很抱歉，今天一直沒上網，沒能及時回複您。

非常感謝您讓我聽到不同的聲音。

• SULFA ALLERGY
  • Sulfonylureas contain a sulfonamide group in their structure
  • The sulfonamide group is different from the one that is found in sulfa-based antibiotics
  • Patients with a history of allergy to sulfa-based antibiotics may have a slight increase in risk of an allergic reaction to sulfonylureas
   
  • Cross-reactivity between sulfa-based antibiotics and sulfonamide nonantibiotics, NEJM (2003) [PubMed abstract]
    • A cohort study in the NEJM looked at the risk of an allergic reaction to nonantibiotic sulfonamides in patients who had a previous reaction to a sulfa-based antibiotic
    • The study found the following:
      • Patients with a history of sulfa-based antibiotic allergy who subsequently took nonantibiotic sulfonamides (including sulfonylureas) had a 10% risk of having a reaction to the nonantibiotic sulfonamide
      • In patients without a history of allergic reaction to a sulfa-based antibiotic, 1.6% had a reaction to a nonantibiotic sulfonamide
      • In addition, patients with a history of sulfa-based antibiotic allergy had a 14% chance of having a reaction to a penicillin antibiotic. This finding led researchers to conclude that a history of allergic reactions in general may be more predictive of a reaction than reactions to any specific medication [15]
  
  
  • StraightHealthcare analysis:
    • Sulfonylureas may be prescribed to patients with a history of sulfa-based antibiotic allergy
    • Patients should be aware that a cross-sensitivity reaction may occur with a risk of around 10%
    • Patients with a history of severe reactions to sulfa-based antibiotics should avoid nonantibiotic sulfonamides if they can. If not, then the initial dosing should be done under medical supervision.

如果交叉反應的危險度達到10%，並不是罕見。尤其是第二次給藥，意味著我老公對Sulfonylureas過敏，就不應該再開Sulfonylureas藥物。我老公服用25天才出現過敏反應，明顯是IV型變態反應(遲發型變態反應），而不是I型變態反應。

所有跟帖： 

• 對，俺看重的也是第二次給藥。就算第一次不違反常規， -水中撈月- ♂ (131 bytes) () 08/25/2018 postreply 15:29:08

• 所以，這個醫生腦子在那一刻壞特了? -hello2002- ♀ (178 bytes) () 08/25/2018 postreply 15:32:06

• 應該沒有，隻是和這樓主的觀點相近，隻要我開的藥不違背大多數人的出現的反應， -水中撈月- ♂ (44 bytes) () 08/25/2018 postreply 15:38:24

• 這個醫生是水平有問題，不知道後麵那種藥也含有sulfa。 -相對強度- ♂ (0 bytes) () 08/26/2018 postreply 08:35:29

• 既然有10%交叉反應，不管是醫生還是藥劑師都應該給與警醒 -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 15:53:27

• Sulfonylurea hypersensitivity Glimepiride should not be used in -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 16:30:52

• 法庭衡量的時候就像天平，你請一個專家站你這一邊，對付請一個專家說不一定是這樣結果站他那一邊，最後就看誰請的專家有力和人數多， -金筆- ♂ (452 bytes) () 08/25/2018 postreply 15:41:42

• 您說的對 -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 15:56:54

• 在當地醫院住院時， -yxw_88- ♀ (1177 bytes) () 08/25/2018 postreply 15:43:35

• Drug induced exfoliative dermatitis -yxw_88- ♀ (587 bytes) () 08/25/2018 postreply 16:08:16

• 從你的回帖不難看出，你是一個很聰明的人，希望 -惡俗老狼- ♂ (2561 bytes) () 08/25/2018 postreply 18:54:27

• 謝謝，我的確學到了很多知識，我會慢慢消化 -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 19:01:29

• 我真的很感謝您，我能更明確地知道我應該從哪裏入手 -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 19:10:11

• 我寫錯了，先用的Glimepiride，再用的Glipizide -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 19:19:01