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Various toxicities: case report A 67‑year‑old woman developed oral toxicities including angioedema, mouth ulcers, glossitis and angular stomatitis during treatment with telmisartan for hypertension. Additionally, she also developed atrophic gastritis and abdominal pain during treatment with metoprolol, chlorothiazide and telmisartan for hypertension and antiplatelet therapy with aspirin/ clopidogrel. She also developed mouth ulcer bleeding during treatment with antiplatelet therapy with aspirin/clopidogrel [routes not stated; not all durations to reactions onset and outcomes stated]. The woman, who presented with complaints of glossitis, severe mouth ulcers spreading over the oral mucosa and lips associated with bleeding and severe pain, was admitted on 4 February 2018. She also complained of dysphagia which restricted food intake. Her medical history revealed hypertension for 12 years and had been receiving atenolol. On 10 January 2018, she had visited a clinic to check her fitness for bilateral cataract surgery. Due to poorly controlled hypertension concurrently with grade 1 chronic white matter ischaemic changes in her brain, atenolol was switched to metoprolol 25mg daily, aspirin/clopidogrel 75/75mg daily and chlorothiazide 12.5mg daily. On 24 January, she had visited the hospital for cataract surgery. Upon routine investigations, hypokalaemia was noted. Chlorothiazide was replaced with telmisartan 40mg daily and was advised to revisit after three days for bilateral cataract surgery. The first dose of telmisartan was administered on 26 January 2018. Two days later, she reported of one episode of high fever spike, mouth ulcers, mild symptoms of angioedema such as heavy tongue, lip swelling and throat congestion with mild swallowing difficulty in the morning. Her fever was managed with paracetamol at home. However, angioedema progressed rapidly over three days followed by flare of mouth ulcers with bleeding, dysphagia and severe pain. She was admitted to current hospital for further management. On admission, her vitals was stable. The dermatology consultation reported multiple erosions over her buccal mucosa with fissuring over the angles of mouth and an inflamed, bald tongue suggestive of glossitis and angular stomatitis. The woman received treatment with choline salicylate and triamcinolone [triamcinolone acetonide], which was further changed to benzocaine and clotrimazole along with povidone‑iodine and multivitamins. The ear, nose and throat specialist confirmed stomatitis and grade III dysphagia. Laboratory investigations revealed hypoalbuminaemia and elevated liver enzymes, C‑reactive protein, erythrocyte sedimentation rate and absolute eosinophil count. Within two days of hospitalisation, she experienced mild pain relief. However, mouth ulcers, dysphagia and bleeding did not show any significant prognosis. She complained of dysphagia and abdominal pain. The gastroenterologist was consulated and atrophic gastritis was noted, which required management with antacids. Considering th