Verapamil-associated Stevens-Johnson syndrome

Stevens-Johnson syndrome (SJS) is a complication infrequently associated with the use of calcium-channel blocking agents. A 59-year-old woman developed symptoms typical of SJS approximately ten days following the initiation of sustained-release verapamil for hypertension management. Symptoms consisted of a generalized red macular rash associated with swelling of the face, tongue, lips, and mouth as well as a fever of 40 degrees C. Resolution of symptoms began approximately four days after verapamil discontinuation. Rechallenge with verapamil was not performed. Although SJS appears to be a rare adverse effect of this drug, the potential complications warrant the inclusion of SJS in the differential diagnosis of patients presenting with malaise, fever, rash, and a history of verapamil ingestion.