Reactions 1060 - 16 Jul 2005

★Loperamide

First report of a fixed drug eruption: case reportA 58-year-old woman developed a fixed drug eruption

associated with loperamide [therapeutic indication not stated].The woman, who had been self-administering loperamide,

ibuprofen, tetrazepam and paracetamol [acetaminophen]/codeine [dosages and duration of treatment not stated],presented with multiple flat, symmetrical, purplish-red lesionsin the intergluteal and groin areas. Her skin eruption wasdiagnosed as a fixed drug eruption.

All of the woman’s medications were discontinued and herskin eruption resolved within 9 days. One month later, shepresented with a skin eruption identical in appearance andlocation to the previous skin eruption. She reported havingtaken two or three loperamide 2mg tablets a few days beforesymptom onset. Loperamide was discontinued and her skineruption resolved after 10 days.

Author comment: The imputability of loperamide andfixed drug eruption was analysed using Naranjo’s method ofestimating the probability of adverse drug effects, which gavea result of "probable" causality.Matarredona J, et al. Fixed drug eruption caused by loperamide. Medicina Clinica124: 198-199, No. 5, 12 Feb 2005 [Spanish; summarised from a translation] -Spain 807220146

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of fixed drug eruptionsassociated with loperamide. The WHO Adverse Drug Reactionsdatabase contained 100 reports of rash and five of fixed eruptionassociated with loperamide.

1

Reactions 16 Jul 2005 No. 10600114-9954/10/1060-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved