Severe cutaneous adverse reaction to drug excipient following brand-to-generic switch of levetiracetam.

Autor:	Lim JA; Department of Internal Medicine, Hospital University Sains Malaysia, School of Medical Science, Kota Bharu, Kelantan, and Dermatology Unit, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Jamil A; Dermatology Unit, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Ramli NA; Department of Internal Medicine, Hospital University Sains Malaysia, School of Medical Science, Kota Bharu, Kelantan, Malaysia., Johar FM; Reconstructive Sciences Unit, Hospital University Sains Malaysia, School of Medical Science, Kota Bharu, Kelantan, Malaysia., Nor M; Department of Internal Medicine, Hospital University Sains Malaysia, School of Medical Science, Kota Bharu, Kelantan, Malaysia.
Jazyk:	angličtina
Zdroj:	American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists [Am J Health Syst Pharm] 2024 Jan 24; Vol. 81 (3), pp. e69-e72.
DOI:	10.1093/ajhp/zxad264
Abstrakt:	Purpose: Levetiracetam is an antiepileptic drug known for its high tolerability, and severe adverse drug reactions are rare. We report the case of a severe cutaneous adverse drug reaction in a patient who was switched from brand-name to generic levetiracetam. Summary: A 29-year-old woman undergoing contrast-enhanced computed tomography developed lesions over her trunk starting 6 hours after imaging. Although initially diagnosed as an allergy to the radiocontrast agent, the condition progressively worsened into toxic epidermal necrolysis-drug reaction with eosinophilia and systemic symptoms overlap syndrome, despite adequate hydration and treatment. Investigation of the patient's medications revealed that she had been switched from brand-name to generic levetiracetam a week before the onset of symptoms. Levetiracetam was immediately discontinued, with the patient recovering after 2 weeks of intensive care. Adverse drug reaction analysis identified excipients in generic levetiracetam as the likely cause of the severe reaction. Conclusion: This is the first reported case of severe cutaneous drug allergy after a brand-to-generic switch for levetiracetam. Brand-to-generic switches of medications can potentially cause severe allergic reactions due to differences in excipients. (© American Society of Health-System Pharmacists 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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