Pharmacy World and Science

, Volume 27, Issue 3, pp 170–174 | Cite as

Cross Hypersensitivity Syndrome between Phenytoin and Carbamazepine

  • Nerea Moyano Sierra
  • Benito GarcíaEmail author
  • Javier Marco
  • Susana Plaza
  • Francisco Hidalgo
  • Teresa Bermejo


Objective: To evaluate the incidence of cross anticonvulsant hypersensitivity syndrome (AHS) between phenytoin (PHT) and carbamazepine (CBZ) in hospitalized patients.

Method: Retrospective chart review about the cross AHS was retrieved from pharmacy adverse drug reaction program from 1998 to 2002 in a 450-bed teaching hospital.

Main outcome measures: AHS was defined as the appearance of at least two symptoms with the first anticonvulsant drug (ACD). Cross AHS was considered if after withdrawal of a first ACD because of hypersensitivity symptoms, a new episode with similar or new symptoms appeared after exposure to a second ACD. The following symptoms were considered– rash, fever, hepatotoxicity, lymphadenopathies or hematological disturbances.

Results: Cross AHS between PHT and CBZ was observed in nine cases (45). After the cross-reaction event, four of them were treated with valproic acid, two with vigabatrin, two with phenobarbital and one with no treatment without developing further AHS.

Conclusions: AHS is a severe complication of aromatic ACD that can compromise the future choice of therapy. Because of the high incidence of clinical cross-reaction between these two drugs, non-aromatic ACD alternatives, must be considered.


Anticonvulsant hypersensitivity syndrome Carbamazepine Cross-reaction Phenobarbital Phenytoin 


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Copyright information

© Springer 2005

Authors and Affiliations

  • Nerea Moyano Sierra
    • 1
  • Benito García
    • 1
    Email author
  • Javier Marco
    • 1
  • Susana Plaza
    • 1
  • Francisco Hidalgo
    • 1
  • Teresa Bermejo
    • 1
  1. 1.Hospital Severo OchoaLeganésSpain

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