Allergy Asthma Respir Dis.  2013 Jun;1(2):172-175. 10.4168/aard.2013.1.2.172.

Anaphylaxis caused by muscle relaxant (eperisone hydrochloride)

Affiliations
  • 1Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea. doc4u@hanmail.net

Abstract

Eperisone hydrochloride is an antispasmodic drug, decreasing spasticity of skeletal muscle and alleviating stiffness, and as a consequence, controlling pain. It is preferably prescribed with other analgesics, beneficially less decreasing alertness compared with other antispasmodics. Its fatal drug adverse reactions were rarely reported. A 70 year-old female with hives, swollen face, hoarse voice, and near fainting admitted via emergency department. She suffered from the series of the fatal symptoms after administration of the pills, prescribed for her neck pain. Two months before, she had experienced hives on similar medications. At presentation, she revealed hypoxemia and hypotension, and treated with epinephrine, glucocorticoids and antihistamines. Among the medicines she took, eperisone hydrochloride was proven as the causative medicine and others were excluded in oral provocation tests. The positive result in intradermal test with eperisone hydrochloride suggested immediate-type hypersensitivity reaction. We report a case of anaphylaxis to eperisone hydrochloride, one of the widely prescribed medicines in clinical practice, previously without awareness of drug adverse reaction.

Keyword

Anaphylaxis; Eperisone; Muscle relaxants; Immediate hypersensitivity; Drug hypersensitivity

MeSH Terms

Analgesics
Anaphylaxis
Anoxia
Drug Hypersensitivity
Emergencies
Epinephrine
Female
Glucocorticoids
Histamine Antagonists
Humans
Hypersensitivity
Hypersensitivity, Immediate
Hypotension
Intradermal Tests
Muscle Spasticity
Muscle, Skeletal
Muscles
Neck Pain
Parasympatholytics
Propiophenones
Syncope
Urticaria
Voice
Analgesics
Epinephrine
Glucocorticoids
Histamine Antagonists
Parasympatholytics
Propiophenones

Figure

  • Fig. 1 Generalized hives with periorbital and neck angioedema developed in 30 minutes after oral administration of eperisone hydrochloride 25 mg in oral provocation test.

  • Fig. 2 Intradermal tests with eperisone hydrochloride and saline as a negative control. 11 mm×9 mm sized wheal reaction was observed at intradermal injection of eperisone hydrochloride (E). No wheal was seen in saline (-).


Cited by  3 articles

Eperisone-Induced Anaphylaxis: Pharmacovigilance Data and Results of Allergy Testing
Kyung Hee Park, Sang Chul Lee, Ji Eun Yuk, Sung-Ryeol Kim, Jae-Hyun Lee, Jung-Won Park
Allergy Asthma Immunol Res. 2019;11(2):231-240.    doi: 10.4168/aair.2019.11.2.231.

Overview of anaphylaxis in Korea: diagnosis and management
Gwang Cheon Jang, Yoon-Seok Chang, Sun Hee Choi, Woo-Jung Song, Soo-Young Lee, Hae-Sim Park, Hye-Ryun Kang, Yeong-Min Ye, Hyun-Jung Jin, Mi Yong Shin, Soo-Jin Lee, Hye One Kim, Jihyun Kim, Jae-Woo Jung, Hee-Bom Moon, Youngmin Ahn
Allergy Asthma Respir Dis. 2013;1(3):181-196.    doi: 10.4168/aard.2013.1.3.181.

A case series of eperisone-induced immediate hypersensitivity
Dong Yoon Kang, Jin Lee, young-Hee Sohn, Sung Yoon Kang, Yoon Sook Cho, Hye-Ryun Kang
Allergy Asthma Respir Dis. 2017;5(4):228-231.    doi: 10.4168/aard.2017.5.4.228.


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