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What Are The Symptoms Of A Sulfa Allergy

What Is A Sulfa Allergy

ALLERGIC REACTION TO SULFA! 9 Day Cellulitis Follow Up | Dr. Paul

A sulfa allergy is a rash or more serious reaction to sulfa drugs. These drugs can treat a range of health problems from eye infections to rheumatoid arthritis .

Sulfa drugs, also called sulfonamides, include antibiotics as well as other types of drugs. Allergies happen most often with antibiotics. About 3 percent of people have some type of reaction to them.

Tell your doctor right away if you think youâre having a reaction to a sulfa drug. Theyâll decide whether to take you off the drug and how to treat your symptoms.

If I Have A Reaction From Bactrim Can I Take

1.. Acetazolamide. Prescribed for the prevention of altitude sickness, yes, you can. With any new medication, watch for rash or severe side effects.
2. Celecoxib . An anti-inflammatory commonly used for musculoskeletal pain, yes, you can take that.
3. The diuretics Bumetanide and Furosemide . Doctors prescribe them for lower extremity swelling and heart failure. Yep, you can take these.
4. Diabetes medications Glimepiride,Glipizide and Glyburide. Yep.
5. Thiazide diuretics Chlorthalidone and HCTZ treat high blood pressure and are OK to take even if you have an allergy to Bactrim.
6. Migraine medications, the triptans Eletriptan, Frovatriptan,Sumatriptan, etc., are safe in those with reported sulfa allergy.
7. Antibiotic Eyedrops:Gentamicin sulfate, Polytrim , Atropine sulfate, Neomycin , and other sulfur-based eye drops are safe to use in those with self-reported sulfa allergy. There is one eye drop you should NOT use and that is Blephamide eye drops.

To sum it up: the evidence from clinical trials suggests that folks who have had an allergic reaction to the generic antibiotic TMP/SMX do not need to avoid all sulfa-type drugs, including those listed above.

Is It Common To Have A Sulfite Sensitivity

If youre not asthmatic, sulfite sensitivity would be very unusual. If you do have asthma, your chances of being sensitive to sulfites is in the range of between 1 in 40, and 1 in 100. If you suspect you may be sensitive to sulfites, you should be evaluated by a board-certified Allergy/Immunology physician before starting on a program of lifelong avoidance of foods and beverages that contain sulfite.

A note from Cleveland Clinic

If you have a sulfite sensitivity, youll need to avoid substances containing sulfites throughout your life. Talk to your healthcare provider for directions on what to avoid and what to do if you ever have a reaction.

Last reviewed by a Cleveland Clinic medical professional on 10/16/2020.

References

  • Food and Drug Administration. Chapter 19: Undeclared Major Food Allergens and Food Intolerance Substances. Accessed 11/18/2021.
  • Vally H, Misso N. Adverse reactions to the sulphite additives. Gastroenterol Hepatol Bed Bench. 2012 Winter 5: 16-23. Accessed 11/18/2021.
  • Food Allergy Canada. Sulphites. Accessed 11/18/2021.
  • American Academy of Allergy Asthma & Immunology. Food Allergy. Accessed 11/18/2021.
  • American College of Allergy, Asthma & Immunology. What Causes Asthma? Accessed 11/18/2021.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

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Allergic Reaction To Sulfa

Below is a list of symptoms commonly experienced by those who have an allergy to sulfa drugs:

  • Skin rash or hives

In more severe cases, allergic reactions to sulfa can also include:

  • Sulfonamide drug hypersensitivity syndrome: If you suffer from this condition as a result of an allergic reaction to sulfa, you might experience rash, fever, and organ problems within 1 to 2 weeks of starting the drug.
  • Drug eruption: This will result in red or swollen round patches, which will begin to form anywhere from 30 minutes to 8 hours.
  • Stevens-Johnson syndrome: Stevens-Johnson syndrome is among one of the most severe allergic reactions a patient can have after taking a drug containing sulfa. Some of its symptoms include blisters and peeling skin.

Other common allergic reactions associated with sulfa drugs include headaches, difficulty sleeping, cloudy urine, low blood counts, and anaphylaxis.

Beware While Using Medicines

Pin on Allergies

When you buy medicine from a pharmacy over the counter make sure to tell the pharmacist about your allergy and while buying a generic medicine make sure that it does not contain Sulfa. Remember, sulfa allergy can be caused by other drugs than antibiotics. You must know the drugs that can lead to this allergy.

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Dr Roach: Severe Reaction To Sulfa Drug Made His Life Miserable

Dear Dr. Roach: I am a 78-year-old male in fairly good health. I recently was prescribed Bactrim for an ear infection but didnt know I am allergic to sulfa. I had a severe reaction to the drug: a raging, very itchy rash on most of my body. It made my life miserable. I was given prednisone, which did not help a great deal. I was also given hydroxyzine and triamcinolone ointment, which helped somewhat. I had this condition for three months before the rash and itch subsided. Since this episode I have talked to many people who have either had a reaction to sulfa or know someone who has.

Why do doctors continue to prescribe sulfa drugs when there seems to be such a high probability that there will be a reaction? Why hasnt a test been developed to determine if a person has this allergy before prescribing it?

A.R.

Dear A.R.: All antibiotics share the risk of allergic reactions some more than others.

Attempts to create a test to predict a sulfa allergy have not been successful, and none is available.

Doctors need to have a healthy respect for sulfa allergies, and prescribe these medicines only when the benefit would outweigh the risk.

S.H.

Dear S.H.: Withdrawal symptoms in people stopping depression medications of the class of paroxetine are common. However, paroxetine tends to be the most difficult of these.

Other approaches include switching to an easier medication to stop, such as fluoxetine , which lasts a long time in the body, and so it usually is easier to stop.

What Is A Sulfa Drug

Sulfa drugs, also known as sulfonamides, are antibiotics as well as other drugs used to treat a variety of health conditions such as eye infections or rheumatoid arthritis. Sulfa antibiotics were introduced in 1936.1 The most common sulfa drugs are used as burn creams, vaginal suppositories, eye drops, and to treat infections.1

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Coughing Wheezing Or Shortness Of Breath

These symptoms are especially common reactions among those who have already been diagnosed with asthma. Also, asthma patients are more likely to have a sulfa sensitivity than people without asthma. A sulfa allergy can trigger asthma-like symptoms, worsen asthma symptoms, and even cause pneumonia-like reactions. If this occurs, a visit to an emergency care center is in order, as symptoms can become life-threatening.

Treatment For Allergic Reaction To Sulfa Drugs

Pharmacology – Sulfa Allergy and Loop Diuretics – by Dr. Busti

These side effects are very serious and could be fatal if not treated immediately. Higher doses of medication also entail higher risks of side effects.

  • The best treatment that can be done is to stop giving the patient more sulfa drugs.
  • Though it is very difficult to reverse or take out the drugs from the system, it is very important that the side effects are treated. Very dangerous side effects such as Stevens-Johnson syndrome and toxic epidermal necrolysis should be addressed immediately.
  • There is no specific test either skin or blood test that can detect a person of having sulfa allergy.
  • If the allergy symptoms are severe, it is necessary for the patient to consult his doctor.
  • Once a person knows of having allergy to sulfa, they should always inform the doctors about this allergy, whenever they visit them so that another episode can be prevented.

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Sulfa Vs Sulfite Allergy

A sulfa allergy sounds like a sulfite allergy, but theyâre very different. Sulfa drugs treat health conditions. Sulfites are preservatives used in many foods, drinks , and medications.

Sulfites can trigger asthma symptoms and, on rare occasions, can cause anaphylaxis. Itâs common for people who have asthma to be sensitive to sulfites. But itâs unusual for other people.

Sulfa drugs and sulfites are not related. Neither are their allergies. Thereâs no need to give up dried fruit, wine, or other items that have sulfites if youâre sensitive to sulfa drugs.

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What Drugs Are Sulfa Drugs

Drugs containing sulfa are used to treat several different health conditions, including eye infections and rheumatoid arthritis . These types of drugs, which are also known as sulfonamides, and include antibiotics and other types of drugs. Allergic reactions to sulfa can occur, incidentally they occur most often with antibiotics.

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Incidence And Risk Factors

Determining the true incidence of sulfonamide allergies is challenging, as allergy history is often self-reported by patients. A retrospective review of electronic medical records from patients receiving care in San Diego County through Kaiser Permanente aimed to determine the incidence and prevalence of self-reported antimicrobial allergies . The study evaluated 411,543 patients who had at least one outpatient visit during 2007. Antimicrobial allergy rates were calculated by determining the number of patients reported as having an allergy to the antimicrobial they were prescribed in 2007 divided by the sum of all patients who received that antimicrobial during 2007. The antimicrobial allergy rates were then stratified by gender to account for differences in incidence reporting. Sulfa allergy incidence among males and females was found to be 2.23 percent and 3.42 percent , respectively. Additionally, sulfa antimicrobials were associated with the highest incidence rates of antimicrobial allergies for both males and females compared to penicillin, cephalosporin, fluoroquinolone, tetracycline, and macrolide antimicrobials .

What Are The Mechanisms For Adverse Reactions To Sulfites

The Symptoms of a Sulphur Allergy

Mechanisms for adverse reactions can vary, and include:

  • Reflex contraction of the airways caused by inhaling sulfur dioxide. This mechanism may explain the rapid onset of symptoms when drinking liquids like beer or wine, when sulfur dioxide is inhaled during the swallowing process.
  • A partial deficiency of the enzyme sulfite oxidase , in some people with asthma who react to sulfites.
  • Other mechanisms yet to be fully understood.

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What Are The Treatment Options

If you have an allergic reaction to sulfa drugs, treatment will be centered on relieving your symptoms. Your doctor may prescribe antihistamines or corticosteroids to relieve hives, rash, and itching. A bronchodilator may be prescribed if you have respiratory symptoms.

Your doctor may recommend a desensitization procedure if you need medication and there isnt a sulfa-free alternative. Desensitization involves slowly introducing the medication at low doses until an effective dose is reached and tolerated. Youll be monitored for allergic reactions as the medication doses are increased.

Both anaphylaxis and Stevens-Johnson syndrome require immediate medical attention. If youre having an anaphylactic reaction, epinephrine will usually be given.

If you develop Stevens-Johnson syndrome, youll likely be admitted to an intensive care unit. Treatment for Stevens-Johnson syndrome includes:

  • corticosteroids to control inflammation
  • antibiotics to prevent or control skin infections
  • intravenous immunoglobulins to halt the progress of the disease

What Are The Drugs To Avoid If Anyone Has Sulfa Allergies

Sulfonamide has been used for over seventy years. A certain sulfa drug was the first antibiotic to be introduced. Presently, these drugs are used in bun creams, eye drops, vaginal suppositories and many other medications as well. Someone who is allergic to sulfa drugs must avoid these medications

  • Sulfamethoxazole-trimethoprim

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How Is A Sulfite Sensitivity Diagnosed

Your doctor may suspect sensitivity to sulfites based on your medical history and aspects of your asthma. The diagnosis of sulfite sensitivity can be confirmed by a “challenge” in which sulfite is administered in solutions or capsules of increasing concentration.

The challenge is done in a step-by-step fashion. Small doses of sulfite are used, so the asthma reaction that happens is usually mild. In most cases, the initial solution dose is too small for the sulfite-sensitive person to react, so increasing doses are administered, waiting 20 to 30 minutes between steps. Once a reaction takes place, its measured by lung function studies and can be quickly reversed with an inhaled bronchodilator medication. The entire challenge procedure takes less than 2 to 2-1/2 hours.

Do People Who React To Sulfites Need To Avoid Sulfates Or Sulfur

Sulfite Allergy: What You Need to Know

No. Some medications have a sulfate component , and most soaps and shampoos contain compounds such as sodium lauryl sulfate. These are not usually allergenic and do not cause reactions in sulfite-sensitive people. Elemental sulfur which is used in gardening may cause difficulty breathing if inhaled but is not usually a specific problem for sulfite-sensitive people.

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Safe Medications For People With Sulfa Allergies

Not all drugs that contain sulfonamides cause reactions in all people. Many people with sulfa allergies and sensitivities may be able to safely take the following medications but should do so with caution:

The ability to take these medications can vary from person to person. If you have a sulfa allergy and are unsure if you should take any of these medications, talk with your doctor.

Symptoms of an allergic reaction to sulfites include:

  • swelling of the mouth and lips
  • wheezing or trouble breathing

If you experience more serious symptoms of a sulfite allergy, contact your doctor. Anaphylaxis requires emergency medical attention.

According to the Cleveland Clinic, people with asthma have between a 1 in 20 and 1 in 100 chance of having a reaction to sulfites.

Sulfites are common in processed foods, condiments, and alcoholic beverages, such as red and white wine. Sulfites occur naturally in wine during fermentation, and many winemakers add them to help the process along.

For the past two decades, the Food and Drug Administration has required winemakers to display the warning contains sulfites if levels exceed a certain threshold. Many companies voluntarily add the label to their products as well.

If you have sensitivities, you should avoid food products with the following chemicals on the label:

How Are Drug Allergies Treated

The primary concern when treating drug allergies is relieving the symptoms:

  • Common symptoms such as rash, hives, and itching can often be controlled with antihistamines and occasionally corticosteroids.
  • For coughing and lung congestion, bronchodilators may be prescribed.
  • For more serious, anaphylactic symptoms epinephrine is usually injected.

Desensitization is occasionally used for treatment of drug allergy, particularly when no testing is available or feasible. This technique is designed to allow your body to temporarily tolerate allergy-causing agents as long as you continue to use the medication.

For example, during penicillin desensitization, small amounts of penicillin are injected periodically at increasingly larger levels until your immune system learns to tolerate the drug. Desensitization procedures are not a cure for drug allergy.

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What Symptoms Could I Experience If I Have A Sulfite Sensitivity

People with sulfite-sensitive asthma experience asthma symptoms when they eat foods or drink beverages that contain sulfites. Estimates regarding the prevalence of sulfite sensitive asthma vary. Most reactions happen due to inhalation of sulfur dioxide that comes from sulfite-containing foods you eat or drink.

Get Help With Your Case Today

maynydesign: Celebrex And Allergy To Sulfa

If you suffered a severe allergic reaction to prescribed medication, especially if you told your physician about your allergy, this could be a viable medical malpractice claim and you could be entitled to fair and just compensation.

At Rash Mueller, our team of attorneys in Weston is dedicated to fighting on behalf of the wrongfully injured and will do what it takes to ensure the responsible party is held accountable. Backed by 25 years of legal experience, you can trust that your case will be in good hands with us.

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What Is The Main Use Of Sulfites

Sulfites are used as preservatives in some drinks, foods and medications. Low levels of natural sulfites are also found in many foods. Sulfites release sulfur dioxide gas, which is the active component that helps preserve drinks, foods and medications.

Sulfites have been used since Roman times to preserve food flavour and colour, inhibit bacterial growth, reduce food spoilage, and help preserve medications.

Sulfa Allergies Vs Sulfite Allergies

Allergies to sulfonamides, also known as sulfa drugs, are common.

Sulfa drugs were the first successful treatment against bacterial infections in the 1930s. Theyre still used today in antibiotics and other medications, like diuretics and anticonvulsants. People with HIV are at particular risk for sulfa sensitivity.

Because their names are similar, people often confuse sulfa with sulfites. Sulfites occur naturally in most wines. Theyre also used as a preservative in other foods. Sulfites and sulfa medications are chemically unrelated, but they can both cause allergic reactions in people.

Symptoms of an allergic reaction to sulfa include:

  • swelling of the face, mouth, tongue, and throat
  • drop in blood pressure

Rarely, cases of serum sickness-like reactions can occur around 10 days after a sulfa drug treatment begins. Symptoms include:

You should contact a doctor immediately if you have these symptoms.

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