Multiple Drug Intolerance Syndrome (MDIS, Multiple Drug Allergy Syndrome, Multiple Drug Hypersensitivity Syndrome, MDH) covers a spectrum of real and imagined reactions to medications.
Multiple drug intolerance syndrome refers to intolerance to multiple unrelated drugs (>= 3 drug classes that are chemically, pharmacologically and immunogenically unrelated). The intolerance is usually observed on multiple different occasions.
Some patients may have so many intolerances that it is difficult to perform surgery or treat common conditions.
Some of these patients have allergies to multiple drugs and chemicals, as can be shown be allergy testing and drug challenges. When testing this group additives to drug formulations (preservatives, coloring agents, etc) should be investigated. For example, m-cresol may be a preservative used by several manufacturers. A patient with allergic symptoms can sometimes receive an essential drug if premedicated with sodium cromolyn or an oral H1-antihistamine (Schiavino et al).
Some of the patients fit a profile of high anxiety and depression, and the patient is often overweight and middle-aged with multiple somatic complaints. These patients may benefit from addressing psychological issues and to look for objective evidence of drug intolerance.
In general it is a good idea to minimize the number of drugs that the patient is receiving until a full investigation can be completed.
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