Celecoxib, a selective cyclo-oxygenase-2 inhibitor, is a diaryl-substituted pyrazole by-product containing a sulfonamide substituent. Due to this structural part, celecoxib is contraindicated to be used in sufferers who’ve demonstrated allergic reactions to sulfonamides. Nevertheless, there’s a lack of knowledge demonstrating cross-reactivity amongst sulfonamide medicines.
A sulfonamide is any compound with an SO2NH2 moiety. The most important distinction between sulfonamide antimicrobials and different sulfonamide-containing medicines similar to furosemide, thiazide diuretics and celecoxib, is that sulfonamide antimicrobials include an fragrant amine group on the N4 place. This permits for division of the sulfonamides into 2 teams: fragrant amines (i.e., sulfonamide antimicrobials) and nonaromatic amines.
As well as, sulfonamide antimicrobials include a substituted ring on the N1-position; this group is just not discovered with nonaromatic amine-containing sulfonamides. Opposed reactions to sulfonamide antimicrobials embrace kind I, or immunoglobulin (Ig) E-mediated reactions, hypersensitivity syndrome reactions, and extreme pores and skin reactions similar to poisonous epidermal necrolysis.
The fragrant amine portion of the sulfonamide antimicrobial is taken into account to be essential within the growth of latter 2 reactions. In prone people, the hydroxylamine metabolite is unable to be detoxified resulting in a cascade of cytotoxic and immunological occasions that finally leads to the hostile response.
Since celecoxib doesn’t include the fragrant amine, hostile reactions similar to hypersensitivity syndrome reactions and poisonous epidermal necrolysis wouldn’t be anticipated to happen on the similar frequency as they do with sulfonamide antimicrobials. Equally, for IgE-mediated reactions, the N1-substituent and never the sulphonamide moiety is necessary in figuring out specificity to antibodies.
Celecoxib and different nonaromatic amine-containing sulfonamide medicines don’t include the N1-substituent. Cross-reactivity among the many numerous sulfonamide-containing medicines has additionally not been substantiated by printed case stories. Actually, conflicting info exists within the literature. Experiences displaying lack of cross-reactivity steadiness the few case stories suggesting cross-reactivity.
Cross-reactivity between sulfonamide medicines must be primarily based on scientific information, together with chemistry, metabolism, immune responses and scientific information. Primarily based on the present info, there isn’t any documentation for cross-reactivity between sulfonamide antimicrobials and different sulfonamide medicines, similar to celecoxib.
Individuals who have a sulfa allergy can react to some medicines that include sulfa.
Sulfonamide antibiotics that may trigger a response
Antibiotics containing chemical compounds known as sulfonamides can set off a response you probably have a sulfa allergy. These antibiotics embrace mixture medication:
Sulfamethoxazole-trimethoprim (Septra, Bactrim)
Different medicines that will trigger a response
Different sorts of sulfa medicines could set off a response in some individuals who have a sulfa allergy:
Sulfasalazine (Azulfidine), used to deal with Crohn’s illness, ulcerative colitis and rheumatoid arthritis
Dapsone, used to deal with leprosy, dermatitis and sure sorts of pneumonia
Take into account, you probably have a response to a sulfonamide antibiotic, you should still be capable of take different sulfonamide medicines with out having a response.
Sulfonamide medicines that could be OK
Sure diabetes medicines — glyburide (Glynase, Diabeta) and glimepiride (Amaryl), for instance
Some nonsteroidal anti-inflammatory medication, similar to celecoxib (Celebrex)
The migraine remedy sumatriptan (Imitrex, Sumavel Dosepro)
Sure “water capsules” (diuretics), similar to furosemide (Lasix) and hydrochlorothiazide (Microzide)
An allergy to sulfonamide medicines is completely different from having an hostile response to wine or meals that accommodates sulfites. Having a response to sulfites in one thing you eat or drink does not imply you will be allergic to sulfonamide remedy.
If in case you have HIV/AIDS, you could have an elevated sensitivity to sulfonamide medicines. At all times inform your physician about your sensitivities to remedy.
There aren’t any diagnostic exams for sulfa allergy. Nevertheless, sulfa desensitization is likely to be an choice, particularly if remedy containing sulfamethoxazole is required.