Delayed-onset carbamazepine-induced angioedema: a case report

Carbamazepine is commonly used for epilepsy, neuralgia, vestibular paroxysmia, and bipolar disorder. Although most adverse effects are mild and transient, angioedema is a rare but potentially life-threatening hypersensitivity reaction. Angioedema typically occurs within 24 to 168 hours of drug exposure. We report a case of delayed-onset carbamazepine-induced angioedema in a 64-year-old man treated for vestibular paroxysmia. Three weeks after starting carbamazepine 200 mg/day, he developed pruritic erythematous patches with marked swelling on the face and hands. The medication was immediately discontinued, and treatment with corticosteroids and antihistamines resulted in complete resolution within three weeks. This case highlights that carbamazepine-induced hypersensitivity reactions can occur later than commonly recognized, emphasizing the need for continued vigilance beyond the typical risk period. Physicians should maintain awareness of this potentially serious adverse reaction throughout the treatment course.