Allergy Asthma Immunol Res.  2017 May;9(3):278-280. 10.4168/aair.2017.9.3.278.

Levodropropizine-Induced Anaphylaxis: Case Series and Literature Review

• Song JW
• Jang YS
• Jung MC
• Kim JH
• Choi JH
• Park S
• Hwang YI
• Jang SH
• Jung KS

• KMID: 2371729
• DOI: http://doi.org/10.4168/aair.2017.9.3.278

Abstract

Levodropropizine is commonly used as an antitussive drug for acute and chronic cough. It is a non-opioid agent with peripheral antitussive action via the modulation of sensory neuropeptide levels in the airways. Thus, levodropropizine has a more tolerable profile than opioid antitussives. However, we experienced 3 cases of levodropropizine-induced anaphylaxis. Three patients commonly presented with generalized urticaria, dyspnea, and collapse after taking cold medication including levodropropizine. To find out the culprit drug, we performed skin tests, oral provocation tests (OPTs), and basophil activation tests (BATs). Two patients were confirmed as having levodropropizine-induced anaphylaxis by OPTs, and one of them showed positive to skin prick tests (SPTs). The other patient was confirmed by skin tests and BATs. When we analyzed pharmacovigilance data related to levodropropizine collected for 5 years, most cases (78.9%) had allergic reactions, such as rash, urticaria, angioedema, and anaphylaxis. Therefore, physicians should consider that levodropropizine can be a culprit drug, when anaphylaxis occurs after taking anti-cough or common cold medication.

Keyword

Anaphylaxis; antitussive agents; drug-related side effects and adverse reactions

MeSH Terms

Anaphylaxis*
Angioedema
Antitussive Agents
Basophils
Chiroptera
Common Cold
Cough
Drug-Related Side Effects and Adverse Reactions
Dyspnea
Exanthema
Humans
Hypersensitivity
Neuropeptides
Pharmacovigilance
Skin
Skin Tests
Urticaria
Antitussive Agents
Neuropeptides

Figure

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  Figure Expression of CD63 on basophils induced by levodropropizine in the patient and controls. Controls consisted of 1 atopic and 1 non-atopic individuals. SI indicates stimulation index (percentage of basophils activated by the drug divided by the percentage of activated basophils in the negative controls). SI, stimulation index (percentage of basophils activated by the drug divided by the percentage of activated basophils in the negative controls).

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