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VARIOUS › ALLERGENS › ALLERGENS › Allergen extracts
flowers
V01AA10
Forms & Strengths
- Standardized allergen extract for subcutaneous immunotherapy (SCIT)
- Aqueous diagnostic prick test extract (various concentrations/weight-to-volume ratios)
- Multi-allergen mix formulations
Adult Dosing
- Immunotherapy initiation: Usually 0.05 mL of the lowest dilution (e.g., 1:100 or 1:1,000 w/v or 10-100 bioequivalent allergy units/mL)
- Dose escalation: Weekly or bi-weekly incremental increases of 0.05-0.1 mL until maintenance dose is achieved
- Maintenance dose: Typically 0.5 mL of the highest tolerated concentration (e.g., 1:10 w/v or 1:100 w/v), administered every 2 to 4 weeks
- Diagnostic prick test: 1 drop applied topically and pricked with a lancet
Pediatric Dosing
- Safety and efficacy not well established in children under 5 years of age
- Children aged 5 years and older follow a similar titration schedule to adults, often requiring more conservative dose escalation based on tolerability
Indications
- Treatment of IgE-mediated allergic rhinitis, rhinoconjunctivitis, and mild allergic asthma triggered by flower and plant pollen allergens
- Diagnostic skin prick testing for type I immediate hypersensitivity to specific flower/plant allergens
Mechanism of Action
- Induces peripheral T-cell tolerance and regulatory T-cell (Treg) induction
- Stimulates production of blocking antibodies, primarily IgG4, which compete with allergen-specific IgE
- Downregulates mast cell and basophil activation upon subsequent allergen exposure
Contraindications
- Severe, unstable, or uncontrolled asthma
- History of systemic allergic reaction or anaphylaxis to previous allergen immunotherapy
- Concomitant treatment with beta-blockers (may blunt response to epinephrine during anaphylaxis)
- Active systemic inflammatory disease, autoimmune disease, or malignancy
Adverse Reactions
- Local injection site reactions (erythema, swelling, pruritus)
- Systemic allergic reactions (urticaria, angioedema, rhinitis, bronchospasm)
- Anaphylaxis (rare, but potentially life-threatening)
Drug Interactions
- Beta-adrenergic blocking agents (may increase risk of severe anaphylaxis and antagonize epinephrine treatment)
- ACE inhibitors (may potentiate anaphylactoid reactions)
- Tricyclic antidepressants and monoamine oxidase inhibitors (may potentiate systemic side effects of sympathomimetic rescue agents like epinephrine)
- Antihistamines and corticosteroids (may suppress skin test reactivity or mask early systemic symptoms of immunotherapy)
Curated Content: Needs Vetting Before Put to Clinical Use