Unsuspected Benzyl Alcohol Hypersensitivity

To the Editor: Benzyl alcohol has weak local anesthetic and antipruritic properties and is the most common bacteriostatic agent found in premixed injectable drugs and in diluents used for the reconstitution of parenteral medications.¹ We recently evaluated drug hypersensitivity in a 55-year-old man who had had sudden onset of fatigue, nausea, and diffuse angioedema shortly after an intramuscular injection of vitamin B₁₂ containing benzyl alcohol as a preservative. These symptoms had also been noted by the patient when three such injections were administered over the preceding six years, after total gastrectomy for the Zollinger-Ellison syndrome. Similar symptoms had.