Disease class
- Not indicated. See instructions
- Not indicated. See instructions
- Not indicated. See instructions
- Other immunomodulators
Solution for subcutaneous administration Allergoid pollen wormwood for treatment (Allergoidum ex polline Absinthii pro curatione)
Instructions for medical use drug
Indications for use
The drug is intended for the diagnosis and treatment of allergies to wormwood pollen.
Release form
solution for subcutaneous administration 10000 PNU/ml; bottle (bottle) 5 ml with solvent and empty bottle, cardboard pack 1.
Storage conditions
In a dry place, protected from light, at a temperature of 4–8 °C.
Best before date
ATX classification:
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Select the section Allergic diseases Symptoms and manifestations of allergies Diagnosis of allergies Treatment of allergies Pregnant and lactating Children and allergies Hypoallergenic life Allergy calendar
Wormwood is a representative of herbaceous (less often shrubby) plants, distributed very high throughout Russia. There is no region where this herb does not grow, but most of it is in middle lane and further south, in the steppe area. It is also found abroad - throughout the northern hemisphere, in America, Europe and even in some areas of Africa.
There are almost 200 species of this plant, among which the most famous is wormwood, which is used incl. in medicine, as well as silver wormwood. The scope of application of the herb is extremely wide:
- medicine (is the main substance or component of drugs for the treatment of diseases of the gastrointestinal tract);
- perfumes and cosmetics (including essential oils);
- food industry (beverage production - absinthe, vermouth, tarragon, aromatic tea and etc);
- cigar production;
- landscape design, sand reinforcement, feeding needs, etc.
All options for use are dangerous for allergy sufferers, since hay fever, food, contact, and respiratory allergies can develop.
If we talk about allergies to wormwood pollen, i.e. about hay fever, the timing of when wormwood blooms is important. Of course, each region of our large country has its own period:
- in the Volga region flowering begins in June,
- by July the south, Siberia and north-west “join”.
During processing, wormwood allergens can also end up in “derivatives” - drinks, oils, cosmetics, etc. - which causes food allergies, contact allergies, etc.
What can be the most dangerous thing in terms of allergies? Anything that contains an allergenic component:
- alcoholic and non-alcoholic drinks,
- medications,
- perfumes.
Among the “exotic” species are allergies to wormwood cigars, as well as to wormwood ether in the bath
Both of these options are dangerous, since in the first case the allergen is deliberately released in large quantities inhaled into the lungs, which with a high degree of probability can cause anaphylactic shock.
In the second situation blood vessels already expanded, the skin is steamed, so several times more allergen enters the bloodstream than with normal conditions, which is also, of course, very dangerous.
It is possible to develop an allergy to “derivatives” of wormwood without previous hay fever (although this rarely happens). You can suspect the possibility of hypersensitivity in the presence of other allergic diseases, especially, as well as food allergies.
Photo: some varieties of wormwood
Wormwood (Artemisia absinthium)
This is how wormwood blooms
Common wormwood (Artemisia vulgaris)
Blooming wormwood
Allergens
Illustration: Wormwood Characterized a large number of allergens. Here are some of them:
- Art v 1 - defensin, main allergen,
- Art v 2 - 34-48 kDa protein,
- Art v 3 - lipid transfer protein,
- Art v 4 - profilin,
- Art v 5 - calcium binding protein,
- Art v 6 - pectate lyase.
In addition to them, wormwood also contains other allergens that require further research.
Cross reactivity
This phenomenon includes the presence of an inadequate reaction to plants of other species in the absence of sensitization directly to their proteins, but only with an allergy to wormwood. This is due to the presence of similar areas - epitopes - in the protein composition of various representatives of nature.
First of all, one can expect extensive cross-reactivity between individual members of the Artemisia genus of the Asteraceae family.
Thus, cross-allergy to wormwood can be diagnosed if there is an excessive reaction to:
Illustration: Wormwood Cross-allergy to quinoa and wormwood is one example of cross-reactivity within an isolated species." weeds" This also includes hypersensitivity to ragweed, plantain, goosefoot, goldenrod, nettle, etc.
Symptoms of an allergy to wormwood
The symptoms of allergy do not have significant features that distinguish it from hypersensitivity reactions that occur in response to other allergens. With hay fever the following appear:
- Allergic conjunctivitis: hard work lacrimal glands, redness, itching, swelling of the mucous membranes, slight transient decrease in vision clarity;
- Allergic rhinitis: runny nose, accompanied by profuse mucus, itching in the nose, sneezing, difficulty in nasal breathing;
- Allergic pharyngitis and bronchitis: cough, swelling of the mucous membranes, difficulty swallowing (feeling foreign body), difficulty breathing.
Bronchitis without treatment quickly turns into bronchial asthma which is accompanied by:
Scheme: Normal bronchi, bronchi with asthma and bronchospasm - bronchospasm;
- wheezing;
- heaviness in the chest;
- dyspnea.
When wormwood is consumed internally, the following develop:
- nausea or vomiting;
- burning in the esophagus, abdominal pain;
- flatulence, increased gas formation;
- problems with stool.
In addition, for cross allergies characteristic of hay fever oral allergy syndrome:
- indigestion;
- swelling of the mucous membranes of the mouth and pharynx;
- burning, itching in the mouth.
Photo: Itchy skin is one of the manifestations of an allergic reaction If an allergen comes into contact with the skin, and also as an “additional” manifestation of hay fever or food allergies develop:
- skin rash;
- redness;
- itching sensation;
- peeling;
- hives;
- swelling of subcutaneous fat.
Unfortunately, there are known cases of development of especially severe conditions, life-threatening:
- anaphylactic shock;
- Quincke's edema.
Can people with an allergy to wormwood be drafted into the army?
The army is a topic in which nothing can be said with certainty. The likelihood of a call for allergies depends on the severity of exacerbations, their frequency, the ability to quickly stop them, and the need for antihistamines. In any case, the fact of allergy must be documented.
Allergy to wormwood in children and pregnant women
During pregnancy allergies often appear that have not previously occurred - this is due to weakening of the immune system in order to protect the fetus. Hypersensitivity is accompanied by all the “standard” symptoms for it, but they are more intense and bring more inconvenience. Often join:
- general weakness,
- headache,
- sometimes the temperature even rises.
Most dangerous for a pregnant woman with allergies food allergy, especially against the background of existing gestosis. It can lead to intoxication and dehydration of the body.
In a mother with breastfeeding allergic reactions in the absence of such, they appear less frequently and have absolutely no features.
But in infants, to whom the allergen comes from breast milk, they appear in the form:
Photo: Allergic fireworks, which is typical for children with rhinitis - stool disorders,
- skin rash,
- tearfulness,
- temperature rise.
In general, an allergy to wormwood in children is also characterized by:
- severity of the current;
- frequency of generalization of manifestations;
- high likelihood of skin symptoms;
- availability systemic problems(headache, fever, weakness, etc.).
In addition, in a child, respiratory symptoms of allergies easily “flow” into bronchial asthma.
Treatment of allergies to wormwood
Allergy treatment should be complete and comprehensive and include not only the use of medications, but also lifestyle adjustments.
Drug treatment
First of all, of course, they “save” from allergies medications with antihistamine effect
. These can be tablets, drops, sprays, ointments - depending on the location of the symptoms.
The list of active ingredients is huge, here are just a few of them:
- desloratadine (Erius);
- chloropyramine (Suprastin);
- fexofenadine (Telfast);
- cetirizine (Zyrtec).
Of course, ideally, the drug should be prescribed by a doctor, but any drug will be suitable as first aid for a sharply worsened allergy.
Hormonal drugs are prescribed only for local action.
For skin allergies
- hormonal ointments(Advantan, Akriderm, Dermovate),
- moisturizing creams and ointments (Bepanten, Panthenol).
For rhinitis
- hormonal sprays in the nose (Nasonex, Nazarel, Avamis),
- vasoconstrictor drops in the nose (but no more than 5 days in a row!),
- rinsing the nose saline solutions (saline NaCl 0.9% or ready-made preparations, for example, AquaLor, AquaMaris).
Food allergies
It is permissible to use enterosorbents:
- Polysorb,
- Smecta,
- Activated carbon.
Treatment bronchial asthma strictly requires specialist intervention, is carried out mainly with inhaled steroids through the system step therapy depending on the severity of the disease.
The therapy described above is symptomatic and cannot affect pathological process. For this there is immunotherapy - ASIT. These are “wormwood allergy injections” - means for subcutaneous administration, as well as oral allergens.
Preparation “Wormwood allergen” – group weeds, and there are whole sets of allergens that make it possible to treat this pathology. Options for “anti-allergy vaccine (selected by an allergist after a full diagnosis):
- Sevapharma. Allergens of wormwood, as well as various mixtures of herbs;
- NPO Microgen. Allergoid pollen wormwood;
- Diater. Wormwood, mixtures of herbs;
- Antipollin. Wormwood, weeds.
When to start treating wormwood allergies using the ASIT method?
Recommended timing: 2-3 months before the expected dusting season. Accordingly, in each region of the country this time is different; it is necessary to consult an allergist. The price of the drug Allergen wormwood is rather high, regardless of which company produces the medicine (from 12,000 per course and above). However, the effectiveness of this method has been proven clinical trials and experience of use.
The need for antihistamines in people who have completed a course of ASIT decreases and sometimes disappears altogether; exacerbations do not bother them, or occur in a mild, almost imperceptible form.
Treatment with traditional and non-traditional methods
Photo: Wormwood pollen under a microscope Allergy treatment traditional methods and means alternative medicine possible, but not advisable.
Medicinal herbs
Although many drugs traditional medicine(this applies to a greater extent medicinal herbs) are effective and efficient, they are not safe neither for people without allergies, nor especially for those with allergies!
Any plant can cause both cross and “direct” allergies, up to the development of life-threatening conditions.
Alternative medicine offers its own methods that supposedly will help cope with such a phenomenon as an allergy to wormwood.
Homeopathy
Treatment with wormwood grains, i.e., in fact, homeopathy is not just unfounded and unproven, but life-threatening! It is permissible to resort to this only by willing adults in specialized centers(which must contain at least adrenaline to relieve the symptoms of anaphylactic shock).
The use of such methods for children is unacceptable!
Salt caves
Treatment salt caves() for hay fever - an excellent method! It helps relieve inflammation respiratory tract, thereby eliminating the symptoms of rhinitis and sometimes even bronchitis. The use of acupuncture and balneotherapy is not prohibited, but only on the recommendation of a specialist.
Remedies such as a spell for wormwood allergies, prayers, etc. cannot be taken seriously in an article based on fundamental medical knowledge. Their only possible effect from this point of view – psychosomatics, self-persuasion.
Preventive actions
As mentioned above, treatment of allergies is by no means limited to the use of medications. First of all, it is necessary to ensure the elimination of the allergen. In addition, it is important to lead a hypoallergenic lifestyle. Eating if you are allergic to wormwood should also be conscious and correct. How to avoid worsening an allergic reaction? The following recommendations must be followed:
- do not go outside in windless, dry weather or on hot days;
- try to walk after rain, during wind, early in the morning;
- ventilate the room only when it rains;
- install good system ventilation and air conditioning, use HEPA or ULPA filters;
- frequently carry out wet cleaning, use vacuum cleaners with filters;
- do not use cosmetics, perfumes, essential oils with wormwood content;
- stop smoking;
- If you are allergic to wormwood, you must follow a diet.
If you have an allergic reaction to wormwood, can you drink propolis?
About half of propolis consists of various aromatic acids and their esters, flavonoids, and is present in it pollen. Therefore, it is likely that, just as hypersensitivity to wormwood gives cross reaction with honey, she will do the same with propolis. However, this is not an axiom, and after consulting a doctor, you can try to introduce a minimum dose of propolis into your diet. It is not recommended, since red pepper is one of the cross-allergens for wormwood. And due to the fact that this is a rather aggressive agent, it can cause “ Double punch"on the skin.
Diet for allergies
A diet for hay fever based on wormwood has largest list restrictions. All products containing the plant should be excluded, including:
- absinthe;
- vermouth;
- tea with wormwood;
- tarragon.
In addition, you should be especially careful when consuming foods on the list of cross-allergens (described above).
- mayonnaise;
- mustard;
- zucchini;
- eggplant;
- beets;
- carrot;
- lettuce;
- Jerusalem artichoke;
- chicory;
- watermelons;
- oranges;
- grapefruits;
- lemons;
- tangerines;
- peas;
- nuts;
- absinthe;
- vermouth;
- anise;
- coriander;
- caraway;
- curry.
As with birch, not all of these products are absolutely contraindicated. The possibility of their use depends on individual characteristics immune system allergy sufferer, severity of allergy, treatment used.
It is worth noting that the likelihood of developing oral allergic syndrome is high, but not one hundred percent, so it is possible to introduce one “representative” of cross-allergens into the diet.
If a reaction does not develop to the minimum dose of the allergen, you can increase it, but not much (for example, one orange per week).
Approximately 25% of patients with wormwood allergy report subsequent food hypersensitivity (in descending order):
- honey and royal jelly,
- sunflower seeds,
- daisies,
- pistachios,
- hazelnut,
- salad,
- beer,
- almond,
- peanut,
- other nuts,
- carrot,
- apple.
The menu for a child with allergies requires special attention and should be discussed with a nutritionist and allergist. It is important that while trying to eliminate all allergens, you do not create a calorie, nutrient, or useful substances in the child's diet. Therefore, each excluded product must be replaced.
Among other things, it is advisable, at least during the period of exacerbation, to follow a general gentle diet with the exception of “aggressive” foods - alcohol, fast food, highly allergenic foods, spicy, fried, fatty foods.
Where to go for wormwood allergies
It's pretty complex issue, since it is difficult to find a region in Russia where this plant is not present. You should choose a non-steppe area with a warm climate.
- It can be sea coasts(including abroad), mainland and island Southern Europe.
- Another variant - more northern regions of the country. By the time the grass has already faded in the younger areas, in the northern territories it will only begin to gather dust, so you can try to guess.
Where in Russia is there no wormwood?
Unfortunately, this plant is found everywhere, except, perhaps, in the far north. Pollen is less abundant in northern latitudes.
If this was not done for one reason or another, then it is best to leave the period of exacerbation until the second trimester, when it is already possible to use some antihistamines, and the allergy will not cause significant harm to either the woman or her child.
Thus, wormwood allergy is a fairly broad topic with its own pitfalls. How to live with allergies? If you follow everything carefully preventive recommendations and expert advice, then allergies do not bring unbearable inconvenience. However best option– is to cure it with immunotherapy.
1.
P N001539/01
Registration date: 05.03.2009
Wormwood pollen allergoid for treatment
Grass pollen allergoids
Release forms:
MIBP - allergen
2. Wormwood pollen allergoid for treatment
Registration certificate number: P N001539/01
Registration date: 05.03.2009
Legal entity in whose name it is issued registration certificate: Federal State unitary enterprise"Research and production association for medical immunobiological preparations "Microgen" of the Ministry of Health and social development Russian Federation/ Russia
Trade name medicinal product: Wormwood pollen allergoid for treatment
International nonproprietary or chemical name: ~
Release forms: solution for subcutaneous administration 10000 PNU/ml, bottles - 1
Information about production stages: Manufacturer (All stages, including release quality control), Federal State Unitary Enterprise "Research and Production Association for Medical Immunobiological Preparations "Microgen" of the Ministry of Health and Social Affairs
Pharmacotherapeutic group: MIBP - allergen
3. Wormwood pollen allergoid for treatment
Registration certificate number: P N001539/01
Registration date: 05.03.2009
Legal entity in whose name the registration certificate was issued: Microgen NPO Federal State Unitary Enterprise / Russia
Trade name of the medicinal product: Wormwood pollen allergoid for treatment
International nonproprietary or chemical name: Grass pollen allergoids
Release forms:
Information about production stages: Manufacturer (All stages of production), Microgen NPO FSUE [Allergen, Stavropol], 115088 Moscow, 1st Dubrovskaya st., 15, Russia
Pharmacotherapeutic group: MIBP - allergen
4. Wormwood pollen allergoid for treatment
Registration certificate number: P N001539/01
Registration date: 05.03.2009
Legal entity in whose name the registration certificate was issued:
Trade name of the medicinal product: Wormwood pollen allergoid for treatment
International nonproprietary or chemical name: Grass pollen allergoids
Release forms: solution for subcutaneous administration 10 thousand PNU/ml, bottles - 1
Information about production stages:
Normative documents: Change No. 2 to P N001539/01-300413, 2014, Wormwood pollen allergoid for treatment;
Pharmacotherapeutic group: MIBP - allergen
5. Wormwood pollen allergoid for treatment
Registration certificate number: P N001539/01
Registration date: 05.03.2009
Legal entity in whose name the registration certificate was issued: Federal State Unitary Enterprise "Research and Production Association for Medical Immunobiological Preparations "Microgen" of the Ministry of Health of the Russian Federation (FSUE "NPO "Microgen" of the Ministry of Health of Russia) / Russia
Trade name of the medicinal product: Wormwood pollen allergoid for treatment
International nonproprietary or chemical name: Grass pollen allergoids
Release forms: solution for subcutaneous administration 10 thousand PNU/ml, bottles - 1
Information about production stages: Manufacturer (All stages, including release quality control), Federal State Unitary Enterprise "Research and Production Association for Medical Immunobiological Preparations "Microgen" of the Ministry of Health of the Russian Federation
Normative documents: P N001539/01-300413, 2013, Wormwood pollen allergoid for treatment;
Pharmacotherapeutic group: MIBP - allergen
6. Wormwood pollen allergoid for treatment
Registration certificate number: P N001539/01
Registration date: 05.03.2009
Legal entity in whose name the registration certificate was issued: Federal State Unitary Enterprise "Research and Production Association for Medical Immunobiological Preparations "Microgen" of the Ministry of Health of the Russian Federation (FSUE "NPO "Microgen" of the Ministry of Health of Russia) / Russia
Trade name of the medicinal product: Wormwood pollen allergoid for treatment
International nonproprietary or chemical name: Grass pollen allergoids
Release forms: solution for subcutaneous administration 10 thousand PNU/ml, bottles - 1
Information about production stages: Manufacturer (All stages, including release quality control), Federal State Unitary Enterprise "Research and Production Association for Medical Immunobiological Preparations "Microgen" of the Ministry of Health of the Russian Federation
Normative documents: Change No. 1 to P N001539/01-300413, 2013, Wormwood pollen allergoid for treatment;
Pharmacotherapeutic group: MIBP - allergen
7. Wormwood pollen allergoid for treatment
Registration certificate number: P N001539/01
Registration date: 05.03.2009
Legal entity in whose name the registration certificate was issued: Federal State Unitary Enterprise "Research and Production Association for Medical Immunobiological Preparations "Microgen" of the Ministry of Health of the Russian Federation (FSUE "NPO "Microgen" of the Ministry of Health of Russia) / Russia
Trade name of the medicinal product: Wormwood pollen allergoid for treatment
International nonproprietary or chemical name: Grass pollen allergoids
Release forms: solution for subcutaneous administration 10000 PNU/ml, bottles - 1
Information about production stages: Manufacturer (All stages, including release quality control), Federal State Unitary Enterprise "Research and Production Association for Medical Immunobiological Preparations "Microgen" of the Ministry of Health of the Russian Federation
Normative documents: P N001539/01-030518, 2018, Wormwood pollen allergoid for treatment;
Pharmacotherapeutic group: MIBP - allergen
8. Wormwood pollen allergoid for treatment
Registration certificate number: P N001539/01
Registration date: 05.03.2009
Legal entity in whose name the registration certificate was issued: Joint-Stock Company"Research and Production Association for Medical Immunobiological Preparations "Microgen" (JSC "NPO "Microgen") / Russia
Trade name of the medicinal product: Wormwood pollen allergoid for treatment
International nonproprietary or chemical name: Grass pollen allergoids
Release forms: solution for subcutaneous administration 10000 PNU/ml, bottles - 1
Information about production stages: Manufacturer (All stages, including release quality control), Joint Stock Company "Research and Production Association for Medical Immunobiological Preparations "Microgen" (JSC "NPO "Microgen"), 355019, Stavropol Territory, Stavropol, st.
Normative documents: Change No. 1 to R N001539/01-030518, 2018, Wormwood pollen allergoid for treatment;
Release form: Liquid dosage forms. Solution for skin scarification application
General characteristics. Compound:
Active substance: 10,000 PNU of wormwood pollen allergen in 1 ml of solution for diagnosis and treatment.
Excipients: sodium phosphate, disubstituted, 12-hydrate, potassium phosphate, monosubstituted, sodium chloride, phenol (preservative), water for injection.
Pharmacological properties:
Pharmacodynamics. Main active principle pollen allergens is a protein-polysaccharide complex, which makes it possible to diagnose hypersensitivity to a patient by skin testing this species plant pollen and use it for immunotherapy of hay fever.
Indications for use:
— specific diagnostics and treatment of hay fever, atopic, caused by hypersensitivity to wormwood pollen.
Indications for diagnosis are clinical manifestations diseases and medical history data, and for immunotherapy, skin testing data with a specific allergen.
Important! Get to know the treatment
Directions for use and dosage:
Skin testing and allergen treatment should be carried out through:
— 1 week after the tuberculin test;
— 2 weeks after use inactivated vaccines and therapy antihistamines;
— 4 weeks after the use of live vaccines;
- 8-12 weeks after using the BCG vaccine.
In order to identify contraindications, the doctor on the day of diagnosis allergy tests and on the day of specific immunotherapy, examines the patient.
I. Specific diagnostics.
The drug is used for skin tests (scarification, prick test and intradermal injection).Skin tests are performed once. If the results are questionable, they can be repeated 2 days after the local reaction to the previous tests has subsided. When positive results, it is allowed to repeat skin tests with pollen allergens no more than once a month.
Simultaneously with the allergen, skin tests are performed with a test control liquid and with a 0.01% histamine solution, which is prepared by diluting a 0.1% solution of histamine dihydrochloride (1 part) with a 0.9% solution of isotonic sodium chloride for injection (9 parts). The diluted histamine solution is good for 6 hours from the moment of preparation.
Skin tests are performed on inner surface forearm or on the skin of the back. It is allowed to carry out up to 15 tests with pollen allergens of various types at one time.
The metal cap of the bottles (with allergens or test control liquid) is wiped with alcohol. The central cover of the cap is removed with sterile tweezers, and the rubber stopper, pre-treated with alcohol, is pierced with a sterile needle.
The skin of the inner surface of the forearm is wiped with 70° alcohol and allowed to dry. Drops of the test allergens, a drop of test control liquid and a drop of 0.01% histamine solution are applied to the disinfected skin using sterile syringes separate for each allergen at a distance of (30±10) mm from each other. The allergen drawn into the syringe should not be poured back into the bottle.
Through drops of the drug with sterile scarification or injection needles, individual for each allergen and for each patient, two parallel scratches 5 mm long are applied (scarification) or the skin is injected to a depth of no more than 1-1.5 mm (prick test).
If an allergen test gives negative reaction, and the anamnesis contains data on increased sensitivity to this allergen or, if it is necessary to carry out allergometric titration to determine the initial dose for specific immunotherapy, intracutaneous tests are performed.
Intradermal tests are performed on the inner surface of the forearm. The skin is stretched with a downward movement of the finger, the needle is inserted at an angle of 15° to the surface of the skin, and it is necessary to ensure that the needle hole is completely hidden in the epidermis; the needle should be thin with a short point.
Using sterile, individually marked syringes for each allergen and for each patient with a scale of 0.02 ml, 0.02 ml of the allergen and test control liquid are injected strictly intradermally, a sample with 0.01% histamine is performed using the scarification method.
Diagnosis using a prick test (prick test) is carried out in accordance with methodological recommendations USSR Ministry of Health 10-11/20 dated March 10, 1985.
Evaluation of diagnostic skin tests. The result of diagnostic tests is taken into account after 15-20 minutes (reaction immediate type) in the absence of a reaction to the test control liquid and in the presence of a positive test for histamine.
Scheme for recording skin reactions (scarification, prick test).
| Reaction assessment | Legend | Size and nature of the reaction |
| Negative | - |
No blister or hyperemia; |
| Positive | + | Blister 2-3 mm, hyperemia; |
| Positive | ++ | Blister 4-5 mm, hyperemia; |
| Positive | +++ | Blister 6-10 ml, hyperemia or blister 6-10 mm with pseudopodia, hyperemia; |
| Positive | ++++ | Blister more than 10 mm, hyperemia or blister more than 10 mm with pseudopodia, hyperemia. |
Scheme for recording skin reactions (intradermal).
| Reaction assessment | Legend | Size and nature of the reaction |
| Negative | - | The dimensions are the same as in the control. |
| Positive | + | A blister with a diameter of 4-7 mm, surrounded by erythema. |
| Positive | ++ | The blister is 8-14 mm in diameter, surrounded by hyperemia. |
| Positive | +++ | A blister 15-20 mm in diameter with pseudopodia, surrounded by hyperemia. |
| Positive | ++++ | A wheal greater than 20 mm in diameter with pseudopodia and/or lymphangitis and/or additional peripheral wheals and bright erythema. |
II.Specific immunotherapy. Specific immunotherapy is carried out in cases where it is impossible to exclude contact of a sensitized patient with an allergen. Indications for specific immunotherapy are determined by an allergist based on medical history, clinical manifestations of the disease, results of skin testing, taking into account contraindications.
During specific immunotherapy, the allergen is administered subcutaneously. Other routes of allergen administration for medicinal purposes can only be used on the basis Guidelines, approved by the Ministry of Health of the Russian Federation.
An allergist is responsible for the preparation and use of allergen dilutions under aseptic conditions.Approximate diagram specific immunotherapy for hay fever.
| Allergen dilution | Dose (ml) | Notes |
| 1 | 2 | 3 |
| 10 -5 1:100000 1.0 PNU/ml |
0.1
|
Specific immunotherapy is not started After each injection of the patient's allergen A contraindication for increasing the dose is Detailed description of the specific technique |
| 10 -4 1:100000 1.0 PNU/ml |
0.1
|
|
| 10 -3 1:100000 1.0 PNU/ml |
0.1
|
|
| 10 -2 1:100000 1.0 PNU/ml |
0.1
|
|
| 10 -1 1:100000 1.0 PNU/ml |
0.1
0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 |
Features of application:
Use during pregnancy and breastfeeding.
Immunotherapy is contraindicated during pregnancy and lactation.Use in children.
When carrying out specific diagnostics and immunotherapy, children should be guided by the order of the Ministry of Health of the Russian Federation dated November 4, 2002. “On improving allergy care for children in the Russian Federation.”Special instructions.
Help with reactions general type and anaphylactic shock. In cases where, during the administration of an allergen with diagnostic or therapeutic purpose the patient experiences general weakness or agitation, anxiety, a feeling of heat throughout the body, redness of the face, rash, difficulty breathing, abdominal pain, the following measures must be taken:First aid: Immediately stop introducing the allergen; lay the patient down (head below feet), turn head to the side, move lower jaw, remove removable dentures.
1. If the allergen was injected into a limb, apply a tourniquet above the injection site for 25 minutes.
2. Inject injection site with 0.3-0.5 ml of 0.1% adrenaline solution with 4.5 ml of 0.9% solution sodium chloride.
3. Apply ice or a heating pad to the injection site. cold water for 10-15 min.
4. Inject subcutaneously or intramuscularly into the limb free from the tourniquet 0.3-0.5 ml of a 0.1% adrenaline solution (0.15-0.3 ml for children).
5. Call a doctor immediately.
First medical aid. If steps 1-5 are completed and there is no effect, you should:
1. Inject subcutaneously or intramuscularly 0.3-0.5 ml (for children 0.15-0.3 ml) of a 0.1% adrenaline solution at intervals of 5-10 minutes. The frequency and dose of adrenaline administered depends on the severity of the reaction and indicators blood pressure. In case of severe anaphylactic shock, a solution of adrenaline must be administered intravenously in 20 ml of 0.9% sodium chloride solution. The total dose of adrenaline should not exceed 2 ml (1 ml for children) of a 0.1% solution. It should be remembered that repeated administration of small doses of adrenaline is more effective than single administration of a large dose.
2. If blood pressure does not stabilize, it is necessary to urgently begin intravenous drip administration of norepinephrine (or mezatone) 0.2-1.0-2.0 ml per 500.0 ml of 0.9% sodium chloride solution.
3. Intramuscularly or intravenously inject glucocorticosteroid drugs: prednisolone 60-120 mg (children 40-100 mg), dexamethasone 8-16 mg (children 4-8 mg) or hydrocortisone succinate or hemisuccinate 125-250 mg (children 25-125 mg ).
4. Inject intramuscularly 2.0 ml (for children 0.5-1.5 ml) of Tavegil 0.1% solution or Suprastin 2.5%.
5. For bronchospasm, 10.0 ml (for children 2-3 ml) of a 2.4% solution of aminophylline in a 0.9% solution of sodium chloride is injected intravenously.
6. Cardiac glycosides, respiratory analeptics (strophanthin, korglykon, cordiamine) are administered according to indications.
7. If necessary, mucus from the respiratory tract and vomit should be sucked out and oxygen therapy administered.
All patients with anaphylactic shock are subject to hospitalization. Transportation of patients is carried out after removal from threatening condition resuscitation team, because During the evacuation, a repeated drop in blood pressure and development is possible.
The doses of administered drugs and the doctor’s tactics are determined clinical picture, but in all cases it is necessary, first of all, to administer adrenaline, glucocorticoids, and antihistamines.
The administration of phenothiazine antihistamines (pipolfen, diprazine, etc.) and calcium supplements is not recommended.
Use in pediatrics. When carrying out specific diagnostics and immunotherapy, children should be guided by the order of the Ministry of Health of the Russian Federation dated November 4, 2002. “On improving allergy care for children in the Russian Federation.”
Side effects:
Reaction to introduction. A local reaction to the allergen occurs within 15-20 minutes (immediate type reaction). The duration of the local reaction is from 30 to 40 minutes.
In particularly sensitive patients, a systemic allergic reaction may occur. In this regard, in the office where specific diagnostics and specific immunotherapy patients should be pharmacological preparations and tools for emergency care.
Contraindications:
Contraindications for specific diagnostics.
- acute infections;
- any localization during an exacerbation;
— systemic diseases connective tissue;
— hormone therapy, therapy with antihistamines andbronchospasmolytics.
Contraindications for specific immunotherapy.
- exacerbation allergic disease;
- severe form of atopic;
— autoimmune diseases;
— ;
- acute infections;
— tuberculosis of any localization during the period of exacerbation;
— malignant neoplasms and blood diseases;
— chronic diseases in the stage of decompensation;
- cardiovascular diseases;
— pregnancy and lactation;
- in the period of exacerbation;
- hormonal therapy, therapy with antihistamines and bronchospasmodics.
Storage conditions:
Allergens are stored in accordance with SP 3.3.2.1248-03 in a dry place, protected from light and out of reach of children, at a temperature of 4 °C to 8 °C. Transportation is carried out in accordance with SP 3.3.2.1248-03 at a temperature from 4 °C to 8 °C. The shelf life of the allergen is 2 years, the test control and dilution liquids are 5 years.
Vacation conditions:
On prescription
Package:
5 ml - glass bottles (1) complete with test control liquid 4.5 ml vial. (1 pc.), dilution liquid 4.5 ml fl. (7 pcs.) and an empty sterile bottle. (1 pc.) - cardboard packs.
Filterable list
Active substance:
Instructions for medical use
Wormwood pollen allergoid for treatment
Instructions for medical use - RU No. P N001539/01
date last change: 20.11.2012
Dosage form
Solution for subcutaneous administration.
Compound
The drug contains in 1 ml:
Allergoid pollen wormwood - 10000±2500 PNU;
Excipients:
Formaldehyde - no more than 0.14 mg, phosphate buffer solution - up to 1 ml.
Phosphate buffer solution contains (in 1 ml):
Sodium hydrogen phosphate dodecahydrate - 1.5 mg (equivalent to 0.6 mg sodium hydrogen phosphate); potassium dihydrogen phosphate - 0.216 mg; water for injection - up to 1 ml.
Complete with the allergoid, a diluting liquid for the allergoid is produced.
Dilution liquid for allergoid - 0.0001 M phosphate buffer solution contains (in 1 ml): sodium hydrogen phosphate dodecahydrate - 1.5 mg (equivalent to 0.6 mg sodium hydrogen phosphate); potassium dihydrogen phosphate - 0.216 mg; water for injection - up to 1 ml.
Description of the dosage form
The allergoid from wormwood pollen is clear liquid from yellow to Brown.
The dilution liquid for the allergoid is a clear, colorless liquid.
Characteristic
It is a dialyzed water-salt extract of protein-polysaccharide complexes isolated from wormwood pollen, treated with formaldehyde.
Pharmacological group
MIBP - grass pollen allergens.
Indications
Specific immunotherapy for adults and children over 5 years of age with allergic rhinoconjunctivitis, atopic bronchial asthma, atopic dermatitis, sensitive to wormwood pollen.
Indications for treatment are clinical manifestations of the disease, medical history, and skin testing with a specific allergen.
Indications for specific immunotherapy are determined by an allergist, taking into account contraindications.
Contraindications
Contraindications for specific immunotherapy:
1. Exacerbation of an allergic disease.
2. Immunodeficiency states.
5. Mental illness during the period of exacerbation.
6. Heavy bronchial asthma, poorly controlled by pharmacological drugs (forced expiratory volume in 1 second is less than 70% after adequate pharmacotherapy).
7. Cardiovascular diseases, in which complications from the use of epinephrine (adrenaline) are possible.
8. Childhood up to 5 years.
9. Pregnancy, lactation period.
10. Tuberculosis of any localization during the period of exacerbation.
11. Any chronic diseases in the acute stage.
12. Acute infections.
13. Systemic glucocorticosteroid therapy, therapy (β-adrenergic agonists and antihistamines.
Use during pregnancy and breastfeeding
Contraindicated.
Directions for use and doses
The allergoid is administered subcutaneously. Allergoid dilutions are prepared using allergoid dilution liquid. Store dilutions of the allergoid at a temperature of 2 to 8 °C, the period of use is no more than 1 month.
An allergist is responsible for the preparation and use of allergoid dilutions under aseptic conditions for specific immunotherapy and the use of dilutions. Treatment is carried out by an allergist in an allergology office or a specialized hospital department in the remission stage of the underlying disease.
The dilutions of the drug, the administered volume (dose) and the recommended regimen and recommended dosage regimen are given in Table 1.
Table 1. Approximate scheme of specific desensitization (a*, b*)
| Allergoid dilution | PNU/ml | Dose (ml) | Note |
| 1 | 2 | 3 | 4 |
| 1:10 000 | 1,0 | Injections are made strictly subcutaneously in the lateral area of the shoulder, at the border of the middle and lower third (at a distance of 12-15 cm above the elbow). The first injections at a dilution of the allergen of 1:10,000, 1:1,000 are given daily or every other day. Subsequent injections of dilutions of 1:100 and 1:10 with an interval of 3 days. If the patient tolerates allergoid injections well at a dose of 0.9 ml of 1:10 dilution, injections of undiluted allergoid (10,000 PNU/ml) should be continued in increasing doses with an interval of 7 days. In case of local or general reactions, treatment continues at the discretion of the doctor. After each allergoid injection, the patient should be observed by a doctor for at least 60 minutes. During this time, the doctor notes the possible occurrence of local and general reactions, exacerbation of the underlying disease. If general reactions of the body or a hyperergic reaction occur at the injection site within 24 hours, the patient should immediately consult a doctor. A contraindication for increasing the dose is a local reaction in the form of an infiltrate larger than 25 mm, a general reaction of the body, or an exacerbation of the underlying disease. In these cases, the dose is reduced and the intervals between injections are extended until good tolerance is achieved. Allergoid injections should be stopped 1-2 weeks before the wormwood begins to bloom. |
|
| 1:1 000 | 10 | ||
| 1:100 | 100 | ||
| 1:10 | 1000 | ||
| Undivorced | 10 000 |
a*) the initial dose is determined by allergometric titration.
b*) in patients with high sensitivity ( high degree severity of skin tests), treatment begins at the discretion of the doctor, with a dilution of 1:100,000 or 1:1,000,000.
Side effects
When an allergoid is administered, local and general reactions. In some cases, in highly sensitive patients with specific allergoid immunotherapy, general reactions may occur, which are manifested by symptoms varying degrees severity: from moderately severe - coughing, sneezing, headache, urticaria, facial swelling, conjunctivitis, rhinitis, bronchospasm, exacerbation of the underlying disease to anaphylactic shock in rare cases. Local reactions are expressed by the formation of edema and hyperemia at the injection site.
After each injection, the patient should be observed by an allergist for at least 60 minutes. During this time, the doctor should note the skin reaction to the administration of the allergoid and the general condition of the patient. The patient should inform the doctor about long-term reactions. In the room where specific immunotherapy of patients is carried out, there should be pharmacological drugs and instruments for providing emergency care.
Precautionary measures
In cases where, during the administration of the allergoid or during the follow-up period for 60 minutes, the patient experiences general weakness or agitation, anxiety, a feeling of heat throughout the body, redness of the face, rash, cough, difficulty breathing, abdominal pain, the following should be carried out: Events:
Prehospital care with anaphylactic shock.
1. Immediately stop administering the allergoid from wormwood pollen, place the patient on the couch (head below feet), turn the head to the side, extend the lower jaw, remove existing dentures.
2. Apply a tourniquet to the site above the allergoid injection, if possible.
3. Inject the injection site with 0.3-0.5 ml of adrenaline solution (dilute 1 ml of 0.1% adrenaline solution in 3-5 ml of 0.9% sodium chloride solution).
4. Apply an ice pack to the injection site.
5. Administer 0.3-0.5 ml of 0.1% adrenaline solution (for children 0.05-0.1 ml/year of life) intramuscularly or intravenously at intervals of 5-10 minutes. The frequency and dose of administered adrenaline depends on the severity of the shock and blood pressure readings. The total dose of adrenaline should not exceed 1 ml of a 0.1% solution. Repeated administration of small doses of epinephrine is more effective than a single administration of a large dose.
6. Provide access fresh air or give oxygen. If the breathing rhythm is disturbed or difficult to carry out artificial ventilation lungs (ventilator).
7. Urgently call a doctor, and at the same time call the resuscitation team.
Before the arrival of the resuscitation team, it is necessary to provide medical care and conduct constant monitoring of hemodynamic parameters and state of function external respiration(FVD).
Hospital care for anaphylactic shock.
1. When extremely in serious condition patient and pronounced violations hemodynamics inject slowly 5 ml of 0.01% adrenaline solution intravenously; when the effect is achieved, the administration is stopped. For children, 0.1 ml/kg of a 0.01% solution is administered slowly over several minutes.
2. If (BP) does not stabilize, urgently start an intravenous drip of norepinephrine (phenylephrine, dopamine) 0.2% 1.0-2.0 ml per 500 ml of 5% glucose solution for infusion or sodium chloride solution for injection 0.9 %.
3. Inject glucocorticosteroids intravenously: prednisolone - 60-180 mg (children 5 mg/kg) or dexamethasone - 8-20 mg (children 0.3-0.6 mg/kg), or hydrocortisone - 200-400 mg (children 4-8 mg/kg). Depending on the condition, the administration of hormones is repeated and continued for at least 4-6 days to prevent allergic reactions of the immunocomplex or delayed type.
4. Only when blood pressure has stabilized, administer 2.0 ml of a 2% solution of chloropyramine (children 0.1-0.15 ml/year of life) or 0.1% clemastine intramuscularly.
5. Symptomatic therapy according to indications. For bronchospasm, 10.0 ml of a 2.4% solution of aminophylline in a 0.9% sodium chloride solution for injection is injected intravenously (children 1 ml/year of life). If necessary, cardiac glycosides and respiratory analeptics are administered.
6. If necessary, accumulated secretions and vomit are sucked out of the respiratory tract and oxygen therapy is started.
7. For patients receiving β-blockers, additional administration of salbutamol and/or glucagon 1 ml intravenously is indicated.
8. In case of acute laryngeal edema, intubation or tracheotomy is indicated.
All patients with anaphylactic shock are subject to mandatory hospitalization for a period of at least 10 days in order to continue observation and treatment, because 2-5% of patients who have suffered anaphylactic shock experience late allergic reactions.
The doses of administered drugs and the doctor’s tactics are determined by the clinical picture, but in all cases it is necessary, first of all, to administer adrenaline and glucocorticosteroid drugs. The administration of phenothiazine drugs and calcium supplements is contraindicated.
special instructions
Influence on the ability to drive vehicles and machinery.
Not described.
Release form
Solution for subcutaneous administration, 10,000 PNU/ml, 5.0 ml in a bottle; dilution liquid for allergoid, 4.5 ml in a bottle. Available as a set: 1 bottle of allergoid, 8 bottles of diluting liquid for the allergoid, 1 empty sterile bottle in a cardboard box along with instructions for use.
Storage conditions
In accordance with SP 3.3.2.1248-03, in a place protected from light and out of reach of children at a temperature of 2 to 8 °C. Freezing is not allowed.
Transportation conditions.
In accordance with SP 3.3.2.1248-03 at temperatures from 2 to 8 °C. Freezing is not allowed.
Best before date
Allergoid - 2 years, diluting liquid for allergoid - 5 years. A drug that has expired cannot be used.
Conditions for dispensing from pharmacies
Dispensed by prescription.
R N001539/01 dated 2018-05-03
Allergoid pollen wormwood for treatment - instructions for medical use - RU No.
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