Anaphylactoid Reaction to a Cyclooxygenase-2 Inhibitor in a Patient Who Had a Reaction to a Cyclooxygenase-1 Inhibitor

• Published in: The New England journal of medicine Vol. 345; no. 25; p. 1856
• Main Authors: Schellenberg, R. Robert, Isserow, Saul H
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 20.12.2001
• Subjects: Anaphylaxis - chemically induced; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Cyclooxygenase 1; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors - adverse effects; Diclofenac - adverse effects; Drug Combinations; Humans; Isoenzymes - antagonists & inhibitors; Lactones - adverse effects; Male; Membrane Proteins; Middle Aged; Misoprostol - adverse effects; Osteoarthritis - drug therapy; Prostaglandin-Endoperoxide Synthases; Sulfones
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM200112203452518

To the Editor: Recent studies 1 – 3 have suggested that cyclooxygenase-2 (COX-2) inhibitors can be safely used in patients with asthma who have documented intolerance to COX-1 inhibitors such as aspirin and nonsteroidal antiinflammatory drugs. On the basis of these observations, we chose to treat a subject who had had an adverse reaction to a nonsteroidal antiinflammatory drug with the COX-2 inhibitor rofecoxib (Vioxx) in a supervised hospital setting. A 63-year-old man with no history of asthma or allergic disease began treatment with diclofenac–misoprostol (Arthotec) in June 2001 for osteoarthritis. After one week of use, facial flushing and itching of the . . .