Drugs associated with tachyphylaxis: results from a retrospective pharmacovigilance study using disproportionality analysis.

Background: Tachyphylaxis is the rapid development of drug tolerance following repeated administration.

Objectives: To evaluate the United States Food and Drug Administration Adverse Event Reporting System (USFDA AERS) data for drugs significantly associated with tachyphylaxis using disproportionality analysis.

Methods: Disproportionality analysis was used for detecting safety signals for identifying drugs associated with tachyphylaxis. Frequentist and Bayesian statistical methods were employed to detect signals, identifying anesthetics, immunosuppressants, antineoplastics, and psychoactive drugs with positive associations.

Results: Data from 29,153,222 reports between 2004 and 2024 were examined, and 242 reports of tachyphylaxis included. Tachyphylaxis was observed with corticosteroids, opioids, antihistamines, psycholeptics, nitroglycerin, antineoplastics, immunosuppressants, sympathomimetics, psychoanaleptics and psycholeptics that are well documented. Tachyphylaxis was also observed with propofol, cisatracurium, oxcarbazepine, and cabergoline emphasizing the need for further investigation. Hospitalization was reported in 16.9% of cases, with 5% leading to disability and 2.5% resulting in death.

Conclusion: While this study provides valuable insights into drug-related tachyphylaxis, limitations such as underreporting and lack of detailed clinical context exist. Future research should focus on understanding underlying mechanisms and developing strategies to mitigate tachyphylaxis in long-term treatments.