Living With a Medication Allergy

Although medications are given to help people, nearly all can have side effects. About 5% to 10% of adverse reactions to commonly used medications are allergic, which means that a person’s immune system overreacts to the drug and causes an allergic response.

Adverse reactions to medications are experienced by most individuals at some point in their life, and consequences can sometimes be severe. It is important to recognize allergic reactions because at times, they can progress and be life-threatening, such as in the case of anaphylaxis. In fact, there are an estimated 106,000 deaths each year related to serious drug reactions.

Most drugs can trigger an allergic response. However, there are certain medications that are more likely to produce allergic reactions than others because of their chemical structure. These medications include:

• Antibiotics
• Aspirin or ibuprofen
• Anticonvulsants
• Heart medications
• Hormones, such as insulin
• Certain anesthetics, such as neuromuscular blockers
• Vaccines
• Cancer medications

Wellness

Severe consequences can occur when an allergic person’s immune system produces the allergic antibody called IgE (immunoglobulin E) in response to a drug. When the person̢��‰��s body encounters the drug again, IgE antibodies bound to certain cells, called mast cells, can result in an explosive release of histamine and other chemicals. This triggers symptoms of an allergic reaction. The most frequent symptoms include:

• Skin rashes, particularly hives
• Itching
• Respiratory problems, such as wheezing
• Swelling of areas of the body and face

Treatment for drug allergies

When an adverse reaction to a medication is minimal, treatment is limited to discontinuation of that drug. However, if a more severe reaction occurs, an allergist/immunologist may need to be seen for appropriate diagnosis and treatment.

This includes treating the acute reaction and also in preventing future ones. In most cases, patients with drug allergies can be safely given an alternative medication. However, when there is no alternative available and the medication is essential, an allergist/immunologist may recommend desensitization to the medication.

This involves gradually introducing the medication in a specific way such that it is tolerated at therapeutic doses.

When to see an allergy/asthma specialist

Patients should see an allergist/immunologist if they:

• Have a history of penicillin allergy and likely will need antibiotics in the future.
• Allergists can perform specific tests for penicillin allergy
• Have a history of penicillin allergy and have an infection with no effective alternative therapeutic options, except for a penicillin class antibiotic.
• Have a history of multiple drug allergies.
• May be allergic to protein based bio-therapeutics and require uses of these materials.
• Have a history of an adverse reaction to aspirin or non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen.
• Require chemotherapy medication for cancer and have experienced a prior reaction to those medications.
• Have a history of possible allergic reactions to local anesthetics.
• Are HIV-infected patients with a history of adverse reactions to trimethoprim-sulfamethoxazole (TM-S)and need this therapy.

Drug desensitization may be appropriate for many of the above circumstances so that necessary drugs may be tolerated and taken.