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December 1987

Dantrolene for Amphotericin B—Induced Rigors

Arch Intern Med. 1987;147(12):2220. doi:10.1001/archinte.1987.00370120156032

To the Editor.  —The article by Gross et al, "Prevention of Amphotericin B—Induced Rigors by Dantrolene" that appeared in the August 1986 issue of the Archives1 was of interest since it suggested a solution to a bothersome adverse effect of an increasingly used antifungal agent. Premedication regimens to control these reactions to amphotericin B may include acetaminophen, hydrocortisone, antihistamines, and phenothiazines, but their efficacy is uncertain and has never been demonstrated in prospective trials. Burke et al, in a small but randomized study, demonstrated that meperidine hydrochloride (Demerol), in doses of 50 mg or more, alleviate the chills and rigors associated with amphotericin B infusions.2 Our anecdotal experience with meperidine agrees with Burke's findings, but there are occasional patients who do not respond to meperidine hydrochloride.

Report of a Case.  —We recently cared for a 32-year-old man with the acquired immunodeficiency syndrome (AIDS), complicated