Replacement med for Bactrim/Sulpha-based products

[Daggar]

One course of action while awaiting LFT results for Holly is to stop the sulfatrim/cotrimoxazole treatment this week and redo lab work next Friday. They want to rule out this drug before altering the cytoxan dosage.

Just curious - has anyone had an adverse reaction to the sulpha-based products (bactrim-septra-etc)?

What would be the replacement drug for this? I've read a bit about an inhalation (nebulizer) product called pentamidine that is taken once a month but I'm not sure if it is used with WG patients??

[Sangye]

Sulfa allergies are quite common. Pentamidine is extremely harsh drug. I hope she doesn't wind up taking that. There is a way to desensitize if it's a sulfa allergy. It seems that would be preferable to taking bactrim off her list of useable drugs and using pentamidine.

[Daggar]

Yes the Nephrologist mentioned the desensitizing.....

I've only found atovaquone and pentamidine for replacement drugs but like you say there are serious concerns with them as well..... atovaquone can effect the liver as well.:confused1:

I guess I should "be patient" and await the results instead of "looking for answers"..... I find myself doing that a lot lately.

[drz]

Sulfa allergies are quite common. Pentamidine is extremely harsh drug. I hope she doesn't wind up taking that. There is a way to desensitize if it's a sulfa allergy. It seems that would be preferable to taking bactrim off her list of useable drugs and using pentamidine.

Sangye, don't go scaring the children. I have been on pentamide for several months. I know the treatment staff wear masks, put filters on the equipment and put you in a room with negative ventilation, but they tell me it is not that toxic although it is best avoided by pregnant mothers and some other people. I guess it prevents some type of pneumonia that might kill me. I haven't noticed any problems while taking it so far.

I have a sulfa allergy so I get the trimethoprim part of bactrim but not the sulfa part and that has prevented my recurrent bladder infections so far. We discussed the desensitization option earlier here in some other threads. Some doctors like mine don't want to run the risk of this procedure unless it is absolutely necessary.

A lot of the drugs I have been given for Wegener's are given like this: "This is a horrible drug with dangerous side effects, but without it you would be dead by now so...." That makes the choice for me real easy.

[Daggar]

They're all nasty I suppose -- not so much if you have no alternative. It all depends on the severity of the illness at the time...

[Sangye]

drz, it is a very harsh drug. It's contraindicated for anyone with kidney disease and numerous other conditions many Weggies have. The Wikipedia article on pentamidine is quite accurate in its description of the risks and side effects. If it's the only choice, then obviously you have to take the risk. But if it's a question of desensitizing to bactrim or using pentamidine, it would be worth grilling the doctors about which is more dangerous.