A number of conditions may cause the combination of flushing and hypotension.
Drugs and toxins:
(1) nicotinic acid
(2) calcium channel blocker
(3) phosphodiesterase-5 inhibitors
(4) vancomycin
(5) angiotensin-converting enzyme (ACE) inhibitor
(6) opiates
(7) curare
Foods:
(1) capsaicin
(2) ethanol
(3) sulfites
(4) monosodium glutamate (MSG)
(5) scombroidosis
Anaphylaxis:
(1) physical exercise
(2) cold stimulus
(3) hypersensitivity reaction
Endogenous causes:
(1) sepsis
(2) carcinoid syndrome
(3) mastocytosis
(4) medullary carcinoma of thyroid
(5) vasoactive intestinal peptide (VIP) secreting tumors
(6) pheochromocytoma
(7) systemic capillary leak syndrome
Idiopathic