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What Is A Sulfa Allergy

Sulfa Allergy Diagnosis & Tests

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

It is important to quickly diagnose the condition and start with the treatment. Diagnosis relies on a careful history and physical examination.

History of Symptoms:

Your allergist may ask you details regarding the drug, such as:

  • Name of the drugs taken
  • Your doctors prescription
  • The time when the drug was taken
  • What symptoms were noticed first
  • When did the symptoms appear?
  • If any other multivitamin or herbal medications are taken

Your allergist may also ask you about other drug allergies and a family history of allergies.

All this investigation will give him a clear picture about your health status and drug allergy.

Besides this, there are no tests available that can be used to identify sulfa allergy.

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.

How To Prevent A Sulfa Allergic Reaction

There are no diagnostic tests for sulfa allergy. However, some tips for prevention of a further allergic reaction to sulfa drugs include:

  • Make sure all healthcare providers, including your dentist and pharmacy, are aware of your drug allergies. This will help them be aware of which medications should be avoided.
  • If you have previously had a severe or anaphylactic reaction to sulfa drugs, carry an emergency epinephrine syringe .
  • Carry a medical alert card with you or wear a medical alert bracelet that alerts care staff of your allergy. This will ensure proper treatment if you have a reaction and are unable to verbally alert medical providers of your allergy.

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Beware While Using Medicines

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.

Other Medications That May Cause A Reaction

Sulfa Allergy: Symptoms, Causes, Diagnosis, and Treatment

Other types of sulfa medications may trigger a reaction in some people who have a sulfonamide antibiotic allergy:

  • Sulfasalazine , used to treat Crohn’s disease, ulcerative colitis and rheumatoid arthritis
  • Dapsone, used to treat leprosy, dermatitis and certain types of pneumonia

Keep in mind that if you have a reaction to a sulfonamide antibiotic, you may still be able to take other sulfonamide medications without having a reaction.

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Sulfonamide Type 1 Allergic Reaction

Three percent of patients develop a sulfonamide allergy reaction to compounds containing the SO2NH2 moiety. This allergic reaction is typically caused by sulfonamide antibiotic drugs, including Sulfamethoxazole, Sulfadiazine and Sulfacetamide. The allergic reaction these antimicrobial agents is caused by an improper breakdown of the aromatic amine connected to the sulfone group. A type 1 IgE mediated immune reaction is the most type of allergic reaction to sulfonamides, and caused by the release of histamine into the blood. The most common symptom of this allergic reaction is the development of a maculopapular or urticarial rash within one to three days of drug administration. The rash may be flat or raised, and begins as discreet pink or red spots that begin on the trunk of body, and eventually cluster together to form sheets of blotchy rashes on the extremities. A urticarial rash is typically involves swelling, redness and itching of the skin. In severe cases, swelling in deeper layer of skin tissues, anaphylaxis, loss of consciousness and hypotension may occur.

  • Three percent of patients develop a sulfonamide allergy reaction to compounds containing the SO2NH2 moiety.
  • The most common symptom of this allergic reaction is the development of a maculopapular or urticarial rash within one to three days of drug administration.

Sulfonamide Drug Hypersensitivity Syndrome

A hypersensitivity reaction to sulfonamide develops within seven to 14 days of drug administration 3. This allergic reaction is the result of a delayed T cell mediated reaction, and it begins with a high fever and headache. Next, the individual develops a maculopapular rash that begins in the trunk of the body, and spreads to the extremities. In severe cases, the individual may develop Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. These deadly skin reactions begin with the eruption of painful, red blisters that begin on the trunk of the body and migrates to the extremities. These lesion erupt, and cause the top layer of the skin to peel away in large amounts, allowing bodily fluids to leak. Immediate discontinuation of the drug is required to prevent involvement of the internal organs, primarily the heart, lungs, kidneys and liver. Continued use of the drug can result in pneumonia, acute liver failure, inflammation of the heart sac and breathing difficulties.

  • A hypersensitivity reaction to sulfonamide develops within seven to 14 days of drug administration 3.
  • Immediate discontinuation of the drug is required to prevent involvement of the internal organs, primarily the heart, lungs, kidneys and liver.

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The Food Additive That Can Trigger Asthma Symptoms

Sulfites have been used for centuries, mainly as food additives to enhance flavor and preserve freshness. But these sulfur-based compounds also occur naturally in foods, such as fermented beverages and wines. They’re also used as a preservative in a variety of medications to help increase shelf life.

Examples of sulfites include:

  • Potassium metabisulfite
  • Sulfur dioxide

Exposure to sulfites can cause a host of adverse effects in sensitive people, ranging from mild to potentially life-threatening. Here’s how a sulfite allergy is diagnosed and how you can prevent a reaction if you’ve been diagnosed with this allergy.;

Sulfa Vs Sulfur Vs Sulfite Vs Sulfate Vs

Sulfonylureas, Sulfonamide, and Sulfasalazine – Sulfa Containing Drugs and Sulfa Allergy

As mentioned, sulfa is a colloquial designation for sulfonamide antibiotic, but the prefix sulf is found in an enormous number of other medications that may contain sulfur, sulfites or bisulfate including penicillin antibiotics, reflux medications, pain medications, blood pressure medications, and a variety of supplements. For example ferrous sulfate is a common medication used to treat iron deficiency. ;The chemical structure for the popular diuretic Lasix contains sulfur. ;;Neither of these medications cross react with sulfonamide antibiotics.

The use of trimethoprim/sulfamethoxazole to ear infections in children has decreased significantly because of an increase in bacterial resistance to these antibiotics.; However,;this and other;sulfonamide antibiotics are still frequently used to to treat urinary track infections and skin infections with MRSA.

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Treatment Of Sulfa Allergy

  • Completely avoiding sulfa-containing medication is the best way to protect yourself against sulfa allergy
  • To treat the symptoms of sulfa allergy, such as hives, itching, redness and rash, your doctor may prescribe corticosteroids or antihistamines
  • Bronchodilator may also be advised if respiratory symptoms persist
  • Desensitization is a procedure, which your doctor may recommend if there is no sulfa-free alternative available. During this procedure, a low dose of the sulfa-containing drug is introduced to a point where the dose is effective and well tolerated. This process is monitored for allergic reactions
  • Stevens-Johnson syndrome and anaphylaxis are life-threatening conditions that require immediate medical attention and treatment. Antibiotics, corticosteroids and intravenous immunoglobulins are the different modes of treatment.

What Does A Sulfa Allergy Rash Look Like

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The reaction can also cause these serious skin reactions: Sulfonamide drug hypersensitivity syndrome: Rash, fever, and organ problems begin within 1 to 2 weeks after you start the drug. Drug eruption: Red or swollen, rounded patches form in 30 minutes to 8 hours.

Subsequently, question is, what does an antibiotic rash look like? Amoxicillin rash may also show up as hives, which are red or white bumps that develop on the skin. Or, it may appear as a maculopapular rash with areas that resemble flat, red patches.

In this regard, what does drug allergy rash look like?

Drug Reaction with Eosinophilia and Systemic SymptomsThe skin rash associated with this type of reaction looks similar to a morbilliform eruption. It is usually red, flat, and itchy, and it may cover large areas of skin. There is often swelling in the face, hands, and lymph nodes. Many people also have a fever.

What drugs should be avoided with sulfa allergy?

Avoid the following medications if you’re allergic or have a sensitivity to sulfa:

  • antibiotic combination drugs such as trimethoprim-sulfamethoxazole and erythromycin-sulfisoxazole.
  • sulfasalazine used for Crohn’s disease, ulcerative colitis, and rheumatoid arthritis.

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What Is Sulfa Allergy

Sulfa allergy is a type of allergy that occurs when Sulfa in the antibiotic enters the bloodstream in humans to overreact. Sulfonamide antibiotics are mostly known to cause a reaction leading to this allergy. Antibiotics that have chemicals called sulfonamides also triggers a reaction if you are suffering from sulfa allergy. The manifestation of the allergy can be different in different people. The symptoms of this allergy are as follow:

Drug List For Sulfa Allergy

Sulfa Allergy: Drug List, Symptoms, Treatment, and More

This author has been verfied for credibility and expertise

Sulfa allergy is the allergic response that occurs from the presence of the compound structure SO2NH2. This compound can be found in the molecular makeup of many different drugs. The term “sulfa” was initially a description of a specific category of drugs, namely the sulfonamide group of anti-infective medications often used in the treatment of bacterial infections. However, there are other drugs whose chemical makeup contains molecules similar to SO2NH2 and are thus suspected of being able to cross-react in the body and elicit an allergic response.

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

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What Diuretic Is Safe With Sulfa Allergy

Even if you’re allergic to antibiotics that have sulfa, you might be able to take some other types of sulfa drugs without a reaction. Sumatriptan , a migraine drug. Water pills, or diuretics, including furosemide and hydrochlorothiazide

can you be allergic to diuretics? In rare cases, diuretics may cause serious side effects. These can include: allergic reaction. kidney failure.

Beside above, does Diurex have sulfa in it?

No, DIUREX Max Water Caplets do not contain sulfa drug ingredients. Do DIUREX Max Water Caplets help you lose weight? DIUREX Max Water Caplets help relieve temporary water weight gain, bloating and other discomforts associated with the premenstrual and menstrual periods.

What foods to avoid if you are allergic to sulfa?

Avoid the following medications if you’re allergic or have a sensitivity to sulfa:

  • antibiotic combination drugs such as trimethoprim-sulfamethoxazole and erythromycin-sulfisoxazole.
  • sulfasalazine used for Crohn’s disease, ulcerative colitis, and rheumatoid arthritis.

A Headache Dizziness Or Light

An allergic reaction causes inflammation in the body, and that inflammation can occur in your head, causing a throbbing headache or a migraine. When histamine is released during an allergic reaction, it may cause symptoms that are not visible to the naked eyesuch as vasodilation in the brain. Dizziness and light-headedness can be caused by a plummet in blood pressure, also due to histamine release.

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Medications That Contain Sulfites

Sulfites are added to some medications for their antioxidant properties as well as to prevent browning of medications. Sulfites are added to injectable epinephrine to prevent browning.

However, epinephrine has not been reported to cause adverse reactions in people with a sulfite allergy and should not be withheld in an allergic emergency. Injectable epinephrine may prove life-saving in people with a sulfite allergy who are experiencing anaphylaxis.

Some inhaler solutions used to treat asthma contain sulfites, although many asthma drugs have had sulfites removed due to safety concerns. People with a sulfite allergy should avoid medications containing sulfites, except for injectable epinephrine .

Here are examples of medications that contain sulfites:

Sulfa Allergies Vs Sulfite Allergies

Sulfur Allergy Medical Course

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:

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

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

  • fever

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

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What Is Sulfa Drugs Allergy

It is still being advised in cases where other groups of antibiotics are considered to be not as potent as this. Some people tend to overreact to the commonly advised dosages of these drugs. This has been attributed to some variation in your bodys defense system or the immune system. You may develop allergic reactions that resemble any other allergy a few minutes or few hours after you consume the drug. Some of the common symptoms include formation of rashes on the skin. Although these drugs generally result in mild reactions, it may at times lead to life threatening situations that need immediate care.Sulfa drugs allergy is noted to affect about 3% of all people. Although not very common, some people are more prone to be allergic to sulfa drugs. The exact reason for this allergy is not known. People suffering from disorder such as HIV/AIDS are known to at a higher risk of being allergic to sulfa drugs than others.

Sulfa Drugs Were The First Antibiotics

Sulfa drugs were the first chemicals available to treat bacterial;infections in humans. ;The proper designation for;this class of drugs;is sulfonamide;but they became knows as sulfa antibiotics with their widespread use as powders and pills during WW ll. ;Although sulfa antibiotics saved lives, their use decreased significantly after the introduction of penicillin because of frequent adverse reactions and emerging bacterial resistance.

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Sulfa Sulfur Sulfate Sulfite: Which Causes An Allergy

Lauren R. Cirrincione, PharmD; Kimberly K. Scarsi, PharmD

What constitutes a sulfa allergy?

Response from Lauren R. Cirrincione, PharmD Postdoctoral Research Associate, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, Nebraska
Response from Kimberly K. Scarsi, PharmD Associate Professor, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, Nebraska

A chart review of 2.4 million patients in California found that approximately 4% reported an allergy to sulfonamide antimicrobials. The term “sulfonamide antimicrobial” includes trimethoprim/sulfamethoxazole , sulfadiazine, and erythromycin/sulfisoxazole. Sulfonamide antimicrobials differ in chemical structure from nonantimicrobial sulfonamides, and those structural differences are implicated in hypersensitivity associated with sulfa antimicrobials.

Drug allergy, broadly called “hypersensitivity,” is an immune-mediated response against a medication. Hypersensitivity reactions may present either immediately or be delayed . Immediate hypersensitivity is generally immunoglobulin E -mediated urticaria, angioedema, rhinitis, bronchospasm, or anaphylaxis. Delayed hypersensitivity is T-cell dependent, presenting as either a maculopapular rash or more serious blistering and mucosal involvement, presaging Stevens-Johnson syndrome or toxic epidermal necrolysis.

In conclusion:

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Causes Of Sulfa Allergy

Sulfa Allergy: Symptoms, Causes, Diagnosis, and Treatment

A sulfa allergy takes place when your immune system identifies the drug as a dangerous substance. Thus, your body develops antibodies specific to the drug and attack against it.

The presence of sulfonamide in certain antimicrobial drugs can give rise to negative response when an individual has a sulfa allergy.

Such an allergic response takes place due to differences in the molecular structure between types of sulfonamides.

Chemically, sulfonamide antibiotics are different from other sulfonamides non-antibiotics because they have an arylamine group. This arylamine group is associated with hypersensitivity and allergies.

A cross-reactivity between arylamine sulfonamides is common and thus, its use must be avoided in individuals who are sensitive to it.

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Why Sulfites Are Added To Foods

Sulfites are added to foods for various reasons. These include:

  • Reducing bacterial spoilage
  • Slowing the browning of fruit, vegetables, and seafood
  • Inhibiting growth of bacteria during fermentation of wines
  • Conditioning of dough in the frozen pie and pizza crust
  • Bleaching effect for maraschino cherries and hominy

In the past, sulfites were added to fresh foods in restaurants and grocery stores to prevent browning. An increase in reactions led the Food and Drug Administration to ban the use of sulfites in fresh foods in 1986, particularly on fresh lettuce in salad bars.

The FDA now requires that any food containing more than 10 parts per million concentration of sulfites to be declared on the label. This is because foods that contain less than 10 ppm of sulfites have not been shown to cause symptoms, even in people allergic to sulfites.

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:

  • headache
  • swelling of the mouth and lips
  • wheezing or trouble breathing
  • asthma attack
  • anaphylaxis

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.

  • sulfur dioxide

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