Which drug combination is the most common causative regimen for DRESS syndrome in India and accounts for >30% of DRESS cases associated with antiepileptic therapy?
- A Carbamazepine + levetiracetam
- B Phenytoin + phenobarbitone
- C Lamotrigine + valproate ✓
- D Oxcarbazepine alone
Correct answer: C. Lamotrigine + valproate
Explanation
Lamotrigine combined with sodium valproate dramatically increases plasma lamotrigine levels (valproate inhibits lamotrigine glucuronidation) and is the most common drug combination precipitating DRESS. This pharmacokinetic interaction raises lamotrigine to toxic levels, leading to immune sensitisation. Carbamazepine and phenytoin cause DRESS individually but the lamotrigine-valproate combination carries the highest documented risk in clinical practice.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.