About the book

This widely acclaimed book has evolved and expanded into the Litt's Drug Eruption & Reaction Manual, an authoritative guide to adverse drug reactions and reaction patterns. With improved adverse events listings and a comprehensive classification system for reaction patterns, Litt's Manual is a valuable resource for anyone dealing with drug prescription.

The intuitive look-up format and comprehensive coverage make it a helpful diagnostic aid for medical practitioners and an important reference tool for educators, lecturers, pharmacists and students. In retaining its unique focus on drug eruptions, which is much beloved by dermatologists, this edition is also essential for anyone researching, teaching and practising cutaneous medicine.

How can the book help with practice?

1. Look at the drug profile to see if a particular drug is known to cause the reaction; check in the list of drugs that cause important reactions to see if other drugs in the class might not cause it.
EXAMPLE: a patient prescribed with a macrolide antibiotic (clarithromycin) presented with tinnitus. The drug profile shows this is reported in one report; the list of drugs shows it is reported for many other macrolide antibiotics (so there would be no point in changing to those), but not for roxithromycin or telithromycin, so those could be considered if appropriate for the initial indication of infection.

2. Look at the class reaction tables to see if a reaction is attested for all drugs in that class, for a majority, or is specific to one or two.
EXAMPLE: A patient prescribed a statin presented with eczema. The class reaction tables show that this reaction has not been attested for fluvastatin, lovastatin, pitavastatin or rosuvastatin so those could be considered as substitutes.
EXAMPLE: If the same patient had presented with pruritus, the tables show that this has been attested for a majority of drugs in the class, suggesting that this may be a class reaction. However there are no reports for fluvastatin or pitavastatin, so one of these may be the most suitable alternative.

The 28th edition, for 2022, published in both print and electronic forms. Order a copy at Litt’s Drug Eruption & Reaction Manual - 28th Edition - Neil H. Shear (routledge.com)

For testimonials about previous editions of this text, please watch the video at http://www.youtube.com/watch?v=ZHAXKPAkBIA&feature=youtu.be

The current edition of this classic text features in addition tables of reactions caused by classes of drugs, and shows at a glance whether a reaction is attested for all drugs in a class, for a majority of them, for a significant minority of them, or not at all. The table for Calcium channel blockers is reproduced below. 

Calcium channel blockers

  A D F I Nic Nif Nis V =
Skin
Acneform eruption [1] [1]
AGEP [21] [3] ?
Anaphylaxis [1] [1]
Angioedema [6]
(6%)
[3] [1] [1] [2] [3]
Dermatitis (<10%) [1] [1]
Diaphoresis [2] [1] [2] [2]
Ecchymoses [1]
Eczema [1] [1]
Edema [20]
(5–14%)
[4]
(<10%)
[1] [6]
(7%)
[3] [1] [1] ✓✓
Erythema [2] [2]
Erythema multiforme [2] [11]
(31%)
[5] [4]
Erythema nodosum [2] [1]
Exanthems [2] [17]
(31%)
[2] [1] [9] [1] [8]
Exfoliative dermatitis [6] [5] [2]
Facial edema
Hyperkeratosis [1] [2]
Hypersensitivity [1] [2]
Lichenoid eruption [1] [3]
Linear IgA [1] [1]
Lupus erythematosus [5] [3] [2]
Peripheral edema [44]
(34%)
[1]
(5–8%)
[6]
(22%)
[2]
(7%)
[12]
(6%)
[6]
(22%)
[1]
(<10%)
Petechiae [1]
Photosensitivity [11] [5] [4]
Pigmentation [2] [10]
Pruritus [3] [6] [1]
(6%)
[3] [6]
Pseudolymphoma [1] [1]
Purpura [1] [3] [1] [3] [1]
Pustules [2]
Rash (<10%) [4] [3] [2] [2] ✓✓
Stevens-Johnson syndrome [1] [4] [3] [5]
Telangiectasia [5] [2] [2]
Toxic epidermal necrolysis [2] [4] [2]
Toxicity [2] [2] [1]
Ulcerations [1]
Urticaria [1] [5] [1] [3] [7] [5] ✓✓
Vasculitis [2] [6] [4] [2]
Xerosis
Hair
Alopecia [2] [4] [5]
Hair pigmentation [1] [1]
Nails
Nail dystrophy [1] [1] [1]
Mucosal
Gingival hyperplasia/hypertrophy [30]
(31%)
[10]
(74%)
[5]
(2–10%)
[1] [2] [75]
(75%)
[10]
(19%)
✓✓
Oral ulceration [1] [1]
Xerostomia [1] [2] [1] ✓✓

A Amlodipine; D Diltiazem; F Felodipine; I Isradipine; Nic Nicardipine; Nif Nifedipine; Nis Nisoldipine; V Verapamil.

These tables concentrate on skin, hair, nails, and mucosal reactions.

The following conventions are used in these tables:
reaction noted (package inserts)
[3]number of published reports of a reaction
(8%)highest incidence that has been noted or reported
?20 reports or over, or an incidence of 20% or over, recorded for this reaction for a minority of drugs in the class
at least half the drugs in the class selection have this reaction noted or reported
✓✓all drugs in the class selection have this reaction noted or reported
Note:reactions noted or reported for only one drug in a class selection have been excluded