I had a bad time with Lamictal, is taking Fluconazole just as dangerous.

June 2, 2021 3:08 PM

...for me? Will Fluconazole that's recorded as having given rashes, Steven-Johnson syndrome, etc. affect me negatively?

I do have calls into the doc and I spoke to the pharmacist, who merely told me "Steven-Johnson syndrome has been reported with this drug" (It has a lot of other similar scary side effects, such as rash, listed as I read the accompanying material). I know my doc says he will let me try Lamictal again (They caught the precursor (?) before it progressed.)

I also know they have to report side effects even if it's 1/100 of 1%. That person always seems to be me.

I simply don't know enough about how drugs work/chemistry to know if it happened once, will it happen again? Or is it nothing that can be predicted?

posted by Rumi'sLeftSock to Health & Fitness (6 answers total)

Nobody here can be more helpful than your doctor or pharmacist. If they think the benefit justifies the risks, then then they're probably right. If you don't trust your doctor or pharmacist, maybe find new ones (although I know how difficult that can be).
posted by nixxon at 3:36 PM on June 2, 2021 [1 favorite]

my NP will not let me re-try lamictal, because i got a rash the first time around and she thinks that i'm at a much higher risk for SJs. but your dr is really the only one who can help you with this
posted by megan_magnolia at 5:39 PM on June 2, 2021

I am also prone to side effects and had an drug allergy reaction to Lamictal. After a doctor confirmed it was not SJ syndrome, my pdoc took me off entirely until the rash fully cleared and then brought me back up to a therapeutic dose in extremely small steps with two weeks in between. We got there but it took a long time which was challenging in its own right. That said, I’ve now been on it without issue for four years. Feel free to memail me and best of luck.
posted by jeszac at 8:26 PM on June 2, 2021 [1 favorite]

1) You should listen to your doctor.

2) You should listen to actual researchers and scientists ahead of yahoos like me on the internet, and I hope someone will show up with real knowledge.

3) If I'm reading the Pathophysiology and Prevention sections here right, genetics determines whether you're likely to get SJS in response to a drug. But the genetic predisposition is drug specific: one form of a gene might predict a reaction to Lamictal, another might predict a reaction to sulfa drugs, etc. (Note that under Prevention, they talk about recommending gene testing for some drugs — but the form of the gene they recommend testing for is different for each drug.)

So if I'm reading this right, your doctor is correct and reacting to Lamictal doesn't necessarily mean you'll have the same reaction to anything else. But please don't listen to me. I'm just a Lamictal-taking weirdo with a recreational special interest in genetics. Please listen to people way smarter than me who have way more of a background on this stuff.
posted by nebulawindphone at 6:31 AM on June 3, 2021

Response by poster: First of all, my original doc said he would NOT let me try it Lamictal again (sorry typo).
Then, Lamictial is an anti-seizure but the other one is an anti-fungal.
Finally, this doc called back and said she thought it would be safe for me to take.
posted by Rumi'sLeftSock at 11:09 AM on June 3, 2021

I would ask my doctor if they could share what sources of evidence they're using and what they get from them. I do trust their professional judgment, but it helps me to understand when they have a precise read on risk and benefit, versus when they have uncertainty but their point estimate for the benefit far exceeds the risk. And to feel confident they're not overlooking anything in the manner of humans. I'm in a position to select doctors who think this is reasonable rather than a challenge to their authoritah so this works for me.
posted by away for regrooving at 12:29 AM on June 4, 2021