Angioedema possibly associated with ezetimibe

Background Angioedema has been reported during ezetimibe post-marketing surveillance; no causality has been established. Aim To describe a case of delayed angioedema possibly associated with ezetimibe therapy. Clinical details A 64-year-old female presented with angioedema and urticaria developing progressively over 2 days, 3 months after starting ezetimibe. She had no respiratory compromise, infectious symptoms or swelling of the tongue or pharynx. She was moderately distressed, and vital signs were normal. She was not taking an ACE inhibitor, angiotensin II antagonist, aspirin or NSAID. She denied complementary medicine use or change in diet. She had no previous drug, food, or food additive allergies and no family history of angioedema. Standard laboratory tests were within normal limits. Outcome Swelling responded to prednisolone and promethazine. Ezetimibe, the suspected precipitant was discontinued. Swelling resolved 4 days after presentation. 10 months after ceasing ezetimibe, she had no further episodes of angioedema or urticaria. Conclusion Close monitoring and reporting of future cases of ezetimibe-associated angioedema will be required to fully characterise the nature of this potential adverse drug reaction.