Curious re: celebrex and sulfa

[cayuse]

Has anyone here that has an allergy to sulfa drugs ever taken
Celebrex? I am running out of options for the arthritis and my rheumatologist suggested I try Celebrex. I have received and read conflicting opinions on whether or not it’s contraindicated for people with known sulfa allergies. The doctor’s opinion is that I “should” be fine, but I thought I would investigate any first hand experiences if I could. I realize we are all different and our reactions may vary, I’m just curious as to others responses to the medication if they also have sulfa allergies.

Biologics, and DMARDs are off the table because of the side effects I experienced and the infection risk.

Thanks!

[eosinophil]

The risk of a reaction is very low but unfortunately the only way to know is to try it.

The reason the risk is low is because the highly allergenic part of the sulfa antibiotics is not shared with celebrex, so the majority of people with a history of type 1 hypersensitivity reactions (standard immediate allergic reaction) to sulfa antibiotics are fine with meds like celebrex. However, there is no way to know if the part of the sulfa drug that YOU reacted to is that non-shared bit. If you reacted to something in the sulfa drug that IS shared then you will react to the celebrex.

However, reacting to something OTHER than the allergenic part of the sulfa antibiotics is very, very unlikely so you are likely to be just fine with the celebrex.

You might consider a graded challenge: give 1/10 of a standard celebrex dose in the doctor’s office and watch for an hour or so. If okay, give the rest and be observed for another hour or so. If you tolerate that it means you are not pre-sensitized to the celebrex and your risk for anaphylaxis from it is the same as the general population.

Good luck! I certainly would think celebrex has a much preferable side effect profile compared to the biologics!

[cayuse]

Thank you for the explanation!
I was considering asking the doctor if I could take the first dose at his office and sit around for awhile. My sulfa allergy was “immediate” and I don’t want a repeat performance if I can help it. I will also ask about the initial dose being small, as you described.
Your advice is appreciated!

[Kyrabee]

Cayuse, you would probably need to get something done at a compounding pharmacy to do the kind of “challenge” that eosinophil is talking about. Celebrex only comes in 100mg and 200mg capsules so no way to get a tiny dose except getting it compounded.

Celebrex does not contain the ‘piece’ of the molecule that is thought to be responsible for the allergic reactions to sulfonamides.
However, I have seen one nasty skin reaction to Celebrex in a sulfa allergic patient although Celebrex is capable of causing skin rashes in non sulfa allergic patients too so no way to tell. For obvious reasons, that patient was not rechallenged with Celebrex. I guess what you have to decide is if it is worth the risk of cross reaction (quite low) vs the benefit it might give you.
I would definitely take it at the MD’s office and be observed for awhile since you had an immediate reaction to sulfa.

I have a sulfa allergy (rash) and take hydrochlorothiazide with no problem. It too has a sulfa component.

Good luck. I hope you find something to help.

Susan

[cayuse]

OK, well Celebrex being a capsule changes things. For some reason I thought it might also come in an IM form as an injection so the dose could be decreased. I have no idea where I got that from!
If I get brave, I will try it. I’m on indocin now an have tried just about every anti inflammatory pulse methotrexate,enbrel and humira.
I may ask for jingles that day though, just to be on the safe side
Thank you Susan!

[RPM]

I am not a doctor, nor do I play one on television.

I am, however, allergic to sulfa.

Twice, two different people who ARE doctors prescribed BP meds for that had a substance that was “not sulfa, but like sulfa.” The first med made me almost unable to breathe. It was terrifying. The second doctor told me I “should” be OK on the second med. So did my current pharmacist. My former pharmacist said she would not recommend I take the med. I did not.

I have experienced other side effects from other meds in my time (I am ultra-sensitive to all prescription meds). None of those was a terrifying as the feeling I could not breathe no matter how hard I inhaled.

If there is ANY question in your mind, don’t take it. Just my nonmedical, nonprofessional opinion.

Even if I weren’t allergic to sulfa I would not take Celebrex. Those TV-commercial side effects are terrifying in their own right.

I have chronic aches and pains. Unpleasant to downright painful. Don’t know if they’re arthritis-related or not. All I ever take for them is ibuprofen and occasionally acetaminophen or aspirin. Those work better than prescription pain pills.

[RMJacobs]

If you can’t take DMARDs and biologics, what does your doctor say about potential joint damage? To me that is the scariest part of the equation. I have minimal joint damage because I got started on DMARDs very early in this journey.

It really sucks that nothing has worked out for you. Have you used the older/lower level DMARDs such as plaquinel? I was going to ask about sulfasalazine, but I guess that one is out with the sulfa allergy. And what about antibiotic therapy (minocycline)? That actually kept me off “real” DMARDs for a couple of years.

Best of luck on all this. It’s horrid enough to be dealing with these inhumane diseases, but to have problems with the meds that keep them under control is just awful. Hugs to you.

Rebecca

[cayuse]

RPM, I am also sensitive to most prescription meds and usually end up taking smaller doses of meds than most people. I hear you about the warnings on TV too. Sometimes you end up having side effects that are not generally listed and then no one wants to hear about THAT. But I am at the point I have to do something. I have psoriatic arthritis and the prognosis is not good.
Like wheelchair and shortened life expectancy not good, so I’ve been told. But the scenerio you describe with the allergies is “not good” either! Sorry to hear you went through that.

Rebecca, I hope YOU are doing better! The joint damage is a concern, hands and feet are “warping”. I JUST spoke with the rheumatologist Friday about plaquinel. He did not think I could tolerate it, but I could try it and see. His worry was it might make the psoriasis part worse.
I did try minocycline for three month this spring and it did not work. Oddly enough, it worked for the joint pain several years ago when I was on it for something else though.

Thanks to you both, all the input is appreciated.

[Jarpur]

Family member with a sulfa allergy did have a reaction to Celebrex soon after taking it (think it was within about an hour; it’s been several years so I don’t recall all the details). He hadn’t realized he shouldn’t take it and wondered what was going on when he had the bad reaction.

Best wishes that you find a solution.

[Jazzy_s_mom]

Interesting thread and I almost never stop in to this forum section.

I have an anaphylaxis reaction to sulfa and I have taken celebrex in the past with no issues. It has been at least 10 years since I have taken it as there was some sort of recall of the celebrex at the time I was taking it so I just stopped and never refilled the Rx. My sulfa allergy has been known since I was a young child.

[cayuse]

[QUOTE=Jazzy’s mom;8448268]
Interesting thread and I almost never stop in to this forum section.

I have an anaphylaxis reaction to sulfa and I have taken celebrex in the past with no issues. It has been at least 10 years since I have taken it as there was some sort of recall of the celebrex at the time I was taking it so I just stopped and never refilled the Rx. My sulfa allergy has been known since I was a young child.[/QUOTE]

Thank you for the info. I decided to put the Celebrex on the back burner and I started plaquenal
a week or so ago. If that is unhelpful, I will probably try the celebrex.