Adrenaline (epinephrine) injected into the outer mid-thigh muscle is the first line treatment for potentially life threatening, severe allergic reactions (anaphylaxis). Adrenaline is a natural hormone released by the body in response to stress. When injected, adrenaline rapidly reverses the effects of anaphylaxis by reducing throat swelling, opening the airways, and maintaining heart function and blood pressure. Adrenaline autoinjectors contain a single, fixed dose of adrenaline, and have been designed to be given by non-medical people, or by the patient themselves (if they are not too unwell).
Allergen avoidance is essential in the management of severe allergies to foods, insects and drugs (medications). It is important to have strategies in place to minimise the risk of exposure to allergens that that can result in anaphylaxis.
Allergen minimisation can be useful in the management of allergic rhinitis (hay fever). If it is possible to identify the causative allergen/s, minimising exposure to the confirmed allergens may reduce symptoms.
Allergic rhinitis medications include non-sedating antihistamines (tablets, syrups, nasal sprays, eye drops), intranasal corticosteroid (INCS) sprays, combination medications containing antihistamine and INCS and natural salt water nasal sprays or rinses.
Allergen immunotherapy (also known as desensitisation) is the closest thing we have for a "cure" for allergy, reducing the severity of symptoms and the need for medication. It involves regular administration of gradually increasing doses of allergen extracts over a period of 3-5 years. It can be given as injections or as sublingual (under the tongue) tablets, sprays or drops. It is usually recommended for the treatment of potentially life-threatening allergic reactions to stinging insects. It often recommended for treatment of allergic rhinitis due to pollen or dust mite allergy (and sometimes asthma) when symptoms are severe, the cause is difficult to avoid (such as grass pollen), medications don't help or cause adverse side effects or when people prefer to avoid medications.
Oral immunotherapy for food allergy is currently the subject of research in Australia and New Zealand, and is yet to enter routine clinical practice. People who have a diagnosed food allergy must avoid the food trigger unless they are participating in a research study led by a clinical immunology/allergy specialist.
New immunotherapy methods for food allergies have been developed as a result of recent research. Once approved these are expected to be available for routine use in the near future.
- New immunomodulation therapy for severe atopic dermatitis (eczema) has also been developed as a result of recent research. Once approved this is expected to be available for routine use in the near future.
For more information visit www.allergy.org.au/patients/allergy-treatment
© ASCIA 2018
ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand
Postal address: PO Box 450 Balgowlah NSW 2093 Australia
This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. Development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
Content updated October 2018