Medicines That Can Cause Rash

• Antibiotics- penicillin, sulfa-based antibiotics
• Anti-seizure medications- phenytoin, valproic acid
• Anti-pain medications- codeine, hydromorphone, oxycodone
• Anti-inflammatories- ibuprofen, naproxen
• Blood pressure and heart medicines- captopril, hydrochlorothiazide
• Anti-uric acid (or gout) medicines- allopurinol
• Medicines used to treat side effects to chemotherapy such as nausea and vomiting or diarrhea- ondansetron, aprepitant, loperamide, octreotide
• Corticosteroids- such as dexamethasone, prednisone
• Medicines for low levels of blood cells- such as filgrastim or pegfilgrastim
• Blood thinners- enoxaparin, warfarin

signs That a Rash May Be Serious

• Swelling of the lips or eyelids
• Sneezing, welts, and intense itching all over the body
• Fever, uncontrollable diarrhea or sneezing, and abdominal
  or back pain
• Difficulty breathing, tightness in the throat, or fainting

Grading the Severity of a Rash

Determining how severe a rash is will depend on several factors, including how much of the skin is affected (the skin on the palm of the hand represents about one percent of the entire area of the body's skin surface) and whether the rash affects emotional or physical well-being.

Grade 1 (Mild) A mild rash that is usually not associated with pain, itching, or burning and does not always require treatment. Grade 1 rashes usually cover less than 10 percent of the skin (the face, scalp, and neck are about 10 percent of the skin).
 

Grade 2 (Moderate) This severity of rash is probably the most common and is usually associated with pain, itching, burning, or some other discomfort. Treatments include creams, ointments, or pills, and the anti-cancer medication causing it can usually be continued. By the time a rash is grade 2 or worse, it can affect a person's self-esteem. The rash may also affect a person's ability to prepare meals, shop, use the telephone, or handle money. Grade 2 rashes usually cover 10 to 30 percent of the skin on the body (the entire face, chest, and upper back are approximately 20 percent of the skin)
 

Grade 3 (Severe) Rashes this severe are not that common. Grade 3 rashes are usually itchy or painful and may result in skin infections that require oral antibiotics or admission to the hospital. A grade 3 rash may affect a person's ability to bathe, get dressed, eat, use the toilet, or take medications. Grade 3 rashes usually cover more than 30 percent of the skin (the face, entire back and chest, and stomach are more than 30 percent) and will often require an interruption or reduction of the anti-cancer treatment.
 

Grade 4 (Very Severe) Rashes this severe are extremely rare. They are life-threatening and require urgent treatments (intravenous medicines or surgical procedures). At this grade, anti-cancer medications need to be stopped, sometimes indefinitely, and another medication is then used.

How Rash Is Treated: The Three I's

For most medication-induced rashes, choosing a treatment is based on stopping the three I's:

• Inflammation
• Itching
• Infections