The Hospice Clinician Blog

Which drugs should hospice patients with a sulfa allergy avoid?

The word "sulfa" refers to sulfonamides which are a specific class of antibacterial drugs. Common sulfa antibacterial drugs include Bactrim and Septra. There are also a limited number of other drugs which contain a sulfonamide-like configuration within their molecular structure. The anti-inflammatory drug, Celebrex, is one of these. Hospice patients with sulfa allergies should avoid all sulfonamide antibacterial drugs and certain other drugs which contain a sulfonamide-like configuration.

Do not confuse the term "sulfa" with the element sulfur, or sulfates and sulfites. Sulfur, sulfites, and sulfates are not closely related to sulfonamides an are not likely to cause any adverse effects in people with a "sulfa allergy".

Many commonly used drugs are compounds which contain a sulfate or sulfite component. Sulfates and sulfites are just counter-ions that consist of sulfur and oxygen which are used to chemically balance many cationic drugs. Morphine sulfate is one of these drugs. Drugs like morphine sulfate do not pose any increased risk of adverse reaction to a patient with a "sulfa" allergy. The presence of a sulfate or sulfite in the name of a drug does not pose an increased risk for drug allergy in a patient with a sulfa allergy.

In addition to the sulfonamide antibacterial drugs, hospice patients with sulfa allergy may need to avoid specific drugs from other pharmacologic classes that contain a sulfonamide-like configuration within their structure.

These include a select few drugs from the following categories: diuretics, oral hypoglycemics, NSAIDs, and antiepileptic drugs. The following table lists these specific drugs as well as the sulfonamide antibacterial drugs.

Drugs to Avoid in Sulfa Allergic Patients

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