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Treatments and drugs

By Mayo Clinic staff

The only way to avoid an allergic reaction is to avoid the foods that cause signs and symptoms. However, despite your best efforts, you may come into contact with a food that causes a reaction.

For a minor allergic reaction, over-the-counter or prescribed antihistamines may help reduce symptoms. These drugs can be taken after exposure to an allergy-causing food to help relieve itching or hives. However, antihistamines can't treat a severe allergic reaction.

For a severe allergic reaction, you may need an emergency injection of epinephrine and a trip to the emergency room. Many people with allergies carry an epinephrine autoinjector (EpiPen, EpiPen Jr, Twinject). This device is a combined syringe and concealed needle that injects a single dose of medication when pressed against your thigh. If your doctor has prescribed an epinephrine autoinjector:

  • Carry it with you at all times. It may be a good idea to keep an extra autoinjector in your car or in your desk at work.
  • Always be sure to replace epinephrine before its expiration date, or it may not work properly.
  • Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to administer the drug — if they're with you in an anaphylactic emergency, they could save your life.

Experimental treatments
While there's ongoing research to find better treatments to reduce food allergy symptoms and prevent allergy attacks, there isn't any proven treatment that can prevent or completely relieve symptoms. Unfortunately allergy shots (immunotherapy), a series of injections used to reduce the effect of other allergies such as hay fever, aren't effective for treating food allergies. Two treatments that have shown some promise are:

  • Anti-IgE therapy. The medication omalizumab (Xolair) interferes with the body's ability to use IgE. The drug is currently being studied for treatment of allergic asthma and food allergies. However, this treatment is still considered experimental and more research needs to be done on the drug's long-term safety. It has been associated with a potential increased risk of anaphylaxis.
  • Oral immunotherapy. Researchers have been studying the use of oral immunotherapy (OIT) as a treatment for food allergy. Small doses of the food you're allergic to are swallowed or placed under your tongue (sublingual). The dose of the allergy-provoking food is gradually increased. Initial results look promising, even in people with peanut allergy. But, more research needs to be done to ensure that this treatment is safe.
References
  1. Burks W. Clinical manifestations of food allergy: An overview. http://www.uptodate.com/home/index.html. Accessed Nov. 11, 2010.
  2. Food allergy: An overview. National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/foodAllergy/Documents/foodallergy.pdf. Accessed Nov. 11, 2010.
  3. Lack G. Food allergy. New England Journal of Medicine. 2008;359:1252.
  4. Atkins D. Food allergy: Diagnosis and management. Primary Care: Clinics in Office Practice. 2008;35:119.
  5. Hoffman A, et al. Pollen food allergy syndrome: Update on the allergens. Current Allergy and Asthma Reports. 2008;8:413.
  6. Chapman JA, et al. Food allergy: A practice parameter. Annals of Allergy, Asthma and Immunology. 2006;96:S1.
  7. Fleischer DM, et al. Oral food challenges in children with a diagnosis of food allergy. The Journal of Pediatrics. In press. Accessed Nov. 11, 2010.
  8. Fried AJ, et al. Anti-IgE in the treatment of allergic disorders in pediatrics. Current Opinion in Pediatrics. 2010;22:758.
  9. Scurlock AM, et al. An update on immunotherapy for food allergy. Current Opinion in Allergy and Clinical Immunology. 2010;10:587.
  10. Xiu-Min L. Complementary and alternative medicine in pediatric allergic disorders. Current Opinion in Allergy and Clinical Immunology 2009;9:161.
  11. Li X. Traditional Chinese herbal remedies for asthma and food allergy. Journal of Allergy and Clinical Immunology. 2007;120:25.
  12. Teuber SS, et al. Unproved diagnostic and therapeutic approaches to food allergy and intolerance. Current Opinion in Allergy and Clinical Immunology. 2003;3:217.
  13. Guidelines for the diagnosis and management of food allergy in the United States: Summary of the NIAID sponsored expert panel report. Bethesda, Md.: National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/foodallergy/clinical/Pages/default.aspx. Accessed Dec. 13, 2010.
DS00082 Feb. 11, 2011

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