More Drugs Associated with Stevens-Johnson Syndrome (SJS)

Washington, DCA litany of over-the-counter drugs can cause Stevens-Johnson Syndrome (SJS), the most common being Ibuprofen, anti-convulsants (such as Dilantin); antibiotics and Nonsteroidal anti-inflammatory drugs (NSAIDs). Recently the biopharmaceutical company Cephalon Inc. announced that its cancer drug Treanda has been associated with SJS.

In April 2009, the FDA asked Cephalon to update Treanda's prescribing information to include an increased risk of severe skin toxicity after the company reported two cases of SJS and toxic epidermal necrolysis ("TEN") in patients treated with both Treanda and allopurinol; one of these cases was fatal. Allopurinol is known to cause SJS/TEN. In the non-fatal case, the patient also received other drugs that can cause SJS. (Treanda treats indolent non-Hodgkin's lymphoma and/or chronic lymphocytic leukemia.)

This isn't the first time that a drug made by Cephalon has been associated with SJS.
Modafinil was first approved for improving wakefulness in narcolepsy, and in 2004 to improve wakefulness in patients with excessive sleepiness associated with obstructive sleep apnea/hypopnea syndrome and shift work sleep disorder. Cephalon also asked that the drug be used to treat ADHD in treating children and adolescents. But in 1998 the FDA's Psychopharmacologic Drugs Advisory Panel found that modafinil was not safe for treating children and adolescents with ADHD due to its potential to cause SJS in this population. Consequently, Cephalon announced that it will stop development of the drug for this indication.

And now with the recent outbreak of swine flu, there is the risk of people using medications such as Tamiflu or Relenza without doctor's advice-- these two antiviral drugs have also been associated with SJS. Memories of the SARS outbreak in 2003 have caused fear amongst some people and they are stocking up on medications, but members of the health community have warned that taking drugs such as Tamiflu unnecessarily might increase resistance to the drug and possibly cause an allergic reaction—which could lead to SJS.

Roche Laboratories, the manufacturer of Tamiflu, says it is the most prescribed flu medication for the treatment of flu in patients who have been symptomatic for no more than two days. Tamiflu is approved for children aged 1 year and older and adults, but according to its safety labeling (and an announcement by the US Chamber of Commerce) cases of SJS and TEN have been reported by patients using this flu medication.

SJS has also been associated with different anticonvulsant agents or non-steroidal anti-inflammatory drugs, such as the oxicams. As well, genetic factors are suspected in drug-induced blistering disorders such as TEN/SJS. Health officials warn that any suspected drug causing an allergic reaction should not be used in the blood relatives of the victim.

To date there is no cure for SJS/TEN. Survivors of TEN/SJS should not take the suspected medication or related compounds. The patient is treated at a burn center or intensive care unit to reduce the risk of infection and intravenous fluid replacement is initiated. If you or someone you love has had an allergic reaction to a drug that led to SJS, you should seek legal help.