2019 Volume 122 Issue 6 Pages 898-904
Anaphylactic reactions induced by opioids are extremely rare. We encountered an 84-year-old woman with tongue cancer who had a past history of anaphylactic shock induced by codeine phosphate and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and loxoprofen. For her cancer diagnosis, she desired only pain relief at home without any detailed examinations or aggressive treatments, including drip or tube feeding. Morphine and oxycodone are structurally similar to codeine. Therefore, we chose fentanyl and acetaminophen, in order to avoid the risk of cross-sensitivity with codeine. We administered palliative sedation with diazepam suppository in the terminal phase. We report the clinical course of this patient, including a review of the literature on opioid allergy, NSAIDs intolerance (hypersensitivity).
