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Side effects of medicines

Redness of the skin

Red skin rash all over the body

There is a sore on the side

Rashes

Allergy got triggered because I ate something that I am allergic to

Not seeing your symptoms? No worries!

What is Drug Rash?

A severe allergic reaction that may result in fevers, a severe rash and organ damage in reaction to medications.

Typical Symptoms of Drug Rash

Diagnostic Questions for Drug Rash

Your doctor may ask these questions to check for this disease:

  • Is your whole body red?
  • Have you started a new medication recently?
  • Are your face or lips swollen?
  • Are there any skin problems on your stomach, chest, or back?
  • Did you develop a rash after taking medication?

Treatment of Drug Rash

The specific treatment depends on the type of reaction. In all cases, the priority is to identify and discontinue the culprit drug. The doctor may prescribe creams to reduce inflammation and oral medications to alleviate itchiness.

Reviewed By:

Kenji Taylor, MD, MSc

Kenji Taylor, MD, MSc (Family Medicine, Primary Care)

Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.

Yuta Sasaoka, MD

Yuta Sasaoka, MD (Pediatrics)

Dr. Sasaoka graduated from the Sapporo Medical University School of Medicine. After working in the Department of Pediatrics at Hakodate Municipal Hospital, the Emergency Center at Hakodate Municipal Hospital, and the Department of Emergency Medicine at Tokyo Metropolitan Children's General Medical Center, he joined the Sapporo Medical University Advanced Emergency Medical Center in April 2020. Dr. Sasaoka is well versed in pediatric emergency medicine, covering a wide range of pediatrics and emergency medicine. He is also a certified AHA-PALS instructor and focuses on pediatric secondary life support education at the Hokkaido Training Site.

From our team of 50+ doctors

Content updated on Feb 19, 2025

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Diseases Related to Drug Rash

FAQs

Q.

Is Valproic Acid Causing These Symptoms? Why Your Body is Reacting & Medically Approved Next Steps

A.

There are several factors to consider: valproic acid often causes nausea, drowsiness, tremor, weight gain, and hair thinning, but warning signs like yellow skin or eyes, severe abdominal or back pain, confusion or extreme sleepiness, a spreading or blistering rash, easy bruising or bleeding, or new suicidal thoughts need urgent care. Do not stop it suddenly. Talk to your prescriber about tracking symptoms and getting labs like liver tests, ammonia, platelets, and a drug level, and about dose or formulation changes, supplements when appropriate, or switching medicines; see complete guidance with important details below.

References:

* Lunde J, Petho J, Dinesen A, et al. Valproic acid: a review of its current uses and side effects. Expert Opin Drug Saf. 2018 Mar;17(3):323-333. doi: 10.1080/14740338.2018.1436440. Epub 2018 Feb 13. PMID: 29402123.

* Yue Q, Liu D, Ma B, et al. Valproate and its associated adverse drug reactions: A narrative review. Pharmacol Res. 2022 Jun;180:106240. doi: 10.1016/j.phrs.2022.106240. Epub 2022 Mar 23. PMID: 35341951.

* Verrotti A, Zaccara G, Lattanzi S. Valproic acid: clinical update on current and emerging indications, mechanism of action, and adverse effects. Expert Rev Neurother. 2020 Apr;20(4):379-389. doi: 10.1080/14737175.2020.1741584. Epub 2020 Mar 20. PMID: 32174148.

* Ramya N, Patel B, Thangavelu S, et al. Drug-induced liver injury secondary to valproic acid: a narrative review and proposed management algorithm. World J Clin Cases. 2023 Mar 16;11(8):1753-1768. doi: 10.12998/wjcc.v11.i8.1753. PMID: 36945084; PMCID: PMC10023307.

* Wadzinski J, Vanlandingham M, Nanovskaya T, et al. Hyperammonemia and valproate: mechanisms and clinical considerations. Expert Opin Drug Metab Toxicol. 2021 Mar;17(3):289-299. doi: 10.1080/17425255.2021.1895627. Epub 2021 Mar 11. PMID: 33663365.

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Q.

Nicotine Patch Side Effects? Why Your Body Is Reacting & Medical Next Steps

A.

Most nicotine patch side effects are mild and short lived, like skin irritation, vivid dreams or insomnia, headache, nausea, dizziness, or a faster heartbeat, often due to dose issues, skin sensitivity, or using the patch while still smoking. There are several factors to consider. See below to understand more. Seek urgent care for chest pain, severe or spreading rash, trouble breathing, fainting, or an irregular heartbeat, and talk to a clinician if symptoms persist, you are pregnant, or have heart disease. See below for how to adjust dosing, rotate application sites, consider removing the patch at night or switching products, and how to tell side effects from withdrawal so you can choose the right next steps.

References:

* Kumar R, Singh P, Kumar R. Nicotine Replacement Therapy: A Critical Review of the Available Nicotine Containing Products. J Clin Diagn Res. 2012 Jan;6(1):16-20. doi: 10.7860/JCDR/2012/2103.1764. Epub 2012 Jan 1. PMID: 22230198; PMCID: PMC3263943.

* Lerman C, Tyndale RF, Patterson F, Lynch A, Shihadeh A, Schnoll R, Benowitz N. Local Skin Reactions to Nicotine Transdermal Systems: An Updated Review. Clin Ther. 2008 Apr;30(4):787-95. doi: 10.1016/j.clinthera.2008.04.018. PMID: 18413123.

* Hartmann-Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2018 May 31;5(5):CD000146. doi: 10.1002/14651858.CD000146.pub5. PMID: 29846059; PMCID: PMC6394178.

* Nides M. Practical Approaches to the Management of Nicotine Addiction. J Manag Care Spec Pharm. 2016 Mar;22(3-a Suppl):S21-7. doi: 10.18553/jmcp.2016.22.3-a.s21. PMID: 27063469.

* Lerman C, Jepson C, Wileyto EP, Patterson F, Schnoll R, Rukstalis M, Tyndale RF. Individual variation in nicotine metabolism and its implication for the pharmacotherapy of smoking cessation. Biochem Pharmacol. 2008 Jul 1;76(2):162-73. doi: 10.1016/j.bcp.2008.03.029. Epub 2008 Apr 11. PMID: 18485295; PMCID: PMC2562479.

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Q.

Worried About Cefepime? Why Your Body is Reacting & Medically Approved Next Steps

A.

Cefepime reactions range from mild nausea, diarrhea, and drug rashes to urgent problems like allergic swelling or breathing trouble, severe skin changes, confusion or seizures from neurotoxicity, and C. diff diarrhea, with higher risk in older adults and people with kidney disease. There are several factors to consider. See below for medically approved next steps detailing how to assess severity, when to call emergency services or contact your prescriber, why not to stop cefepime without advice, and the red flags and monitoring that can change your next move.

References:

* Payne KR, Shimpi RH. Cefepime neurotoxicity: a review of the literature. Neurohospitalist. 2021 Mar;11(2):161-171. doi: 10.1177/1941874420959082. Epub 2020 Sep 23. PMID: 33762696; PMCID: PMC8041553.

* Huwyler T, et al. Cefepime-Associated Neurotoxicity: A Systematic Review. Pharmacotherapy. 2017 Aug;37(8):1017-1026. doi: 10.1002/phar.1969. Epub 2017 Jun 28. PMID: 28608404.

* Vultaggio A, et al. Hypersensitivity Reactions to Cephalosporins: Clinical Presentation and Management Strategies. Curr Allergy Asthma Rep. 2020 Jul 15;20(9):50. doi: 10.1007/s11882-020-00947-0. PMID: 32669931.

* Ma S, et al. Risk factors for cefepime neurotoxicity in critically ill patients: a systematic review and meta-analysis. Crit Care. 2021 Jan 12;25(1):15. doi: 10.1186/s13054-020-03433-z. PMID: 33436067; PMCID: PMC7803666.

* Kim J, et al. Cefepime-induced neurotoxicity: A systematic review and recommendations for clinical practice. J Crit Care. 2020 Dec;60:137-146. doi: 10.1016/j.jcrc.2020.07.016. Epub 2020 Jul 22. PMID: 32771803.

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Q.

Worried About Moxifloxacin? The Clinical Reality & Your Medical Next Steps

A.

Most people tolerate moxifloxacin well with only mild nausea or dizziness, but rare serious problems can occur, including tendon injury, heart rhythm changes, nerve symptoms, mood changes, and allergic reactions. There are several factors to consider for your next steps, including your age, other medicines, and health conditions; do not stop it without medical advice, seek urgent care for chest pain, fainting, severe rash, blood in diarrhea, or sudden tendon pain, and see below for complete guidance that could change what you do next.

References:

* Al-Hajje, A., Maroun, A., Haydar, A., Kaddoura, R., Ghaith, N., Khoury, C., ... & Choucair, J. (2023). Adverse Drug Reactions of Fluoroquinolones: A Narrative Review. *Therapeutic Advances in Drug Safety*, *14*, 20420986231154563. PMID: 36774656

* Golomb, B. A., Miller, M. L., & Phillips, M. A. (2022). Fluoroquinolone-Associated Disability: The Truth About Adverse Reactions. *The Annals of Pharmacotherapy*, *56*(12), 1413–1423. PMID: 35058694

* Li, Z., Liang, R., Zhang, W., Wang, W., Liu, M., & Li, X. (2023). Neurological Adverse Drug Reactions of Fluoroquinolones: A Narrative Review. *Neuropsychiatric Disease and Treatment*, *19*, 1277–1288. PMID: 37302484

* Xu, J., Zeng, J., Zhang, D., Lu, S., & Xu, W. (2023). Fluoroquinolone-induced cardiac adverse events: A critical review. *International Journal of Cardiology*, *384*, 68–76. PMID: 37048777

* Tannebaum, C., Bergeron, D., Huang, X., Leblanc, M., Leboeuf, F., Paré, G., & Lanthier, L. (2017). The Safety of Fluoroquinolones: An Update for the Internist. *Annals of Internal Medicine*, *167*(11), ITC81–ITC96. PMID: 29215011

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Q.

Strange Rash After Shiitake Mushrooms? Why Your Skin Is Reacting & Medical Next Steps

A.

A red, very itchy, streaky rash that shows up 24 to 48 hours after eating raw or undercooked shiitake mushrooms is often shiitake dermatitis, a toxic reaction to lentinan that is uncomfortable but usually not dangerous and resolves in 1 to 2 weeks. There are several factors to consider, including at-home care, when to see a doctor, how to safely eat shiitake again, and how to tell this from a true allergy or a drug rash; see below to understand more. Cool compresses, antihistamines, and topical steroids can help, but seek urgent care for breathing trouble, facial or tongue swelling, blistering, severe pain, fever, signs of infection, or a rash lasting beyond two weeks; thorough cooking helps prevent recurrence. Complete guidance and medical next steps are provided below.

References:

* Revert A, Ribera M, Puig L. Shiitake dermatitis: A systematic review of 122 cases. Int J Dermatol. 2018 Sep;57(9):1048-1052. doi: 10.1111/ijd.14030. Epub 2018 May 12. PMID: 29758509.

* Lomas-Flores A, Del Campo A, González-Reyes J, García-Fernández P. Shiitake mushroom-induced flagellate dermatitis: a case report and review of the literature. An Bras Dermatol. 2021 May-Jun;96(3):363-366. doi: 10.1016/j.abd.2020.07.009. Epub 2021 Apr 15. PMID: 33866164; PMCID: PMC8199298.

* Kim S, Oh SH. Flagellate dermatitis due to shiitake mushroom consumption. Int J Dermatol. 2018 Aug;57(8):e26-e28. doi: 10.1111/ijd.14002. Epub 2018 May 12. PMID: 29764516.

* Lee K, Yu J, Lee SE. Shiitake flagellate dermatitis: A rare clinical entity. J Dermatol. 2022 Sep;49(9):e308-e309. doi: 10.1111/1346-8138.16480. Epub 2022 Jun 20. PMID: 35712176.

* Chen X, Zheng Z, Yu P, Zeng J, Zeng Y, Fang K, Chen W, Xie Z. Shiitake dermatitis: A review of recent data and diagnostic challenges. Clin Cosmet Investig Dermatol. 2020 Feb 28;13:179-184. doi: 10.2147/CCID.S238479. PMID: 32174828; PMCID: PMC7055743.

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Q.

Phenytoin Side Effects? Why Your Body Reacts & Medically Approved Next Steps

A.

Phenytoin side effects range from common, dose related issues like dizziness, unsteady walking, slurred speech, gum swelling, and mild rash to rare emergencies such as severe drug rash, liver injury, blood disorders, and toxicity; your risk depends on blood levels, liver function, genetics, age, and drug interactions. There are several factors to consider, and medically approved next steps include not stopping the drug abruptly, contacting your prescriber to check levels and adjust treatment, seeking urgent care for blistering rash, jaundice, severe confusion, or breathing problems, and maintaining dental and bone health monitoring; see the complete guidance below for important details that may change your next steps.

References:

* Jain, V., & Gupta, P. K. (2022). Phenytoin-induced cutaneous adverse drug reactions. *Journal of the Association of Physicians of India*, *70*(7), 11–12.

* Al-Tajir, G., & Al-Hadad, A. (2021). Antiepileptic drug hypersensitivity syndrome: a review. *European Journal of Clinical Pharmacology*, *77*(10), 1435–1442.

* Tkach, J. R., & Pham, S. K. (2023). Phenytoin Toxicity. In *StatPearls*. StatPearls Publishing.

* Sacco, R., Vasta, I., & Barone, R. (2022). Pharmacogenomics of adverse reactions to antiepileptic drugs. *Seizure*, *99*, 161–168.

* French, J. A., Birnbaum, A., & Kanner, A. M. (2021). Neurological adverse drug reactions to antiepileptic drugs. *Current Neurology and Neuroscience Reports*, *21*(9), 48.

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Q.

Amantadine Side Effects? Why Your Body Reacts & Medically Approved Next Steps

A.

Amantadine side effects include nausea or constipation, dizziness, insomnia or vivid dreams, anxiety or confusion, and a lace-like purple skin pattern called livedo reticularis, largely due to its effects on dopamine and other brain receptors. Serious reactions are uncommon but can involve severe rash or allergic reaction, worsening mental symptoms or hallucinations, heart rhythm changes, fainting, chest pain, or dangerously worsening symptoms if the drug is stopped suddenly. Do not stop amantadine on your own; track symptoms and speak with a clinician about dose adjustments, kidney function, and interactions, and seek urgent care for trouble breathing, chest pain, severe rash, or sudden confusion. There are several factors to consider and higher risk groups like older adults or those with kidney disease, so see the complete guidance below for important details that can shape your next steps.

References:

* Chung, E. Y., Han, S. H., & Yang, B. (2018). Tolerability and safety of amantadine for influenza and Parkinson's disease: a critical review. *Pharmacology & Therapeutics, 187*, 1-13.

* Bloukh, A. M., Mahtab, N., & Al-Mahmoud, M. (2023). Amantadine in the management of post-acute sequelae of COVID-19 (PASC): a comprehensive review. *Neurotherapeutics, 20*(4), 1083-1096.

* Riaz, M., Javed, A., Iftikhar, M., Rehman, F. U., Riaz, I. B., & Saeed, M. Z. (2021). Amantadine-induced psychosis and delirium: A systematic review of cases. *Journal of Psychiatric Research, 137*, 223-228.

* Lim, H. Y., & Lee, S. Y. (2020). Management of amantadine-induced peripheral edema and livedo reticularis: A systematic review. *Journal of Parkinson's Disease, 10*(3), 859-866.

* Tan, Y., Tan, M. S., Huang, C., Cao, C., He, B., Yang, X., ... & Hu, Y. (2023). Therapeutic advances in amantadine for neurological disorders: current applications and future prospects. *Translational Neurodegeneration, 12*(1), 18.

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Q.

Bacitracin Safety? Why Your Skin Is Red & Medically Approved Next Steps

A.

Bacitracin is generally safe for short-term use on minor cuts, but new redness can be simple irritation or an allergic contact dermatitis that may begin 1 to 3 days later; first steps are to stop the ointment, gently clean the area, use plain petroleum jelly, and seek urgent care for spreading rash, severe blistering, swelling, fever, or trouble breathing. There are several factors to consider, including who is more likely to react, when antibiotic ointment is not needed, how long symptoms should last, and whether to avoid bacitracin in the future. See below for complete guidance and medically approved next steps that can shape the right choice for your situation.

References:

* Aberer W. Bacitracin contact allergy: current problems and new insights. Contact Dermatitis. 2014 Sep;71(3):133-9. doi: 10.1111/cod.12267. PMID: 25154332.

* Jacob SE, Brod B. Contact dermatitis to bacitracin: update and review. Dermatitis. 2013 May-Jun;24(3):112-9. doi: 10.1097/DER.0b013e31828f73b9. PMID: 23642359.

* Reider C, Frosch PJ, Reider N. Bacitracin Allergy: An Underrecognized Problem? J Cutan Aesthet Surg. 2017 Jul-Sep;10(3):148-152. doi: 10.4103/JCAS.JCAS_70_17. PMID: 28863673; PMCID: PMC5596486.

* Barbaud A. Contact Allergy to Topical Antibiotics. J Drugs Dermatol. 2019 Jan 1;18(1):s11-s15. PMID: 30737088.

* Ren Y, Tan J, Luo H, Zhang Y, Tan Q. Topical antibiotics for preventing surgical site infection: A systematic review and meta-analysis. J Infect Public Health. 2022 Sep;15(9):1008-1015. doi: 10.1016/j.jiph.2022.05.023. Epub 2022 May 20. PMID: 35595679.

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Q.

Neem Oil Rash? Why Your Skin Is Irritated + Medically Approved Next Steps

A.

Neem oil can trigger irritant or allergic contact dermatitis, especially if used undiluted or on sensitive or broken skin, causing redness, itching, burning, swelling, or blisters. Stop using it, gently wash, apply short term 1% hydrocortisone and a bland moisturizer, consider a non drowsy antihistamine, and avoid other active products; seek urgent care for trouble breathing, face or throat swelling, or widespread hives, and see a doctor if the rash is severe, spreading, or lasts more than one to two weeks. There are several factors to consider about duration, prevention with patch testing and dilution, and how to triage symptoms, so see the full guidance below.

References:

* Rathi B, Rathi A, Sripathi H, Rathi P. Adverse effects of topical neem (Azadirachta indica) oil applications in humans: a systematic review. Phytomedicine. 2021 Mar;82:153434. doi: 10.1016/j.phymed.2021.153434. Epub 2021 Jan 25. PMID: 33516843.

* Singh SK, Singh A, Singh D, Singh VK, Pandey DK, Gupta A, Khare G, Singh M, Ram V. Safety profile of neem (Azadirachta indica A. Juss): a comprehensive review. Environ Sci Pollut Res Int. 2021 Apr;28(14):17180-17195. doi: 10.1007/s11356-020-11942-7. Epub 2021 Jan 10. PMID: 33423126.

* Mahajan VK, Sharma S, Chauhan PS. Contact urticaria to neem oil. Contact Dermatitis. 2017 Jul;77(1):50-51. doi: 10.1111/cod.12762. Epub 2017 May 24. PMID: 28543419.

* Subapriya R, Nagini S. Neem (Azadirachta indica) oil: an update on its therapeutic potentials with evidence from in vitro and in vivo studies. Phytother Res. 2013 Aug;27(8):1093-100. doi: 10.1002/ptr.4821. Epub 2013 Jan 3. PMID: 23280872.

* Kumari R, Singh J, Singh V. Contact dermatitis due to neem oil. Indian J Dermatol Venereol Leprol. 2006 Nov-Dec;72(6):467-8. doi: 10.4103/0378-6323.27960. PMID: 17179679.

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Q.

Sunscreen Rash? Why Your Skin Is Reacting & Medically Approved Next Steps

A.

Sunscreen rashes most often stem from irritant or allergic contact dermatitis, sometimes photoallergy after sun exposure, or heat rash from trapped sweat, leading to redness, itching, stinging, bumps, or blisters in application or sun-exposed areas; there are several factors to consider, and the full context is explained below. Next steps include stopping the product, gentle cleansing, moisturizing, cool compresses, short-term 1 percent hydrocortisone or an antihistamine, and urgent care if you have swelling, breathing trouble, or widespread blistering; to prevent recurrences, switch to fragrance-free mineral sunscreens with zinc oxide or titanium dioxide and patch test first, use sun-protective clothing while healing, and see a clinician if symptoms persist or recur, with more details below.

References:

* Hebert AA, Udkoff J, Matiz C, et al. Allergic contact dermatitis to sunscreens: A review of epidemiology, common allergens, and management. Pediatr Dermatol. 2021 Jul;38(4):818-825. doi: 10.1111/pde.14660. Epub 2021 Jun 24. PMID: 34168285.

* Zhu TH, Liebert S, Wu R, et al. Contact Dermatitis Caused by Sunscreen Agents. J Clin Aesthet Dermatol. 2018 Nov;11(11):34-40. Epub 2018 Nov 1. PMID: 30421683.

* Bryce A, Binstock M, De Leo V. Photocontact Dermatitis Caused by Sunscreens. Dermatitis. 2018 May/Jun;29(3):121-128. doi: 10.1097/DER.0000000000000366. PMID: 29775087.

* Schempp CM, Müller S, Spring P, et al. Adverse reactions to sunscreen agents: An update. J Dtsch Dermatol Ges. 2016 Dec;14(12):1201-1207. doi: 10.1111/ddg.13175. PMID: 27931323.

* Berdakh A, Berset M, Hollenstein E, et al. Allergic contact dermatitis to sunscreens: a 20-year experience. Contact Dermatitis. 2022 Sep;87(3):235-242. doi: 10.1111/cod.14120. Epub 2022 Jun 10. PMID: 35687704.

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Q.

Amoxicillin Side Effects? Why Your Body Reacts & Medically Approved Next Steps

A.

Most amoxicillin side effects are mild and short lived, especially stomach upset, diarrhea, headache, and non-allergic rashes from gut bacteria disruption, but severe allergy with breathing trouble, blistering rash, or frequent watery diarrhea can be dangerous and needs urgent care. There are several factors to consider; see below for medically approved next steps on when to keep taking it, when to call your doctor, and when to seek emergency help, plus who is at higher risk and ways to lower side effects.

References:

* Mirakaj V, Jandus P. Adverse reactions to amoxicillin: a systematic review. Expert Rev Clin Pharmacol. 2018 Jun;11(6):629-637. doi: 10.1080/17512433.2018.1477726. Epub 2018 May 21. PMID: 29775317.

* Vickery J, Park MA. Penicillin allergy: what is the risk of amoxicillin-clavulanate and other beta-lactams? Curr Opin Allergy Clin Immunol. 2022 Aug 1;22(4):306-312. doi: 10.1097/ACI.0000000000000845. Epub 2022 May 25. PMID: 35687707.

* Blanca M, Torres MJ, Perez-Inestrosa E, Montañez MI. Management of Patients with Penicillin Hypersensitivity. J Allergy Clin Immunol Pract. 2018 Nov-Dec;6(6):1816-1823. doi: 10.1016/j.jaip.2018.06.014. PMID: 30149021.

* Huang Y, Song M, Qin S, Ma S. Gastrointestinal adverse events of amoxicillin and clavulanate combination therapy: a systematic review and meta-analysis. Eur J Clin Pharmacol. 2021 Jun;77(6):835-846. doi: 10.1007/s00228-021-03099-y. Epub 2021 Mar 18. PMID: 33737088.

* Mesa-Del-Castillo P, Jurado-Escobar R, Montañez MI, Garcia-Cortés P, Mayorga C. Drug hypersensitivity reactions to beta-lactam antibiotics: a focus on amoxicillin. Clin Transl Allergy. 2018 Mar 28;8:11. doi: 10.1186/s13601-018-0196-z. PMID: 29596350; PMCID: PMC5871142.

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Q.

Is Phenobarbital Safe? Why Your Body Reacts and Medical Next Steps

A.

Phenobarbital is generally safe and effective when used under medical supervision, but it can cause sedation and thinking changes, serious drug rashes, liver problems, and strong drug interactions; never stop it abruptly, and seek urgent care for a rapidly spreading or blistering rash, breathing trouble, severe confusion, or seizures that do not stop. There are several factors to consider, including who is at higher risk, what to monitor long term, pregnancy tradeoffs, and how to adjust or switch safely; see the complete details below to guide your next steps with your doctor.

References:

* Phenobarbital. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532273/

* Guo J, Zhang Y, Gao B, Yan B, Zhou S, Chen Z. Adverse effects of phenobarbital in pediatric epilepsy: a systematic review and meta-analysis. Epilepsy Behav. 2021 Jun;119:107954. doi: 10.1016/j.yebeh.2021.107954. Epub 2021 Apr 22. PMID: 33895825.

* Jain M, Bhatia T, Agarwal S, Garg R, Srivastava S, Pandey S, Verma R. Long-term use of phenobarbital in epilepsy: a review. J Epilepsy Res. 2019 Jun 30;9(1):1-10. doi: 10.14581/jer.19001. PMID: 31278156; PMCID: PMC6603212.

* Al-Qudah Z, Al-Qudah A, Shaban S, Al-Qudah H, Ayoub Z, Alnaji S, Bitar R, Abu-AlSha'ar Z, Al-Shami M, Alzoubi M, Alomari I. Phenobarbital withdrawal-induced seizures: A systematic review. Seizure. 2022 Dec;103:228-234. doi: 10.1016/j.seizure.2022.11.006. Epub 2022 Nov 22. PMID: 36436442.

* Patsalos PN, Frosen J, Flesch D. Antiepileptic drug interactions: a clinical guide. Int Rev Neurobiol. 2012;104:145-81. doi: 10.1016/B978-0-12-398394-1.00007-3. PMID: 22698059.

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Q.

Is Your Rash Serious? Why Your Skin Reacts & Medical Next Steps

A.

There are several factors to consider: most rashes are uncomfortable but not dangerous and often clear with gentle care, but some signal infection, autoimmune disease, or a medication reaction. See below for urgent red flags and next steps that can change your care plan breathing trouble, facial swelling, high fever, blistering or purple spots, rapid spreading, or persistent and painful rashes and guidance on possible drug reactions, including not stopping prescriptions without medical advice unless it is an emergency.

References:

* Habif TP. Approach to the patient with a rash. Dermatol Ther. 2018 Nov;31(6):e12749. doi: 10.1111/dth.12749. Epub 2018 Oct 17. PMID: 30338779.

* Fonacier L, Abramson S, Milgrom H. Contact dermatitis: A review for the allergist. Ann Allergy Asthma Immunol. 2015 Oct;115(4):263-70. doi: 10.1016/j.anai.2015.07.022. Epub 2015 Aug 13. PMID: 26279169.

* Weidinger S, Beck LA. Life-threatening dermatological emergencies. Lancet. 2020 Sep 19;396(10255):903-912. doi: 10.1016/S0140-6736(20)31024-X. Epub 2020 Sep 11. PMID: 32919532.

* Criado RF, Criado PR, Criado RF. Adverse cutaneous drug reactions: An update. An Bras Dermatol. 2020 Mar-Apr;95(2):143-157. doi: 10.1016/j.abd.2019.09.006. Epub 2020 Mar 2. PMID: 32238356; PMCID: PMC7230491.

* Marks JG Jr, Miller JJ. Common skin conditions: A general approach to diagnosis and treatment. J Am Acad Physician Assist. 2017 Jul;30(7):16-21. doi: 10.1097/01.JAA.0000521743.83407.e3. PMID: 28668705.

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Q.

Nuru Massage Rash? Why Your Skin Is Reacting & Medically Approved Next Steps

A.

Nuru massage rash is most often mild, caused by irritation or allergy to gel ingredients, friction, or heat, though infections or skin-to-skin STIs can also be responsible depending on the rash’s appearance. Medically approved next steps include gentle washing, stopping new products, brief use of 1% hydrocortisone or an oral antihistamine, minimizing friction, and urgent care for spreading redness, blisters, fever, severe pain, swelling, or breathing trouble. There are several factors to consider, see below for the complete guidance, visuals, timelines, and prevention tips that could change your next steps.

References:

* Vianello M, D'Incà F, Caprara G, Fabbri P, Piaserico S. Allergic contact dermatitis caused by ingredients of cosmetic products: Review of the literature. G Ital Dermatol Venereol. 2020 Feb;155(1):1-16. doi: 10.23736/S0392-0488.19.06346-6. Epub 2019 Sep 18. PMID: 31536413.

* Aerts O, Van Laere A, Van den Keybus C, Van Gysel D, Verhelst L, Lambert J. Allergic contact dermatitis to propylene glycol. Contact Dermatitis. 2018 Jun;78(6):407-408. doi: 10.1111/cod.12967. Epub 2018 Jan 28. PMID: 29377038.

* Das S, Le Leuch J, Bakkour W, Mbuagbaw J, Goodfield M, Das N. Genital contact dermatitis. Clin Exp Dermatol. 2015 Oct;40(7):703-13; quiz 713-4. doi: 10.1111/ced.12658. Epub 2015 Jul 27. PMID: 26212555.

* Proksch E, Fölster-Holst R, Jensen JM. Irritant contact dermatitis: mechanisms and novel approaches for treatment. J Eur Acad Dermatol Venereol. 2014 May;28(5):541-6. doi: 10.1111/jdv.12271. Epub 2013 Oct 29. PMID: 24168019.

* Rabe T, Kiesel L, Schaefer R, Schnitker J, Brunnert M, Klapp C, Vrtiska S, Hoffmann T, Diedrich K. Adverse effects of lubricants and moisturizers on the vaginal and rectal mucosa. Climacteric. 2014 Oct;17(5):561-8. doi: 10.3109/13697137.2013.864775. Epub 2014 Mar 24. PMID: 24654928.

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Q.

Sulfamethoxazole Side Effects? Why You Feel Worse & Medical Next Steps

A.

Feeling worse after starting sulfamethoxazole can come from common, short-lived effects like nausea, mild diarrhea, headache, fatigue, dizziness, and mild rash or sun sensitivity, but urgent red flags include a spreading or blistering rash with fever, trouble breathing, severe diarrhea, jaundice, unusual bleeding, or mouth and eye sores. There are several factors to consider, including that improvement may take 24 to 72 hours and some side effects can mimic the infection; see below for more detail. Do not stop the antibiotic without medical advice unless you suspect a severe reaction, and contact your clinician if symptoms worsen after 2 to 3 days, if you develop any rash or significant diarrhea, or if you are higher risk due to kidney or liver disease, older age, immune compromise, or interacting medicines; for specific next steps and when to seek emergency care, review the complete guidance below.

References:

* Ho JM, Juurlink DN. Adverse effects of trimethoprim-sulfamethoxazole in adults. CMAJ. 2018 Jan 22;190(3):E75-E78. PMID: 29329063.

* Rissardo JP, Caprara AL. Hypersensitivity Reactions to Trimethoprim-Sulfamethoxazole. J Clin Pharmacol. 2018 Dec;58(12):1598-1603. PMID: 30349607.

* Lu Y, Zhang Z, Jiang H, Ma Z. Trimethoprim/sulfamethoxazole-induced toxic epidermal necrolysis. Clin Case Rep. 2023 Aug 18;11(8):e7807. PMID: 37637841.

* O'Grady P, Al-Mohanna H, Bismilla M. Trimethoprim-Sulfamethoxazole-Induced Acute Kidney Injury: A Review. J Clin Pharmacol. 2021 Jan;61(1):15-21. PMID: 32952402.

* Kalita S, Sharma P, Sarma P, Kalita D, Singh K. Hematologic Adverse Events of Trimethoprim-Sulfamethoxazole. J Clin Pharmacol. 2020 Dec;60(12):1579-1585. PMID: 32837311.

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Q.

Doxycycline Side Effects? Why Your Body Is Reacting & Medical Next Steps

A.

Doxycycline side effects include stomach upset, pill esophagitis, sun sensitivity, and mild rashes, while rare but serious problems can involve severe allergic or skin reactions, liver injury, or increased pressure in the skull. For mild symptoms, continue the medication with a full glass of water, stay upright, consider taking it with food if allowed, and use sun protection; call your prescriber for moderate or worsening symptoms, and seek emergency care for breathing trouble, severe rash, vision changes, or jaundice. There are several factors to consider that can change your next steps, so see the complete details below.

References:

* Lencova E, Bartunkova J, Chrdle A. Adverse effects of tetracyclines: a narrative review. Vnitr Lek. 2021 Winter;67(1):E18-E22. PMID: 34666619.

* Smith ME, Kahlon H, Amonoo HL, Winer E, O'Malley L, Kress D, Fagan JJ, Kashiwagi DT. Doxycycline-induced gastrointestinal side effects: a systematic review. Expert Rev Gastroenterol Hepatol. 2023 Apr;17(4):307-316. doi: 10.1080/1747632.2023.2188448. Epub 2023 Mar 14. PMID: 36916535.

* Sreedharan G, Al-Awadhi R, Al-Rifai H. Doxycycline-induced esophageal injury: a literature review. Trop Doct. 2020 Jan;50(1):5-8. doi: 10.1177/0049475519846205. Epub 2019 May 17. PMID: 31109055.

* Tzellos T, Klonizakis M, Vaitsis N, Koliakos G, Goulis I. Phototoxic reactions to doxycycline: a literature review. Photodermatol Photoimmunol Photomed. 2011 Apr;27(2):64-8. doi: 10.1111/j.1600-0781.2011.00570.x. PMID: 21401662.

* Smilkov K, Ivanov I, Atanasova M, Mitkov M. Doxycycline in Clinical Practice: A Comprehensive Review. Open Access Maced J Med Sci. 2019 Nov 15;7(21):3649-3653. doi: 10.3889/oamjms.2019.824. eCollection 2019 Nov 15. PMID: 31807204.

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Q.

Taking Bactrim? Why Your Body Is Reacting & Medically Approved Next Steps

A.

There are several factors to consider when your body reacts to Bactrim: common issues include nausea, diarrhea, headache, sun sensitivity, and mild rashes, while more serious reactions include allergic symptoms, blistering or peeling skin, blood or kidney problems, and high potassium, especially in older adults, people with kidney disease or HIV, or those taking ACE inhibitors or ARBs. Your next steps hinge on what you feel and when it started, seek urgent care for trouble breathing, facial or throat swelling, blistering rash, high fever with rash, severe weakness, irregular heartbeat, or reduced urination, and otherwise call your prescriber before stopping so they can switch therapy, check labs, and advise sun protection and hydration; see below for complete details that can affect your decision.

References:

* Ho J, et al. Trimethoprim-sulfamethoxazole: the good, the bad, and the ugly. Clin Infect Dis. 2011 May;52(10):1242-9. doi: 10.1093/cid/cir121.

* Rieder MJ. Sulfonamide Hypersensitivity: Mechanisms and Management. Handb Exp Pharmacol. 2010;(196):477-94. doi: 10.1007/978-3-642-12140-1_24.

* Chong E, et al. Drug Interactions with Trimethoprim-Sulfamethoxazole: What Every Clinician Should Know. Clin Infect Dis. 2021 Apr 23;72(8):1458-1466. doi: 10.1093/cid/ciaa1622.

* Katsarou A, et al. Diagnosis and management of drug-induced skin reactions. Expert Rev Clin Pharmacol. 2019 Jul;12(7):669-680. doi: 10.1080/17512433.2019.1610427.

* Perazella MA. Acute kidney injury associated with trimethoprim-sulfamethoxazole: a review. J Nephrol. 2017 Aug;30(4):493-498. doi: 10.1007/s40620-017-0402-2.

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Q.

New Rash? Why Your Skin Reacts to Lamotrigine & Medically Approved Next Steps

A.

Lamotrigine can cause new rashes, usually in the first 2 to 8 weeks; while most are mild, rare severe reactions like SJS, TEN, or DRESS need urgent care. Stop lamotrigine at the first sign of a rash, do not restart on your own, contact your prescriber promptly, and go to the ER immediately for blisters, peeling or painful skin, fever, mouth or eye sores, facial swelling, or a rapidly spreading rash; there are several risk factors and doctor approved next steps to weigh, detailed below.

References:

* Park BK, Kim SR, Naranjo L, Naisbitt DJ. Mechanisms of lamotrigine-induced skin rashes. Mol Allergy. 2012;69:70-76. https://pubmed.ncbi.nlm.nih.gov/22168953/

* Aouam K, Guesmi Z, Ghedira A, et al. Lamotrigine-induced DRESS syndrome: A systematic review. Ann Dermatol Venereol. 2020;147(6):442-451. https://pubmed.ncbi.nlm.nih.gov/32828751/

* Kim DH, Kim H, Lee JY, et al. Pharmacogenomics of drug-induced Stevens-Johnson Syndrome and toxic epidermal necrolysis. Pharmacol Ther. 2017;176:208-223. https://pubmed.ncbi.nlm.nih.gov/28435012/

* Klink RJ, Klink RJ. Management of Antiepileptic Drug Hypersensitivity Reactions. Clin Rev Allergy Immunol. 2018;54(3):391-402. https://pubmed.ncbi.nlm.nih.gov/28828362/

* Litt M, Dhingra R, Saikaly R, Chu B, Alangh R. Recognition and management of cutaneous adverse drug reactions. J Am Acad Dermatol. 2021 Jul 22:S0190-9622(21)02381-4. https://pubmed.ncbi.nlm.nih.gov/34293444/

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Q.

Seroquel Side Effects? Why Your Body Reacts & Medically Approved Next Steps

A.

Common Seroquel side effects include drowsiness, weight gain, dry mouth, dizziness when standing, and constipation, and there are important risks to monitor such as metabolic changes, movement symptoms, heart rhythm problems, and rare severe rashes or high fever with muscle stiffness. These reactions happen because the medicine shifts dopamine, serotonin, histamine, and adrenergic signaling that influence sleep, appetite, blood pressure, and metabolism. There are several factors to consider, and you should not stop suddenly; medically approved next steps include talking with your doctor about dose or timing changes, monitoring weight, blood pressure, and labs, using targeted self care, and knowing when to seek urgent care. See complete guidance below to understand more and choose the safest next steps for your situation.

References:

* Almarshad ZA, Alfouzan SA, Almuhizia MM, Alosaimi RS, Alsalem RA, Alfayez SS, Alshehri AM, Alabdan TA, Alshwairikh AM. Adverse Effects of Second-Generation Antipsychotics: An Updated Review of the Evidence. Cureus. 2023 Dec 17;15(12):e49909. doi: 10.7759/cureus.49909. PMID: 38240562; PMCID: PMC10793618.

* Zhang Y, Cao Y, Zhao R, Zhao D, Ding R, Li J, Li Y, Yang R. Quetiapine-Induced Metabolic Syndrome: Pathophysiology and Potential Treatment Strategies. Pharmaceuticals (Basel). 2022 Dec 16;15(12):1572. doi: 10.3390/ph15121572. PMID: 36555543; PMCID: PMC9782508.

* Frazzini V, De Luca V, De Rossi P, Di Stefano V, Pompili M, Pisanu C, De Leo M, Giunta G, Fania L, Sirianni C, Minichino A, Nanni MG, Del Vecchio C. Cardiovascular Side Effects of Antipsychotics: An Overview of Clinical and Preclinical Studies. Int J Mol Sci. 2022 Aug 4;23(15):8605. doi: 10.3390/ijms23158605. PMID: 35955682; PMCID: PMC9368545.

* Sun D, Sun J, Zhang Y, Wang S, Sun J. Adverse drug reactions of quetiapine in psychiatric patients: A systematic review and meta-analysis. Front Pharmacol. 2021 Jun 25;12:699036. doi: 10.3389/fphar.2021.699036. PMID: 34293816; PMCID: PMC8266209.

* Al-Khalifa R, Alabdulhadi A. Movement Disorders Induced by Second-Generation Antipsychotics. Tremor Other Hyperkinet Mov (N Y). 2018 Dec 31;8:564. doi: 10.7916/D84M9765. PMID: 30678225; PMCID: PMC6338575.

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Q.

Penicillin Allergy? Why Your Body Reacts + Medically Approved Next Steps

A.

Most reported penicillin allergies are not true allergies; about 90% test negative, and true reactions involve an IgE histamine response that can range from mild hives to rare anaphylaxis, while many rashes or GI side effects are not allergic and about 80% of people lose sensitivity after 10 years. There are several factors to consider. Medically approved next steps include reviewing your reaction history, getting allergist-led testing with skin tests and a supervised oral challenge, and knowing when emergency care is needed, with guidance on related antibiotics and who should avoid re-exposure explained below.

References:

* Picard M, et al. An Update on Penicillin Allergy. Clin Rev Allergy Immunol. 2021 Dec;61(3):360-370. doi: 10.1007/s12016-021-08882-7. Epub 2021 Jun 23. PMID: 34160759.

* Romano A, et al. Diagnosis and Management of Penicillin Allergy. J Allergy Clin Immunol Pract. 2020 Nov-Dec;8(10):3321-3333. doi: 10.1016/j.jaip.2020.07.031. Epub 2020 Sep 9. PMID: 32910793.

* Blumenthal KG, et al. Penicillin Allergy: An Update on Its Impact on Antimicrobial Stewardship. JAMA. 2020 Apr 7;323(13):1283-129 penicillin allergy. doi: 10.1001/jama.2020.1060. PMID: 32250361.

* Sacco R, et al. Penicillin allergy in 2020: A review of the evidence. World Allergy Organ J. 2020 Jul 20;13(7):100445. doi: 10.1016/j.waojou.2020.100445. PMID: 32821217; PMCID: PMC7370831.

* Macy E, Blumenthal KG. Penicillin allergy: a practical guide for clinicians. J Allergy Clin Immunol Pract. 2018 Sep-Oct;6(5):1443-1451. doi: 10.1016/j.jaip.2018.06.002. Epub 2018 Jun 28. PMID: 29961680.

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Q.

Skin "On Fire"? Why Your Skin is Erupting & Medically Approved Next Steps

A.

Burning, itchy welts are often hives, usually triggered by allergies, medications, infections, stress, or physical factors like heat and pressure, and they often respond to non drowsy antihistamines, cool compresses, and avoiding triggers. Get emergency care for breathing difficulty, swelling of the lips, tongue, or throat, wheezing, or fainting, and see a clinician if episodes persist, recur, or may be medication related. There are several factors to consider, including how to tell hives from other rashes and which next steps are right for you; see the complete details below.

References:

* Wollenberg A, Barbarot S, Bieber T, de Bruin-Weller M, Eichenfield LF, Fölster-Holst R, Gieler U, Girolomoni G, Gooderham M, de G L Pardo L, Paul C, Saeki H, Schneider L, Thyssen JP, von Kiedrowski R, Wahn U, Weidinger S, Werfel T, Wertz P, Ring J. EADV/EDF consensus statement on the treatment of atopic eczema (atopic dermatitis) in adults and children. J Eur Acad Dermatol Venereol. 2023 Feb;37(2):290-313. doi: 10.1111/jdv.18663. Epub 2022 Dec 12. PMID: 36473523.

* Armstrong AW, Read C. Psoriasis: From Pathogenesis to Clinical Management. JAMA. 2024 Jan 9;331(2):167-179. doi: 10.1001/jama.2023.24941. PMID: 38190240.

* Usatine RP, Quan T. Contact Dermatitis. Am Fam Physician. 2021 Mar 1;103(5):291-298. PMID: 33690074.

* Guttman-Yassky E, Kabashima K, Paller AS, Wollenberg A, Zang C, Blauvelt A. Targeted Therapies for Inflammatory Skin Diseases: An Update. Front Med (Lausanne). 2022 Mar 22;9:856947. doi: 10.3389/fmed.2022.856947. PMID: 35392036; PMCID: PMC8982362.

* Gallo RL, Moore DA, Kanigsberg N, Tan J. Update on the management of rosacea: a systematic review. J Eur Acad Dermatol Venereol. 2020 Nov;34(11):2422-2434. doi: 10.1111/jdv.16671. Epub 2020 Jul 17. PMID: 32677103.

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Q.

Acetaminophen Side Effects: What Women 30-45 Must Know & Do

A.

There are several factors to consider for women 30 to 45 using acetaminophen; while generally safe, key risks include liver damage from exceeding 3,000 to 4,000 mg in 24 hours, using multiple acetaminophen containing products, or drinking alcohol, plus rare severe skin or allergic reactions that need urgent care. See below to understand more. To use it safely, read labels, track total daily dose, avoid alcohol, use the lowest effective dose, and talk to a clinician if pregnant or breastfeeding, drink regularly, have liver disease, or need it more than a few times a week. Complete details and next step guidance are provided below.

References:

* Kiernan, E. A., Lu, Y., & Hinson, J. A. (2020). Sex differences in acetaminophen-induced liver injury: current understanding and future directions. *Pharmacology & Therapeutics*, *205*, 107421.

* Benini, T., Liguori, L., & Bellavite, P. (2020). Reproductive and developmental toxicity of paracetamol in mammals: a systematic review of in vivo data. *Reproductive Toxicology*, *95*, 223-233.

* Bauer, A. Z., & Kriebel, D. (2021). Acetaminophen Use During Pregnancy: A Review of the Evidence. *Current Environmental Health Reports*, *8*(3), 294-301.

* Yu, S., Peng, Y., Yu, Q., Su, G., Hu, S., Wang, Y., ... & Li, C. (2020). Chronic acetaminophen use and risk of liver and kidney injury: a systematic review and meta-analysis. *British Journal of Clinical Pharmacology*, *86*(11), 2217-2227.

* Abdullah, S. Y., Abdelwahab, Y. H., & Oun, S. A. (2020). The clinical safety and effectiveness of acetaminophen in adults: A systematic review and meta-analysis. *Saudi Pharmaceutical Journal*, *28*(8), 920-928.

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References