Drug Allergy

Drug Allergy Guidelines (ACAAI/AAAAI)

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Biologic Modifiers ÎAllergic drug reactions ranging from cutaneous lesions to severe anaphylaxis may occur during treatment with recombinant interferons. (C) ÎBoth cutaneous and systemic allergic reactions have been reported after treatment with infliximab, a human monoclonal antibody against tumor necrosis factor-α (TNF-α). (C) ÎBoth cutaneous and systemic allergic reactions have been reported after treatment with both murine and humanized monoclonal antibodies. (C) ÎRare anaphylactic reactions to anti-IgE humanized monoclonal antibody (omalizumab) were described during phase III clinical trials and during the postmarketing surveillance period. (C) ÎThe cytokine release syndrome must be distinguished from anaphylactoid and anaphylactic reactions due to anticancer monoclonal antibodies. (C) Complementary Medicines ÎAllergic reactions may occur after use of complementary medicines such as bee pollen, echinacea, and vitamins. (C) Other Agents ÎN-acetylcysteine may cause anaphylactoid reactions. (C) ÎAnaphylactoid reactions and deaths have been associated with intravenous iron preparations, particularly iron-dextran. (C) ÎLife-threatening anaphylactic reactions have occurred after intravenous use of isosulfan blue and Patent Blue V dyes. (C) ÎAnaphylactoid reactions may occur after treatment with colloid volume expanders, mannitol, Cremophor® -EL, and preservatives. (C) ÎPreservatives and additives in medications rarely cause immunologic drug reactions. (C) 21

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