What is DRESS syndrome, the allergic reaction caused by Meftal-Spas?

One of the most commonly prescribed pain-killers by medical practitioners, Meftal-Spas is under scanner as Indian Pharmacopoeia Commission (IPC) has issued a safety alert on its consumption.

The drug is commonly used for treating menstrual stomach cramps, osteoarthritis,rheumatoid arthritis and mild to moderate fever. 

Manufactured by Blue Cross Laboratories Meftal-Spas is a widely prescribed drug. It is also sold under different names by brands like Mankind Pharma Ltd, Cipla, Alkem Laboratories, Leeford Healthcare, etc.

What IPC said

• The IPC has said that the drug’s main component, mefenamic acid can cause adverse reactions including the Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome.
• The commission in its alert has said that the preliminary analysis of adverse reactions from the Pharmacovigilance Programme of India  (PvPI) database had revealed DRESS syndrome.

What is DRESS Syndrome?

• The DRESS syndrome is an allergic skin reaction to certain drugs, among which melanic acid used in Meftal-Spas is now found to be a cause of it.
• It occurs when the immune system overreacts to certain drugs, resulting in type 4 hypersensitivity reaction that can cause multiple symptoms throughout the body such as fever, rashes, and blood abnormalities.
• The mortality rate of this syndrome is 10% and experts classify this disease as type 4 hypersensitivity reaction.
• It is considered as a serious drug reaction, which can affect the body’s main organs within 2-6 weeks of a person's exposure with the drug.

Symptoms

• DRESS syndrome can have a variety of symptoms, which also leads to some experts calling it an idiosyncratic multisystem reaction to a drug.
• Symptoms which generally appear within 2-6 weeks of contracting the syndrome are fever, skin rashes, high eosinophil count in blood, swollen lymph nodes and inflammation of internal organs.

What is the treatment?

• According to Medical News Today, the withdrawal of medication is the most important factor in treating the disease.
• This might be enough to stay the progression of the disease as well as prevent any abnormalities.
• In some cases, Systemic corticosteroids are administered to patients to resolve the symptoms. However, a 2014 study found that systemic corticosteroids only manage the disease when the patient starts taking them at an early stage.
• It is pertinent to identify the drug that caused a reaction in the immune system and stop its consumption.

The prescription of this drug might reduce as it’s main salt composition mefenamic acid is found to be a potential trigger for DRESS syndrome.