Stevens-Johnson Syndrome From Combined Allopurinol and Angiotensin-Converting Enzyme Inhibitors: A Narrative Review

Authors

Isabella M. Fabian, Louisiana State University Health Sciences Center, Shreveport, LA
Kirsten Maddox, Louisiana State University Health Sciences Center, Shreveport, LA
Cameron Robicheaux, Louisiana State University Health Sciences Center, Shreveport, LA
Rahib K. Islam, LSU Health Sciences Center - New OrleansFollow
Ahmed Anwar, Department of Psychology, Quinnipiac University, Hamden, CT
Bradley Dorius, Louisiana State University Health Sciences Center, Shreveport, LA
Christopher L. Robinson, Harvard Medical School, Boston, MA
Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences University of the Pacific, Stockton, CA
Giustino Varrassi, Paolo Procacci Foundation, Rome, ITA
Shahab Ahmadzadeh, Louisiana State University Health Sciences Center, Shreveport, LA
Sahar Shekoohi, Louisiana State University Health Sciences Center, Shreveport, LA
Alan D. Kaye, Louisiana State University Health Sciences Center, Shreveport, LA

Document Type

Article

Publication Date

1-8-2024

Publication Title

Cureus

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.

First Page

e51899

PubMed ID

38333456

Volume

16

Issue

1

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Recommended Citation

Fabian, Isabella M.; Maddox, Kirsten; Robicheaux, Cameron; Islam, Rahib K.; Anwar, Ahmed; Dorius, Bradley; Robinson, Christopher L.; Kaye, Adam M.; Varrassi, Giustino; Ahmadzadeh, Shahab; Shekoohi, Sahar; and Kaye, Alan D., "Stevens-Johnson Syndrome From Combined Allopurinol and Angiotensin-Converting Enzyme Inhibitors: A Narrative Review" (2024). School of Medicine Faculty Publications. 2345.
https://digitalscholar.lsuhsc.edu/som_facpubs/2345
10.7759/cureus.51899