Anaphylactic reactions to ketoconazole.

1673 available suggests that convulsions are the only serious complication of acute zimeldine overdosage. [Sales of zimeldine in all countries were discontinued by Astra Pharmaceuticals in September 1983 because of the company's concern about reports of serious neurological side effects including the Guillain Barr6 syndrome.] I Dawling S, Braithwaite RA. Simplified method for monitoring tricyclic antidepressant therapy using gas-liquid chromatography with nitrogen Effect of zimeldine, a new antidepressant, on appetite and body weight. Anaphylactic reactions to ketoconazole Ketoconazole is an effective and widely prescribed oral antimycotic drug. We report a hitherto undescribed side effect, severe anaphylaxis, which was observed in two patients; in one anaphylaxis was probably related to prior sensitisation to miconazole. A 26 year old woman was treated in July 1982 with miconazole cream (Daktarin) for suspected mycosis of the right foot. After 10 days the site of application became red, and one day later widespread macules, papules, and vesicles appeared. She was referred to a dermatologist, who diagnosed contact dermatitis to miconazole with eczematoid reaction. An epicutaneous test of the Daktarin cream base yielded a negative result. In May 1983 she was prescribed ketoconazole 200 mg daily for dermato-mycosis of the breasts (confirmed by direct microscopy). She took the first tablet at 2015. About 45 minutes later she noticed that her hands, feet, lips, and earlobes were itching and beginning to swell. She became dizzy and collapsed several times; during these periods she was incontinent for urine. On examination, after roughly another 15 minutes, severe angio-oedema and pronounced erythema of the face, hands, and feet were found. She was fully conscious, her blood pressure was 85/50 mm Hg, and her radial pulse was weak and accelerated. She was treated with 2 mg clemastine fumarate intravenously, and within 15 minutes angio-oedema had diminished and blood pressure risen to 100/60 mm Hg. Treatment was continued with 50 mg mebhydrolin, and the following morning all symptoms had disappeared. Besides an oral contraceptive she had not been taking any other drugs. She had never experienced an allergic reaction before except for the reported contact dermatitis to miconazole. A 52 year old man was prescribed ketoconazole 200 mg daily for dermato-mycosis of the right foot (confirmed by direct microscopy). He took the first tablet at 1915. About half an hour later he noticed that his hands and feet had begun to swell and were itching severely. His general practitioner saw him at …