Allergen lmmunotherapy (Allergy Injections) Information for Patients


What is allergen immunotherapy?
Allergen immunotherapy is also referred to as allergy injections. It is prescribed for patients with allergic rhinitis (hay fever), allergic asthma, or life threatening reactions to insect venom. It is the only medical treatment that could potentially modify allergic disease and would be considered for patients with moderate or severe symptoms that are not controlled by environmental control measures and/or medications.

What is a typical build-up schedule?
You will receive injections in two phases: build-up phase and maintenance phase
• Build-up phase: This phase can range from 3-6 months depending on your starting dilution and the frequency in which you receive your injections. Injections will be given 1-2 times a week, and the dose will be increased to gradually reduce your sensitivity to your allergies. Your allergist will prescribe your immunotherapy order depending on your particular allergies. Therefore, you may need 1-4 injections at each visit. The continuation of injections will lead to further improvements resulting in fewer symptoms and use of fewer medications. Depending on your starting dilution, you will increase the dosage on 3-6 vials of allergen extract before beginning your maintenance dose, and you will need 6 injection visits per vial. You will see your allergist when you begin your maintenance vial.
• Maintenance phase: This phase will begin when you reach the maintenance dose. You will receive the maintenance dose every 2-4 weeks for at least 3-5 years. You should see your allergist yearly to evaluate the effectiveness of your therapy.

What will happen if I am late for my injections?
• During the build-up phase: It is important to maintain injections at the proper time interval. If a lapse in your injections should occur, an appropriate dose adjustment will be necessary. During the build-up phase, the injections may be given every 3-14 days in order to increase the dose. If you are 15-28 days late, your last dose will be repeated. After 28 days late, your dose will be appropriately adjusted. A decrease in dose will be necessary, and you will resume your build-up phase. You will see your allergist prior to beginning your maintenance vial.
• During the maintenance phase: You will have up to 42 days to continue your maintenance dose. After 42 days, your dose will be appropriately adjusted. A decrease in dose will be necessary, and you will need to build back up to your maintenance dose.

Why do I need to wait in the office for 30 minutes after my allergy injections?
Allergy injections should be administered in a facility that has a physician and trained staff capable of recognizing and managing adverse reactions. Most serious reactions develop within 30 minutes after the allergy injection. However, a delayed systemic reaction could occur. Therefore, you should carry an epinephrine auto-injector with you on the day of your injections. An epinephrine auto-injector is an injection of epinephrine that is used to treat serious life threatening reactions, but does not take the place of medical treatment. You will need to get emergency medical treatment after you inject epinephrine.

What is a local reaction?
A local reaction is not uncommon. It is a swelling, redness, and itching at the site of the allergy injection. You will need to inform the medical staff of swelling that is a quarter size or larger, so that if needed a dose adjustment can be made to your next injection. A local reaction can be managed with a cool compress, topical corticosteroids, or antihistamines.

What is a systemic or serious reaction?
A systemic reaction occurs less commonly and may include hives, wheezing, coughing, tightness of the chest, lightheadedness, faintness, nausea, and vomiting. Although rare, serious reactions may result in significant respiratory reactions or anaphylactic shock, which may be life threatening. A serious reaction usually occurs within 30 minutes after an injection. You should remain in the medical facility for 30 minutes after you receive injections and immediately report any symptom to the medical staff. You should carry an epinephrine auto-injector with you on the day of your injection in case a serious reaction should occur after leaving the medical facility.

What is a rapid-build up?
You will receive injections in two phases: build-up phase and maintenance phase

• Build-up phase: Your allergist has chosen to have your immunotherapy administered by rapid-build up. This phase is administered with the supervision of your physician as an office visit. It is administered by increasing the dilution on a daily basis. You will come into the office for approximately 3 sets of injections at 30 minutes apart in order to complete one vial. This will take approximately 2 hours. You will return weekly to continue your rapid build-up until your allergist discontinues the rapid build-up or you begin your maintenance vial. At that time, you will build-up on 1 set of injections in the injection room 1-2 times a week until you reach your maintenance dose. This could take approximately 6 injection visits to reach your maintenance dose. Depending on your starting dilution, you will increase the dosage on 3-6 vials of allergen extract before beginning your maintenance dose. The dose will be increased to gradually reduce your sensitivity to your allergies. Your allergist will prescribe your immunotherapy order depending on your particular allergies. Therefore, you may need 1-4 injections per set. The continuation of injections will lead to further improvements resulting in fewer symptoms and use of fewer medications.

• Maintenance phase: This phase will begin when you reach the maintenance dose. You will receive the maintenance dose every 2-4 weeks for at least 3-5 years. You should see your allergist yearly to evaluate the effectiveness of your therapy.