Cutaneous Adverse Events Caused by Sulfonamide-Containing Drugs: Reality or Perception?

The term “sulfa
allergy”, originally coined for the
sulfonamide antibiotics, has become associated with any drugs that
contain a sulfonamide moiety. This raises a question: should medicinal
chemists avoid making sulfonamide-containing compounds in drug discovery
programs? The negative perception of sulfonamides is not supported
by any systematic study or data analysis. To address this gap, an
analysis of postmarketing reports of cutaneous AEs for drugs with
and without a sulfonamide group was conducted. The analysis revealed
no evidence of association between the presence of a sulfonamide moiety
and a high reporting rate of cutaneous AEs and indicated that the
risk of such AEs was associated with the presence of certain structural
alerts and higher daily doses. These results strongly suggest that
sulfonamide-containing compounds are not at a higher risk of presenting
with a cutaneous adverse drug reaction compared with non-sulfonamides
and that medicinal chemists should not avoid use of the sulfonamide
group.