Phenylephrine
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Anaphylaxis: case report A 51-year-old man developed anaphylaxis after receiving phenylephrine. The man took a Bisolgrip tablet, which contained phenylephrine 10mg along with paracetamol [acetaminophen] and chlorphenamine, for a cold. Ten minutes after taking a second dose [dosage not stated], he noticed a generalised urticarial eruption, and eyelid and rhinoconjunctival oedema. In an hour, the rhinoconjunctivitis and urticaria cleared. The angioedema resolved in 4 days. Skin prick tests with phenylephrine eye drops, paracetamol, chlorphenamine, pseudoephedrine, ephedrine and epinephrine [adrenaline] were negative. Intradermal tests with phenylephrine eye drops, pseudoephedrine, ephedrine and epinephrine were also negative. Oral challenge tests with paracetamol, chlorphenamine, pseudoephedrine and ephedrine were negative. The man developed generalised urticaria and rhinoconjunctivitis 30 minutes after oral challenge with an accumulated dose equivalent to a whole Bisolgrip tablet. He received an antihistamine and his symptoms disappeared 1 hour later. At a later date, prick and intradermal tests with pure phenylephrine were also negative. He was told to avoid oral or topical phenylephrine-containing products. Author comment: "[A]n apparent grade II anaphylaxis after taking phenylephrine has been described but could not be completely confirmed." Rojas-Hijazo B, et al. Anaphylactic reaction after intake of phenylephrine and tolerance of other sympathomimetic drugs. Journal of Investigational Allergology 801100654 and Clinical Immunology 17: 421-422, No. 6, 2007 - Spain
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Reactions 16 Feb 2008 No. 1189
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