L Artemether/Lumefantrine; Art Artesunate; A/P Atovaquone/Proguanil; C Chloroquine; H Hydroxychloroquine; M Mefloquine;
P Pyrimethamine; Quc Quinacrine; Qud Quinidine; Qun Quinine; S Sulfadoxine
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CLASS REACTIONS ANTIPSYCHOTICS
ANTIPSYCHOTICS
Ap As Chl Clo H L O Pal Per Q R Z =
SKIN
Candidiasis • •
Ecchymoses • •
Furunculosis • •
Psoriasis [2] •
Ap Aripiprazole; As Asenapine; Chl Chlorpromazine; Clo Clozapine; H Haloperidol; L Lurasidone; O Olanzapine; Pal Paliperidone; Per Perphenazine;
Q Quetiapine; R Risperidone; Z Ziprasidone;
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ANTIPSYCHOTICS CLASS REACTIONS
Seborrhea • •
Ulcerations • •
Vesiculobullous • •
eruption
Xerosis • • •
HAIR
MUCOSAL
Glossitis • •
Glossodynia [1] •
Oral ulceration • •
Tongue edema • • • • •
Tongue pigmentation • •
Xerostomia [7] [1] [1] [3] [4] [11] [1] [22] [7] [1] ü
(15%) (<10%) (6%) (21%) (19%) (31%) (18%) (<5%)
Ap Aripiprazole; As Asenapine; Chl Chlorpromazine; Clo Clozapine; H Haloperidol; L Lurasidone; O Olanzapine; Pal Paliperidone; Per Perphenazine;
Q Quetiapine; R Risperidone; Z Ziprasidone;
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CLASS REACTIONS BENZODIAZEPINES
BENZODIAZEPINES
A Cln Clo D L M O =
SKIN
MUCOSAL
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BETA BLOCKERS CLASS REACTIONS
BETA BLOCKERS
A B C N P S =
SKIN
Photosensitivity [1] •
HAIR
Xerostomia • [1] • ü
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CLASS REACTIONS BIOLOGICS
BIOLOGICS
Ald Alm Be Bo C D E G Ib In Ip L P R =
SKIN
Acneform eruption [6] [62] [2] [27] [32] [2] • [1] [1] [18] ü
(83%) (97%) (<10%) (73–80%) (66–85%) (81%)
AGEP [1] [1] [1] [7]
Dermatitis [2] [1] [1] [4] [1] [4] [1] [12] [1] [2] ü
(80%) (<10%) (30%) (6%) (12%)
Dermatomyositis [1] [1] [2]
Erythema [5] [1] [1] [2] [3] [2] (18%) [1] [5] [2] [3] (5%) [5] [2] üü
(41%) (14%) (<10%) (65%) (16%)
Erythema [1] [1] [2] [1] [1]
multiforme (16%) (16%)
Ald Aldesleukin; Alm Alemtuzumab; Be Bevacizumab; Bo Bortezomib; C Cetuximab; D Dasatinib; E Erlotinib; G Gefitinib; Ib Imatinib; In Interferon
Alfa; Ip Ipilimumab; L Lenalidomide; P Panitumumab; R Rituximab
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BIOLOGICS CLASS REACTIONS
Ald Alm Be Bo C D E G Ib In Ip L P R =
Hand–foot [12] [5] [1] [3] [2] [3] [1] [1] [3] ü
syndrome (57%) (6%) (30–60%) (10%) (23%)
Malignant • [1]
lymphoma
Ald Aldesleukin; Alm Alemtuzumab; Be Bevacizumab; Bo Bortezomib; C Cetuximab; D Dasatinib; E Erlotinib; G Gefitinib; Ib Imatinib; In Interferon
Alfa; Ip Ipilimumab; L Lenalidomide; P Panitumumab; R Rituximab
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CLASS REACTIONS BIOLOGICS
Ald Alm Be Bo C D E G Ib In Ip L P R =
Peripheral edema (28%) (13%) [1] [5] [1] [3] • [5] [4] [1] [1] ü
(8%) (83%) (40%) (44%) (75%) (83%) (12%) (14%)
Petechiae • [1]
(<10%)
Photosensitivity [1] [1] [1] [3] [2]
(<10%)
Pigmentation [1] [1] [1] [1] [12] [3] [1] [2] [1] ü
(>10%) (16%) (60%) (21%) (23%) (16%)
Pruritus [7] (14– [1] [1] [9] [4] [8] [5] [3] [4] [22] [3] [9] [8] üü
(24%) 24%) (91%) (11%) (40%) (14%) (21%) (61%) (10%) (30%) (65%) (42%) (91%) (14%)
Pseudolymphoma [1] [3] [1]
Rash [2] [5] [16] [9] [47] [10] [112] [63] [26] [5] [28] [16] [30] [12] üü
(42%) (13– (91%) (67%) (89%) (34%) (80%) (66–85%) (69%) (11%) (83%) (36%) (91%) (58%)
40%)
Rosacea [1] [2] [1] [1] [1]
Ald Aldesleukin; Alm Alemtuzumab; Be Bevacizumab; Bo Bortezomib; C Cetuximab; D Dasatinib; E Erlotinib; G Gefitinib; Ib Imatinib; In Interferon
Alfa; Ip Ipilimumab; L Lenalidomide; P Panitumumab; R Rituximab
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BIOLOGICS CLASS REACTIONS
Ald Alm Be Bo C D E G Ib In Ip L P R =
Toxicity [6] [1] [9] [4] [18] [7] [9] [10] [9] [4] [3] [6] [26] [3] üü
(16%) (38%) (63%) (36%) (84%) (68%) (30– (35%) (75%) (95%) (12%)
44%)
Transient [1] [2]
acantholytic
dermatosis
Xerosis (15%) [1] [1] [14] [1] [12] [12] [2] [1] [1] [2] [12] ü
(>10%) (16%) (49%) (<10%) (56%) (53%) (<10%) (>10%) (13%) (16%) (62%)
HAIR
Alopecia [2] [5] (5%) [3] [10] [6] [2] [16] [3] [3] [1] ü
(10%) (43%) (<10%) (14%) (10– (48%) (19%) (54%)
15%)
Hair changes [3] [4] [2] ?
(20%) (9%)
Hair pigmentation [2] [3]
(18%)
Hirsutism [1] [1]
NAILS
Ald Aldesleukin; Alm Alemtuzumab; Be Bevacizumab; Bo Bortezomib; C Cetuximab; D Dasatinib; E Erlotinib; G Gefitinib; Ib Imatinib; In Interferon
Alfa; Ip Ipilimumab; L Lenalidomide; P Panitumumab; R Rituximab
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CLASS REACTIONS BIOLOGICS
Ald Alm Be Bo C D E G Ib In Ip L P R =
MUCOSAL
Mucositis [11] [2] [10] [1] [10] [4] [2] [1] [4] ü
(75%) (45%) (>10%) (16%) (21%) (6–17%) (15%) (75%)
Stomatitis [1] [1] [8] [1] [3] [1] [10] [7] [1] [4] [2] ü
(22%) (14%) (75%) (43%) (25%) (26%) (6–17%) (30%) (100%) (69%)
Xerostomia [1] (11%) [1] [1] [4] [1] (7%) ü
(33%) (44%) (41%)
Ald Aldesleukin; Alm Alemtuzumab; Be Bevacizumab; Bo Bortezomib; C Cetuximab; D Dasatinib; E Erlotinib; G Gefitinib; Ib Imatinib; In Interferon
Alfa; Ip Ipilimumab; L Lenalidomide; P Panitumumab; R Rituximab
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BISPHOSPHONATES CLASS REACTIONS
BISPHOSPHONATES
A E I P R Z =
SKIN
Angioedema [2] • • ü
Candidiasis (6%) (12%)
HAIR
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CLASS REACTIONS CALCIUM CHANNEL BLOCKERS
SKIN
A Amlodipine; D Diltiazem; F Felodipine; I Isradipine; Nic Nicardipine; Nif Nifedipine; Nis Nisoldipine; V Verapamil
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CALCIUM CHANNEL BLOCKERS CLASS REACTIONS
Ulcerations [1] •
HAIR
NAILS
MUCOSAL
A Amlodipine; D Diltiazem; F Felodipine; I Isradipine; Nic Nicardipine; Nif Nifedipine; Nis Nisoldipine; V Verapamil
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CLASS REACTIONS CEPHALOSPORINS
CEPHALOSPORINS
Cdxl Cclor Ctan Coxm Cnir Cixm Ctxm Czim Caxn Cpm CF Cple =
SKIN
Hypersensitivity [1] [4] [1] [2] [1] [4] [2] [2] [1] ü
Jarisch–Herxheimer [1] [1]
reaction
Pruritus [1] [4] • • • [1] [3] [3] [2] [3] [7] [1] üü
(9%)
Pseudolymphoma [1] [1]
Rash • [2] [2] [1] • [2] [3] [5] [5] [12] [9] [1] üü
(12%) (51%) (10%)
SDRIFE [1] [1]
1st generation: Cdxl Cefadroxil; 2nd generation: Cclor Cefaclor, Ctan Cefotetan, Coxm Cefuroxime; 3rd generation: Cnir Cefdinir, Cixm Cefixime,
Ctxm Cefotaxime, Czim Ceftazidime, Caxn Ceftriaxone; 4th generation: Cpm Cefepime; 5th generation: CF Ceftaroline Fosamil; Cple Ceftobiprole
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DMARDS CLASS REACTIONS
SKIN
Dermatitis [1] [4] • [3] [1] [4] [2] [4] [2] [2] ü
Dermatomyositis [5] [4] [1] [14]
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CLASS REACTIONS DMARDS
Ab Ad Az Ce Cy E G H I M P R S =
Exanthems [10] [1] [2] [4] [4] [5] [8] [1] [23] ü
(5%) (<5%) (15%) (23%)
Exfoliative dermatitis [1] [3] [5]
Herpes simplex [3] [1] [3] [4] [1] [4] [2] [2] ü
(>5%) (35%) (10%)
Herpes zoster [3] [10] [8] [3] [2] [5] [11] [7] [7] ü
(27%)
Hidradenitis [2] [1] [2] [1] [1]
Hypersensitivity [2] [3] [28] • [2] [1] [11] [4] [3] [5] [21] ü
(11%) (9%)
Kaposi’s sarcoma [1] [14] [5] [1] [3]
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DMARDS CLASS REACTIONS
Ab Ad Az Ce Cy E G H I M P R S =
Lupus erythematosus [16] [1] [25] [3] [35] [43] [1] [34] ü
(59%)
Lupus syndrome [3] [1] [3] [11] [1] [1]
Pruritus • [6] [1] [1] [2] [2] [13] [8] [1] [2] [8] [8] ü
(12%) (14%) (47%) (20%) (<5%) (44– (14%) (10%)
50%)
Pseudolymphoma [1] [6] [1] [2] [10] [2]
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CLASS REACTIONS DMARDS
Ab Ad Az Ce Cy E G H I M P R S =
Psoriasis [13] [39] [6] [2] [19] [2] [13] [56] [4] [4] [1] ü
(19%)
Purpura [4] [5] [1] [1]
Rash [6] [4] [10] [2] [1] [7] [3] [4] [13] [11] [6] [12] [19] üü
(23%) (12%) (<10%) (5%) (7– (15%) (<10%) (25%) (5%) (44– (58%) (>10%)
12%) 50%)
Raynaud’s phenomenon [2] [1] [3]
Squamous cell carcinoma [5] [5] [11] [12] [4] [1] [1] [2] ü
Stevens-Johnson [2] [1] [1] [1] [4] [5] [9] ü
syndrome
Toxic epidermal [1] [1] [3] [2] [8] [2] [3] [13] ü
necrolysis (<10%)
Toxicity [1] [3] [1] [2] [1] [1] [2] [9] [3] ü
(6%) (75%) (10%) (12%)
Tumors [1] [8] [1] [1] [1]
(14%) (11%)
Ulcerations [1] • [1] [12]
Urticaria [1] [3] [5] • [2] [2] [2] [6] [4] [2] [5] [11] ü
(17%) (44– (8%) (<5%)
50%)
Vasculitis [2] [9] [5] • [3] [23] [1] [1] [18] [9] [7] [4] [4] üü
(13%) (25%) (63%) (>10%)
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DMARDS CLASS REACTIONS
Ab Ad Az Ce Cy E G H I M P R S =
HAIR
Alopecia [5] [9] [1] [2] [5] [2] [6] [25] [3] [1] [6] ü
(54%) (20%) (10%)
Alopecia areata [7] [6] [1] [1] [3]
NAILS
MUCOSAL
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CLASS REACTIONS DPP-4 INHIBITORS
DPP-4 INHIBITORS
Alog Lina Saxa Sita =
SKIN
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EGFR INHIBITORS CLASS REACTIONS
EGFR INHIBITORS
C E G L Nec Nil P Sor Sun =
SKIN
Acneform eruption [62] [27] [32] [4] [1] [1] [18] [6] [1] üü
(97%) (73–80%) (66–85%) (90%) (23–43%) (<10%) (81%) (<10%) (<10%)
AGEP [1] [1] [2]
C Cetuximab; E Erlotinib; G Gefitinib; L Lapatinib; Nec Necitumumab; Nil Nilotinib; P Panitumumab; Sor Sorafenib; Sun Sunitinib
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CLASS REACTIONS EGFR INHIBITORS
Rash [47] [112] [63] [25] [9] [16] [30] [51] [17] üü
(89%) (80%) (66–85%) (55%) (76–81%) (56%) (91%) (30–75%) (14–38%)
Rosacea [1] [2] [1]
Toxicity [18] [9] [10] [6] [2] [7] [26] [16] [24] üü
(63%) (84%) (68%) (46%) (8%) (95%) (75%) (67%)
Ulcerations [1] [2] [1]
Xerosis [14] [12] [12] [1] [2] [2] [12] [6] [3] üü
(49%) (56%) (53%) (29%) (67%) (13–17%) (62%) (14%) (17%)
HAIR
NAILS
C Cetuximab; E Erlotinib; G Gefitinib; L Lapatinib; Nec Necitumumab; Nil Nilotinib; P Panitumumab; Sor Sorafenib; Sun Sunitinib
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EGFR INHIBITORS CLASS REACTIONS
MUCOSAL
C Cetuximab; E Erlotinib; G Gefitinib; L Lapatinib; Nec Necitumumab; Nil Nilotinib; P Panitumumab; Sor Sorafenib; Sun Sunitinib
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CLASS REACTIONS FLUOROQUINOLONES
FLUOROQUINOLONES
B C L M N =
SKIN
Edema • [1]
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FLUOROQUINOLONES CLASS REACTIONS
B C L M N =
MUCOSAL
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CLASS REACTIONS NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)
SKIN
Exanthems [11] [7] [6] [2] [3] [9] [7] [3] [1] [1] [9] [1] [8] [9] üü
(18%) (49%) (<5%) (11%) (14%) (>5%) (<5%)
Excoriations [1] [1]
(6%)
Exfoliative dermatitis [1] [1] [1] • [1] [1] • • • [1] • ü
Facial edema [1] [1] [2] • [1]
Fixed eruption [22] [2] [4] [2] [2] [15] [2] [1] [25] [15] [5] ü
(18%) (24%)
A Aspirin; C Celecoxib; D Diclofenac; E Etodolac; F Flurbiprofen; Ib Ibuprofen; In Indomethacin; Ktp Ketoprofen; Ktl Ketorolac; Mx Meloxicam;
Np Naproxen; O Oxaprozin; P Piroxicam; S Sulindac
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NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) CLASS REACTIONS
A C D E F Ib In Ktp Ktl Mx Np O P S =
Peripheral edema [1] [2] [1] [1] [2] • [1] [1] [1] ü
(5%)
Petechiae • •
Pruritus [6] [6] [6] [7] [1] [5] [3] [4] [1] [3] [5] (<10%) [6] [5] üü
(>5%) (<10%) (<10%) (<5%) (<5%) (<10%) (<10%) (<10%) (17%) (<10%) (<10%)
Purpura [8] [1] [2] [1] [5] [1] [1] • [4] [2] [2] ü
(<10%)
Purpura fulminans [2] [1]
Rash (<10%) [11] [4] [5] • [2] [1] [1] [1] [3] [2] [2] [1] (>10%) üü
(40%) (>10%) (>10%) (>10%) (>10%) (<10%) (3–9%) (>10%)
SDRIFE [1] [1] [1]
Stevens-Johnson [6] [2] [5] • • [10] • • • [1] [1] [2] [2] [5] üü
syndrome (17%)
Toxic epidermal [9] [5] [4] • [1] [8] [6] [1] • [1] [5] [4] [12] [13] üü
necrolysis (6%)
A Aspirin; C Celecoxib; D Diclofenac; E Etodolac; F Flurbiprofen; Ib Ibuprofen; In Indomethacin; Ktp Ketoprofen; Ktl Ketorolac; Mx Meloxicam;
Np Naproxen; O Oxaprozin; P Piroxicam; S Sulindac
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CLASS REACTIONS NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)
A C D E F Ib In Ktp Ktl Mx Np O P S =
Urticaria [72] [11] [7] • • [10] [7] [6] [1] [4] [6] • [7] [4] üü
(83%) (>10%) (<5%)
Vasculitis [2] [4] [3] [2] [1] [8] [5] [1] • [9] [3] • ü
Vesiculobullous [2] [1]
eruption
HAIR
MUCOSAL
Glossitis • •
A Aspirin; C Celecoxib; D Diclofenac; E Etodolac; F Flurbiprofen; Ib Ibuprofen; In Indomethacin; Ktp Ketoprofen; Ktl Ketorolac; Mx Meloxicam;
Np Naproxen; O Oxaprozin; P Piroxicam; S Sulindac
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PROTON PUMP INHIBITORS (PPI) CLASS REACTIONS
SKIN
Acneform eruption • • • • ü
AGEP [1] [2]
Exanthems • [1] • ü
Exfoliative dermatitis [1] [1] [3] ü
Facial edema [2] [1] [1] • ü
Fixed eruption [2] [1]
Fungal dermatitis • •
Herpes zoster • • •
Psoriasis [1] •
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CLASS REACTIONS PROTON PUMP INHIBITORS (PPI)
D E L O P R =
Gingivitis • •
Glossitis [1] • • ü
Oral candidiasis • [3] • ü
Stomatitis [2] [1] • • ü
Tongue edema • [1]
Xerostomia • • [2] • • ü
(<10%)
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STATINS CLASS REACTIONS
STATINS
A F L Pi Pr R S =
SKIN
Ecchymoses • •
HAIR
Alopecia [1] •
MUCOSAL
Cheilitis • [1]
Stomatitis • [2] ?
(64%)
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CLASS REACTIONS TNF INHIBITORS
TNF INHIBITORS
A C E G I =
SKIN
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TNF INHIBITORS CLASS REACTIONS
A C E G I =
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CLASS REACTIONS TNF INHIBITORS
A C E G I =
HAIR
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TYROSINE-KINASE INHIBITORS CLASS REACTIONS
TYROSINE-KINASE INHIBITORS
Aft Axt Cbo Crz Dsa Erl Gft Imt Lpt Lnv Nlo Nnt Srf Snt Vnd =
SKIN
Acneform eruption [25] [2] [27] [32] [2] [4] [1] [6] [1] [4] ü
(92%) (<10%) (73– (66– (90%) (<10%) (<10%) (<10%) (35%)
80%) 85%)
AGEP [1] [1] [7] [2]
Hand–foot [2] [15] [17] [1] [3] [2] [3] [9] [2] [2] [113] [68] [4] ü
syndrome (10%) (64%) (50%) (30– (76%) (47%) (89%) (45– (36%)
60%) 65%)
Herpes (<10%) •
Aft Afatinib; Axt Axitinib; Cbo Cabozantinib; Crz Crizotinib; Dsa Dasatinib; Erl Erlotinib; Gft Gefitinib; Imt Imatinib; Lpt Lapatinib; Lnv Lenvatinib;
Nlo Nilotinib; Nnt Nintedanib; Srf Sorafenib; Snt Sunitinib; Vnd Vandetanib
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CLASS REACTIONS TYROSINE-KINASE INHIBITORS
Aft Axt Cbo Crz Dsa Erl Gft Imt Lpt Lnv Nlo Nnt Srf Snt Vnd =
Hypersensitivity • [2]
Pruritus [2] [1] [4] [8] [5] [3] [3] [13] [1] [10] [3] [2] ü
(13%) (8%) (14%) (21%) (61%) (10%) (33%) (21%) (19%) (21%) (<10%) (11%)
Psoriasis [3] [1] [1] [2]
Rash [49] [3] [1] [4] [10] [112] [63] [26] [25] [1] [16] [4] [51] [17] [34] üü
(92%) (14%) (30%) (16%) (34%) (80%) (66– (69%) (55%) (23%) (56%) (41%) (30– (14– (67%)
85%) 75%) 38%)
Rosacea [2] [1] [1]
Aft Afatinib; Axt Axitinib; Cbo Cabozantinib; Crz Crizotinib; Dsa Dasatinib; Erl Erlotinib; Gft Gefitinib; Imt Imatinib; Lpt Lapatinib; Lnv Lenvatinib;
Nlo Nilotinib; Nnt Nintedanib; Srf Sorafenib; Snt Sunitinib; Vnd Vandetanib
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TYROSINE-KINASE INHIBITORS CLASS REACTIONS
Aft Axt Cbo Crz Dsa Erl Gft Imt Lpt Lnv Nlo Nnt Srf Snt Vnd =
Toxicity [3] [2] [7] [9] [10] [9] [6] [2] [7] [16] [24] [9] ü
(36%) (84%) (68%) (30– (46%) (75%) (67%) (48–
44%) 50%)
Ulcerations [1] [2] [1]
Xerosis [6] (10%) [1] [1] [12] [12] [2] [1] [1] [2] [6] [3] [3] ü
(15%) (23%) (<10%) (56%) (53%) (<10%) (29%) (20%) (13– (14%) (17%) (15%)
17%)
HAIR
Alopecia [1] [2] (16%) [1] [3] [10] [6] [2] [2] (12%) [4] [2] [26] [5] [1] üü
(7%) (6%) (7%) (<10%) (14%) (10– (33%) (<10%) (71%) (67%) (5–
15%) 12%)
Hair changes (34%) [4] [1] [2] ?
(20%) (26%)
Hair pigmentation [2] [2] [2] [8] ?
(34%) (38%)
Hypertrichosis [4] [2]
NAILS
Aft Afatinib; Axt Axitinib; Cbo Cabozantinib; Crz Crizotinib; Dsa Dasatinib; Erl Erlotinib; Gft Gefitinib; Imt Imatinib; Lpt Lapatinib; Lnv Lenvatinib;
Nlo Nilotinib; Nnt Nintedanib; Srf Sorafenib; Snt Sunitinib; Vnd Vandetanib
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CLASS REACTIONS TYROSINE-KINASE INHIBITORS
Aft Axt Cbo Crz Dsa Erl Gft Imt Lpt Lnv Nlo Nnt Srf Snt Vnd =
MUCOSAL
Mucositis [10] [1] [1] [1] [10] [4] [2] [2] [12] [18] [2] ü
(50– (30%) (16%) (21%) (6– (15%) (11– (28%) (~60%) (14%)
90%) 17%) 35%)
Oral mucositis [1] [1] [1] ?
(33%) (20%)
Oral ulceration [1] [1] [3] (41%) • [1]
(15%) (5%)
Oropharyngeal pain [1] (25%) [1] ?
(10%)
Rhinorrhea (11%) •
Stomatitis [19] [1] (51%) [1] [1] [10] [7] [1] [3] • [1] [13] [17] [2] ü
(50– (15%) (11%) (26%) (6– (41%) (47%) (28%) (60%) (33%)
90%) 17%)
Xerostomia [1] [1] [1] (17%) [1] [1] [2] ?
(20%) (33%) (44%) (11%) (<10%) (~60%)
Aft Afatinib; Axt Axitinib; Cbo Cabozantinib; Crz Crizotinib; Dsa Dasatinib; Erl Erlotinib; Gft Gefitinib; Imt Imatinib; Lpt Lapatinib; Lnv Lenvatinib;
Nlo Nilotinib; Nnt Nintedanib; Srf Sorafenib; Snt Sunitinib; Vnd Vandetanib
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J Ketoderm
Ketoisidin
ketoconazole
ketoconazole
Jacutin lindane
Ketolar ketamine
Jadelle levonorgestrel
Ketonic ketorolac
Jadenu deferasirox
Kevadon thalidomide
Jalyn dutasteride, tamsulosin
Kevzara sarilumab
Janumet metformin, sitagliptin
Keytruda pembrolizumab
Januvia sitagliptin
Khedezla desvenlafaxine
Jardiance empagliflozin
KI potassium iodide
Jenamicin gentamicin
Kidrolase asparaginase
Jetrea ocriplasmin
Kie potassium iodide
Jezil gemfibrozil
Kildane lindane
Jodatum potassium iodide
Kineret anakinra
Jodid potassium iodide
Kinidin quinidine
Jublia efinaconazole Kisqali ribociclib
Jumex selegiline Klacid clarithromycin
Jurnista hydromorphone Klaricid clarithromycin
Juvederm hyaluronic acid Klexane enoxaparin
Juxtapid lomitapide Klonopin clonazepam
Kloramfenicol chloramphenicol
K Klozapol clozapine
Kabikinase streptokinase Kodapan carbamazepine
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Y Zithromax
Zitromax
azithromycin
azithromycin
Yamatetan cefotetan ziv-aflibercept aflibercept
Yasmin oral contraceptives Zmax azithromycin
Yaz oral contraceptives Zocor simvastatin
Yectamid amikacin Zocord simvastatin
Yentreve duloxetine Zofran ondansetron
Yervoy ipilimumab Zofron ondansetron
YF-VAX yellow fever vaccine Zohydro ER hydrocodone
Yosprala aspirin, omeprazole Zoldan-A danazol
Yuma hydroxychloroquine Zole miconazole
Yurelax cyclobenzaprine zoledronic acid zoledronate
Zolinza vorinostat
Z Zoloft sertraline
Zaltrap aflibercept ZoMaxx Drug-Eluting Coronary Stent zotarolimus
Zanaflex tizanidine Zometa zoledronate
Zanosar streptozocin Zomig zolmitriptan
Zantab ranitidine Zonegran zonisamide
Zantac-C ranitidine Zontivity vorapaxar
Zantac ranitidine Zorac tazarotene
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