Allergenic Extract, Bee and Wasp

Hymenoptera venom preparations should be used only by or under the direction of physicians experienced in administering allergens to the maximum tolerated dose and only where adequate means for treating severe systemic reactions are immediately available.

Allergenic extracts may potentially elicit a severe life-threatening systemic reaction, rarely resulting in death1. Because of the possibility of severe systemic reactions, the patient should be instructed in the recognition of anaphylactic symptoms, observed in the office for at least 30 minutes after each injection, and warned to return to the office if symptoms of an allergic reaction occur.

Patients receiving beta-blockers may not be responsive to epinephrine or inhaled bronchodilators, and the risk of severely complicating the treatment of systemic reactions should be carefully considered before a decision to treat is reached.

Treatment with ACE-Inhibitors should be Stopped at least 24 hours Prior to injection due to An increased risk of anaphylactic reaction based on inhibition of theangiotensinmetabolism.

In patients with increased baseline serumtryptaselevels and/ormastocytosis, the risk of systemic allergic reactions and the severity of these may be increased.

Patients suffering ofmastocytosismay expect less efficacy compared with the general insect venom allergic population.<