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food

V01AA08

Forms & Strengths

Standard dietary food extracts and allergens for in vivo testing
Various concentrations for skin prick testing

Adult Dosing

Skin prick testing: 1 drop of allergen extract applied topically and pricked into the epidermis
Intradermal testing: 0.01 to 0.02 mL injected intradermally if prick test is negative or equivocal
Sublingual or subcutaneous immunotherapy: Dosing highly individualized based on extract standardization and patient sensitivity

Pediatric Dosing

Skin prick testing: 1 drop of allergen extract applied topically and pricked into the epidermis (typically for children >1 year of age)
Immunotherapy: Individualized titration schedule based on extract potency and clinical hypersensitivity profile

Indications

Diagnosis of IgE-mediated food allergies via skin testing
Specific immunotherapy for documented IgE-mediated food hypersensitivity (off-label or specialized standardized extracts)

Mechanism of Action

Introduction of specific food proteins to mast cells and basophils sensitized with food-specific IgE
Triggers cross-linking of surface IgE, resulting in degranulation and localized wheal-and-flare response in diagnostic testing
Repeated low-dose exposure in immunotherapy induces desensitization, regulatory T-cell induction, and eventual immune tolerance

Contraindications

History of severe systemic anaphylaxis to the specific food extract
Uncontrolled moderate-to-severe asthma
Dermatographism or generalized skin conditions that interfere with skin test interpretation
Active acute systemic illness or fever

Adverse Reactions

Local skin reactions (pruritus, erythema, swelling at test site)
Systemic allergic reactions including generalized urticaria, rhinitis, and conjunctivitis
Severe systemic anaphylaxis (bronchospasm, hypotension, laryngeal edema)
Gastrointestinal distress (nausea, cramping, vomiting during challenge or immunotherapy)

Drug Interactions

Beta-blockers (may blunt the therapeutic response to epinephrine during treatment of severe anaphylaxis)
Antihistamines (will suppress skin test reactivity; must be washed out prior to diagnostic testing)
Tricyclic antidepressants and monoamine oxidase inhibitors (may potentiate systemic side effects of sympathomimetic rescue medications)

Curated Content: Needs Vetting Before Put to Clinical Use