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Re: Drug Rash!!

Posted by yxibow on October 28, 2006, at 2:14:46

In reply to Drug Rash!!, posted by butternut on October 27, 2006, at 19:35:05

> Hi all,
> I started 150 mg of Wellbutrin about two weeks ago. This was to try to counteract the sexual side affects of Lexapro, which is otherwise working well for me.
> On Wednesday morning I woke up with an itchy red rash all over my chest, stomach and neck. I figured it was the Wellbutrin and so didn't take my pill that morning. The rash spread a bit over the course of the day. It's now in my inner and outer thighs and back, and a little on my arms and legs. My pdoc referred me to my family doctor, who said I should come in right away and probably start prednisone. However, his secretary said there were no appointments available. So, I saw my allergist instead. He said that he doesn't see a lot of drug allergies in his practice (he deals mostly with really long-term type allergies) but that he didn't think prednisone was necessary. Just stop the Wellbutrin and the rash will go away.
> I was happy not to have to take prednisone, but MY GOD IT ITCHES!! Now it's Friday night, and the rash doesn't look worse, but it doesn't look much better, and it's very very itchy.
> Does anyone know if this is normal? Anyone know how long it takes a drug rash to go away? I shudder to think it wasn't the Wellbutrin but the Lexapro I've been taking for 4 1/2 months. I am still taking the Lexapro.

I would say if you developed a rash after only two weeks on the Wellbutrin that it would be the culprit.

From the PI:

"A patient should stop taking WELLBUTRIN XL and consult a doctor if experiencing allergic or anaphylactoid/anaphylactic reactions (e.g., skin rash, pruritus, hives, chest pain, edema, and shortness of breath) during treatment." (XL, SR, and I hope you're not taking the original formulation as it can cause more seizures, are basically similar in those regards.)

Since you're not experiencing anaphylactic (shortness of breath), it is conceivable it could disappear during treatment but I would be wary of that myself.

Definitely prednisone is a medication to avoid at all possible circumstances unless it is medically necessary to have a systemic corticosteroid. It is normally prescribed only for low cortisol conditions, MS, etc. It can cause weight gain, but more importantly, it can increase a chance of infection and cause depression.

What you have is called sebaceous dermatitis. You can get that from poison ivy or any material. Since you have it on more than just your arms, I would say it could take two to four weeks or more to heal.

I once got it on my arm while doing volunteer work in a botanical garden and I thought it was medicine related but in fact it was just something I picked up from something in the gardens. It went away in about a week, but that was on just one arm. So it will take a while unfortunately.

You can use OTC 1% hydrocortisone, judiciously, since it covers an extensive part of your body and can therefore be absorbed internally (like a small dose of prednisone). Or you can see a dermatologist and they may prescribe something like a common somewhat more powerful corticosteroid called fluocinolone acetonide.

Also Benadryl 2% (maximum OTC) cream works too to some extent but there is again a caveat -- you have it all over parts of your body to the point that if you lather on a cream or gel of Benadryl onto large portions of your body you may become drowsy from absorbing Benadryl transdermally as if you took a pill (or 2). So that is also again something to use judiciously.

Actually, taking a Benadryl pill (H1 blockade) also could clear up some of it, while making one sleepy. H2 blockers like Zantac may augment it, depending on the allergic response you have.

Discuss this with a dermatologist I think.

So the discontinue idea is a good thing I would imagine and use the above carefully. And it also will just go away, which is true, longer of course untreated, just more uncomfortable and itchy. That part is up to you and your doctor(s).

Just my 2c

-- Jay




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