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Levamisole

Reviews at PMID 23269350, 23298805 and 30166200. Levamisole is an anti-helminthic veterinary dewormer. The drug is sometimes used to treat the nephrotc syndrome (PMID 30008268). The drug now appears to be present in most seized cocaine samples (PMID 25544694) (see also under 'cocaine'). Levamisole may cause profound agranulocytosis and consequent infection. Unexplained agranulocytosis in the young should raise the suspicion of exposure to levamisole-tainted cocaine. Levamisole is also notable for inducing a distinctice cutaneous vasculitis (w/wo ANCA) which, in typical cases, has a predilection to localize in the earlobes, nose and face. See under 'systemic vasculitis' and 'ANCA-related vasculitis' IV and X. Levamisole is biotransformed into the amphetamine aminorex, a drug which causes PHTn. Although no PHT case has been reported yet (Oct, 2013), vigilance is indicated. See also under aminorex and PMID 19298880. The drug can also induce mutifocal leukoencephalopathy (PMID 16862045)

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic