Olfactory disorders due to medicinal drugs: an analysis and review of the literature.

Introduction. - Olfactory disorders caused by medicinal drug intake are an uncommon occurrence. However, such an etiology should be systematically tak en into account and investigated, as olfactory loss may be reversible once the particular treatment has been stopped. Current knowledge and key points. -An analysis of the literature shows that of the large number of drugs that are apparently responsible for olfactory disorders, this adverse side effect has in fact only been observed in anim al study populations, and no clinical case report has been made on the subj ect. The real toxicity to man is therefore only hypothetical. Of the 150, 0 00 cases recorded in the pharmacovigilance centers in France, only 68 have reported olfactory complications (0.05% of cases) and only 22% of the medic al files on this disorder reach a satisfactory level of plausibility. Cardi ovascular drugs are mainly implicated in the development of olfactory disor ders. Of these, certain drugs in particular should be mentioned: conversion enzyme (ACE) inhibitors which are responsible for taste disorders, some be tablockers, and a calcium antagonist (a dihydropyridine derivative). Olfact ory disorders have also been reported following administration of drugs use d in anesthesia, in cancerology, endocrinology (carbimazole), in immunology (interferon), in the treatment of infectious diseases (ciprofloxacine, dio xycycline, terbinafine), and in rheumatology (D-penicillamine). Future prospects and projects. - It is frequently difficult to establish a direct relationship between drug exposure and an olfactory disorder, and it is often not easy to determine with any certainty the causative role of th e drug in the development of this disorder. (C) 2000 Editions scientifiques et medicales Elsevier SAS.