Immunotherapy Safety for the Primary Care ... - U.S. Coast Guard

• Negative (swelling up to 15mm; i.e., dime size) – progress
according to schedule.
• “A” (swelling 15-20 mm; i.e., dime to nickel size) – Follow
Allergist’s written instructions (e.g., continue to advance).
• “B” (swelling 20 – 25 mm; i.e., nickel to quarter size) – Follow
Allergist’s written instructions (e.g., repeat last dose given)
• “C” (swelling persisting more than 12 hours or over 25mm; i.e.,
quarter size or larger) – Follow Allergist’s written instructions (e.g.,
decrease dosage by 1 dose).
• Systemic reactions (hives, sneezing, itching, asthma, difficulty breathing, or
shock) – Immediate care/action, then follow Allergist’s written instructions.
• Generally, the subsequent allergen extract dose is reduced to 1/3 of the last
dose that did not cause a reaction and repeated 3 times before advancing
per schedule.
• If the injections cause repeated reactions or are suspected of causing
repeated delayed symptoms, or if reactions prevent progression of treatment,
contact the Allergist for further instructions.