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Medications that can cause histamine release

Medications that can cause histamine release
Antibiotics – Ciprofloxacin, vancomycin
Barbiturates
Opioids*
Neuromuscular antagonists
  • Quaternary amine – Succinylcholine
  • Benzylisoquinolinium compounds – Atracurium, cisatracurium, doxacurium, mivacurium, tubocurarine
Plasma expanders – Dextran, polygeline (Haemaccel [brand name])
Radiocontrast agents
The medications listed above can cause nonimmunologic histamine release, which can predispose patients to vancomycin reactions and/or prevent successful vancomycin desensitization.
* Fentanyl rarely induces histamine release.
Reproduced and modified with permission from: Wazny LD, et al. Desensitization protocols for vancomycin hypersensitivity. The Annals of Pharmacotherapy 2001; 35:1458. Copyright © 2001 Harvey Whitney.
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