Drugs Associated with DRESS
The exact incidence of DRESS is unknown but estimated to vary from one case among 1,000 to 10,000 drug exposures. DRESS may occur from an interplay of several factors: a) drugs, b) viral reactivation (notably, HHV-6), c) immune dysfunction d) genetic predisposition. Some populations have genetic factors that are identified with certain drugs and susceptibility, i.e., the drug allopurinol found in populations of Han Chinese: HLA-B*58:01, and the drug vancomycin found in populations of European, Japanese, Thai, and Han Chinese descent: HLA-A*32:01.
While many drugs have been identified to cause DRESS, the most frequently reported are antibiotics and anticonvulsants.
​
​
​
​
​
​
​
Here, you will find a list of reported DRESS drugs, their intended use, and genetic association, if known. Drugs with the highest frequency of causing DRESS are identified with an asterisk. This list is not comprehensive and will be updated as more cases are reported and new gene/drug associations are identified. ​
​
It's important to note that even if a person has had DRESS to a specific drug, they may be able to take other non-related medications on this list safely. Individual risk should be discussed with your doctor. Rarely, some patients may have multiple-drug allergies or be at risk for reactions to other drugs post-DRESS recovery.
​
Sources: "Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. Part I. Epidemiology, pathogenesis, clinicopathological features, and prognosis" - Wei et al., "Updates on the Immunopathology and Genomics of Severe Cutaneous Adverse Drug Reactions" - M. Krantz, E. Phillips, "Drug Reaction with Eosinophilia and Systemic Symptoms (DReSS)/Drug-Induced Hypersensitivity Syndrome (DiHS)—Readdressing the DReSS" - H. Stilton, N. Shear, R. Dodiuk-Gad,
FDA (FAERs Event Reporting), MedlinePlus (NIH National Library of Medicine), DRESS Syndrome Foundation Patient Registry
​
Five drugs are reported to cause 50% of DRESS cases, and 56% of reported deaths: Anticonvulsants: carbamazepine, lamotrigine
Antibiotics: minocycline, trimethoprim/sulfamethoxazole (bactrim), vancomycin,
Antigout: allopurinol