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Allergy to sulfasalazine? Or something else?

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Ulcerative Colitis
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Posted 6/18/2013 4:27 AM (GMT 0)
If I didn't have bad luck, I wouldn't have any luck at all lately...

Started sulfasalazine 2 weeks ago. Instantly started helping my UC. Awesome! Until 3 days ago. Friday I felt extremely tired, had a headache, stomachache, nausea, dizziness. Also noticed my chest looked a little red. Could also have been anxiety attack, although it lasted most of the day. Saturday felt great all day. My arms started to look a little splotchy, but only in certain lighting. Sunday felt fine, except that my cheeks looked flushed. Today, my cheeks flushed off and on, and my face itched a little. Still some splotchiness on my arms, which got worse after dinner. Decided to go to urgent care, and while waiting the splotchiness turned into a full-on rash on my arms, stomach, and legs. Not raised and not itchy, mostly just splotchy, and looks better or worse depending on the lighting. Have a 99.9 degree fever. The doctor at urgent care couldn't tell me anything one way or the other. Could be reaction to the sulfa, could be something I ate, could be viral, who knows. No help at all there.

I would hate to stop a med that is actually working, if I am not in fact allergic to it. If I stop, and the rash goes away, the only way to tell if it was the sulfa, is to restart and see if I react again, correct? Which could be very dangerous.

Any advice??

Posted 6/18/2013 10:43 AM (GMT 0)
I didn't have these kind of side effects on sulfa but others which made me stop it. I would talk to your GI about it.
Posted 6/18/2013 3:39 PM (GMT 0)
I would talk to the pharmacist and your GI. Have you been out in the sun? I think there are possible side effects made worse by sun exposure when you're taking sulfazine.
Posted 6/18/2013 4:07 PM (GMT 0)
The fever and time you've been taking it, to me, seems to indicate something other than an allergic reaction to the drugs. Have you ever taken sulfa antibiotics? If you've taken them with without a problem I doubt it's the meds. If it is an allergic reaction it sounds somewhat like contact dermatitis. Have you changed laundry detergents recently? Started gardening?

Though, if you were out a lot that weekend, could have been heat exhaustion, especially if you weren't drinking enough water. That was my first guess looking at symptoms, though I'd assume a decent doctor would have ruled that out first.
Posted 6/18/2013 5:48 PM (GMT 0)
Update: Fever and rash are still here. GI said to stop the sulfasalazine, but didn't give me any other options for meds, so I have no idea what I'm supposed to do now.

Frankly, I am concerned I could have DRESS syndrome http://en.wikipedia.org/wiki/DRESS_syndrome from the sulfa. Neither the urgent care or my GI seem to have heard of it, I am debating going to the hospital and asking that they run a full battery of tests. I know it is a rare side effect, but my rash, fever, and duration of time on the med all fit.

I should also add I have not spent any time in the sun, and have not used any new body care products, detergents, etc, and have not eaten any new foods. I SO wish this was something unrelated to the sulfasalazine, but I don't think there are any other possible culprits.

Posted 6/18/2013 6:46 PM (GMT 0)
You don't quite hit the temperature mark for DRESS, your rash would not be maculopapular (maculopapular rashes have raised bumps) and according to one diagnostic criteria the time frame is actually too short, so I wouldn't worry about that too much unless you've also got swollen glands. If you're still very worried, have your doctor draw some blood and do a CBC and check ALT levels.
Posted 6/18/2013 6:50 PM (GMT 0)
Is there any reason you were taking sulfasalazine instead of a mesalamine-based drug (Asacol, Lialda, Apriso)? Most GIs prescribe mesalamine instead of sulfasalazine because there are so many people who cannot take sulfa drugs.
Posted 6/18/2013 8:16 PM (GMT 0)
After 4 weeks on sulfasalazine I got constant headaches and a 101 fever. I stopped and both were gone in 3 days. I started again and they came back in 3 days.

I changed to balasalazide and no problem since. 30% of people get intolerence reactions to sulfasalazine that force them to stop using. The most common is headaches. Rash is pretty common also. 90% of those people can switch to other 5asa type drugs.
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