Sulfa Allergy Symptoms, Testing & Treatment

in St. Louis, Missouri

What Drugs Should Be Avoided With Sulfa Allergy?

Sulfa allergy reactions may be caused by oral medications (taken by mouth) or topical medications (applied to the skin).

Antibiotics that contain sulfa include:

• Dapsone
• Mafenide
• Sulfacetamide
• Sulfadiazine
• Sulfadoxine
• Sulfamethizole
• Sulfanilamide
• Sulfasalazine
• Sulfisoxazole
• Trimethoprim / Sulfamethoxazole (Trade names Bactrim and Sulfatrim)

Antibiotics with sulfonamides are commonly prescribed for burn infections, eye infections, urinary tract infections (UTIs), vaginitis, cystitis, inflammatory bowel disease (IBD), rheumatoid arthritis, crohn’s disease, ulcerative colitis, leprosy, dermatitis, pneumonia, and several other conditions bacterial infections.

Beyond antibiotics, other classes of drugs may contain sulfa. The following are some examples.

• Certain blood sugar medications contain sulfa, including glyburide and glimepride.
• Celecoxib (trade name Celebrex), a common nonsteroidal anti-inflammatory drug (NSAID), also includes sulfa.
• Some diuretics contain sulfa.
• Sumatriptan, a migraine medication, also contains sulfa.

Sulfa Allergy Symptoms

Sulfa allergy symptoms are most commonly skin rashes, hives, and sensitivity to sunlight after taking a medication containing sulfonamides, though you may experience additional symptoms. More severe symptoms are also possible, such as swelling in the throat or shortness of breath.

Common Sulfa Allergy Symptoms

Less Common Sulfa Allergy Symptoms:

• Difficulty swallowing
• Difficulty breathing
• Muscle and joint aches
• Sore throat
• Fever and flu-like symptoms
• Skin blisters and peeling skin

Severe Sulfa Allergy Symptoms (Rare):

• Anaphylaxis (life threatening allergic reaction)
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis (TEN)

Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN) are conditions that cause your skin, mouth or genitals to develop rashes and blisters, and then peel. Seek immediate medical attention if you experience anaphylaxis, Stevens-Johnson syndrome, or TEN.

in St. Louis, Missouri

How To Test For Sulfa Allergy?

Unfortunately, there are very few options to test for sulfa allergy. In fact, many common resources state that there are no diagnostic tests for sulfa allergy. However, a recent study at Vanderbilt has shown that an oral drug challenge can disprove sulfa allergy in low-risk cases, when allergic reactions have been only mild or moderate. An oral drug challenge is when you take a medication under the supervision of an allergist.

Sulfa Allergy Treatment

It’s impossible to know if you have a sulfa allergy prior to your first reaction. If you experience any of the sulfa allergy symptoms described above, contact the doctor that prescribed your medication immediately to see if there’s an alternative medication that you can start to take.

For immediate allergy symptom relief, antihistamines and/or corticosteroids may help.

Avoiding medications and drugs with sulfonamides is key to preventing future reactions:

• Communicate with your healthcare providers. Make your allergy known to every healthcare provider that you visit so that they can avoid medications with sulfonamides and prescribe alternatives.
• Carry a medical alert card or wear a medical alert bracelet that alerts care staff of your sulfa allergy.
• Be sure to read the ingredients lists on medications before you take them.

If you must take a medication containing sulfa, desensitization may be an option. Desensitization consists of taking more and more of a medication that you’re allergic to until you can safely tolerate a full dose. Desensitization may help you get through a course of medication, but it will not cure your sulfa allergy.

References