From the Guidelines
No, you should not take Lortab if you have a morphine allergy, as it contains hydrocodone, an opioid medication related to morphine, and there is a risk of cross-reactivity between different opioids. Lortab is a combination of hydrocodone and acetaminophen, and hydrocodone is an opioid that can cause allergic reactions in individuals with a morphine allergy 1. According to a study published in Critical Care in 2013 1, hydromorphone may be safely administered to patients who report a type 2 allergy to morphine, but this does not apply to hydrocodone. Allergic reactions to opioids can range from mild skin rashes to severe, life-threatening anaphylaxis.
Before taking any opioid medication, you should inform your healthcare provider about your morphine allergy. They can evaluate your specific situation and may recommend alternative pain management options such as non-opioid analgesics (like acetaminophen or NSAIDs), or if an opioid is necessary, they might consider medications from a different class or perform allergy testing to determine which medications are safe for you. Some key points to consider when managing pain in patients with a morphine allergy include:
- Informing your healthcare provider about your morphine allergy before taking any medication
- Considering alternative pain management options, such as non-opioid analgesics
- Evaluating the risk of cross-reactivity between different opioids
- Possibly performing allergy testing to determine which medications are safe for you. Always consult with your healthcare provider before taking any medication if you have known drug allergies 1.
From the Research
Opioid Allergy and Cross-Reactivity
- The risk of IgE-mediated reactions (IMRs) caused by opioids is low in patients with historical IMRs to opioids 2.
- Opioid allergy documentations may propagate alert fatigue and unwarranted prescribing changes 2.
- A retrospective study found no cross-reactivity among any of the opioid drug classes, resulting in 100% re-exposure tolerance rates with all study arms 3.
- The removal of erroneous opioid allergy labels has a unique importance in the population with acute or chronic pain 4.
Lortab and Morphine Allergy
- Lortab is a combination of acetaminophen and hydrocodone, which is a semi-synthetic opioid derived from morphine.
- If a patient has an allergy to morphine, it is possible that they may also react to hydrocodone, as they are both opioids.
- However, the cross-reactivity between morphine and hydrocodone is not well established, and more research is needed to determine the safety of administering Lortab to patients with a morphine allergy 5.
Diagnosis and Management of Opioid Allergy
- Opioid skin testing and IgE assays are of limited application in diagnosing opioid allergy 4.
- Drug provocation testing (DPT) is the gold standard for diagnosis, but it is often underutilized 4.
- Basophil activation testing (BAT) may be a useful tool in evaluating patients with suspected opioid allergy, but more research is needed to determine its efficacy 4.