ALLERGEN IMMUNOTHERAPY

Allergen immunotherapy (allergy injections or shots) is used to decrease your allergic sensitivity to inhalant allergens such as pollens (trees, grasses & weeds), mold spores, dust mites, cats, dogs and stinging insect venoms.

Procedure

The procedure involves receiving injections of purified, sterile extracts made from the allergens to which you had a positive skin test. The injections are begun with small doses of dilute extracts which are gradually increased until the maintenance dose is reach, at which point the interval may be gradually extended to two, three and then, finally, to every four weeks. It usually takes at least six months to reach maintenance dose; however, missed doses and/or reactions to a previous dose can slow the procedure by preventing safe increases.

Reactions

Allergen immunotherapy is safe if the appropriate guidelines are followed. Reactions to allergy injections can occur and range from a small swelling at the site of the injection, called a local reaction, to a more severe systemic or generalized reactions which can include hives, swelling of the throat, cough, sneezing, itching, watery nose or eyes, shortness of breath, wheezing or faintness due to a low blood pressure (anaphylaxis). Systemic reactions are rare and generally occur within 20 minutes of receiving your injection, hence the importance of waiting in the office for that period of time. Swelling at the site of the injection and rarely a slight worsening of your symptoms may occur for a day or so following an injection. These delayed reactions should be reported because the subsequent dose of your allergy shots may have to be adjusted.

Response

Allergen immunotherapy is effective. However, the response is gradual and the degree of response varies from person to person. Improvement in symptoms does not usually occur until the maintenance dose is achieved and it may take up to two years before maximal benefit is obtained. If there is no clear benefit after two years, immunotherapy should be discontinued. If there is substantial benefit, immunotherapy should be continued for
three to five years, at which point, consideration should be given to stopping the injections for an observation period. Most people continue to do well off injections while others will only have a minimal increase in symptoms easily controlled by safe medications. Some individuals may have to resume immunotherapy.

It is important that you have periodic evaluations while on immunotherapy. Changes in the content or dosing schedule may be necessary to optimize your results.

Check in with the receptionist when you come in for your injection after swiping your ID card. Allergy injections are given on a walk-in basis in the Greenwich office only. In both the Norwalk and Stamford offices, allergy injections are given by appointment only. Please
cancel if you are unable to keep an injection appointment. If you notice that someone who came in after you is called for an injection before you, remind the receptionist that you are here.

If you have a fever, you must be fever-free for 48 hours.

If you are taking antibiotics, you may have an injection 48 hours after starting the medication.

Tell the nurse if you had a reaction to your last injection, if you are ill or if you are having allergy and/or asthma symptoms so your dosage may be adjusted. Sometimes your injection may need to be skipped altogether.

BE PREPARED TO WAIT THE FULL 20 MINUTES after you receive your injection. It is our policy that all patients wait this designated amount of time after every injection.

Have your arm checked by the nurses after you have completed your 20-30 minute waiting period.

Do not exercise after your injection for at least two hours. The optimum waiting period before you exercise is four hours.

It takes approximately 20 weekly and 6 bi-weekly injections to reach maintenance provided your injections are received weekly and no reactions occur. The dosage may need to be decreased if you are having large local reactions or delayed reactions and this will cause your build-up to be delayed. Some people require a lower dose to control their symptoms; it varies depending on your body.

If you have received other inoculations or immunizations, you must wait 48 hours before receiving an allergy injection.

If you start any new medications, especially those for blood pressure, heart disease, chronic headache or glaucoma, advise the nurses! Some medications interfere with allergy injections. A few of them include: Blocadren, Corgard, Corzide, Inderal, Inderide, Lopressor, Normodyne, Trandate, Sectral, Tenoretic, Tenormin, Timolide, Visken and Timoptic.

If you are pregnant, please notify the office.

Please ask if you have any questions.

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