Pseudotumor Cerebri/ Diamox Sulfa Allergy Concern

[elmosworld]

I have been recently diagnosed with Pseudotumor Cerebri.  I was diagnosed after my MRI came back normal, and my Lumbar puncture showed an opening pressure of 30.  I was informed that I have swelling of my right optic nerve and do get headaches occasionally.  I am 5-7" and weigh between 125 to 130 pounds.  My opthalmologist prescribed Diamox ER 500mg twice daily for treatment.  I was informed by my pharmacist when going to fill my prescription yesterday that because of my Sulfa Drug Allergy that there is a possibility that I may experience a reaction to the Diamox prescribed.  The pharmacist had stated that Diamox is a level 2 derivative of Sulfa and that the chance of an allergic reaction is there but small.  My big concern is that I was diagnosed with a Sulfa allergy as a child when a Sulfa Based Opthalmic Ointment was used to treat an eye infection and I broke out in hives after using the drug.  My daughter used Sulfa Antibiotics to treat a UTI and over the course of a week her face swelled up.  The pharmacist had mentioned taking the medication and trying benadryl and if I have a reaction to seek medical treatment immediately.  He told me that Diamox is pretty much one of a kind in treating my condition.  I am wondering what the true probability is of an allergic reaction to this medication and if trying the medication would normally be the "OK" thing to do.  Any advice or comments would be appreciated.  Thanks.

[ccb04]

My child took an antibiotic over a month ago for what we thought was a sinus infection. After an eye exam we found that her optic nerves are swollen bilaterally. The eye dr said the antibiotic could be making the nerves swollen. Is this true?                                              thanks  ccb04

[Ray T Oyakawa, MD]

You need to discuss this with your doctor.  Most patients with sulfa allergies do not react to diamox in my experience.

Dr. O.

[CSBDR]

You seem well-educated on your situation, and ask great questions.  

It sounds as if only your right optic nerve is affected, and your headaches are not severe.

Diamox and weight loss for overweight individuals are typical first-line treatment approaches.  You seem to have a true allergy to sulfa, and reactions to Diamox are a definite possibility.  The cardiac drug Digoxin has been reported to lower the cerebrospinal pressure as well and has been beneficial for patients with your disease.  

Another option if the nerve shows progressive damage is to have a surgery called optic nerve sheath fenestration to protect the nerve from raised intracranial pressure.  

Let your neuro-ophthalmologist know of your allergy to Diamox and inquire about Digoxin.

Best of luck