Allergies to Medications

You have a rash on your chest, and it's spreading. You have no idea where it came from. Did you start taking a new medicine recently? Is it a different form of the same medicine? You say, "Well, I have taken this medicine before, and nothing ever happened like this!" But even if you have taken a medication before, you can still develop an allergy the next time you take it. Or if you are taking a new form, you might have a sensitivity to one of its components (a filler, not actually an active ingredient). Medication allergies produce some most serious reactions, so if you think you are having such a reaction, watch out. Stay aware of any progression of your symptoms - see treatment and remedies below. If it is worsening, seek consult with a medical practitioner. 

Note: An allergy is NOT the same as an intolerance. An allergy presents with an inflammatory response by the immune system. An intolerance is the inability of the body to process a drug, causing side effects like nausea, dizziness, or stomach upset

Symptoms of an Allergic Reaction

An allergic reaction to medication may present in a few different ways: As a red pinpoint rash, as hives, a fever, a runny nose, watery eyes, and even difficulty breathing and/or wheezing. The severity can worsen quickly if the medicine is given in a shot form or through an IV. It may begin while you are taking the medication, or you can have a delayed reaction to a medication - it might show up several days after taking a medication. Or...you may have been taking it for a while, then BOOM! You develop an allergic reaction!

Scratching an Itchy Rash

SYMPTOMS:

Usually, the most severe allergic reactions occur within an hour of taking the drug.

Drug allergy signs and symptoms may include:

• Skin rash (hives, redness, small scattered red bumps) and a rash called

  exfoliative dermatitis (redness, sometimes purplish splotches with peeling skin) - a severe skin reaction that spreads over large portions of the body. This occasionally comes on after taking various medications, especially certain antibiotics.

• Itching

• Fever

• Swelling

• Shortness of breath

• Wheezing

• Runny nose

• Itchy, watery eyes

• FULL BLOWN ANAPHYLAXIS

The following symptoms are characteristic of a late drug reaction:

• RASH

• fever

• Joint pain

• Swelling

​Typically, nausea, vomiting, and diarrhea are NOT an allergy to a drug but are an intolerance to that drug.

While any medication, herb, supplement can cause an allergic reaction, some are more notorious for causing reactions than others:

• Antibiotics, are frequent rash-causing culprits. This is especially true of penicillins (i.e., Amoxicillin, Augmentin) and sulfas (i.e., Bactrim). Note: Only 10 percent of those told they had a penicillin allergy in their childhood actually do have an allergy to penicillin (1). Testing will usually

• NSAIDs (non-steroidal anti-inflammatories), including aspirin (may not be classic "allergy"), ibuprofen (i.e., Advil, Motrin), and naproxen (i.e., Aleve, Naprosyn)

• ACE inhibitors, the most common of which are Lisinopril, Enalapril, and Benazepril, are used for lowering blood pressure

• Chemotherapeutic or cancer drugs

• Anticonvulsants (seizure medications) - particularly the older medicines like Tegretol and Dilantin

• Be careful with herbal products if you have grass/ragweed allergies - always check for potential cross-reactivities.

Conventional Over-the-Counter Approaches to Medication Allergies

If you suspect that you may be having an allergic reaction to a medication, you should

take an antihistamine (histamines are the cause of inflammation) ASAP. Most common:

Antihistamines include the following (taken as directed):

• Benadryl (diphenhydramine)

• Zyrtec (cetirizine),

• Claritin (loratadine).

• Allegra (fexofenadine)

• Zyrtec and Benadryl are generally considered better than the others, and Zyrtec is reportedly as efficacious as Benadryl and has a longer-lasting effect (2).

  Follow the directions on the label.

If you believe you are having a reaction to your medication, you need to stop taking your medicine.*and follow up with a healthcare provider as soon as you can. If it is progressing rapidly and becoming severe, seek treatment ASAP - always remember you can dial 911.

*Be sure to tell the prescribing doctor right away that you stopped your medicine so they can get you on a substitute if needed.

Suppose you have a known history of chronic-recurrent problems with hives (urticaria), which do not respond very well to your regular antihistamines. You can try cimetidine (what used to be Tagamet) in addition to your antihistamines, which may help because it is a different type of histamine blocker.

Alternative/Herbal Approaches to Medication Allergies

Unless you know a lot about these herbs, if you are having allergic symptoms, you should use conventional over-the-counter or prescribed medications if available. Overall, herbal remedies are not typically used for serious medication allergies. The following are reported to have antihistaminic properties:                              

• Goldenrod -  Goldenrod has anti-inflammatory and antihistaminic effects.

• Butterbur - This is thought to be a very effective consideration for allergies, but it is not to be  used long-term (3) 

• Quercetin - Some literature suggests that it is as effective as our standard over-the-counter antihistamines (see  above)

• Horseradish or Wasabi. 

• ​Horehound 

• Bromelain - Has also been found very effective in relieving some allergy symptoms (4)

• Mullein Leaf

• Nettle Leaf

• Rosemary 

Prescriptive Treatment of  Medication Allergies 

If you end up going to urgent care or ER, if your reaction is not severe, they may give you IV or IM  diphenhydramine (Benadryl) and possibly cimetidine (IV). and/or possibly an IV or IM corticosteroid shot. If severe, you will likely be treated with an injection of epinephrine, which is very effective. Epinephrine may be followed by injectable diphenhydramine and/or corticosteroids. 

If you suspect that you are experiencing a reaction to a medication, and it is slowly progressing over hours to days, take an antihistamine (in allergy, the body produces histamines, which cause inflammation). Commonly used antihistamines include the following: Benadryl (diphenhydramine), Zyrtec (cetirizine), Allegra (fexofenadine), and Claritin (loratadine). Zyrtec and Benadryl are generally better than the others. It is also as efficacious as Benadryl and has a longer-lasting effect. Also, you need to stop your medicine (If you stop taking your medication, be sure to tell the prescribing healthcare provider right away so they can get you on a substitute if needed).

IT IS IMPERATIVE FOR YOU TO SEEK MEDICAL ASSISTANCE IF YOU THINK YOU ARE HAVING A RAPIDLY PROGRESSING ALLERGIC REACTION. YOU MAY BE HAVING AN ANAPHYLACTIC REACTION!! (Some people will initially take 50 mg of Benadryl at the onset of symptoms, before or during the process of seeking medical assistance). It is good to keep this medication in your medicine cabinet).

If it is progressing rapidly and becoming severe, seek treatment ASAP - DIAL 911.