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Drug-induced flushing reaction
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Drug-induced flushing reaction

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Contributors: Michael W. Winter MD, Benjamin L. Mazer MD, MBA
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Synopsis

Drug-induced flushing reaction is characterized by episodic erythema and warmth of the head, neck, and arms associated with the use of a medication or other drug. A physiological reaction of cutaneous vasodilatation, an involuntary response of the central nervous system, that increases cutaneous blood flow and produces flushing. Onset is hours to days. Common medications that trigger a flushing reaction include nicotinic acid (niacin), vasodilators, calcium channel blockers, nitroglycerin, anti-inflammatories, cholinergics, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors. Other drugs including opiates, amyl nitrite and butyl nitrite, cocaine, heroin, alcohol, and amphetamines, as well as alcohol combined with drugs, can cause severe reactions with flushing.

Management aims to identify and discontinue the triggering agent. Certain medications known to cause moderate drug-induced flushing reaction, such as infused vancomycin, may be treated by giving patients diphenhydramine and ranitidine, then restarting vancomycin at a reduced dosage.

Codes

ICD10CM:
R23.2 – Flushing

SNOMEDCT:
403618004 – Drug-induced flushing

Differential Diagnosis & Pitfalls

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Updated: 09/19/2018
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Drug-induced flushing reaction
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Drug-induced flushing reaction : Flushing
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