Adverse drug reaction of the month
Commentary
anaphylactic reactions to paracetamol
I Stephenson, J M D Nightingale
Department
of Gastroenterology, Leicester Royal Infirmary, Leicester LE1 5WW,
UK
Correspondence to: Dr Nightingale
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Paracetamol is a widely consumed antipyretic and analgesic agent used either in combination or as a single agent. The general safety of paracetamol in therapeutic dosage has allowed it to become a freely available over-the-counter preparation. A safety evaluation of non-narcotic analgesics in therapeutic doses ranked paracetamol as among the safest in their study.1
Most patients are not asked or do not mention paracetamol as a cause of allergy or anaphylaxis when questioned, and indeed it is not listed in textbooks of medicine as a cause of drug induced allergy. A review of drug induced anaphylaxis failed to identify paracetamol as a trigger.2 Cases of acute hypersensitivity have been reported in the literature ranging from self limiting cutaneous symptoms such as urticaria and maculopapular rashes to severe systemic circulatory failure, bronchospasm, and angioedema. In some cases anaphylactic reactions have been confirmed by accidental or intentional drug rechallenge.3-9
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