Allergy Injections

There are several ways of managing nasal and eye allergy symptoms and asthma including: allergen avoidance, use of allergy and asthma medications, and allergy injections. Depending on the severity of symptoms, allergen avoidance measures and medications by themselves may not be entirely effective. It is possible to identify and treat the underlying condition instead of simply treating the symptoms.

Allergy injections (also known as immunotherapy or desensitization) currently are the only FDA approved and most effective form of treating the underlying mechanisms that cause allergic disorders. Patients all over the world have benefited from them since 1911.

The allergy vaccine recipe is based on the allergy skin test results and clinical relevance. The is a customized process. The allergens are bought from the manufacturing companies. A minute amount of the vaccine is injected under the skin in the upper arm and the dose is increased carefully at weekly intervals following established protocols. You may receive several injections during each visit and it may take 6-12 months to reach an optimal or maintenance dose. You may not notice significant improvement in the symptoms until reaching maintenance. Once the maintenance dose is reached, the time interval between injections is slowly increased from weekly to biweekly and later on every 3-4 weeks. The injections are continued for a total of 3-5 years for maximum benefit and may be discontinued after discussing with your physician. Overall, about 80%-90% of patients notice clinical improvement from the injections.

Those individuals who are afraid of needles should not worry, as the injections are significantly less painful, if at all, than deep intramuscular injections used for routine immunizations. The shots are given with a very fine tipped needle subcutaneously in the arms just below the surface of the skin to minimize discomfort. Children and adults do very well after experiencing the first few injections.

Allergy injections may help you in the following ways:

Significantly reduce allergy and asthma symptoms
Reduce the need for routine or prn medications
Prevent complications from severe allergy and asthma
Increase overall quality of health and life

The following complications can result from allergy injections:

Local reactions: It is normal to have small, red, itchy bumps at the site of injections and nothing needs to be done further. The reactions reduce with time. The reactions should be less than the sized of a quarter.

Large local reactions: Large bumps, which are red, itchy or painful, and greater than or equal to the size of a quarter may develop up to 24-48 hours after the injections. You may apply topical hydrocortisone ointment and ice pack locally as well as take antihistamines by mouth to get relief. Sometimes these reactions may precede the onset of more serious systemic reactions in future. If you develop large local reactions, please inform your nurse or doctor for dose adjustments.

Systemic reactions: These are very rare (1% incidence) but could be serious. Most of the reactions appear within 30 minutes after the injections. That is why you should always wait in the doctor's office for at least 30 minutes after the injections, and always take the injections at a physician's office with trained people and appropriate equipment. Sometimes the reactions could appear after leaving the office. If this happens, you should inform the doctor right away, carry and use your EpiPen that should be brought with you to each injection. This will be prescribed to you at the start of allergy injections along with oral steroids. Call 911 and go to the emergency room by ambulance. You should not exercise for 4 hours after the injections. People with asthma should not take the injections if they are symptomatic from asthma or if their peak flow meter readings are below 80% of their personal best.

Patients Taking Any Of These Medications Cannot Receive Shots

Beta Blockers

acetobulol
atenolol
Betapace/ Betapace AF (sotalol/sotalol AF)
betaxolol
bisoprolol
Brevibloc (esmolol)
Bystolic (nevibolol)
carvedilol
Coreg (carvedilol)
Coreg CR
Corgard
esmolol
Inderal/ Inderal LA (propranolol)
InnoPran XL (propranolol)
Kerlone (betaxolol)

labetalol
Levatol (penbutolol)
Lopressor (metoprolol)
metoprolol
nadolol
pindolol
propranolol
Sectral (acebutolol)
sotalol/ sotalol AF
Tenormin (atenolol)
timolol
Toprol-XL (metoprolol)
Trandate (labetalol)
Zebeta (bisoprolol)

There may be others, so please call our office (650) 556-9577 for questions.

Most of the insurances cover the allergy injections. Some insurance policies require you to make copayments with each injection. Your insurance will be billed for the vaccine preparation and administration of the injections. Check with your insurance company for details. Call our office for an appointment if you are interested in this option ((650) 556-9577).