Document Detail


Severe adverse skin reactions to nonsteroidal antiinflammatory drugs: A review of the literature.
MedLine Citation:
PMID:  20101062     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) are described. SUMMARY: A search of the English- language medical literature was conducted to identify studies and cases of SJS and TEN associated with NSAIDs and cyclooxygenase-2-selective NSAIDs available in the United States. Several epidemiologic studies, case reports, and case series involving SJS and TEN associated with NSAIDs were identified. Of the available NSAIDs, oxicam derivatives appeared to have the greatest association with SJS and TEN. The relative risks reported with other NSAIDs are much lower. The risk with cyclooxygenase-2-selective NSAIDs and meloxicam is less clear, since all were introduced after the completion of the epidemiologic studies. SJS or TEN from NSAIDs and cyclooxygenase-2-selective NSAIDs appears to affect the same patient population as other medications that cause SJS or TEN. The risk of SJS or TEN caused by NSAIDs is extremely low (less than 2 per 1 million users per week for oxicam derivatives, less than 1 per 1 million users per week for other NSAIDs, and 6 cases per 1 million person-years for celecoxib). Aspirin is not typically associated with SJS or TEN. Of the other salicylates, SJS or TEN has only been reported with diflunisal. CONCLUSION: The risk of SJS or TEN in patients receiving NSAIDs is extremely low; older patients, women, and patients within the first month of treatment initiation appear to have the greatest risk. Health care providers and patients should be aware of the signs and symptoms of SJS and TEN.
Authors:
Kristina E Ward; Raoul Archambault; Tracey L Mersfelder
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  67     ISSN:  1535-2900     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-02-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  206-13     Citation Subset:  IM    
Affiliation:
College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA. kward@uri.edu
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MeSH Terms
Descriptor/Qualifier:
Adverse Drug Reaction Reporting Systems
Age Factors
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
Cyclooxygenase 2 Inhibitors / adverse effects
Epidermal Necrolysis, Toxic / epidemiology,  etiology*
Female
Humans
Male
Risk Factors
Sex Factors
Stevens-Johnson Syndrome / chemically induced*,  epidemiology
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Cyclooxygenase 2 Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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