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What To Avoid With Sulfa Allergy

Safe Medications For People With Sulfa Allergies

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

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

Drug List For Sulfa Allergy

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.

What Diuretic Is Safe With Sulfa Allergy

. In this regard, can someone with a sulfa allergy take hydrochlorothiazide?

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

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

Simply so, 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.

Recommended Reading: Local Allergy Reports

Drugs To Avoid With Sulfa Allergies

Sulfa antibiotics have been widely used for more than 70 years. The first antibiotic was a sulfa drug introduced in 1936. Today, these drugs include burn creams, vaginal suppositories, and eye drops as well as medications for many types of infections. If youâve had an allergic reaction to one sulfa antibiotic, youâre probably allergic to all of them.

Here are a few examples of common sulfa drugs that could cause problems:

But be sure to tell your doctor if you have a sulfa allergy before taking any of these.

Is It Common To Have A Sulfite Sensitivity

Sulfa Allergy: Symptoms, Causes, Diagnosis, and Treatment

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.

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Sulfonamide Medications That May Be Ok

  • Certain diabetes medications glyburide and glimepiride , for example
  • Some nonsteroidal anti-inflammatory drugs, such as celecoxib
  • The migraine medication sumatriptan
  • Certain “water pills” , such as furosemide and hydrochlorothiazide

An allergy to sulfonamide medications is different from having an adverse reaction to wine or food that contains sulfites. Having a reaction to sulfites in something you eat or drink doesn’t mean you’ll be allergic to sulfonamide medication.

If you have HIV/AIDS, you may have an increased sensitivity to sulfonamide medications. Always tell your doctor about your sensitivities to medication.

There are no diagnostic tests for sulfa allergy. However, sulfa desensitization might be an option, especially if medication containing sulfamethoxazole is needed.

© 1998-2022 Mayo Foundation for Medical Education and Research . All rights reserved. Terms of use.

Are Sulfas Found In Foods

Having an allergy to sulfa drugs is different from having an allergy to food or drinks that contain sulfites. Unless youve had a reaction to sulfites, consuming food or drink that contains sulfites is OK. Conversely, if youve had an allergic reaction to sulfites, it doesnt mean that youll also be allergic to sulfa drugs.

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Drugs Should Be Avoided

Sulfonamide drugs are actually a broad concept. All drugs containing a sulfonamide group structure are considered sulfonamide drugs, not limited to sulfonamide antibiotics. Commonly seen sulfa drugs, such as sulfasalazine for ulcerative colitis, silver sulfadiazine ointment for burns, and sodium sulfa-cetamide eye drops for conjunctivitis, will be marked “It is prohibited for people who are allergic to sulfa drugs.

In fact, there is also a class of drugs. Although the name “sulfa” is not written with sulfa, the chemical structure is similar to that of sulfa antibacterials, which can cause cross-allergic reactions. The following drugs should be used with caution or banned in patients with sulfa allergies:

  • Sulfonylurea hypoglycemic agents: such as tolbutamide, chlorpropamide, glibenclamide , glipizide , gliquidone , Gliclazide , etc. The instructions of these drugs clearly state that “for those who are allergic to sulfonamides are prohibited.”
  • Antipyretic: analgesic and anti-inflammatory drugs Cyclooxygenase-2 inhibitors, such as celecoxib, cannot be used for “known sulfa allergies”.
  • Antihypertensive drugs: Indapamide, such as Shoubishan, Naqili, etc. And the instruction manual also clearly states “prohibited for sulfa allergy”.
  • Drugs for the treatment of glaucoma: Acetazolamide and brinzolamide are carbonic anhydrase inhibitors, and those who cannot tolerate sulfa drugs or other sulfa derivatives cannot tolerate this product.
  • What Is A Sulfite Sensitivity

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

    Sulfites are chemicals used as preservatives to slow browning and discoloration in foods and beverages during preparation, storage and distribution. Sulfites have been used in wine making for centuries.

    You can find sulfites in certain foods and beverages, as well as a variety of medications. The use of sulfites as preservatives in foods and beverages increased dramatically in the 1970s and 1980s. Due to cases of severe reactions to sulfites, a ban by the Food and Drug Administration went into effect in August, 1986. This ban prohibited use of sulfites in fresh fruits and vegetables.

    Although reactions to sulfites were recognized initially with salad bars in restaurants, this has not been a source for sulfite exposure for more than three decades. Sulfites continue to be used in potatoes, shrimp, and beer/wine, and are also used in the pharmaceutical industry. Sulfites are added to many medications, including some of the medications given to treat asthma and allergic reactions.

    Sulfites have been implicated as a cause of asthma symptoms that may range from mild wheezing to potentially life-threatening asthmatic reaction. It is also a very rare cause of anaphylaxis in people who have become allergic to sulfites.

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    Foods To Avoid With Sulfa Allergy

    Those who are known allergic to sulphur and its derivatives such as sulfites and sulfates should avoid food containing them. These foods are listed below:

    • Pickeled onions
    • Canned foods such as fruit salads
    • Alcohol
    • Drugs containing sulphur and its byproducts.
    • Garlic
    • Kale
    • Turnips

    If you suspect sulphur allergy, your doctor may recommend you for skin prick test and blood test for sulphur allergy.

    Remember an adequate diet containing protein will contain sulphur, therefore it is always advisable to consult your physician before eliminating sulphur containing food, lest you may be devoid of proteins which is again harmful to your body.

    Are Supplements Safe For People With Sulfa Allergies

    Many people who are allergic to sulfa drugs mistakenly assume that sulfa and sulfur are related. Sulfa is an abbreviated name for specific antibiotics called sulfonamides. A person who is allergic to these medications should not use them.

    Sulfur, on the other hand, is an essential mineral found in nearly all proteins, vitamin B1, and multiple amino acids. It is not possible to be allergic to sulfur because the body cannot function properly without it.

    Sulfate is simply a combination of the elements sulfur and oxygen and is naturally present in relatively high concentrations in human blood.

    To summarize: the USANA products do not contain sulfa drugs. Someone with a sulfa allergy can safely take all of USANAs supplements.

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    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.

    If I Have A Sulfa Allergy From Bactrim Can I Take These Other Drugs

    Sulfa allergies: Overview and what to avoid

    Heres a list of common sulfa drugs that I get asked about a lot from patients who have had allergic reactions to Bactrim. If youve had an allergic reaction to Bactrim, you do not need to routinely avoid these medications, even though they are technically sulfonamide drugs.

    • is a medication used to prevent altitude sickness, and yes, you can take this if youre allergic to Bactrim. As with any medication, just watch for a rash or any serious side effects.

    • is an anti-inflammatory drug used for joint pain and arthritis, and yes, you can take it if youre allergic to Bactrim.

    • Diuretics like and are prescribed for lower extremity edema and heart failure. Yep, you can take these.

    • , , and are non-insulin medications that treat diabetes type 2. Yep, these are safe if you have a sulfa allergy.

    • Thiazide diuretics like and are used to treat high blood pressure and are fine to take even if youve been told you have a sulfa allergy to Bactrim.

    • Triptan medications that are used to treat migraines, including , , and , have been shown to be safe in those with reported sulfa allergies.

    • used to treat symptoms related to enlarged prostate or benign prostatic hypertrophy , is safe to take in folks with a sulfa allergy.

    • Sulfa-based eye drops like Genoptic , , , and are safe to use in those with reported sulfa allergies. What should youNOTuse with a sulfa allergy? eye drops.

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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.

    Allergic Reaction To Sulphur

    Sulphur is also called sulfur. The compounds of sulphur are used in many fertilizers and pesticides. Sulphur is also found in food and vegetables in traces. It is also used in medicines for various skin and other diseases.

    Some people are allergic to sulfur as their immune system considers it to be harmful to their body. This in turn gives rise to sulphur allergy symptoms.

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    Other Types Of Sulfur Containing Substances

    Elemental sulfur powder is commonly used in gardening, and while irritation may occur from skin contact or inhalation, allergy has not been described.

    Sulfates are in some injectable drugs as sulfate compounds, such as heparin sulfate, dextran sulfate, morphine sulfate. The sulfates in soaps are strong detergents and can irritate the skin or eyes. However sulfate itself does not cause allergic reactions. It is usually safe to use a sulfate when a person has a sulfonamide allergy or a sulfite intolerance.

    Sulfite preservatives are commonly known as sulfur dioxide and metabisulfites, with preservative numbers 220-228. Sulfites can be used to preserve flavour and colour within food, inhibit bacterial growth, stop fresh food from spoiling, and help preserve medication. Sulfites are most often found in wine, dried fruit, and dried vegetables. Sometimes they are used in sausages and salads. They can also occur naturally in low concentrations. Sulfites can cause adverse reactions which are like allergy but do not involve the immune system and are therefore called intolerances. The most common reactions are asthma symptoms and rhinitis reactions. Occasionally urticaria may occur, and very rarely, anaphylaxis .

    There is no relationship between sulfite sensitivity and sulfonamide antibiotic allergy.

    Drugs To Avoid In Sulfa Allergy

    Sulfa Allergies vs Sulfite Allergies

    “The presence of the arylamine moiety is believed central to the pathogenesis of hypersensitivity reactions, and only the antimicrobial sulfonamides contain it.”

    A. Sulfonamides1. Antimicrobial sulfonamidessulfamethoxazole, sulfisoxazole, sulfadiazine2. Non-antimicrobial sulfonamidesdiuretics, hypoglycemic and antihypertensive agents, as well as celecoxib, sulfasalazine, sumatriptan. B. SulfonesDapsoneC. Medications sometimes confused with sulfonamidessulfur atomsamoxicillin, captopril, omeprazole, ranitidine, otherssulfate ionsalbuterol sulfatenotSulfitessulfite sensitivityunrelated to sulfonamide hypersensitivity.Pharmacotherapy **Response to question of use of bisulfate in a patient with reported “anaphylactic sulfa allergy”:The bisulfate ions are not a known source of allergic or even immunologic reactions, and are also not associated with cross-sensitivity to patients with documented sulfonamide allergies. Therefore, this patient should not expect to have a reaction to the bisulfate moiety in the propofol injection.

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    Causes Of Sulfa Allergy

    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.

    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.

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    Other Drugs And Products With Names Stemming From Sulfur

    Some drugs contain a sulfhydryl group or sulfate group in their chemical structure. These drugs have no relationship to sulfonamide allergy.

    However sulfhydryl containing drugs can cause unrelated adverse skin reactions such as a rash or pemphigus .

    Sulfates are also commonly found in soaps and cosmetics allergies to sulfates are extremely rare.

    Sulfites are chemicals used as preservatives in food and drugs, such as sulfur dioxide and sodium sulfite. Allergy to sulfite preservatives can cause anaphylaxis, other rashes, asthma, seizures and death. People with asthma are at higher risk of sulfite allergy. Allergy to sulfites bears no relationship to sulfonamide allergy.

    People who have had allergic reactions to sulfonamide-containing drugs do not need to avoid sulfhydryl drugs, sulfates or sulfites. To prevent confusion, the general term sulfa allergy should not be used. Instead it is better to note the exact drug and reaction involved.

    Sulfa Vs Sulfite Allergy

    Sulfite Containing Foods

    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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