Stevens-Johnson Syndrome (SJS) is a skin disorder associated with the use of a variety of medications, including Ibuprofen, SJS, which have the active ingredient of acetaminophen. Acetaminophen is a common active ingredient to treat pain and reduce fever, included in many prescription and over-the-counter (OTC) drug products.
Ibuprofen, Tylenol and Motrin may cause severe allergic reactions that affect skin and mucous membranes, triggering severe burning and blistering of tissue. In the most serious cases, blindness and death may occur.
A search of the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System uncovered over 100 severe cases, resulting in 67 hospitalizations and 12 deaths. Most cases involved single-ingredient acetaminophen products; the cases were categorized as either probable or possible cases associated with acetaminophen.
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Ibuprofen Stevens Johnson
In about a 30-year period, Health Canada received 4 reports of SJS suspected of being associated with ibuprofen. The reports involved patients ages 13 to 34 years old. The ibuprofen daily dosages ranged from 200 mg to 1200 mg. The onset of reactions varied from the day of administration to approximately 15 days after starting ibuprofen use.
Ibuprofen has been available over-the-counter since 1989, and no warning label or health agency has mentioned a relation to SJS until recently. Cases of SJS are rare, although patients taking ibuprofen should discontinue use and seek medical attention if any rash or fever develop.
The FDA has issued SJS-related warnings on the following:
- Advil Allergy Sinus Tablets
- Advil Cold & Sinus Tablets
- Advil Liqui-Gels
- Advil Migraine Capsules
- Tolectin 600 Tablets
- Tolectin DS Capsules
- Children’s Motrin Chewable Tablets (50 mg ibuprofen)
- Motrin Junior Strength Chewable Tablets (100 mg ibuprofen)
- Motrin Cold & Sinus
Symptoms of Stevens Johnson Syndrome
Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are both life-threatening skin reactions that can result in death. They are medical emergencies that usually require hospitalization.
The conditions usually begin with flu-like symptoms, followed by rash, blistering, and detachment of the upper surface of the skin. While much is still unknown, specialists believe the diseases are caused by allergic reactions to common medications such as Ibuprofen, Tylenol and Motrin.
As the condition progresses untreated, symptoms can increase and worsen over time. Such signs and symptoms include:
• Blisters
• Rashes
• Mouth ulcers
• Swollen eyelids
• Conjunctivitis
• Flu-like symptoms
Further complications can include:
• Permanent blindness
• Dry-eye syndrome
• Photophobia
• Lung damage
• Chronic obstructive pulmonary disease (COPD)
• Asthma
• Permanent loss of nail beds
• Scarring of the esophagus and other mucous membranes
• Arthritis
• Chronic fatigue syndrome
Because many physicians and medical personnel are not familiar with the symptoms, treatment of SJS is frequently delayed, worsening the condition. Severe cases may lead to serious health consequences. SJS can cause blindness and results in death in up to 30 percent of severe cases.
A serious skin reaction can occur at any time, even if you’ve taken acetaminophen (Tylenol or Motrin) previously without a problem. There is currently no way of predicting who might be at higher risk. These reactions can occur with first-time use of acetaminophen or ibuprofen.
Adverse Drug Reactions a Leading Cause of Death
According to researchers at the Mayo Clinic Medical Center, about 70 percent of the adult population, or almost 170 million Americans are prescribed at least one drug.
Accounting for approximately 150,000 deaths per year in the U.S., drug reactions are one of the leading causes of death in the United States.
Because less than one percent of adverse drug reactions are reported to the FDA, and although SJS is considered a rare disease, it may be more prevalent than previously thought.
