Medications That Can Cause Fever

Common Medications Associated with Drug Fever

Beta-lactams, such as penicillins and cephalosporins, are among the most common causes of drug-induced fever, according to the American College of Critical Care Medicine 1
Antimicrobial-induced fever may persist as long as the drug is continued and typically resolves within 1-3 days after discontinuation, as stated by the American College of Critical Care Medicine 1
Antipsychotic medications, particularly phenothiazines, thioxanthenes, and butyrophenones, can cause fever through neuroleptic malignant syndrome, as reported by the American College of Critical Care Medicine 1
Amisulpride can induce fever either through simple hypersensitivity reactions or as part of neuroleptic malignant syndrome, according to Praxis Medical Insights 2

Hypersensitivity reactions are the most common mechanism of drug-induced fever, as stated by the American College of Critical Care Medicine 1
Drug withdrawal, such as from alcohol, opiates, barbiturates, or benzodiazepines, can cause fever with associated tachycardia, diaphoresis, and hyperreflexia, according to the American College of Critical Care Medicine 1

Drug fever typically occurs after 7-10 days of drug administration, with a mean of 21 days and a median of 8 days, as reported by the American College of Critical Care Medicine 1
Fever persists as long as the drug is continued and resolves within 1-3 days after drug discontinuation, according to the American College of Critical Care Medicine and Praxis Medical Insights 1, 2

The primary management of drug fever is discontinuation of the suspected medication, as recommended by the American College of Critical Care Medicine and Praxis Medical Insights 1, 2
Supportive care with antipyretics, such as paracetamol or NSAIDs, and hydration is recommended while waiting for resolution, according to Praxis Medical Insights 2
For neuroleptic malignant syndrome, immediate discontinuation of the antipsychotic, intensive supportive care, benzodiazepines for agitation, external cooling, and IV fluids are recommended, as stated by Praxis Medical Insights 2
Patients who experienced anaphylaxis or toxic epidermal necrolysis should never be rechallenged with the offending drug, according to the American College of Critical Care Medicine 1
For pregnant women with fever, acetaminophen is recommended for treatment, as suggested by the Centers for Disease Control and Prevention 3

Drug fever is a diagnosis of exclusion after ruling out infectious and other causes, and should be considered in the differential diagnosis of critically ill patients, according to the American College of Critical Care Medicine and the Infectious Diseases Society of America 1, 4, 5
In neutropenic cancer patients, drug fever should be considered when fever persists despite appropriate antibiotic therapy, as recommended by the Infectious Diseases Society of America 4
In pregnant women, acetaminophen is preferred for fever management, according to the Centers for Disease Control and Prevention 3
In children, aspirin should not be used for fever management due to the risk of Reye's syndrome, as stated by the American Academy of Pediatrics 6