PEDIATRICS Vol. 92 No. 5 November 1993, pp. 741-742
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Unlisted Ingredients

NEIL L. KAO MD1

1 Dept of Immunology, Rush Presbyterian/St. Luke's Medical Center, Chicago, IL 60612-3824

To the Editor.—

Studies by Kumar et al1,2 demonstrate clearly the number and potential importance of unlisted ingredients. Reactions triggered by these excipients may in fact account for many reported adverse drug reactions, including reactions to antihistamines and corticosteroids, originally thought to be caused by the primary medications. When patients suspected of having a hypersensitivity disease are evaluated for the etiologic factor, excipients should be included among the suspected causative agents. For example, in a patient evaluated recently for the etiology of urticaria, we determined that his toothpaste was the etiologic agent.