Mild to moderate symptoms (e.g., itching, sneezing, hives and rashes) are often treated with antihistamines and oral or topical steroids.
For patients at risk of experiencing a severe reaction to a food allergy (anaphylaxis), epinephrine is prescribed. Epinephrine is the only medication that can reverse the symptoms of anaphylaxis. It is available in an auto-injector (Auvi-Q™, EpiPen® or Adrenaclick®). If prescribed, use epinephrine at the first sign of an allergic reaction and call 911. Request an ambulance and tell the dispatchers that you have just used epinephrine for a suspected food-induced anaphylactic reaction. Patients should always go to the emergency room for further treatment, even if symptoms appear to resolve after epinephrine is administered. Epinephrine is fast-acting. It works within seconds to help control anaphylaxis. It only last for 10-15 minutes.
Once epinephrine is administered, other medications also may be used to control the reaction:
may be given to help reduce inflammation and decrease risk of a biphasic attack. Although steroids do not work fast enough for emergency treatment, they may help prevent a recurrence after the initial reaction has been treated. Steroids are not fast-acting. They can take several hours to work. The effects can last for days.
can treat mild allergic reactions. There are many brands available that are over the counter. Favorites in our practice and recommended for the Food Allergy Action plan is Benadryl or diphenhydramine. Other antihistamines are Claritin, Allegra and Zyrtec. Follow the dosing instructions carefully and be sure to ask your doctor for more information. Antihistamines should NOT be used in place of epinephrine, but could be given after epinephrine. Anti-histamines are not fast-acting. They can take several minutes or even an hour to work. Depending on the anti-histamine the effects can last from 4-24 hours. Benadryl lasts for 4-6 hours.
Rescue inhalers can help as well. However, if there are breathing problems give epinephrine and contact 911. It is okay to give the inhaler after you’ve given the epinephrine. Do not rely on “rescue inhalers” to treat the breathing problems associated with anaphylaxis—use the epinephrine. They can help shortness of breath within minutes but will not help other symptoms of anaphylaxis.
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