STEVENS JOHNSON SYNDROME

SJS Drug Reactions

Accounting for approximately 150,000 deaths per year in the U.S., drug reactions are one of the leading causes of death in the United States.

Yet, because less than one percent of adverse drug reactions are reported to the FDA, the problem is not well-known. So, although SJS is considered a rare disease, it may be more prevalent than previously thought.

Drugs Triggering Stevens-Johnson Syndrome

Almost any prescribed and over-the-counter drug, including adult and children ibuprofen products, can cause the onset of SJS. Stevens-Johnson syndrome has been associated with negative reactions to several different types of drugs, including:

•    Antibiotics
•    Anti-convulsants
•    Barbiturates
•    Nonsteroidal anti-inflammatory drugs (NSAIDs)
•    Sulfa or sulfa-containing drugs
•    Gout medications
•    Accutane
•    Penicillins

SJS Drug Warnings

•    Bextra—In 2005, the FDA requested that Pfizer remove its drug Bextra from the market after studies showed serious risks of developing SJS and other severe disorders.
•    Onfi—In 2014, the FDA warned that the antiepileptic drug Onfi (clobazam) could potentially cause cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). This prompted changes to the drug labels and medication guide, to better warn consumers of the risks.
•    Zyprexa—With a new FDA warning on Zyprexa causing serious skin reactions, there is concern in the medical community about new related cases of SJS as well.
•    Ziprasidone—There are reports of Stevens-Johnson symptoms induced by antipsychotic drugs in the past. The FDA warned in 2015 that cases of Stevens-Johnson syndrome have been reported with ziprasidone exposure, another antipsychotic medication.

Children’s Motrin & SJS

According to the World Health Organization (WHO) Website, the majority of Stevens-Johnson syndrome (SJS) cases are linked to drug exposures. Common over-the-counter medications like Motrin and Tylenol have added warnings to their labels regarding the use of their products, noting past cases of SJS. Ibuprofen, another common NSAID on the market, may also directly cause SJS, according to recent medical reports.

Stevens-Johnson is a severe blistering rash affecting both skin and mucous membranes. The reaction typically begins with burning and painful lesions on the face and torso and extends to the rest of the body. Patients have presented with fever, malaise, myalgia and ocular manifestations. SJS can be fatal, and death occurs in around 5 percent of known cases.

Stevens-Johnson affects people of all ages, but a large number of victims are children. In one high-profile lawsuit filed against Johnson & Johnson, a family was awarded $63 million after a young girl was left permanently blind, which the plaintiffs said was caused by Motrin.

The jury determined that Johnson & Johnson failed to provide sufficient warnings about the potential side effects of Motrin. In fact, as of 2003, the over-the-counter medication for children contained no warning at all.

In 2005, the US Food and Drug Administration instructed makers of ibuprofen and other common painkillers to amend the warning labels on their products.

Johnson & Johnson was found liable in at least two other major cases. In 2011, a California jury awarded a $48 million judgment, and in Philadelphia in the same year, a court awarded $10 million.

What is Stevens Johnson Syndrome?

SJS is a rare condition, which is usually a reaction to a medication or an infection. It presents with flu-like symptoms, followed by a painful rash that spreads and blisters. The top layer of the affected skin dies, sheds and then heals.

SJS is a medical emergency that may require hospitalization. Treatment focuses on eliminating the underlying cause, controlling symptoms and minimizing complications. Recovery can take weeks to months, depending on the severity of the reaction.

Stevens-Johnson syndrome is a rare and unpredictable reaction, usually triggered by a medication or an infection. A reaction to medication may start while you’re using it or up to two weeks after you’ve stopped using it. Drugs that may cause Stevens-Johnson syndrome include:

• Anti-gout medications—allopurinol
• Seizure medications
• Anticonvulsants and antipsychotics
• Pain relievers, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve)
• Antibiotics and anti-infection medications, such as penicillin, azithromycin, Zithromax, amoxicillin. 

What is Toxic Epidermal Necrolysis?

Toxic Epidermal Necrolysis (or Lyell’s syndrome) is a severe form of SJS that causes large sheets of skin to detach from the body. TEN symptoms are often preceded by a fever and large rash. A layer of skin fills with fluid as a reaction from the body’s immune system. The skin begins to sag from the body, leaving the patient vulnerable to serious.  Around 30 percent to 40 percent of TEN patients die.

Stevens Johnson Syndrome Symptoms

If the condition progresses untreated, symptoms can increase and worsen over time. Such signs and symptoms include:

•    Blisters
•    Rashes
•    Mouth sores
•    Swelling of eyelids
•    Conjunctivitis
•    Flu-like symptoms (fever, fatigue, headache, sore throat, cough)

SJS Outcomes & Prognosis

Stevens Johnson Syndrome is a life-threatening condition, and may be misdiagnosed and under-reported by physicians. About 5-15 percent of patients with SJS die, which is why it’s critical that patients are closely monitored by medical professionals. Recovery can take months, depending on the severity of the condition.

Because many physicians and medical personnel are not familiar with the symptoms, treatment of SJS is frequently delayed, worsening the condition. Severe cases may lead to serious health consequences. SJS can cause blindness and results in death in 10 to 30 percent of cases. Further complications can include:

•    Permanent blindness
•    Dry-eye syndrome
•    Photophobia
•    Lung damage
•    Chronic obstructive pulmonary disease (COPD)
•    Asthma
•    Permanent loss of nail beds
•    Scarring of the esophagus and other mucous membranes
•    Arthritis
•    Chronic fatigue syndrome.

Stevens Johnson Lawsuits

Following any drug-related injury, including cases of SJS and other unusual health conditions, injured plaintiffs should contact a medical professional and product liability attorney to determines the root cause of an ibuprofen Stevens Johnson injury and to work toward a medical and legal solution.

The Lyon Firm has experience engaging large drug corporations in defective drug cases and has obtained large injury settlements that have in turn helped victims pay for medical expenses and lost wages due to illness.

Joe Lyon works with pharmaceutical experts and is well-versed in a variety of areas in toxic tort and product liability litigation, and is prepared to represent injured plaintiffs in seeking the maximum benefit following preventable ibuprofen Stevens Johnson injuries.

Drug companies have a duty to properly test their products in trials before they release dangerous drugs to the public, even over-the-counter, where consumers risk their good health.