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Plaquenil and Sulfa Allergies
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raddoe posted:
I was dx in August with Lupus and my Rheumy said she was afraid to start me on Plaquenil since I had a bad reaction to a Sulfa antibiotic I took and the same reaction when a Dr gave me Lasix.

I read that the sulfa in Plaquenil is different from those in antibiotics and most people with Lupus have an allergy to Sulfa but can take Plaquenil without any problems.

What are your thoughts? Recommendations? I think I'm going to tell my Rheumy that I at least want to try Plaquenil and take the risk (I only got a really red rash that looked like measles when I had the reaction).

thanks,
Robin
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allie_bf responded:
I have a sulfa allergy, and have taken Plaquenil for 4 years without any adverse effects. I can say, however, that I have not had any cross allergic reaction to other drugs sometimes associated with sulfa allergies. Whether you try Plaquenil or not is ultimately up to you and your doctor, but a lot will depend on the type and severity of reactions that you've had. Rashes are certainly a lot less severe than respiratory reactions. My reaction to sulfa consisted of wheezing, but no major distress, and Plaquenil was sufficiently different from Gantrisin that my doctor felt comfortable with prescribing it.
 
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R Swamy Venuturupalli, MD, FACR replied to allie_bf's response:
Hydroxychloroquine sulfate (Plaquenil) is not a sulfa drug. That is a misconception. However, hydroxychloroquine can be associated with serious dermatological side effects including severe rashes and exacerbation of psoriasis.
 
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allie_bf replied to R Swamy Venuturupalli, MD, FACR's response:
It is not considered to be a sulfa drug, but it is a sulfate, and one about which comparatively little is known (i.e. after decades of use, it is not even known how this drug works, or for how long.) Given that uncertainty, it is not too surprising that many physicians and pharmacists give the standard warnings about potential reactions "just in case."
 
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nancyj95 responded:
I took it when first diagnosed and turned out to have a terrible allergy-not to the sulfa, but to the quinine in the drug. The itching was unreal and took 3 weeks to get our of my system. I do take sulfasalazine-another sulfa drug that doesn't act like one. My rhuemy told me not to take any others because some regular slafa drugs can cause flares.
 
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bumbleeboo responded:
I too, have a significant sulfa allergy... and ALSO have been taking hydroxychloroquine for a while with no adverse effects. I think it is worth trying. Good luck!
 
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victimoflupe responded:
I too have a sulfa allergy and was hesitant- I too was told same... But I had a deathly dangerous allergic reaction to Plaquenil. unrelated to sulfa... I am allergic to the quinine and me too- like another poster it took nearly 3-4 weeks for it to get out of my system... on top of that I dealt with a less than compassionate care giver who felt I was over dramatizing my reaction until I went to my MD who called her threatening to report her to the boards...

I can attest however that my reaction had nothing to do with my sulfa allergy as my MD and my pharmacist both said one had nothing to do with the other and I trust both as they were shocked to the core at the depth of my reaction...and both were aware of my allergy to sulfa and reaction history to it....


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Dr. R. Swamy Venuturupalli is a board-certified rheumatologist practicing in Los Angeles. He is Clinical Chief of the Division of Rheumatology at Ce...More

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