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  1. Treatments
  2. Medicines (Pharmacological)
  3. Medicine 1: NSAIDs

DRESS SYNDROME

Recently, the Indian Pharmacopoeia Commission issued a warning against the use of Meftal, a commonly used NSAID used to relieve period pain, stating that one of its constituent, mefenamic acid, triggers Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS SYNDROME).

What is DRESS syndrome?

DRESS Syndrome, also called DIHS (Drug-Induced Hypersensitivity Syndrome) is a delayed, life-threatening hypersensitivity drug reaction that can cause severe organ dysfunction. This condition may involve viral reactivation and result in long-term complications.

DRESS occurs from taking one of over 50 medications. Anticonvulsants and antibiotics are the top offenders.

DRESS may occur from an interplay of several factors: drugs, viral reactivation (mostly HHV-6), immune dysfunction, and a genetic predisposition.

The first signs of DRESS are typically fever and widespread, itchy rash. This is often followed by facial edema (swelling) that may begin as moderate and then progress severely to where a patient becomes almost unrecognizable. Later, in the course of illness, patients may develop exfoliative dermatitis, where they shed skin.

The actual incidence of DRESS is unknown because it may vary depending on the type of medication and the immune status of each patient; also, because many cases remain undiagnosed or untreated.1

Although the incidence reported is about 10% in people taking mefenamic acid, the incidence is higher in other medications like anticonvulsants.2 Taking Meftal under a doctor's supervision is advised for the treatment of dysmenorrhea.

References:
  1. DRESS Syndrome Foundation. Drugs associated with DRESS [Internet]. 2024 [cited 2025 May 20]. Available from: https://www.dresssyndromefoundation.org/drugs-associated-with-dress

  1. Rutuja D, Dimpal D, Ganesh S, Piyush B, Rushikesh B, Kajal P, Dhananjay P. Insights into mefenamic acid-induced allergic reactions: a comprehensive clinical and research review. Pharm Res. 2024;8(1):000295. doi:10.23880/oajpr-16000295.

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