Omeprazole
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Anaphylaxis and generalised urticaria: 5 case reports Four patients developed anaphylaxis and one patient developed generalised urticaria during treatment with omeprazole [durations of therapies not stated]. Patient 1, a 59-year-old woman received IV omeprazole 40mg for a stomach ache. Within 5 minutes, she developed an anaphylactic reaction consisting of whole-body pruritus and urticaria, increased sweating, loss of consciousness and hypotension (90/70 [units not stated]). She received epinephrine [adrenaline], methylprednisolone and dexchlorpheniramine. Patient 2, a 59-year-old woman, ingested omeprazole 20mg as a gastric protector. Within 2 hours, she developed generalised urticaria. She received methylprednisolone. Patient 3, a 56-year-old man, ingested omeprazole 40mg as a gastric protector. Within 45 minutes, he developed pruritic erythema, swelling of the palms and soles, dizziness, malaise, generalised urticaria, dysphonia and difficulty swallowing. He received IV methylprednisolone and dexchlorpheniramine. Patient 4, a 37-year-old man with a history of hiatal hernia and gastric ulcer, occasionally self-medicated with omeprazole [dosage not stated]. In the past year, he had experienced four episodes of palm itch, epigastralgia, intense perspiration, generalised cutaneous erythema and angioedema of his hands. For the last two episodes he had required epinephrine and IV saline for sharp decreases in his BP. Following the fourth episode it was noted that he had taken an omeprazole capsule 30 minutes before the reaction. Patient 5, a 30-year-old woman, ingested omeprazole 20mg for epigastralgia. Ten minutes later, she developed pruritic erythema, swelling of the palms and soles, generalised urticaria, nausea, vomiting, difficulty breathing and facial angioedema. She received epinephrine, methylprednisolone and dexchlorpheniramine. Subsequent skin prick tests with omeprazole were positive in all five patients. Additional skin tests (skin prick or intradermal) with pantoprazole, esomeprazole, rabeprazole and lansoprazole were also positive in all patients, suggesting cross-reactivity. Ranitidine was well tolerated in all patients and was used as an alternative. Sobrevia Elfau MT, et al. Study of cross-reactivity between proton pump inhibitors. Journal of Investigational Allergology and Clinical Immunology 20: 803028634 157-61, No. 2, 2010 - Spain
0114-9954/10/1312-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 31 Jul 2010 No. 1312
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