Recurrence with re-exposure was well described and agranulocytosis spontaneously reversed upon discontinuation of therapy. By 1976, several cases of leukopenia and agranulocytosis were reported. ![]() Literature review revealed that significant complications were quickly reported when levamisole was used in inflammatory conditions. The objectives of this article are to review the literature regarding the full spectrum of possible complications related to levamisole use for medical purposes, to review the current scope of levamisole-induced complications in cocaine users and to discuss the pharmacological properties that might explain the motivation behind the large-scale adulteration of cocaine with levamisole. The first case reports of complications related to levamisole in cocaine users were published in 2009. By 2009, the United States Drug Enforcement Administration (DEA) estimated that 69% of the cocaine seized contained levamisole. Levamisole has been identified as a cocaine adulterant in the United States since 2003. ![]() Levamisole is a pharmaceutical with anthelminthic and immunomodulatory properties that was previously used in both animals and humans to treat inflammatory conditions and cancer.
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