Options After An Allergy To Pulmicort

Answer

Thank you for reaching out! I'm sorry to hear about your dad's reaction to the Pulmicort nebulizer solution.

Based on the information you've provided, it's important to consider the nature and severity of his reaction, as well as his previous experience with Advair.

Discussion Regarding Pulmicort Allergy And Cross-Sensitivity

Pulmicort and Advair both contain corticosteroids. Pulmicort contains budesonide, and Advair contains fluticasone along with salmeterol (a long-acting beta agonist).

While corticosteroids share similarities in their chemical and structural composition, they can have different effects on the body, leading to varying clinical outcomes.

Cross-sensitivity between corticosteroids is complex. There have been reports of cross-reactivity based on chemical structures, but establishing definitive conclusions about patterns of cross-reactivity is challenging. Some individuals may exhibit no cross-reactivity, while others may be allergic to more than one systemically administered corticosteroid.

Without an allergy evaluation or challenge procedure, it is not possible to determine a "safe" alternative corticosteroid empirically for an individual who has had an immediate reaction to a specific agent.

Therefore, if your dad has experienced an allergic reaction to Pulmicort, it is advisable to seek evaluation by an allergy specialist. They can provide a comprehensive assessment and advise on the best course of action.

Options

If your dad had a reaction to Pulmicort and has not used other steroids in the past, I'd recommend avoiding systemic use of all corticosteroids until he has been evaluated. There are procedures, such as a graded challenge, that can help select a different agent.

However, since your dad has (I'm assuming here) safely taken Advair in the past with no issues, it would likely be safe to go back to it, as he has shown to tolerate it well.

If your dad has not done so already, be sure he discusses the reaction he had with his doctor for future guidance.

Final Words

I hope this answer was helpful, and please reach back out anytime.