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The metabolic rationale for a lack of cross-reactivity between sulfonamide antimicrobials and other sulfonamide-containing drugs.
Drug Metab Lett. 2012 Jun 01; 6(2):129-33.DM

Abstract

Sulfonamide antimicrobials (sulfamethoxazole) contain an arylamine group, oxidized by CYP2C9 to the hydroxylamine with subsequent auto-oxidation to a highly reactive [-nitroso-] intermediate is a necessary (if not sufficient) cause of drug hypersensitivity. Accordingly, xenobiotics that do not contain an arylamine cannot generate this reactive intermediate and do not cross react with sulfonamide antimicrobials. Despite this well-attested observation, product labeling and direct-to-consumer advertising for non-arylamine therapeutic classes of drugs containing the sulfonamido- functional group persist with a warning of the potential for cross-reactivity. It is hoped that by offering an explicit rationale for the lack of cross-reactivity will provide medical practitioners with a level comfort to proceed with prescribing medications such as thiazide diuretics and celecoxib for patients with a history of hypersensitivity to sulfonamide antimicrobials.

Authors+Show Affiliations

Medicine and Pharmacology, SUNY Upstate Medical University, Syracuse, New York, USA. lehmannd@upstate.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23157194

Citation

Lehmann, David F.. "The Metabolic Rationale for a Lack of Cross-reactivity Between Sulfonamide Antimicrobials and Other Sulfonamide-containing Drugs." Drug Metabolism Letters, vol. 6, no. 2, 2012, pp. 129-33.
Lehmann DF. The metabolic rationale for a lack of cross-reactivity between sulfonamide antimicrobials and other sulfonamide-containing drugs. Drug Metab Lett. 2012;6(2):129-33.
Lehmann, D. F. (2012). The metabolic rationale for a lack of cross-reactivity between sulfonamide antimicrobials and other sulfonamide-containing drugs. Drug Metabolism Letters, 6(2), 129-33.
Lehmann DF. The Metabolic Rationale for a Lack of Cross-reactivity Between Sulfonamide Antimicrobials and Other Sulfonamide-containing Drugs. Drug Metab Lett. 2012 Jun 1;6(2):129-33. PubMed PMID: 23157194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The metabolic rationale for a lack of cross-reactivity between sulfonamide antimicrobials and other sulfonamide-containing drugs. A1 - Lehmann,David F, PY - 2012/02/27/received PY - 2012/05/03/revised PY - 2012/05/30/accepted PY - 2012/11/20/entrez PY - 2012/11/20/pubmed PY - 2013/6/12/medline SP - 129 EP - 33 JF - Drug metabolism letters JO - Drug Metab Lett VL - 6 IS - 2 N2 - Sulfonamide antimicrobials (sulfamethoxazole) contain an arylamine group, oxidized by CYP2C9 to the hydroxylamine with subsequent auto-oxidation to a highly reactive [-nitroso-] intermediate is a necessary (if not sufficient) cause of drug hypersensitivity. Accordingly, xenobiotics that do not contain an arylamine cannot generate this reactive intermediate and do not cross react with sulfonamide antimicrobials. Despite this well-attested observation, product labeling and direct-to-consumer advertising for non-arylamine therapeutic classes of drugs containing the sulfonamido- functional group persist with a warning of the potential for cross-reactivity. It is hoped that by offering an explicit rationale for the lack of cross-reactivity will provide medical practitioners with a level comfort to proceed with prescribing medications such as thiazide diuretics and celecoxib for patients with a history of hypersensitivity to sulfonamide antimicrobials. SN - 1874-0758 UR - https://www.unboundmedicine.com/medline/citation/23157194/The_metabolic_rationale_for_a_lack_of_cross_reactivity_between_sulfonamide_antimicrobials_and_other_sulfonamide_containing_drugs_ L2 - http://www.eurekaselect.com/104978/article DB - PRIME DP - Unbound Medicine ER -