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Stevens-Johnson Syndrome From Combined Allopurinol and Angiotensin-Converting Enzyme Inhibitors: A Narrative Review
Cureus: Journal of Medical Science
  • Isabella M. Fabian, Louisiana State University Health Sciences Center - Shreveport
  • Kirsten Maddox, Louisiana State University Health Sciences Center - Shreveport
  • Cameron Robicheaux, Louisiana State University Health Sciences Center - Shreveport
  • Rahib K. Islam, Louisiana State University Health Sciences Center New Orleans
  • Ahmed Anwar, Quinnipiac University
  • Bradley Dorius, Louisiana State University Health Sciences Center - Shreveport
  • Christopher L. Robinson, Harvard University
  • Adam M Kaye, University of the Pacific
  • Giustino Varrassi, Paolo Procacci Foundation
  • Shahab Ahmadzadeh, Louisiana State University Health Sciences Center - Shreveport
  • Sahar Shekoohi, Louisiana State University Health Sciences Center - Shreveport
  • Alan D. Kaye, Louisiana State University Health Sciences Center - Shreveport
ORCiD
Adam M. Kaye: 0000-0002-7224-3322
Document Type
Article
DOI
10.7759/cureus.51899
Publication Date
1-8-2024
Abstract

Stevens-Johnson syndrome (SJS) is a severe and potentially debilitating skin reaction frequently related to medication use. Allopurinol and angiotensin-converting enzyme (ACE) inhibitors are commonly prescribed medications for prevalent health conditions worldwide, and their interaction associated with SJS warrants further investigation. A comprehensive literature search was performed to investigate cases as studies related to SJS occurring in patients with concomitant use of allopurinol and ACE inhibitors. We identified case reports and studies detailing hypersensitivity reactions, including SJS, attributed to a combination of allopurinol and ACE inhibitors. Despite the drug-drug interactions or lack thereof seen in patient populations, there is no definitive evidence of a pharmacokinetic interaction between allopurinol and ACE inhibitors. We were only able to find one case report specifically detailing SJS in a patient on combined ACE inhibitors and allopurinol. While the exact mechanism of the interaction is unclear, those reported cases of severe hypersensitivity reactions suggest a previous history of impaired renal function as a predisposing factor in the development of SJS. The potential risk of SJS with coadministration of ACE inhibitors and allopurinol is a drug-drug interaction that physicians should be aware of. This topic requires additional attention to determine if this drug combination should be avoided entirely in certain patients.

Creative Commons License
Creative Commons Attribution 4.0 International
Citation Information
Fabian I M, Maddox K, Robicheaux C, et al. (January 08, 2024) Stevens-Johnson Syndrome From Combined Allopurinol and Angiotensin-Converting Enzyme Inhibitors: A Narrative Review . Cureus 16(1): e51899. doi:10.7759/cureus.51899