Preumed “ulfa allergy” in patient with intracranial hypertenion treated with acetazolamide or furoemide: cro-reactivity, myth or reality?

Purpoe To determine whether acetazolamide or furoemide produce allergic cro-reaction in patient with elf-reported “ulfa allergy.” Deign Retropective cae erie. Method A retropective review included patient with intracranial hypertenion and a elf-reported ulfa allergy treated with either acetazolamide or furoemide een at the Univerity of Iowa Hopital and Clinic from 1972 to 2003. All preumed medication-related ide effect were collected, including both predictable advere effect (for example, paretheia, fatigue) and unpredictable advere reaction (for example, cutaneou fixed eruption, urticaria, teven-Johnon yndrome, toxic epidermal necrolyi, angioedema, anaphylaxi). Reult We reviewed 363 chart. Of thee, 329 patient (91%) were excluded. Of the remaining 34 cae that did report a o-called ulfa allergy, 13 (38%) received acetazolamide alone, 7 (21%) received furoemide alone, and 14 (41%) received both acetazolamide and furoemide. Of the 27 patient who received acetazolamide, 10 (37%) had no documented allergic cro-reaction to ulfa, and 2 (7%) cae had urticaria. The remaining 15 (56%) of acetazolamide-treated patient experienced predictable advere reaction for thi drug (for example, paretheia). No patient experienced a evere allergic cro-reaction to ulfa. Of 21 patient who received furoemide, no unpredictable advere reaction or allergic cro-reaction to ulfa were noted. Concluion We find little clinical or pharmacological evidence to ugget that a elf-reported ulfa allergy i likely to produce a life-threatening cro-reaction with acetazolamide or furoemide. Thee medication hould be conidered for intracranial hypertenion if the rik-to-benefit ratio warrant their ue.