What diuretic to use with sulfa allergy
In the majority of cases, a person with a sulfa allergy will own experienced an allergic reaction to one or more of the following antibiotic drugs:
- Septra (sulfamethoxazole and trimethoprim)
- Bactrim (sulfamethoxazole and trimethoprim)
- Pediazole (erythromycin and sulfafurazole)
These reactions are not every that unusual and affect around 3 percent of every people. This is a rate similar to what is seen with other types of antibiotics, including penicillin.
Certain people appear to be at higher risk of sulfa allergy than others.
These include those who, for various reasons, own a suppressed immune system (such as organ transplant recipients and people with HIV/AIDS).
The symptoms and severity of a sulfa allergy can vary but generally involve the appearance of a widespread rash. Occasionally a photosensitive rash may develop, meaning that a rash will happen in areas exposed to sunlight or other UV light while on the medication.
Other serious manifestations of a sulfa allergy include:
There's no validated skin or blood test available to diagnose a sulfa allergy.
The diagnosis is generally made on careful review of the suspected reaction and history of current and previous medication use.
Medications to Avoid
People with a known sulfa allergy should always check with their doctor before starting a new medication. This is especially true for those who own had a previous severe reaction.
In addition to oral antibiotics, topical sulfonamides should be avoided.
- Sulfacetamide eye drops, shampoos, or creams
- Silver sulfadiazine ointments used to treat burns
- Sulfanilamide vaginal preparations
Similarly, the oral drug Azulfidine (sulfasalazine), used to treat inflammatory bowel disease and rheumatoid arthritis, should be avoided.
Keep in mind that the risk of cross-reactivity to non-antibiotic sulfonamides is low. This means that it's generally safe to take the following drugs:
- Diuretics (water pills) such as HCTZ (hydrochlorothiazide) and Lasix (furosemide)
- Oral sulfonylureas-class drugs used to treat diabetes
- Celebrex (celecoxib), a COX-2 inhibitor used to treat arthritis and pain
The first-line of treatment of a sulfa allergy is typically the termination of the suspected drug.
Anaphylaxis requires immediate epinephrine use and medical care.
Stevens-Johnson syndrome or toxic epidermal necrolysis are also potentially life-threatening conditions that require immediate medical evaluation; in severe cases, management in a burn unit may be required.
In milder cases where a sulfa drug is considered essential to the treatment of an infection, an allergist or other qualified physician may supervise the istration of smaller doses and gradually increase them as the drug is better tolerated.
Sulfite and Sulfate Allergies
People will often error a sulfa allergy for a sulfite allergy.
Sulfites are preservatives found in foods and medications. These include:
- Sodium sulfite
- Sodium metabisulfite
- Potassium bisulfite
- Sodium bisulfite
- Potassium metabisulfite
Sulfates are drugs containing sulfuric acid.
As with sulfites, sulfates may cause allergy, but the drugs are in no way related to sulfonamides or sulfa-allergy risk. These include medications such as:
- Albuterol sulfate used to treat bronchial spasms
- Iron sulfate used to treat iron-deficiency anemia
- Chondroitin sulfate used to treat osteoarthritis
- Codeine sulfate, an opioid drug used for pain relief
A Expression From Verywell
The nuances of a sulfa allergy can be tricky to tease out, even for some healthcare providers. That's why it's significant to tell your doctor about any prior reaction you may own had to a sulfa medication (or any other drug for that matter).
Sharing that information will make it easier for your doctor to prescribe a substitute that's less likely to cause an allergy.
It's significant to take every drug-related rash seriously, no matter how mild it may be. In some cases, continuing a sulfa-drug while having mild symptoms may cause those mild symptoms to become severe and life-threatening.
While sulfites can cause an allergy, there is no direct relationship between a sulfa and sulfite allergy—so someone with a sulfa allergy doesn't own to avoid sulfites (or vice versa).