Drug | Clinical reaction(s) | Presumed mechanism |
Aspirin and other NSAIDs | Exacerbations of rhinitis, asthma (in patients with aspirin-exacerbated respiratory disease) Urticaria/angioedema (NOTE: Urticaria may also result from a type I, IgE-mediated allergic reaction) | Inhibited prostaglandin production and enhanced leukotriene production |
Opiates | Pruritus, urticaria | Direct stimulation of mast cells and/or basophils causing release of mediators |
Vancomycin | Flushing during infusion | Direct stimulation of mast cells through MRGPRX2, causing release of mediators |
Radiocontrast media | Anaphylaxis, shock (NOTE: Some may be type I, IgE-mediated allergic reactions) | Unknown mechanism |
Ciprofloxacin | Urticaria (most reactions) | Direct stimulation of mast cells through MRGPRX2, causing release of mediators |
Local anesthetics | Syncope | Vasovagal reflex |
Protamine | Hypotension, pulmonary hypertension | Unknown mechanism |
Choline | Pruritus, urticaria | Unknown mechanism |
Isoniazid | Hepatitis | Unknown mechanism |
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