This guideline outlines the use of Pharmalgen, which is a subcut injection already in use in the UK. It is given in an initial course, then with maintenance injections every month for 3 years. It then provides up to 15 years cover.
Although it is given by Allergy Specialists, we need to know the criteria for use. There are some contraindications to use (see the guideline or SPC). We should refer patients who have had:
A severe systemic reaction. This may include respiratory difficulty such as asthma or laryngeal oedema, hypotension, collapse or loss of consciousness, as well as double incontinence, seizures, or loss of colour vision. It also includes anaphylaxis.
A moderate systemic reaction (may include mild asthma, moderate angio-oedema, abdominal pain, vomiting, diarrhoea and minor or transient hypotensive symptoms such as light-headedness and dizziness) AND one of the following:
- Raised baseline serum tryptase
- High risk of future stings
- Anxiety about future stings