Possible Interaction: Cocaine and Levamisole

“ Levamisole , an anthelmintic drug with cholinergic properties, has been implicated in cases of drug-induced vasculitis when added to cocaine for profit purposes.”

“The United States Public Health Service Administration is alerting medical professionals that a substantial percentage of cocaine imported into the United States is adulterated with levamisole , a veterinary pharmaceutical that can cause blood cell disorders such as severe neutropenia and agranulocytosis.”

“Since consistently turning up in cocaine seizures in 2002, the amount of cocaine adulterated with levamisole has been steadily increasing.”

“The Annals of Internal Medicine published … five cases of agranulocytosis associated with cocaine … levamisole [3] and in Alberta, where some of the first reports of levamisole appeared, over 20 confirmed or probable …, including at least two deaths, have been reported due to adulterated cocaine as of this past August.”

“The purpose of adulterating street cocaine with levamisole is not known, but it has been speculated that it is added intentionally in order to potentiate the effects of cocaine.”

“Illegal use of levamisole by mixing it with cocaine in order to increase the psychotropic effects has also increased in recent years.”

“Although its prevalence has varied over time and geographically, levamisole has been detected in up to 79% of the street supply of cocaine at levels up to 74% by weight.”

“In recent years, the use of cocaine adulterated with levamisole has been associated with ANCA vasculitis and pauci-immune RPGN.”

“In the literature, 52 cases of drug‐induced PG have been documented, of which cocaine laced with levamisole has shown most direct association, with a mean Naranjo score of 9.”

“Presently, levamisole is frequently used as an adulterant in cocaine.”

“It has been shown that both cocaine and levamisole , which is a common adulterant of cocaine, can trigger the formation of ANCAs and lead to the corresponding symptoms.”