Monday, July 27, 2015…MEDICATIONS ON THE NO NO LIST..For Sulfite Sensitive Readers. Hope this helps some people on certain medications.
What Medications Contain Sulfites?
Bronchodilator solutions for asthma ( I don’t have a problem with this)
Adrenalin chloride 1:1000 concentration
Isuprel hydrochloride solution
Topical eye drops
Betamethasone phosphate (Celestone)
Dexamethasone phosphate (Decadron)
Epinephrine (Adrenaline, Ana-Kit, Epi-Pen)
Lidocaine with epinephrine (Xylocaine)
Solutions for total parenteral nutrition and dialysis
How is Sulfite Allergy Treated?
Generally, avoidance of foods and medications containing sulfites should be avoided in people with known or suspected sulfite allergy. This should be successful given the mandate by the FDA to label foods containing less than 10 ppm of sulfites. It is important to note that the terms sulfur dioxide, sodium or potassium bisulfite, sodium or potassium metabisulfite, and sodium sulfite are other names for sulfites.
The FDA ban on sulfites from fresh fruits and vegetables (such as in salad bars) in restaurants has significantly reduced the risk of accidental ingestion of sulfites. However, unlabeled sulfite-containing foods remain in restaurants, with sulfites in potatoes being the major concern.
Therefore, sulfite allergic people should avoid all potato products in restaurants except for baked potatoes with skins intact.
Severe allergic reactions and anaphylaxis may require treatment with injectable epinephrine, asthma symptoms may require the use of inhaled bronchodilator solutions (those that do not contain sulfites). It would be prudent for people with severe sulfite allergy to carry injectable epinephrine (Epi-Pen or Twinject) and to obtain a Medic-Alert bracelet.
What Medications Contain Sulfa?
The following list is by no means comprehensive. People with allergy to sulfa or sulfonamide-related medications should always check with their doctor or pharmacist prior to starting any new medications.
Sulfa antibiotics. In people with adverse reactions to sulfonamide antibiotics, all other sulfonamide antibiotics should be avoided. These include trimethoprim-sulfamethoxazole (Septra®, Bactrim® and generics), sulfadizine, sulfisoxazole, and dapsone.
Topical sulfa antibiotics, such as sulfacetamide eye drops/shampoos/creams, silver sulfadiazine cream, and sulfanilamide vaginal preparations.
Diuretics (water pills). The risk for sulfa-containing diuretic medications causing reactions in sulfa-allergic patients is low. Many diuretic medications, such as hydrochlorothiazide (HCTZ) and furosemide (Lasix) are sulfa-based, while ethacrynic acid (Edecrin) is not. While there is no proof that people with an allergy to sulfa-based antibiotics will also react to sulfa-based non-antibiotics, it is recommended that a sulfa-allergic person take the first dose of a sulfa-based diuretic under direct medical supervision.
Sulfonylureas. Oral medications used for the treatment of diabetes, called sulfonylureas (such as chloropropamide, glyburide, and glipizide), are structurally similar to sulfonamides. While there are a few reports of these medications causing problems in sulfa-allergic patients, these medications are generally tolerated.
Celebrex®. Celecoxib (Celebrex®), a popular COX-2 inhibitor used for the treatment of arthritis and pain control, is a sulfonamide non-antibiotic medication.
Although there have been no reports of sulfa-allergic patients reacting to Celebrex®, it is a theoretical concern, so the recommendation is that sulfa-allergic patients avoid this medication.(I had a huge reaction from Celebrex) Avoid
Sulfasalasine. Sulfasalasine is a sulfonamide that is related to aspirin, and is used for inflammatory bowel disease and rheumatoid arthritis. This medication should not be used in people with sulfa allergy.
Imitrex®. Sumatriptan (Imitrex®), used for the treatment of migraine headaches, is related structurally to sulfonamides, although there is no evidence that people with sulfa allergy are at increased risk for reactions from this medication.
Zonisamide. Zonisamide is a sulfonamide medication used for the treatment of seizures. It has been associated with severe skin reactions, those typically seen with sulfa reactions. This medication should not be used in sulfa-allergic patients.