Nimesulide-induced Fixed Drug Eruption

Nimesulide-induced Fixed Drug Eruption

T.V.Harsha Varun and R.E.Ugandhar

Santhiram College of Pharmacy, Nandyal, Kurnool Dt, Andhra Pradesh

 International Journal of Hospital Pharmacy

Nimesulide is a cyclooxygenase (COX) inhibitor with a high degree of selectivity to COX-2. Nimesulide is a nonsteroidal anti-inflammatory agent with antipyretic and analgesic properties. It is being commonly prescribed in India.[1] Some of the side effects reported with its use are Pruritus, urticaria, purpura, maculopapular rash and localized toxic pustuloderma.[2],[3] Due to severe hepatotoxicity and hemolytic anemia associated with its use, Nimesulide is likely to be withdrawn from the market in many countries.
Case report: The authors report a case of a patient with a history of antihistamine hypersensitivity that developed a bullous form of pigmented fixed drug eruption after Nimesulide. Patch tests performed on residual skin lesion were positive to Nimesulide, confirming that this was the culprit drug.

Keywords: Drug eruption, Fixed drug eruption, Lesion patch testing, Nimesulide, Nonsteroidal anti-inflammatory drugs

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How to cite this article:
T.V.Harsha Varun and R.E.Ugandhar,Nimesulide-induced Fixed Drug Eruption.International Journal of Hospital Pharmacy, 2020, 5:34


1. Kanwar AJ, Kaur S, Thami GP. Nimesulide induced purpura. Dermatolo-gy 2000;201:326.
2. Lateo S, Boffa MJ. Localised toxic pustuloderma associated with nimesu-lide therapy confirmed by patch testing. Br J Dermatol 2002;147:624-5.
3. Saha K. Use of nimesulide in Indian children must be stopped. BMJ 2003;326:713.
4. DrAmandaOakley,Dermatologist,Hamilton,NewZealand,
5. Ayala F, NinoM,Ayala F, Balato N. Bullous fixed drug eruption induced byNIMUSU-LIDE: of a case. Dermatitis 2006;17:160.
6. Naranjo CA,Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reac-tions. Clin Pharmacol Ther 1981;30:239-45.
7. Hern S, Harman K, Clement M, Black MM. Bullous fixed drug eruption due to nimusulide with an unusual immunofluorescence pattern. Br J Dermatol 1998;139:1129-31.
8. Sanmukhani J, Shah V, Baxi S, Tripathi C. Fixed drug eruption with ornidazole having cross-sensitivity to secnidazole but not to other nitro-imidazole compounds: A case re-port. Br J Clin Pharmacol2010;69:703-4.
9. Shiohara T, Mizukawa Y. Fixed drug eruption: A disease mediated by self-inflicted re-sponses of intraepidermalTcells.EurJDermatol2007;17:201-8.
10. Shiohara T. Fixed drug eruption: Pathogenesis and diagnostic tests. Curr Opin Allergy Clin Immunol2009;9:316-21.