Saturday, September 17, 2011

Diabetes Drug Allergies

Diabetes drugs, like many medications, can cause a variety of unwanted effects but diabetes drug allergies are quite rare. If you are allergic to a drug, your immune system is turned on in a harmful way. Skin rash is the most common sign when you take a drug to which you are allergic.

Drug side effects are different from drug allergies. For example, diarrhea is a common side effect of metformin but having this side effect does not mean you are allergic to metformin.

If you are allergic to a drug, it is often dangerous to give you that drug. That’s not the case with what we call side effects. We can often deal safely with side effects.

If you had the side effect of diarrhea from metformin that went away when you stopped it, you could still safely take metformin again. By taking a slow release form of metformin, or a lower dose, or by  taking metformin with food you might be able to prevent the side effect of diarrhea. Allergy to metformin is extremely rare, if it  occurs at all.

Allergies to some drugs, like penicillin and sulfa antibiotics are fairly common. If you are truly allergic to those antibiotics, you should not take them.

One question that comes up in our practice is if you are allergic to sulfa antibiotics can you safely take a sulfonylurea diabetes drug? Sulfonylureas  include glimepiride, glipizide, glyburide and others. Sulfonylureas are cheap and are still used often for diabetes. But sulfonylureas have their drawbacks.

Although sulfa antibiotics have some chemical similarity to sulfonylureas, virtually all people who are allergic to sulfa antibiotics have no problems with sulfonylureas.

Allergies to sulfonylureas are quite rare. In over 27 years of practice in diabetes and endocrinology, I believe I have seen maybe one person allergic to an sulfonylurea.

So all those with sulfa allergies, if you recently were given a prescription for a sulfonylurea don't worry about being allergic to it. There are better and more important things to worry about. 
I’ll discuss some of those in an upcoming post on the sulfonylureas.

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