Carbamazepine is associated with which serious adverse drug reaction?

• A. Hyperkalemic crisis
• B. DILI
• C. Gingival hyperplasia
• D. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Answer: (D)

Carbamazepine carries a notable risk of severe immune‑mediated skin reactions, most famously Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. These conditions are a spectrum of mucocutaneous hypersensitivity that often begin with fever and malaise, then progress to painful rashes, mucosal erosions, and widespread skin detachment. They are medical emergencies requiring immediate drug discontinuation and urgent supportive care, often in a burn or intensive care setting.

This makes the answer the best choice because Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis are the classic, life-threatening reactions strongly linked to carbamazepine. Other options describe problems that are not the characteristic or defining serious ADRs for this drug (for example, gingival hyperplasia is more typical with phenytoin; drug-induced liver injury can occur with many meds, but SJS/TEN is the hallmark dangerous reaction associated with carbamazepine). If any mucocutaneous symptoms appear, stop the drug right away and seek urgent medical attention.