Title: Presumed “sulfa allergy” in patients with intracranial hypertension treated with acetazolamide or furosemide: cross-reactivity, myth or reality? - ScienceDirect
Headings: Presumed “sulfa allergy” in patients with intracranial hypertension treated with acetazolamide or furosemide: cross-reactivity, myth or reality?
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American Journal of Ophthalmology
Original article
Presumed “sulfa allergy” in patients with intracranial hypertension treated with acetazolamide or furosemide: cross-reactivity, myth or reality? ☆
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Content: Of the 27 patients who received acetazolamide and were sulfa allergic, 10 (37%) had no evidence for any definite allergic cross-reaction to sulfa. Two cases, however (7%), had urticaria. One patient experienced a severe urticarial rash 30 days after starting acetazolamide and was switched to ethacyrnic acid. One patient originally unable to tolerate acetazolamide in 1983 because of nausea and vomiting developed an urticarial rash upon rechallenge in 1995. This patient was switched to furosemide with no adverse or allergic cross-reaction to sulfa. The remaining 56% (15) of acetazolamide-treated patients with a self-reported sulfa allergy experienced predictable and typical adverse reactions for this drug. These predictable adverse reactions were paresthesias (66.7%), nausea or vomiting (46.7%), and diarrhea (6.7%) or constipation (6.7%). Some patients had multiple presumed predictable adverse reactions (for example, nausea and paresthesias). Patients also reported nonspecific reactions that were attributed to the medication but not considered to be sulfa cross-reactions including dizziness, slurred speech, unsteady gait, confusion, hyperactivity, paranoia, mood swings, and lip quivering. None of the patients experienced documented allergic cross-reactions to sulfa (for example, Stevens-Johnson syndrome, laryngeal edema or bronchospasm, life-threatening anaphylaxis, or serious mucocutaneous reactions).