Since you are receiving injections of the allergens to which you are allergic, you must be started off on a very low dose and gradually built up, receiving increasing amounts of the allergens. This can be done in three ways:
Rapid build-up (Cluster): This is a quicker approach to building resistance to allergens, reaching maintenance within weeks. There is an increased risk of having a reaction, therefore requiring oral premedication (prednisone, singulair & an antihistamine) prior to each injection visit. Initially there is a bigger time commitment, requiring extended visits of several hours twice a week for 4-6 weeks. Patients would receive 3-4injections at each visit, with a 30 minute waiting period after each injection. These are only done in our offices.
RUSH: This regimen results in reaching maintenance within 2 days. The patients could receive up to 18 injections (or 36 injections if there are 2 vials), in this 2 day process, with each injection at an increased strength until reaching the highest tolerated dose. At the end of both days, the patient will be monitored for 1 ½ -2 hours for any delayed allergic reaction. This approach requires two full days in our office. There is a greater risk of having reactions to RUSH injections when compared to a standard build-up schedule. The level of reaction can vary from mild to severe, which is why we require pre-medicating for the RUSH injections.
You and your provider can together determine the best course of build-up for you.
