Drug Information for Pharmalgen (ALK-Abello A S): Indications and Usage

  • The Pharmalgen venom preparations are indicated for use in the diagnosis and treatment of Hymenoptera sting allergy. The following general considerations should be applied in determining the proper use of these preparations:

    • Approximately two-thirds of adult patients with a history of sting anaphylaxis and a positive venom skin test but who do not receive immunotherapy will experience a systemic reaction if stung by the implicated insect again. These patients should receive therapy4. Children whose reactions have been limited to the skin have an approximately 10% risk of future reactions if stung and not immunized. The nature and severity of these reactions is in general similar to the original reaction and therefore children with this kind of history may not need venom therapy5.
    • The risk of anaphylaxis following a future sting is unknown in patients who have been stung without experiencing a systemic reaction but who are currently venom skin test positive. At this time, no recommendation can be made that such patients receive venom immunotherapy, but they should be counseled on their condition and may benefit from instruction in the self-administration of subcutaneously injected epinephrine. There is an approximately 10% risk of future systemic reactions if prior reactions have consisted of large delayed local reactions6. This risk must be considered in deciding whether or not to recommend venom therapy.
    • Patients with a history of serious systemic reaction to a sting but who are skin test negative to all five venoms are not candidates for therapy. It is not known whether such patients may be resensitized by future stings, and such patients should be retested after any subsequent sting.
    • A small percentage of patients, who have reached the maintenance dose suggested below, may still experience some degree of allergic response upon being stung by the implicated insect.

    Diagnosis: The five individual Hymenoptera venom extracts present in the diagnostic kit (see How Supplied) are indicated for diagnostic skin testing of patients with a history of systemic reactions consistent with insect sting allergy7.

    Treatment: The Hymenoptera venom extracts are indicated for immunotherapy in patients who have a history of a systemic reaction of any severity to a Hymenoptera sting and a positive skin test to one or more of the venoms. Therapy cannot be recommended in the absence of either of those conditions.

    The single-venom extracts are intended for both diagnosis and immunotherapy; the mixed vespid product is intended for immunotherapy only.

    Multiple venom preparations are indicated in patients with multiple skin test sensitivities.

  • Drug Information Provided by National Library of Medicine (NLM).