Medication allergies

February 19, 2007 7:20 AM

Help with understanding severe allergic reactions to medication?

One of my kids (20 yrs old) recently had a very bad allergic reaction to ibuprofen (facial swelling, hives all over) and recently had a severe reaction to Darvocet (not to the acetaminophen part, which he has taken without problems - so I assume it's the Darvon bit). To add to this, one of my brothers had a mild allergic reaction to Aleve, indaverdently took it again a few years later, and nearly died from anaphylactic shock.
Can any of you share your experiences and insight on a) the cumulative nature of allergic reactions, b) what kind of allergic testing have you undergone to help diagnose your sensitivity to medication safely and accurately? I want to get my son to to an allergist but was hoping you could help me understand what to expect from going to one. Thanks!

posted by nj_subgenius to health & fitness (4 comments total)

For sensitivity to medications (at least aspirin and other NSAIDS), there isn't an easy skin or blood test. Instead, the only sure way to test is a medically supervised graded challenge. Generally, if your son has had an allergic reaction to ibuprofen, he should avoid aspirin, naproxen, diclofenac, and all other traditional NSAIDs. The newer COX-2 selective NSAIDs are also can trigger a response in some aspirin-sensitive patients, according to this site. If your son has had an allergic reaction involving hives before, it's possible that he has dormant hives and is more prone to having allergic reactions to drugs. If he has underlying asthma and nasal polyps, then he may have Samter's Triad.

From what I've read, it's possible to desensitize oneself to aspirin, but that is usually only done for Samter's Triad patients to decrease asthmatic symptoms, or in patients who would benefit from aspirin therapy for cardivascular reasons, not for otherwise healthy young people.

(Sorry, I don't have much personal experience with this, but hopefully you can find some search terms from those links.)
posted by twoporedomain at 8:17 AM on February 19, 2007

First, don't try and figure out what the tolerance level is on this on your own.

By the way, it's common for people who don't know they have asthma to discover that because of a sensitivity to an NSAID. Not saying that's the case here; the allergist can help make a diagnosis, if needed.

Allergic reactions--to anything, food and medicine included--can at develop any time. That's how my husband discovered he was allergic to shellfish when he turned 30. It just started making his throat swell up. He'd eaten it all his life, too. It's not an avoidance or tolerance thing. It just happens. As far as I know there is no therapy like allergy shots to circumvent food or medication allergies. The allergist will likely outfit your son with an Epipen and teach him and your family how to use it and recommend a dog tag or ID bracelet stating the allergy/sensitivity so in case he can't talk, it's there. By the way, it's really important that people in your family/who he lives with know what to do in case of a problem. Epipens are really easy to use and can save a person's life. Good luck!
posted by FergieBelle at 8:58 AM on February 19, 2007

If allergies were easily diagnosable and predictable, they wouldn't take the vast toll - hospitalizations, deaths - that they do.

Triad asthma, one of the few predictable medication sensitivities, is completely irrelevant here; shouldn't even have been mentioned, as it has nothing to do with other NSAIDs.

It is not a bad idea to see an allergist - they can do skin testing for substances of concern - but it's not typical to skin-test someone with drugs that they may need to take in the future.

If someone's had several severe allergic reactions, that person is often advised to carry an "epi-pen" - a portable syringe of injectable epinephrine - to abort an anaphylactic attack. But that has to be prescribed by a doctor.
posted by ikkyu2 at 9:24 AM on February 19, 2007

thanks everybody.
posted by nj_subgenius at 10:20 AM on February 19, 2007