Bezafibrate
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Angioedema in an elderly patient: case report A 68-year-old man developed angioedema after receiving bezafibrate [dosage not stated] for hypertriglyceridaemia. The man had started receiving a slow-release formulation of bezafibrate [Bezalip Retard] 22 months earlier and had experienced several episodes of tongue swelling [time to reaction onset not clearly stated]. His symptoms always occurred within 10–15 hours of ingesting bezafibrate and responded to fexofenadine. He then presented to the emergency department with paraesthesia, tongue swelling, shortness of breath, a choking sensation and hoarseness. He had developed numbness and tongue swelling the previous day after ingesting bezafibrate, with his symptoms improving after fexofenadine. He had then taken bezafibrate that evening. On presentation, he had mild respiratory distress with a respiratory rate of 22 breaths/min, a prolonged phase of expiration and scattered expiratory wheezing. Laboratory testing showed a mild increase in his WBC count. The man was diagnosed with an allergic reaction to bezafibrate and admitted for treatment with IV corticosteroids, oral promethazine and nebulised bronchodilators. Sixteen hours postadmission, a tracheotomy was performed after he developed gross swelling of his tongue, stridor and breathing difficulties. Treatment with IV corticosteroids and oral antihistamines was continued until his symptoms abated. His tracheotomy was closed 4 days postadmission and he remained well at follow-up 1 year later. Author comment: "Our case illustrates that angio-edema does not always occur unpredictably . . . [and should] alert physicians that such reactions may occur several months after initiation of treatment and several hours after ingestion of the implicated drug". Frendo M, et al. Delayed bezafibrate-induced angio-oedema in a 68-year-old man. British Journal of Pharmacology 64: 560-561, No. 4, Oct 2007 801091081 Malta
0114-9954/10/1162-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 28 Jul 2007 No. 1162
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