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Sulfites in Medications

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Updated June 24, 2014

What Medications Contain Sulfites?

Bronchodilator solutions for asthma
  • Adrenalin chloride 1:1000 concentration
  • Bronkosol
  • Isuprel hydrochloride solution

Topical eye drops

  • Pred-Mild
  • Pred-Forte
  • Sulfacetamide
  • Prednisol
  • dexamethasone)

Injectable medications

  • Amikacin
  • Betamethasone phosphate (Celestone)
  • Chloropromazine (Thorazine)
  • Dexamethasone phosphate (Decadron)
  • Dopamine
  • Epinephrine (Adrenaline, Ana-Kit, Epi-Pen)
  • Garamycin
  • Gentamycin
  • Isoetharine HCl
  • Isoproterenol (injectable)
  • Hydrocortisone (injectable)
  • Lidocaine with epinephrine (Xylocaine)
  • Meperidine (Demerol)
  • Metarminol
  • Norepinephrine (Levophed)
  • Procaine (Novocaine)
  • Prochloroperazine (Compazine)
  • Promethazine (Phenergan)
  • Solutions for total parenteral nutrition and dialysis
  • Tobramycin

How is Sulfite Allergy Treated?

Generally, avoidance of foods and medications containing sulfites should be avoided in people with known or suspected sulfite allergy. This should be successful given the mandate by the FDA to label foods containing less than 10 ppm of sulfites. It is important to note that the terms sulfur dioxide, sodium or potassium bisulfite, sodium or potassium metabisulfite, and sodium sulfite are other names for sulfites.

The FDA ban on sulfites from fresh fruits and vegetables (such as in salad bars) in restaurants has significantly reduced the risk of accidental ingestion of sulfites. However, unlabeled sulfite-containing foods remain in restaurants, with sulfites in potatoes being the major concern. Therefore, sulfite allergic people should avoid all potato products in restaurants except for baked potatoes with skins intact.

Severe allergic reactions and anaphylaxis may require treatment with injectable epinephrine, asthma symptoms may require the use of inhaled bronchodilator solutions (those that do not contain sulfites). It would be prudent for people with severe sulfite allergy to carry injectable epinephrine (Epi-Pen or Twinject) and to obtain a Medic-Alert bracelet.

Want to keep learning? See if you should also be concerned about sulfa allergy.

Sources:

    1. Chapman JA, Bernstein L, Lee RE, Oppenheimer J. Food Allergy: A Practice Parameter. Ann Allergy Asthma Immunol. 2006; 96: S1-68.
    2. Wilson BG, Bahna SL. Adverse Reactions to Food Additives. Ann Allergy Asthma Immunol. 2005; 95: 499-507.
    3. Bush RK, Taylor SL, Hefle SL. Adverse Reactions to Food and Drug Additives. In: Adkinson NF, Yunginger JW, Busse WW, et al, eds. Middleton’s Allergy Principles and Practice. 6th edition. Philadelphia: Mosby Publishing; 2003:1645-1663.
    4. Lakness J. Allergy Elimination Diets. In: Lawlor GJ, Fischer TJ, Adelman DC, eds. Manual of Allergy and Immunology. 3rd ed. Boston: Little, Brown and Co;1995:559-60.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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