Reactions at Home During Oral Immunotherapy Treatment
General recommendations
This document should be printed, easily accessible and readily available for use in the event of a reaction.
If you are in doubt about symptoms you are experiencing or any eventuality, contact your doctor immediately or visit the Emergency Department. The emergency telephone number is 999.
Should symptoms change or worsen, apply the treatment corresponding to the new situation, as if it were a new reaction.
Below are treatments and recommendations to follow based on the medication prescribed by your doctor, for different types of reactions:
- Antihistamine
- Oral corticoid
- Rescue inhaler
- Adrenaline
Reaction treatment table
| Description of the Reaction | Treatment | Further Recommendations |
|---|---|---|
| Mild mouth itchiness | Drink water and keep calm | If it lasts more than 15 minutes, take 1 dose of antihistamine. If other symptoms appear, you should reconsider the treatment. |
| Itchy mouth, throat, hives around the mouth or slight swelling of the lips | Antihistamine | If symptoms persist in 1–2 hours visit the ER. If other symptoms appear, you should reconsider the treatment. |
| Itching or redness of the face, hives on the face, or swelling of the lips or eyelids | Antihistamine | If symptoms persist in 1–2 hours visit the ER. If other symptoms appear, you should reconsider the treatment. |
| Generalized itching, redness, or hives all over the body, swelling of the hands or feet | Antihistamine + Oral corticoid | After taking the recommended medication, you should go immediately to the ER. If other symptoms appear, you should reconsider the treatment. |
| Mild abdominal pain/discomfort, isolated vomiting/nausea/diarrhea | Antihistamine | If pain lasts more than 45–60 minutes, administer intramuscular adrenaline and immediately visit the Emergency Department. |
| Severe abdominal pain, nausea, vomiting, or ongoing diarrhea | Antihistamine + Oral corticoid | If abdominal pain lasts more than 45–60 min or vomiting/diarrhea persists, administer intramuscular epinephrine and immediately visit the Emergency Department. If other symptoms appear, you should reconsider the treatment. |
| Nasal congestion, watery, itchy eyes, red eyes, sneezing, or runny nose | Antihistamine | If other symptoms appear, you should reconsider the treatment. |
| Clogging/tightness in the throat, salivation/protrusion of the tongue, voice changes | EPIPEN | Visit the Emergency Department if there is no improvement in 5–15 min, and administer a second adrenaline device again. As additional treatment you should use an antihistamine and a corticosteroid. If other symptoms appear, you should reconsider the treatment. |
| Chest tightness, coughing, shortness of breath, wheezing in the chest | EPIPEN + Rescue inhaler | You should go to the ER immediately. If there is no improvement in 5–15 minutes, re-administer the second epinephrine device and the bronchodilator once again. |
| Paleness, listlessness, loss of consciousness, feeling of imminent death | EPIPEN | You should go to the ER immediately. If there is no improvement in 5–15 minutes, re-administer the second epinephrine device. |
| Two or more reactions other than itchy mouth | EPIPEN | You should go to the ER immediately. If there is no improvement in 5–15 minutes, re-administer the second epinephrine device. |
| Two or more reactions, one of which is chest tightness, coughing, shortness of breath, wheezing in the chest | EPIPEN + Rescue inhaler | You should go to the ER immediately. If there is no improvement in 5–15 minutes, re-administer the second epinephrine device. |
Instructions for dose adjustment
If you are unable to attend the scheduled hospital visit to increase the dose of your food, the current dose of the food will be maintained until your next hospital visit for a dosage increase.
You must reduce the dose of the food by half (for example: if you are taking 20 ml this week, you would go on to take 10 ml and return to the usual dose of 20 ml once the disease is over), in case you present any of the following situations:
- Gastroenteritis
- Asthma attack
- Fever (>38ºC axillary)
If you are experiencing previous symptoms of a moderate reaction; hives/swelling all over the body (not exclusively on the face), abdominal pain/nausea or vomiting, sneezing/whining or itchy nose/eyes, that was treated with antihistamine, take the dose that was previously tolerated (for example, if the reaction had it taking 32 ml, it would go down to the previous step of 24 ml).
Contact us if the reaction required EpiPen or consisted of very intense abdominal pain, throat tightness, shortness of breath/coughing/wheezing or feeling dizzy. If it is time to take the next dose of food, you will reduce the dose by half (for example, if you are taking 20 ml, you would take 10 ml) until you receive new instructions from medical personnel concerned in your treatment. If you have a reaction of paleness, weakness, loss of consciousness or a feeling of imminent death the next day, you should not take the dose and should contact your doctor immediately.
If, for any reason, you interrupt the intake of food for three or more days, you will contact your allergist to administer the dose in the hospital. If it is not possible to go to the hospital, you will reduce the dose you previously took by half.
Instructions before taking a dose
- Remember to take the food dose on a full stomach, avoiding fasting.
- You should keep your child under observation for 1–2 hours after the administration of the food.
- You must avoid physical exercise one hour before and during the first 3 hours of administering the food.
- As an analgesic you will use paracetamol (Panadol), avoiding other types of pain-killers (Nonsteroidal Anti-inflammatory – NSAIDs) such as ibuprofen (Brufen, Motrin), Diclofenac (Voltaren), etc.
- The reactions can be triggered by very intense tiredness, significant lack of sleep, vaccination, menstruation or dental loss.
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