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Case Reports
. 2017 May;9(3):278-280.
doi: 10.4168/aair.2017.9.3.278.

Levodropropizine-Induced Anaphylaxis: Case Series and Literature Review

Jae Won Song  1 , Young Sook Jang  1 , Moon Chan Jung  1 , Joo Hee Kim  2 , Jeong Hee Choi  3 , Sunghoon Park  1 , Yong Il Hwang  1 , Seung Hun Jang  1 , Ki Suck Jung  1
Affiliations
Case Reports

Levodropropizine-Induced Anaphylaxis: Case Series and Literature Review

Jae Won Song et al. Allergy Asthma Immunol Res. 2017 May.

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.

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

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Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Figure
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).
See this image and copyright information in PMC

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