{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:54:36Z","timestamp":1777521276435,"version":"3.51.4"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T00:00:00Z","timestamp":1697846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Levetiracetam is an antiepileptic drug known for its high tolerability, and severe adverse drug reactions are rare. We report the case of a severe cutaneous adverse drug reaction in a patient who was switched from brand-name to generic levetiracetam.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>A 29-year-old woman undergoing contrast-enhanced computed tomography developed lesions over her trunk starting 6 hours after imaging. Although initially diagnosed as an allergy to the radiocontrast agent, the condition progressively worsened into toxic epidermal necrolysis-drug reaction with eosinophilia and systemic symptoms overlap syndrome, despite adequate hydration and treatment. Investigation of the patient\u2019s medications revealed that she had been switched from brand-name to generic levetiracetam a week before the onset of symptoms. Levetiracetam was immediately discontinued, with the patient recovering after 2 weeks of intensive care. Adverse drug reaction analysis identified excipients in generic levetiracetam as the likely cause of the severe reaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This is the first reported case of severe cutaneous drug allergy after a brand-to-generic switch for levetiracetam. Brand-to-generic switches of medications can potentially cause severe allergic reactions due to differences in excipients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxad264","type":"journal-article","created":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T18:52:25Z","timestamp":1697914345000},"page":"e69-e72","source":"Crossref","is-referenced-by-count":4,"title":["Severe cutaneous adverse reaction to drug excipient following brand-to-generic switch of levetiracetam"],"prefix":"10.1093","volume":"81","author":[{"given":"Jo Anne","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital University Sains Malaysia, School of Medical Science, Kota Bharu, Kelantan, and Dermatology Unit, Faculty of Medicine, University Kebangsaan Malaysia , Kuala Lumpur , Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adawiyah","family":"Jamil","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Faculty of Medicine, University Kebangsaan Malaysia , Kuala Lumpur , Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nur Amalina","family":"Ramli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital University Sains Malaysia, School of Medical Science , Kota Bharu, Kelantan , Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatimah Mat","family":"Johar","sequence":"additional","affiliation":[{"name":"Reconstructive Sciences Unit, Hospital University Sains Malaysia, School of Medical Science , Kota Bharu, Kelantan , Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mokhtar","family":"Nor","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital University Sains Malaysia, School of Medical Science , Kota Bharu, Kelantan , Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,21]]},"reference":[{"issue":"2","key":"2024012419562422600_CIT0001","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","author":"Naranjo","year":"1981","journal-title":"Clin Pharm Ther."},{"key":"2024012419562422600_CIT0002","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.seizure.2020.01.002","article-title":"Levetiracetam and cutaneous adverse reactions: a systematic review of descriptive studies","volume":"75","author":"Rashid","year":"2020","journal-title":"Seizure"},{"key":"2024012419562422600_CIT0003","first-page":"140","article-title":"Levetiracetam induced drug reaction with eosinophilia and systemic symptoms (DRESS)","volume":"15","author":"Elengoe","year":"2019","journal-title":"Brunei Int Med 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