Tattoo reactions to ink or carrier solutions used in tattooing have previously been reported following initial tattooing, or re-tattooing. Induration, pruritus, nodules, and papules represent the most common clinical presentations. Hypersensitivity to components of red dye, such as mercuric sulfide, and other metal salts, such as cobalt blue, chrome green, cadmium yellow, and nickel have been identified. We report an unusual case of red ink tattoo reaction arising simultaneously in multiple old tattoos following the ingestion of felodipine. Our patient developed a multi-faceted allergic reaction, including dyspnea, fatigue, myalgias, weakness, and thick, well-marginated, indurated plaques confined to the red pigment within numerous multi-colored tattoos, one and a half weeks after initial ingestion of felodipine. Biopsy showed an interface dermatitis with a lymphohistiocytic dermal infiltrate and pigment incontinence. Cessation of felodipine resulted in resolution of the systemic symptoms and rapid, albeit incomplete, improvement of the red plaques within the tattoos.