Table of ContentsView AllTable of ContentsSide EffectAppearanceTimingAt-Home TreatmentSeeing a Provider
Table of ContentsView All
View All
Table of Contents
Side Effect
Appearance
Timing
At-Home Treatment
Seeing a Provider
Drug rash refers to skin reactions as a side effect of certain medications. These rashes can vary from mild to severe and may appear as red spots, hives, or peeling skin. Common drugs that cause such reactions include antibiotics like penicillin, anticonvulsants such as phenytoin, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
Understanding which medications are linked to skin symptoms is crucial for managing and treating drug-induced rashes effectively.
Reproduced with permission from © DermNetdermnetnz.org2023.
Drugs With Rash as a Side Effect
Rashes are one of the most common side effects of many medications. Symptoms can occur immediately or sometimes be delayed several hours, days, or even weeks, as follows:
Even though medications have side effects like rashes, not everyone will get them. Some of the medications that can cause a rash as a side effect include:
Penicillin
Penicillin and other beta-lactam antibiotics are well-known for causing allergic reactions, including rashes. When people have allergy symptoms like a rash with any of the medications in the penicillin family, they should avoid the entire drug group. These include medications such as amoxicillin, dicloxacillin, flucloxacillin, and any other medication with “cillin” at the end.
While taking penicillin, the more common types of skin reactions are hives, or flat, blotchy rashes.
Cephalosporins
Sulfonamides
Sulfonamides, commonly known as sulfa drugs, are a group of antibiotics used to treat various bacterial infections. Sulfonamide allergies can cause several types of skin rashes that range from mild to severe, including hives, rashes, and Stevens-Johnson syndrome.
Rashes can appear within 30 minutes to one to two weeks after starting sulfonamide treatment. The onset can vary depending on the individual’s immune system’s response to the drug.
Phenytoin
Phenytoin(brand name Epanutin), an anticonvulsant used to manage seizures, is associated with rashes that may range from mild to severe. Fortunately, most phenytoin skin rashes are not serious.
Most phenytoin skin rashes start in the first eight weeks of treatment or when the dose is increased too quickly. Phenytoin can also cause the rare side effect of Stevens-Johnson syndrome.
Carbamazepine
Carbamazepine(brand name Curatil) another anticonvulsant, is also linked to various skin rashes, including those that might signal more serious conditions like Stevens-Johnson syndrome or toxic epidermal necrolysis.Although uncommon, these can be life-threatening and cause the skin to blister and peel.
Ibuprofen
Advil and Motrin (ibuprofen) are common NSAIDs that can cause skin reactions, particularly in individuals sensitive to it. Other NSAIDs in this category include aspirin (acetylsalicylic acid) and Aleve (naproxen).While usually mild, these rashes can sometimes develop into more serious conditions.
Skin side effects may include:
Allopurinol
Allopurinol is treats gout, but it can cause rashes that vary in severity. Common early side effects are skin rashes and mild itching. Much less commonly, severe skin conditions such as exfoliative dermatitis (erythroderma) or Stevens-Johnson syndrome can develop.
Methotrexate
Methotrexate, a medication used to treat cancer and autoimmune diseases, can cause skin rashes that range from mild redness to severe peeling and blistering. These rashes are often a sign of drug toxicity. If you are taking methotrexate and develop a rash, call your healthcare provider right away.
Opioids
Opioids, such as morphine, oxycodone, and fentanyl, can cause skin reactions ranging from mild rashes to more severe symptoms like itching or hives. These rashes are often related to allergic reactions or sensitivities to the medication.
All opioids can trigger allergic reactions such as rashes. Most of these reactions are pseudo allergies, which occur because opioids cause the body to release histamine, leading to symptoms like itching, hives, and sweating. A true allergy to opioids is rare and involves more severe symptoms, such as severe skin rashes or trouble breathing.
How Drug Rash Symptoms Look
If you or a loved one is taking a medication and notice a skin rash, contact your healthcare provider for instructions. Here are some things to look for:
Color
Rashes can appear in localized areas or be more generalized, covering large portions of the body. Red and pink areas may be more challenging to see in people with darker skin colors.
Shape and Texture
The shape and texture of drug rash symptoms depend on the kind of rash and may include:
Sensations
Common rash sensations may vary and include:
Timing of Drug Rash
The timing of drug rashes varies widely depending on the type of reaction and the specific medication involved. Symptoms of a drug allergy typically appear within one hour of taking the medication. However, reactions can sometimes be delayed, occurring several hours, days, or even weeks later.
Symptoms of immediate drug rash reactions within one hour may include:
Symptoms of delayed reactions within a few days to two weeks:
Understanding these symptoms' timing is crucial for effectively identifying and managing drug allergies. Immediate reactions are usually easier to diagnose due to their quick onset, whereas delayed reactions may require more detailed patient history and investigation to pinpoint the cause.
Treating a Drug Rash at Home
Treating a drug rash at home involves several steps to manage symptoms and prevent further irritation. If you suspect a rash is due to medication, contact your healthcare provider. They may recommend your stopping the drug and prescribe another medicaiton.
Over-the-counter (OTC) remedies for drug rash include:
If you are taking a medication and think you are having a reaction, contact your healthcare provider for further guidance.
For emergency conditions like difficulty breathing or severe symptoms of asthma or anaphylaxis, go to the emergency room or call 911 immediately.
Summary
Drug rashes are a common side effect of various medications, including antibiotics, anticonvulsants, and NSAIDs. These skin reactions can range from mild hives to severe conditions like Stevens-Johnson syndrome. It’s crucial to identify the medications causing these reactions for effective management and treatment. Always contact your healthcare provider if you suspect a drug rash, and seek immediate medical attention for severe symptoms.
23 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ancuceanu R, Dinu M, Furtunescu F, Boda D.An inventory of medicinal products causing skin rash: Clinical and regulatory lessons.Experimental and Therapeutic Medicine. 2019;18(6):5061-5071. doi:10.3892/etm.2019.7837Medline Plus.Drug allergies.Medline Plus.Stevens-Johnson syndrome/toxic epidermal necrolysis.UpToDate.Patient education: Allergy to penicillin and related antibiotics (beyond the basics).Khan DA, Banerji A, Bernstein JA, et al.Cephalosporin allergy: current understanding and future challenges.The Journal of Allergy and Clinical Immunology: In Practice.2019;7(7):2105-2114. doi: 10.1016/j.jaip.2019.06.001Australian Society of Clinical Immunology and Allergy.Sulfonamide antibiotic allergy.DermNet.Sulfonamides (sulfa drugs) and the skin.NHS.Side effects of phenytoin.MedlinePlus.Carbamazepine.NHS.Side effects of carbamazepine.Medline Plus.Stevens-Johnson syndrome/toxic epidermal necrolysis.Medline Plus.Pain relievers.DermNet.Non-steroidal anti-inflammatory drugs and their skin side effects.Mohammad CM, Che Alhadi S, Wan Fatimah SWM, Salman A, Mohd Zhafri MR, Rasimah I.Delayed hypersensitivity reaction to allopurinol: A case report.Malays Fam Physician.2023;18:11. doi:10.51866/cr.65Sangha AM.Dermatological conditions in skin of color—: managing atopic dermatitis.J Clin Aesthet Dermatol. 2021;14(3 Suppl 1):S20-S22.Medline Plus.Erythroderma.UCSF Health.FAQ: Methotrexate.U.S> Pharmacist.Opioids: Allergy vs. pseudoallergy.Lehloenya RJ, Phillips EJ, Pasieka HB, Peter J.Recognizing drug hypersensitivity in pigmented skin.Immunology and Allergy Clinics of North America. 2022;42(2):219-238. doi:10.1016/j.iac.2022.01.005Johns Hopkins Medicine.Drug rashes.Medline Plus.Drug allergies.Medline Plus.Hives.InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care. Overview:Drug allergies.2023.
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ancuceanu R, Dinu M, Furtunescu F, Boda D.An inventory of medicinal products causing skin rash: Clinical and regulatory lessons.Experimental and Therapeutic Medicine. 2019;18(6):5061-5071. doi:10.3892/etm.2019.7837Medline Plus.Drug allergies.Medline Plus.Stevens-Johnson syndrome/toxic epidermal necrolysis.UpToDate.Patient education: Allergy to penicillin and related antibiotics (beyond the basics).Khan DA, Banerji A, Bernstein JA, et al.Cephalosporin allergy: current understanding and future challenges.The Journal of Allergy and Clinical Immunology: In Practice.2019;7(7):2105-2114. doi: 10.1016/j.jaip.2019.06.001Australian Society of Clinical Immunology and Allergy.Sulfonamide antibiotic allergy.DermNet.Sulfonamides (sulfa drugs) and the skin.NHS.Side effects of phenytoin.MedlinePlus.Carbamazepine.NHS.Side effects of carbamazepine.Medline Plus.Stevens-Johnson syndrome/toxic epidermal necrolysis.Medline Plus.Pain relievers.DermNet.Non-steroidal anti-inflammatory drugs and their skin side effects.Mohammad CM, Che Alhadi S, Wan Fatimah SWM, Salman A, Mohd Zhafri MR, Rasimah I.Delayed hypersensitivity reaction to allopurinol: A case report.Malays Fam Physician.2023;18:11. doi:10.51866/cr.65Sangha AM.Dermatological conditions in skin of color—: managing atopic dermatitis.J Clin Aesthet Dermatol. 2021;14(3 Suppl 1):S20-S22.Medline Plus.Erythroderma.UCSF Health.FAQ: Methotrexate.U.S> Pharmacist.Opioids: Allergy vs. pseudoallergy.Lehloenya RJ, Phillips EJ, Pasieka HB, Peter J.Recognizing drug hypersensitivity in pigmented skin.Immunology and Allergy Clinics of North America. 2022;42(2):219-238. doi:10.1016/j.iac.2022.01.005Johns Hopkins Medicine.Drug rashes.Medline Plus.Drug allergies.Medline Plus.Hives.InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care. Overview:Drug allergies.2023.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ancuceanu R, Dinu M, Furtunescu F, Boda D.An inventory of medicinal products causing skin rash: Clinical and regulatory lessons.Experimental and Therapeutic Medicine. 2019;18(6):5061-5071. doi:10.3892/etm.2019.7837Medline Plus.Drug allergies.Medline Plus.Stevens-Johnson syndrome/toxic epidermal necrolysis.UpToDate.Patient education: Allergy to penicillin and related antibiotics (beyond the basics).Khan DA, Banerji A, Bernstein JA, et al.Cephalosporin allergy: current understanding and future challenges.The Journal of Allergy and Clinical Immunology: In Practice.2019;7(7):2105-2114. doi: 10.1016/j.jaip.2019.06.001Australian Society of Clinical Immunology and Allergy.Sulfonamide antibiotic allergy.DermNet.Sulfonamides (sulfa drugs) and the skin.NHS.Side effects of phenytoin.MedlinePlus.Carbamazepine.NHS.Side effects of carbamazepine.Medline Plus.Stevens-Johnson syndrome/toxic epidermal necrolysis.Medline Plus.Pain relievers.DermNet.Non-steroidal anti-inflammatory drugs and their skin side effects.Mohammad CM, Che Alhadi S, Wan Fatimah SWM, Salman A, Mohd Zhafri MR, Rasimah I.Delayed hypersensitivity reaction to allopurinol: A case report.Malays Fam Physician.2023;18:11. doi:10.51866/cr.65Sangha AM.Dermatological conditions in skin of color—: managing atopic dermatitis.J Clin Aesthet Dermatol. 2021;14(3 Suppl 1):S20-S22.Medline Plus.Erythroderma.UCSF Health.FAQ: Methotrexate.U.S> Pharmacist.Opioids: Allergy vs. pseudoallergy.Lehloenya RJ, Phillips EJ, Pasieka HB, Peter J.Recognizing drug hypersensitivity in pigmented skin.Immunology and Allergy Clinics of North America. 2022;42(2):219-238. doi:10.1016/j.iac.2022.01.005Johns Hopkins Medicine.Drug rashes.Medline Plus.Drug allergies.Medline Plus.Hives.InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care. Overview:Drug allergies.2023.
Ancuceanu R, Dinu M, Furtunescu F, Boda D.An inventory of medicinal products causing skin rash: Clinical and regulatory lessons.Experimental and Therapeutic Medicine. 2019;18(6):5061-5071. doi:10.3892/etm.2019.7837
Medline Plus.Drug allergies.
Medline Plus.Stevens-Johnson syndrome/toxic epidermal necrolysis.
UpToDate.Patient education: Allergy to penicillin and related antibiotics (beyond the basics).
Khan DA, Banerji A, Bernstein JA, et al.Cephalosporin allergy: current understanding and future challenges.The Journal of Allergy and Clinical Immunology: In Practice.2019;7(7):2105-2114. doi: 10.1016/j.jaip.2019.06.001
Australian Society of Clinical Immunology and Allergy.Sulfonamide antibiotic allergy.
DermNet.Sulfonamides (sulfa drugs) and the skin.
NHS.Side effects of phenytoin.
MedlinePlus.Carbamazepine.
NHS.Side effects of carbamazepine.
Medline Plus.Pain relievers.
DermNet.Non-steroidal anti-inflammatory drugs and their skin side effects.
Mohammad CM, Che Alhadi S, Wan Fatimah SWM, Salman A, Mohd Zhafri MR, Rasimah I.Delayed hypersensitivity reaction to allopurinol: A case report.Malays Fam Physician.2023;18:11. doi:10.51866/cr.65
Sangha AM.Dermatological conditions in skin of color—: managing atopic dermatitis.J Clin Aesthet Dermatol. 2021;14(3 Suppl 1):S20-S22.
Medline Plus.Erythroderma.
UCSF Health.FAQ: Methotrexate.
U.S> Pharmacist.Opioids: Allergy vs. pseudoallergy.
Lehloenya RJ, Phillips EJ, Pasieka HB, Peter J.Recognizing drug hypersensitivity in pigmented skin.Immunology and Allergy Clinics of North America. 2022;42(2):219-238. doi:10.1016/j.iac.2022.01.005
Johns Hopkins Medicine.Drug rashes.
Medline Plus.Hives.
InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care. Overview:Drug allergies.2023.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
