My wife has severe angiooedema of her tongue so far tests for C1 inhibitor problems and any related conditions have been negative - however she has proven crohn's disease and has been prescribed tramadol and buprenorphine for pain and it is thought that one or both agents may been involved a a cause - she also gets dystonic tongue reactions (but not oedema) from oral tramadol and promethazine and doses of amitriptyline > 30 mg but not from injectable forms of tramadol and promethazine. Steroids such as prednisolone and dexamethasone cause adverse side effects (agitation and tachycardia with the former and migraine headache and dizziness with the latter. She gets severe itch with oral morphine although injectable form is OK, itch from fentanyl patches (but not injectable form).There is no family history of angiooedema. Certrizine has not been successful in alleviating angiooedema and ranitidine plus fexofenadine are being trialled. After near death from recent attack of angiooedema when she vomited and aspirated and for which it is uncertain that adrenaline actually helped resolve the oedema she has stopped tramadol and buphenorphine patch and returned to oxycodone which she has tolerated well in the past - it is also planned to trial infliximab for Crohn's disease and hopefully further reduce need for strong analgesics. Most importantly the only thing that has tended to ease and stop the angiooedema over the past 6 months of its occurrence has been diazepam either orally if the tablets can be introduced before the tongue swells too much or by im injection - we have had enormous battles explaining this to doctors and nursing staff even though we have witnessed diazepam's effect time and time again (attacks have been at least twice per week and are usually absent or much reduced with regualr use of oral diazepam - attacks do occur if diazepam is missed for a day or so - however attacks when they occur have increased from mild to severe and tolerance to diazepam is occurring)Stress , emotional or physical, dental work seem to be the usual precipitants.
Has anyone else had success with diazepam ( or sublingual loazepam which we have used also)? husband of angiedeemer