Aciclovir
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Angioedema: case report A 69-year-old woman developed angioedema during treatment with aciclovir for non-complicated herpes zoster (shingles) infection. The woman was admitted for an allogeneic stem cell transplant (SCT). Upon admission, ciprofloxacin and fluconazole were started for bacterial and fungal prophylaxis post SCT. It was reported that, she had been receiving treatment with aciclovir [acyclovir; dosage and route not stated] for non-complicated herpes zoster (shingles) infection. Five days after the initiation of aciclovir therapy, she developed allergy in the form of lip and throat swelling and erythema of the face consistent with aciclovir induced angioedema. The woman’s angioedema improved following withdrawal of the aciclovir and treatment with methylprednisolone. Thereafter, she was shifted to the ICU, for aciclovir desensitisation. The day before the desensitisation, she received prednisolone and continued until 24 hours post desensitisation. She also received montelukast and loratadine the day before the desensitisation and both of them were continued permanently as pre-medications. Aciclovir oral suspension 200mg/5ml was used to perform dilution. An hour before the start of desensitisation, montelukast and prednisolone were administered. She was observed for 15 minutes for angioedema, wheezing, arrhythmia, urticaria, chills, fever, oedema, chest pain, persistent vomiting, hypotension and respiratory distress. Post desensitisation, she continued to take aciclovir during the admission. She was discharged home on day 52 post SCT on montelukast and oral aciclovir 200mg twice daily. She continued both medications and was followed up in the outpatient clinic without any further complication. Andrade DC, et al. A case of successful acyclovir desensitization in a bone marrow transplant patient. Journal of Oncology Pharmacy Practice : 1-4, 2020. Available from: URL: http://doi.org/10.1177/1078155220959408 803507862
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Reactions 17 Oct 2020 No. 1826
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