I have a severe sulfite allergy and must avoid medications containing the above. Is there a list of drugs which people like me must avoid? It is very surprisingly difficult to find such information from doctors and pharmacists.
Does Lisinopril contain sulfa additives or sulfites?
Question posted by magpie815 on 5 Sep 2013
Last updated on 5 May 2018
Answers
Lisinopril doesnt contain any sulfa. Sulfa and sulfites are two very different compounds. You may be allergic to both but the two compounds are unrelated. Sulfa is short for sulfonomides which is a type of antibiotic. Sulfites are chemical salts and not related to sulfonomides. Per Mayo Clinic:
I have a sulfa allergy. How can I tell if a medicine contains sulfa?
Answer
from James T C Li, M.D., Ph.D.
Antibiotics containing chemicals called sulfonamides can trigger a reaction if you have a sulfa allergy. Examples of sulfonamide antibiotics include the combination drugs:
Trimethoprim-sulfamethoxazole (Septra, Bactrim)
Erythromycin-sulfisoxazole
Other types of sulfa medications may trigger a reaction in some people who have a sulfa allergy. Examples include:
Sulfasalazine (Azulfidine), used to treat Crohn's disease, ulcerative colitis and rheumatoid arthritis
Dapsone, used to treat leprosy, dermatitis and certain types of pneumonia
Keep in mind, if you have a reaction to a sulfonamide antibiotic, you may still be able to take other sulfonamide medications without having a reaction. Examples of sulfonamide medications that may be OK include:
Certain diabetes medications — glyburide (Glynase, Diabeta) and glimepiride (Amaryl), for example
Some nonsteroidal anti-inflammatory drugs, such as celecoxib (Celebrex)
The migraine medication sumatriptan (Imitrex, Sumavel Dosepro)
Certain "water pills" (diuretics), such as furosemide (Lasix) and chlorothiazide (Microzide)
An allergy to sulfonamide medications is different from having an adverse reaction to wine or food that contains sulfites. Having a reaction to sulfites in something you eat or drink doesn't mean you'll be allergic to sulfonamide medication.
If you have HIV/AIDS, you may have an increased sensitivity to sulfonamide medications. Always tell your doctor about your sensitivities to medication
Another article for you from allergies.com:
What medications should sulfa-allergic patients avoid?
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.
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.
From Healthline:
Allergies to sulfonamides, also known as sulfa, are common. Sulfa drugs were the first successful treatment against bacterial infections in the 1930s. Today, sulfonamides are still used in antibiotics, as well as a host of other medications such as diuretics and anticonvulsants. Nearly 3 percent of people are sensitive to sulfonamides. Because of the prevalence of sulfa allergies, doctors must use care when prescribing them to patients. Those with HIV/AIDS are at particular risk for sulfa sensitivity.
People often confuse sulfa with another compound that begins with letters “s-u-l-f.” Sulfites, which occur naturally in most wines—and are used as a preservative in other foods—are chemically unrelated to the similarly named medications. In fact, perhaps the only other thing sulfites and sulfas have in common besides their names are their ability to cause allergic reactions in large numbers of people. Sulfites are the ninth most common food allergen (behind milk, egg, peanuts, tree nuts, wheat, soy, fish, and shellfish).
Approximately 1 percent of people (mostly asthmatics) are sensitive to sulfites.
Sulfa Allergy Symptoms
Symptoms of an allergic reaction to sulfa include:
hives
swelling of the face, mouth, tongue, and throat
drop in blood pressure
anaphylaxis (a severe, life threatening reaction that requires immediate medical attention)
Very rarely, a patient may exhibit serum sickness-like reactions around 10 days after treatment with a sulfa drug begins. These symptoms include:
fever
skin eruptions
hives
drug-induced arthritis
swollen lymph nodes
Patients with the above symptoms should contact a healthcare provider immediately.
Sulfite Allergy Symptoms
A person who is allergic to sulfites may experience the following symptoms:
headache
rash
swelling of the mouth and lips
wheezing or trouble breathing
asthma attack (in those with asthma)
anaphylaxis
People who experience more serious symptoms of a sulfite allergy should contact a healthcare provider. In the case of anaphylaxis, a person will require emergency medical attention.
Sulfa Medications to Avoid
The following medications should be avoided for those with allergies or sensitivities to sulfa:
antibiotic combination drugs such as trimethoprim-sulfamethoxazole (Septra, Bactrim) and erythromycin-sulfisoxazole
Crohn's disease, ulcerative colitis, and rheumatoid arthritis drug sulfasalazine (Azulfidine)
the leprosy drug Dapsone (also used to treat dermatitis and certain types of pneumonia)
Medications Containing Sulfa That May Be Safe
Not all drugs that contain sulfonamides cause reactions in all people. Many people with sulfa allergies and sensitivities may be able to safely take the following medications:
some diabetes medications including glyburide (Glynase, Diabeta) and glimepiride (Amaryl)
non-steroidal anti-inflammatory drugs such as celecoxib (Celebrex)
migraine medication sumatriptan (Imitrex, Sumavel, and Dosepro)
some diuretics including hydrochlorthiazide (Microzide) and furosemide (Lasix)
Sulfite-containing Products to Avoid
It’s important to note that most groups aren’t sensitive to sulfites, except one—those with asthma. Asthma sufferers have between a 1 in 10 and 1 in 20 chance of having a reaction to sulfites.
Not only do sulfites occur naturally in wines during fermentation, but many winemakers add them to help the process along. For the past two decades, the U.S. Food and Drug Administration (FDA) has required winemakers to display the warning "contains sulfites" if levels exceed a certain threshold. Many companies voluntarily add the label to their products as well.
Individuals with sensitivities should avoid food products with sulfur dioxide, potassium bisulfate, potassium metabisulfite, sodium bisulfite, sodium metabisulfite, and sodium sulfite on the label. Sulfites are common in the following foods and ingredients:
alcoholic beverages including white and red wines and wine coolers
baked goods containing dried fruit and vegetables
beverage bases that include dried citrus fruit
condiments such as pickles, olives, horseradish, pickle and onion relishes, wine vinegar, and salad dressing mixes
cornstarch, modified food starches, spinach pasta, some gravies, hominy, certain breading, batters, and noodle and rice mixes.
dried fruit snacks including trail mixes and peanut butter or cheese filled crackers as well as maraschino cherries and glazed fruits
fish and shellfish such as fresh, frozen, canned or dried shrimp, dried cod, scallops, frozen lobster, and canned clams
fruit fillings, flavored and unflavored gelatin, and pectin gelling agents
fruit juices (canned, bottled, or frozen) including lemon, lime, grape, and apple
jams and jellies
shredded coconut
soups containing seafood or dried soup mixes
sugars including brown, powdered, raw, or white sugar derived from sugar beets
sweet sauces including anything with high-fructose corn syrup, maple syrup, and fruit toppings
teas that are either instant or made from liquid concentrates
any product containing potatoes and vegetables that are pickled or dried
Hope this helps some!
I am confused about this. My pharmacist has on file about my /sulfa/sulfite allergies. When my son went to pick up a new prescription from a new doctor, the pharmacist called to confirm my allergies citing the prescription for Lisinopril had a component of sulphur/sulfa The doctor apologized and reissued another prescription for Lisinopril WITHOUT the water pill component. I remember the difference being one simply said Lisinopril and the other said Lisinopril followed by 4 letters/numerals that started with an H. Can you tell me anything about this?
Related topics
high blood pressure, allergies, lisinopril, medication
Further information
- Lisinopril uses and safety info
- Lisinopril prescribing info & package insert (for Health Professionals)
- Side effects of Lisinopril (detailed)
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