Cross-allergenicity with sulfonamides

However, they increase prothrombin time (PT) when used with warfarin and may possibly exert prothombotic effects via inhibition of endothelial cell function. Celecoxib is cross-allergenic with sulfonamides. Potential cardiotoxicity ... 

N-4 position and a substituted ring at the N-l position. Because of this different chemical structure, cross-allergenicity with the other sulfonamides may not occur. However, because this has not been well studied, if a patient has a reaction to a sulfonamide antibiotic, whether or not he or she will have a reaction to these other sulfonamides remains controversial. Predisposition to allergic reactions is a more likely reason than cross-reactivity between these differing molecules.14 The sulfonamide antibiotics are significant because they account for the largest percentage of antibiotic-induced toxic epidermal necrolysis and Stevens-Johnson syndrome cases.15... 

Hypersensitivity, mostly rashes, which can be severe (Stevens-Johnson syndrome). Assume complete cross-allergenicity between sulfonamides and possibly with sulfonylurea hypo-glycemics. 

All sulfonamides, including antimicrobial sulfas, diuretics, diazoxide, and the sulfonylurea hypoglycemic agents, have been considered to be partially cross-allergenic. Flowever, evidence for this is not extensive. The most common adverse effects are fever, skin rashes, exfoliative dermatitis, photosensitivity, urticaria, nausea, vomiting, diarrhea, and difficulties referable to the urinary tract (see below). Stevens-Johnson syndrome, although relatively uncommon (ie, < 1% of treatment courses), is a particularly serious and potentially fatal type of skin and mucous membrane eruption associated with sulfonamide use. Other unwanted effects include stomatitis, conjunctivitis, arthritis, hematopoietic disturbances (see below), hepatitis, and, rarely, polyarteritis nodosa and psychosis. 

D. Toxicity Drowsiness and paresthesias are commonly reported after oral therapy. Cross allergenicity between these and all other sulfonamide derivatives (other sulfonamide diuretics, hypoglycemic agents, antibacterial sulfonamides) is uncommon but does occur. Alkalinization of the urine by these drugs may cause precipitation of calcium salts and formation of renal stones. Renal potassium wasting may be marked. Patients with hepatic impairment may develop hepatic encephalopathy because of increased ammonia reabsorption. 

Hypersensitivity Allergic reactions, including skin rashes and fever, occur commonly. Cross-allergenicity between the individual sulfonamides should be assumed and may also occur with chemically related dmgs (eg, oral hypoglycemics, thiazides). Exfoliative dermatitis, polyarteritis nodosa, and Stevens-Johnson syndrome have occurred rarely. 

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