Anaphylaxis is a severe, life-threatening reaction to a food, drug, insect venom or contact substance such as latex. The reaction can cause blood pressure to plummet, airways to constrict, tongue to swell, dizziness, fainting, rapid pulse, skin reactions such as hives, and GI distress including nausea, vomiting and diarrhea. Epinephrine is the only drug that can halt and reverse the progression of anaphylaxis, but it must be administered quickly after the onset of symptoms to have the most beneficial effect, which is why those that have been prescribed epinephrine should carry two doses at all times.
Drugs are a major trigger of anaphylaxis, so researchers at RUDN University sought to determine which caused the most instances. They analyzed over 27,000 cases of anaphylaxis recorded in the Russian National Pharmacovigilance database, calculated the drug-induced proportion, and looked for indicators paying special attention to demographics. Their findings were published in the journal Pharmaceuticals.
They found that anaphylaxis comprised 8.3% of drug-induced allergic reactions in adults (mean age 48.2 years), 3.9% in children, and 2% among the elderly, with 53.2% of anaphylaxis occurring in females.
The main causative groups of drugs were:
- 44.6% — antibacterials for systemic use which include antibiotics such as Ceftriaxone;
- 20.0% — local anesthetics;
- 10.1% — cyclooxygenase (COX) inhibitors such as ibuprofen, naproxen and aspirin;
- 6.6% — iodine-containing contrast media;
- 6.2% — cardiovascular drugs including ACEIs, beta blockers and calcium channel blockers.
Fatal reactions were reported in 9.5% (218/2304) of cases, with the mean age of patients 48.0 years and females accounting for 56.4% of cases.
The researchers warn that the proportion of anaphylaxis cases may not be determined by their safety profile but by the frequency of their prescribing.
They wrote:
For example, the leading causative agent determined in our study was ceftriaxone; however, it is also one of the most prescribed drugs to treat various infectious diseases worldwide, ranging from 2.5% of therapeutic prescriptions in Northern Europe to 24.8% in Eastern Europe.
How can you protect yourself? Be sure to discuss all your allergies — including those to drugs and food — with your physician prior to taking a drug or contrast medium.
If you believe you have had a reaction to a drug in the past, discuss this with an allergist who may be able to test you to confirm an allergy.
