Reactions 1414 - 11 Aug 2012

Prasugrel

Pruritic maculopapular rash in an elderly patient:case report

A 76-year-old woman developed an allergic reaction,manifesting as a pruritic maculopapular rash, whilereceiving prasugrel.

The woman presented with crescendo angina pectorisand narrowing of the left anterior descending artery, andunderwent a percutaneous coronary intervention. Sevenyears previously, she had developed a hypersensitivityreaction of clopidogrel, and so she was administeredprasugrel at a loading dose of 60mg, followed by amaintenance dosage of 10mg daily [route not stated]. Twodays later, she developed a pruritic maculopapular rash onher limbs and trunk.

Prasugrel was switched to clopidogrel, and the womanreceived prednisone, cetirizine and chlorphenamine tofacilitate physiological tolerance. Four days later, her rashresolved. At 1 month follow-up, anti-allergic therapy waswithdrawn, and the rash did not recur.

Author comment: "[C]lopidogrel therapy is critical inpatients following percutaneous coronary interventions andoften cannot be stopped even in cases of adverse drugresponse. Alternative treatment with prasugrel can cross-reactand leads to a similar adverse reaction."Raccah BH, et al. Allergic reaction to prasugrel and cross-reactivity withclopidogrel. International Journal of Cardiology 157: e48-e49, No. 3, 14 Jun 2012.Available from: URL: http://dx.doi.org/10.1016/j.ijcard.2011.09.051 -Israel 803075184

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Reactions 11 Aug 2012 No. 14140114-9954/10/1414-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved