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

Aeroallergen Dose Adjustment Schedule
Build up phase (1-2/ wk)
7-13 days late
14-20 days late
21-27 days late
28-34 days late
35-41 days late
42-48 days late
49-55 days late
> 56 days late
Maintenance phase (q30 day)
7-13 days late
14-20 days late
21-27 days late
28-34 days (1 month) late
35-41 days late
42-55 days late
> 56 days (2 months) late
Repeat last dose
Repeat last dose
Go back 1 dose from last given
Go back 2 doses from last given
Go back 3 doses from last given
Call office
Call office
Call office
Repeat last dose
Repeat last dose
Go back 2 doses from last given
Go back 3 doses from last given
Go back 4 doses from last given
Call office
Call office
Special Note:
If ‘going back’ crosses into the
previous vial, go back 1 extra dose
Reaction, local
< dime size (15mm)
nickel size (20mm)
quarter size (25mm)
> quarter size or lasts > 12 hr
Reaction, systemic
Advance per schedule
Advance per schedule
Go back 1 dose from last given. Consider split dose, pre-Rx: H1, NSAIDs, etc.
Go back 2 doses from last given. Call office if intervention not effective.
Rx emergently. Call office for follow up appointment before resuming protocol.