Tell Me Which Pain Meds I’m Allergic To!

It’s not unusual for a doctor to refer a patient to our allergy clinic to answer the question, “what pain medications am I allergic to?”  Surgery of any kind is a bit frightening, but add to that an adverse reaction to one of your pain medications and you know what hits the fan!  Reactions can include hives, difficulty breathing, headaches and a whole lot more.  So what can I do if I’m in a car accident or emergency surgery and I receive a pain medication I’m allergic to?  Will it kill me? 

Consider the following:

  1. Most effective pain meds are opioids and release histamine from the body when taken as pain meds.  We can’t skin test to medications in this category, so we rely on previous history.  That works well for the most part, but “there’s a first time for everything”
  2. The one exception to the above rule is fentanyl.  With this medication, skin testing and treatment for tolerance have been published and offer a good alternative.
  3. Often a procedure called “drug provocation testing (DPT)” is necessary to determine what you can and cannot take for pain medication.  Fortunately, most patients can tolerate the standard protocols used by most hospitals, so no need to worry.  If in doubt, DPT will give you VERY small amounts of medication making sure you can tolerate the drug before moving to a higher dose.  With a little patience & a long afternoon in the doctor’s office, we can usually find a medication that will work.
  4. But don’t take my word for it….the American Academy of Allergy Asthma & Immunology has several references on the subject of allergy to pain meds.  Check it out with the link below:

Prevention of allergic reactions in a patient scheduled for knee replacement who has a history of pain medication allergy and possible contact dermatitis to chromium.

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