VIR and opioids

Q: Vancomycin Infusion Reaction (VIR), popularly known as Red Man Syndrome, can be inhibited by simultaneous administration of opioids? 

A) Yes

B) No

Answer: B

Any drug which potentiate mast cell degranulation can make VIR worse. These include opioids, radiocontrast dye and muscle relaxants.

Such agents should be given with good proximation of vancomycin infusion.

#pharmacology

References:

1. Levy JH, Marty AT. Vancomycin and adverse drug reactions. Crit Care Med 1993; 21:1107.

2. Wong JT, Ripple RE, MacLean JA, et al. Vancomycin hypersensitivity: synergism with narcotics and "desensitization" by a rapid continuous intravenous protocol. J Allergy Clin Immunol 1994; 94:189.