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Sulfa Drug Allergy
Skin rashes are the most common sign of a sulfa allergy. Sulfa drugs are antibiotics; the most commonly prescribed is sulfamethoxazole. A person who develops a sulfa drug allergy should also be cautious around combination antibiotics such as Bactrim. Bactrim contains sulfa.
Sulfa is commonly confused with sulfate-containing salts. Sulfates are in no way related to sulfa, and will not influence a sulfa drug allergy in any way.
Latex is commonly used in hospitals, most often in surgical gloves. Symptoms of a latex allergy are the same as for most allergies: hive and skin rashes are the most common reactions, although life-threatening reactions do occur. Alternatives to latex are available, so be sure to let any medical professionals know of your allergy.
Sulfa antibiotics allergy: Taking sulfa antibiotics can cause an allergic response in some people however this is considered rare. It involves the body's immune system overreacting to the drug. The type and severity of symptoms can vary considerable though skin symptoms are the most common allergic response to drugs.
Sulfa allergies are common, hence medications containing sulfonamides are prescribed carefully. It is important to make a distinction between sulfa drugs and other sulfur-containing drugs and additives, such as sulfates and sulfites, which are chemically unrelated to the sulfonamide group, and do not cause the same hypersensitivity reactions seen in the sulfonamides.
Approximately 3% of the general population have adverse reactions when treated with sulfonamide antimicrobials. Of note is the observation that patients with HIV have a much higher prevalence, at about 60%. People who have a hypersensitivity reaction to one member of the sulfonamide class are likely to have a similar reaction to others.
Hypersensitivity reactions are less common in non-antibiotic sulfonamides, and, though controversial, the available evidence suggests those with hypersensitivity to sulfonamide antibiotics do not have an increased risk of hypersensitivity reaction to the non-antibiotic agents.
Two regions of the sulfonamide antibiotic chemical structure are implicated in the hypersensitivity reactions associated with the class.
The first is the N1 heterocyclic ring, which causes a type I hypersensitivity reaction.
The second is the N4 amino nitrogen that, in a stereospecific process, forms reactive metabolites that cause either direct cytotoxicity or immunologic response.
The non-antibiotic sulfonamides lack both of these structures.
The most common manifestations of a hypersensitivity reaction to sulfa drugs are rash and hives. However, there are several life-threatening manifestations of hypersensitivity to sulfa drugs, including Stevens-Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, hemolytic anemia, thrombocytopenia, and fulminant hepatic necrosis, among others.
Be careful of the following which contain sulfa:
- Sulfamethoxazole
- Trimethoprim-sulfamethoxazole (Septra, Bactrim)
- Erythromycin-sulfisoxazole
These two medications are closely related to sulfonamides and should be avoided by people with sulfonamide allergy:
- Sulfasalazine (Azulfidine), used to treat Crohn's disease, ulcerative colitis and rheumatoid arthritis
- Dapsone, used to treat leprosy, dermatitis and certain types of pneumonia
There are also a number of other medications related to sulfonamides. Although the medications noted below are probably safe for you to take if you have a sulfa allergy, you should first check with your doctor. Examples include, but are not limited to:
- Certain "water pills" (diuretics), such as furosemide (Lasix) and hydrochlorothiazide (Microzide)
- Medications for diabetes, such as glyburide (Glynase, Diabeta, Micronase) and glimepiride (Amaryl)
- Some nonsteroidal anti-inflammatory drugs, such as celecoxib (Celebrex)
- The migraine medication sumatriptan (Imitrex)
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