{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T14:15:14Z","timestamp":1783260914546,"version":"3.54.6"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"abstract":"<jats:p>Morbilliform drug eruptions in palliative care are often misattributed to active drugs, leading to inappropriate \u201copioid allergy\u201d labels. Generic medications contain varying inactive excipients that can trigger delayed hypersensitivity. A man in his 70s with a prior history of ibuprofen-associated angioedema and metoclopramide-associated rash developed a pruritic morbilliform eruption after switching from a Mallinckrodt hydrocodone-acetaminophen product to a Camber oxycodone-acetaminophen formulation (National Drug Code [NDC] 31722-0951-05). During a washout period, the patient successfully tolerated SpecGx-manufactured morphine (NDC 00406-5118-01) and Aurobindo potassium chloride (NDC 65862-0987-99) while the rash resolved. Comparison of NDC data identified croscarmellose sodium as the likely culprit, as it was unique to the offending formulation. Clinicians should document the NDC rather than broad drug classes when reactions occur after a generic substitution to preserve future therapeutic options and ensure continued access to essential analgesia.<\/jats:p>","DOI":"10.1177\/10966218261464673","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T07:24:56Z","timestamp":1783063496000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Formulation\u2014Specific Morbilliform Eruption after a Generic Opioid Switch: A Case Discussion"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8432-2622","authenticated-orcid":false,"given":"Charles","family":"Mulkey","sequence":"first","affiliation":[{"name":"University of Missouri\u2013Kansas City School of Medicine, St. Joseph, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Mosaic Life Care, St. Joseph, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tawanda","family":"Charumuka","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Mosaic Life Care, St. Joseph, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1104080"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.03.011"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2021.12.008"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028019860521"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcq175"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aau6753"},{"key":"e_1_3_2_8_1","volume-title":"Hydrocodone bitartrate and acetaminophen tablets, USP","author":"Mallinckrodt Pharmaceuticals","year":"2025","unstructured":"7.Mallinckrodt Pharmaceuticals. Hydrocodone bitartrate and acetaminophen tablets, USP. Mallinckrodt Pharmaceuticals: Webster Groves, MO; 2025. NDC 00406-0125-10."},{"key":"e_1_3_2_9_1","volume-title":"Oxycodone and acetaminophen tablets, USP","author":"Camber Pharmaceuticals, Inc","year":"2024","unstructured":"8.Camber Pharmaceuticals, Inc. Oxycodone and acetaminophen tablets, USP. Camber Pharmaceuticals, Inc.: Piscataway, NJ; 2024. NDC 31722-0951-05."},{"key":"e_1_3_2_10_1","volume-title":"Morphine sulfate tablets, USP","author":"SpecGx LLC","year":"2025","unstructured":"9.SpecGx LLC. Morphine sulfate tablets, USP. SpecGx LLC: Webster Groves, MO; 2025. NDC 00406-5118-01."},{"key":"e_1_3_2_11_1","volume-title":"Potassium chloride extended-release tablets, USP","author":"Aurobindo Pharma USA, Inc","year":"2024","unstructured":"10.Aurobindo Pharma USA, Inc. Potassium chloride extended-release tablets, USP. Aurobindo Pharma USA, Inc.: Dayton, NJ; 2024. NDC 65862-0987-99."}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261464673","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10966218261464673","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261464673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T13:47:55Z","timestamp":1783259275000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10966218261464673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":10,"alternative-id":["10.1177\/10966218261464673"],"URL":"https:\/\/doi.org\/10.1177\/10966218261464673","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]},"article-number":"10966218261464673"}}