Urticaria paracetamol

The concomitant use of paracetamol may increase the chance of adverse effects, especially erythema and urticaria (4). 

Asthmatic attacks due to non-narcotic analgesics, mostly occur in patients with so-called intrinsic or idiosyncratic asthma (often associated with nasal polyposis, sinusitis and eosinophilia of the blood) (McFadden and Austen 1977). About 10% of patients with this kind of asthma show severe reactions to aspirin, methyl-salicylate, pyrazolone derivatives, indomethacin, ibuprofen, diclofenac and sometimes even phenacetin and paracetamol. (Sodium salicylate is often tolerated.) The special reactivity may appear only in later life and concerns a number of chemically unrelated drugs. In some of these patients analgesic therapy with a morphine derivative such as pentazocine (Fortalgesic) or hyoscine butylbromide (Buscopan) may be necessary. However, in other patients, those with aspirin urticaria rather than asthma, the reaction may also rely on a drug-specific allergic mechanism (de Weck 1971). 

Cutaneous side effects reported are urticaria, fixed drug eruption, maculopapular exanthemas and pigmentary purpura Uses water-soluble prodrug for intravenous administration resulting in the liberation of paracetamol. ABCD A... 

Many patients who respond to aspirin with asthma, rhinitis and urticaria are also sensitive to other analgesic anti-inflammatory drugs. Cross-sensitivity has been demonstrated with indomethacin, mefenamic acid, flufenamic acid, phenylbutazone, paracetamol, fenoprofen and ibuprofen (37, 39, 40C, 44C 4gc 55C 566 57R) Furthermore, cross-sensitivity may also occur with widely used food additives and colourings such as benzoic acid and the acidic yellow dye tartrazine (46 ", 47, 57, 58 ). In Holland tartrazine is used in the colouring of at least 79 pharmaceutical formulations including antibiotics and even preparations... 

Skin reactions such as urticaria have been described but are very rare (210 ). In one report, 28.6% of 42 patients with known aspirin sensitivity developed increased airways resistance following challenge with paracetamol (39 ). However, in other studies, cross-tolerance with aspirin in such patients did not occur or was very uncommon (37, 56 ). 

---