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Cross-sensitivity occurs when a person who is sensitive to a specific drug may also have a reaction to other drugs that are closely related. This is common with nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, and antibiotics. It is important for people to keep a record of their past reactions to medications and wear an emergency bracelet if necessary.
When doctors are prescribing drugs and pharmacists are filling them, one thing both groups are interested in is what kind of sensitivities or allergic reactions people have had to other drugs. Knowing this helps you avoid specific medications that have caused problems in the past. From another perspective, having this information is just as important. Sometimes sensitivity to a specific drug indicates a possible reaction to other specific drugs; this is called cross-sensitivity.
It would be nearly impossible to list all drugs that can cause cross-sensitivity reactions. Some people who show sensitized reactions to drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) may have trouble taking any drug in that class. A person who cannot take ibuprofen may not tolerate naproxen sodium (Aleve®) or medications such as Vioxx®. Because most reactions to NSAIDs aren’t usually anaphylactic, doctors might still try giving another NSAID if needed, but they might try other drugs first to avoid causing cross-sensitivity.
Similar problems exist with some antidepressants, especially when the drugs are closely related to each other. Other people cannot take some types of antibiotics if they have shown sensitivity to an antibiotic that belongs to that group. For example, many people cannot take any form of sulfa antibiotic, and this would include drugs such as Bactrim® and Septra®.
One of the classic examples of cross-sensitivity is penicillin. Those allergic to penicillin should not take certain antibiotics for fear of causing a life-threatening reaction. These drugs include but are not limited to amoxicillin, Augmentin, which contains amoxicillin, ampicillin, oxacillin, and others. Sometimes, people allergic to penicillin also have allergic reactions to antibiotics called cephalosporins, although new research into this suggests the likelihood of a reaction is about 10%. Cephalosporins include the drugs Keflex® and Ceclor®.
The reason cross-sensitivity usually occurs is because the drugs are often created from each other. They may contain some of the same ingredients, possess a similar chemical structure, or be made in a very similar way. The idea is that closely related substances are more likely to cause an allergic or immune reaction, and it is therefore dangerous to risk this, unless there are no other options.
This could be compared to nut allergies. Walnuts and pecans are not the same thing, but if a person is allergic to one type she may be allergic to both because they are similar. Additionally, virtually any nut should be suspected of having the potential to trigger an allergic reaction. So it would be safer to avoid them all.
What the idea of cross-sensitivity means to the average person can vary. When doctors prescribe medications, they normally have a list, often on their computer, that tells them what they can’t prescribe based on sensitivity. This suggests that people really need to keep records of which medications they have had reactions in the past. Serious allergic reactions such as those to penicillin may require additional treatment. Wearing an emergency bracelet that lists extreme allergies could be helpful if a person is in a position where they cannot provide this information by speaking.
