Oxyphenbutazone-induced sialadenitis

Captopril-induced bilateral parotid and submandibular sialadenitis

Two cases of sialadenitis following treatment with captopril are described. In case 1, an upper chest and facial erythema and dryness of the mouth accompanied the swelling of the salivary glands. In case 2, a conjunctival erythema accompanied the sialadenitis. None of the patients had previously used captopril, and, in both cases, the swelling occurred within the first hour after the drug intake; the patients had a complete recovery within a few hours after captopril was withdrawn. It is possible that the reported effect was caused by a type-B idiosyncratic adverse drug reaction.

Salivary gland swelling following naproxen therapy

We report allergic sialadenitis as a novel side-effect of naproxen, a non-steroidal anti-inflammatory drug (NSAID). Bilateral swelling of the major salivary glands and a rash occurred a few days after the patient had taken the drug. High-dose systemic corticosteroid therapy was required to control the disorder. Because the salivary gland swelling was not initially recognized as an adverse drug reaction, further doses of naproxen were given on two occasions, with similar results.

Drug-induced parotitis

Drug-induced parotitis is a relatively uncommon adverse drug reaction. Most of the data on drug-induced parotitis consist of isolated case reports with few attempts at rechallenge to confirm the aetiology. Phenylbutazone and oxyphenbutazone have a significant number of reports suggesting that these drugs may be implicated in causing parotitis. Antipsychotics, particularly thioridazine, have been associated with parotitis. Most of these reports relate the anticholinergic oral drying as a predisposing factor in the development of a parotid gland infection. There is inadequate literature on the histamine (H2) receptor blockers, interferon-alpha, doxycycline, trimipramine, nifedipine, methyldopa, nitrofurantoin, nicardipine, isoproterenol or ritodrine to link them as aetiological agents in the development of parotitis.

Oral manifestations of drug therapy

Increasingly, patients with complicated medical problems are coming to dental offices for treatment. These patients report using a variety of medications to control one or more chronic conditions. Many of these medications produce changes in the mouth because of toxic overdoses, side effects, allergic reactions, or as a consequence of the primary action of the drug. These effects include: xerostomia, gingival hyperplasia, candidiasis, mucositis, stomatopyrosis, gingival bleeding, petechia, salivary gland problems, intrinsic stain, cheilitis, erythema multiforme, lichen planus, ulcerations, taste changes, tardive dyskinesias, and soft tissue pigmentation. This article discusses presentations and causes of oral changes secondary to systemic drug use.