Medications that can cause histamine release

Antibiotics

Ciprofloxacin, vancomycin

Barbiturates

Narcotic analgesics*

Neuromuscular antagonists

Quaternary amine

Succinylcholine

Benzylisoquinolinium compounds

Atracurium, cisatracurium, doxacurium, mivacurium, tubocurarine

Plasma expanders

Dextran, polygeline (Haemaccel [brand name])

Radiocontrast agents

The medications listed above can cause nonimmunologic histamine release, which can predispose patients to vancomycin reactions and/or prevent successful vancomycin desensitization.

* Fentanyl rarely induces histamine release.

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Medications that can cause histamine release