很抱歉，今天一直没上网，没能及时回复您。

非常感谢您让我听到不同的声音。

• 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.

如果交叉反应的危险度达到10%，并不是罕见。尤其是第二次给药，意味着我老公对Sulfonylureas过敏，就不应该再开Sulfonylureas药物。我老公服用25天才出现过敏反应，明显是IV型变态反应(迟发型变态反应），而不是I型变态反应。

所有跟帖： 

• 对，俺看重的也是第二次给药。就算第一次不违反常规， -水中捞月- ♂ (131 bytes) () 08/25/2018 postreply 15:29:08

• 所以，这个医生脑子在那一刻坏特了? -hello2002- ♀ (178 bytes) () 08/25/2018 postreply 15:32:06

• 应该没有，只是和这楼主的观点相近，只要我开的药不违背大多数人的出现的反应， -水中捞月- ♂ (44 bytes) () 08/25/2018 postreply 15:38:24

• 这个医生是水平有问题，不知道后面那种药也含有sulfa。 -相对强度- ♂ (0 bytes) () 08/26/2018 postreply 08:35:29

• 既然有10%交叉反应，不管是医生还是药剂师都应该给与警醒 -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

• 法庭衡量的时候就像天平，你请一个专家站你这一边，对付请一个专家说不一定是这样结果站他那一边，最后就看谁请的专家有力和人数多， -金笔- ♂ (452 bytes) () 08/25/2018 postreply 15:41:42

• 您说的对 -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 15:56:54

• 在当地医院住院时， -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

• 从你的回帖不难看出，你是一个很聪明的人，希望 -恶俗老狼- ♂ (2561 bytes) () 08/25/2018 postreply 18:54:27

• 谢谢，我的确学到了很多知识，我会慢慢消化 -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 19:01:29

• 我真的很感谢您，我能更明确地知道我应该从哪里入手 -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 19:10:11

• 我写错了，先用的Glimepiride，再用的Glipizide -yxw_88- ♀ (0 bytes) () 08/25/2018 postreply 19:19:01