Before delving into the jungle of Danish medicine, I suggest recalling the important. I venture to seem a bore, but there are a lot of questions in the comments from people who want to independently go through Allergy immunotherapy AIT.
Repeat the allergy mantra.
- AIT immunotherapy is prescribed and carried out by an allergist.
- The doctor makes a diagnosis based on your complaints (collects an anamnesis), skin tests (prick tests) and analyzes – ImmunoCap, ISAC allergy test, AllergoSmart.
- Symptoms in allergies are above all. Any tests are just an addition to clarify the diagnosis.
The goal of AIT is to reduce the intensity of symptoms, reduce the amount of medication and, if you’re lucky, go into remission. - AIT treats only major allergen proteins. If the reaction to both major and minor – therapy is ineffective. If only minor, it’s useless.
- How to recognize major and minor proteins? Seek help with molecular diagnostics. Skin tests will not help you with this.
Back to Danish immunotherapy drugs. Medicines are manufactured by ALK Abello company.
ALK Abello is not a young company and has long been known in the EU countries. In 1990, ALK Abello was the first in Europe to produce sublingual drops for AIT.
Now the company is more specialized in tablets for AIT. Although they also release allergens in injections.
In different countries, ALK Abello products are known under different names. For example, medicines with a house dust mite allergen are called ACARIZAX in Europe and Russia, ODACTRA in the USA, and MITICURE in Japan. Keep this in mind if you are considering buying drugs abroad.
Since 2019, in Europe you can buy tablets for AIT from the pollen of trees of the ITULAZAX birch family (alder, beech, hazel, hornbeam, oak). And in Japan, tablets are sold for the treatment of pollinosis of Japanese cedar and cryptomeria – CEDARCURE.
In European pharmacies, you can find ALK Abello medicines in tablets and injections. In Finland, an injection package costs 300 – 450 euros. The prescription is written by a local allergist.
A prescription from a Finnish allergist can be obtained at MedFIN Medical Center. The price of the service is 48 euros.
All details can be found on the website MedFIN Medical Center: https://www.medfin.fi/
Three drugs for sublingual AIT have been certified in Russia:
- Akarizax – an allergen of a tick of house dust (are allowed since 12 years).
- Grazax – grass pollen allergen – timothy grass (allowed from 5 years).
- Ragvizaks – ragweed allergen (allowed from 18 years old).
I believe that the age limit will change. Research is in full swing and perhaps sooner drugs will be available to younger children.
All medicines registered in Russia are pills – lyophilisates, which are obtained by freezing and drying the necessary components. Such tablets taste good, they dissolve quickly and do not need to be washed down.
You can eat already 5 minutes after the tablet has resolved.
A dosage set – a concept known to those who have already passed AIT sublingual drops by Stallergenes – is not relevant in the case of tablets. Since each tablet has the same amount of active substance.
Usually take one tablet a day at the same time. You can eat after 5 minutes after taking the pill. The instruction assures that you can take pills all year round, but it is better to develop an individual treatment regimen with your allergist.
The shelf life of the tablets is 4 years and they do not need to be stored in the refrigerator. Convenient for traveling allergy sufferers.
Now drugs can be bought in allergocenters and, possibly, they will soon appear in pharmacies.
An important point for those who have an anaphylactic reaction to fish. The composition of the medicines includes fish gelatin. It is difficult to believe that one of the most severe allergens is part of the tablets for therapy AIT, but this is a fact.
I wrote a letter to the office of ALK Abello in Denmark with the question: is gelatin dangerous with an acute reaction to fish, but I have not received an answer yet.
In the English-language instructions for the preparations, I found a warning – the available data do not indicate an increased risk of allergic reactions in patients with a history of severe allergy to fish. However, such patients should be careful when starting treatment.
ACARIZAX / MITICURE
ACARIZAX, available in the form of sublingual tablets with an equal number of allergens of European and American house dust mites (Dermatophagoides pteronyssinus и Dermatophagoides farinae ).
The Сomposition of the medicine
- Protein extracts – allergens from the European house dust mite (Dermatophagoides pteronyssinus) and the American house dust mite (Dermatophagoides farinae);
- fish gelatin;
- mannitol;
- sodium hydroxide.
Tablets do not contain: lactose, sucrose, gluten, tartrazine and other azo dyes
Acarisax has been certified in Europe since 2015, in the USA since 2017.
To whom and when is ACARIZAX prescribed
Acarizax is prescribed for allergy sufferers with symptoms of a reaction to a house dust mite – rhinoconjunctivitis, allergic bronchial asthma.
However, symptoms are not everything. It is necessary to pass tests to confirm the reaction to one or more major proteins:
- European house dust mite Dermatophagoides pteronyssinus – Der p 1, Der p 2;
- American house dust mite Dermatophagoides farinae – Der f 1, Der f 2.
Prick test results for ASIT will not be enough. Results often differ from blood tests.
The drug is recommended for allergy sufferers from 12 to 65 years old, but the attending physician can change age restrictions.
How long to take Acarizax, how often, in what dosage – all these questions should be answered by the attending allergist.
Contraindications
- Reaction only to minor proteins of house dust mites;
- if previously there were severe allergic reactions to immunotherapy;
- unstable or poorly controlled asthma (episode of severe exacerbation of bronchial asthma in the last 3 months);
- eosinophilic esophagitis;
- hypersensitivity to the substances that make up the drug;
- adrenaline intolerance;
- cardiovascular diseases;
- hypertension (not contraindicated, but use caution);
- upper respiratory tract infections (temporary contraindication);
- autoimmune diseases;
- inflammation and ulcers on the oral mucosa;
- beta-blocker therapy, including topical dosage forms.
Side effects
Be sure to inform your doctor of any unusual reaction during therapy.
- Itching and swelling in the mouth;
- sore throat;
- dry mouth
- the appearance of ulcers on the oral mucosa;
- ear pruritus;
- itching in the eyes;
- nasal congestion;
- taste change;
- nausea;
- abdominal pain;
- vomiting
- cough;
- rash;
- hives;
- cardiopalmus;
- difficulty swallowing;
- dizziness, weakness, fatigue;
- swelling or swelling of the eyelids or around the eyes, face, lips or tongue.
Instruction: https://apteka.hk/instrukciya/acarizax.pdf
GRAZAX
Grazax medicines are tablets with meadow grass allergens. But from meadow herbs, the preparation contains only an allergen extract of Timothy-grass (Phleum pratense).
The fact is that in most allergy sufferers reactions to herbs develop after an allergy to Timothy-grass. Since the grass proteins are similar, Timothy-grass was chosen for the medicine. In addition, it is believed that the monocomponent – one allergen is better perceived by the immune system.
The Сomposition
- Frozen drops of pollen allergen extract Timothy-grass (Phleum pratense);
- fish gelatin;
- mannitol;
- sodium hydroxide.
Tablets do not contain: lactose, sucrose, gluten, tartrazine and other azo dyes
In Europe, GRAZAX is certified since 2006. In 2014, Grazax received a license from the FDA (U.S. Food and Drug Administration).
Who needs GRAZAX
For those who have a reaction after contact with grass pollen, timothy grass, rhinoconjunctivitis, allergic bronchial asthma. And analyzes confirm that the reaction is precisely to major proteins: Phl p1, Phl p5.
When an allergy sufferer reacts not only to timothy, but also to other meadow herbs with similar proteins – bluegrass, chaff, porcupine – Grazax can also be prescribed. The body will cease to react violently to timothy proteins and at the same time will not perceive similar proteins of other herbs.
Grazax is recommended for allergy sufferers from the age of 5, but the attending physician can change age restrictions.
Contraindications
- reaction only to minor proteins of Timothy-grass;
- if previously there were severe allergic reactions to AIT;
- unstable or poorly controlled asthma (episode of severe exacerbation of bronchial asthma in the last 3 months);
- eosinophilic esophagitis;
- hypersensitivity to the substances that make up the drug;
- adrenaline intolerance;
- heart disease;
- hypertension (with caution);
- upper respiratory tract infections (temporary contraindication);
- autoimmune diseases;
- inflammation and ulcers on the oral mucosa;
- beta-blocker therapy, including topical dosage forms.
Side effects
- Itching and swelling in the mouth;
- sore throat;
- dry mouth;
- the appearance of ulcers on the oral mucosa;
- ear pruritus;
- itching in the eyes;
- nasal congestion;
- taste change;
- nausea;
- abdominal pain;
- vomiting
- cough;
- rash;
- hives;
- cardiopalmus;
- difficulty swallowing;
- dizziness, weakness, fatigue;
- swelling or swelling of the eyelids or around the eyes, face, lips or tongue.
Instruction: https://www.medicines.org.uk/emc/product/315
RAGWIZAX
Sublingual tablets with ragweed allergen protein extract. Ragwizax suitable for AIT from ragweed (Ambrosia). Great news, especially for residents of the southern regions.
Prior to this, AIT from ragweed was carried out by Antipollin, which is registered as a dietary supplement. Allergists often refused to work with him.
Ragweed is a weed and belongs to the Aster family. Ragweed pollen is a severe allergen – if you look at it under a microscope, you can see micro-hooks with which pollen literally clings to the human mucosa.
Ragweed proteins are similar to proteins of other weeds, such as wormwood. Similar but not identical.
The Ragvizax tablet contains pollen extract of ragweed, which is why the drug is recommended for allergy sufferers for ragweed and wormwood. However, allergies with a reaction only to wormwood Ragvizax is unlikely to help.
The Сomposition
- Frozen drops of pollen ragweed allergen extract (Ambrosia artemisiifolia);
- fish gelatin;
- mannitol;
- sodium hydroxide.
Tablets do not contain: lactose, sucrose, gluten, tartrazine and other azo dyes
In Europe, RAGWIZAX has been certified since 2017.
Who needs RAGWIZAX
The medicine is recommended for allergy sufferers with a reaction to ragweed pollen – rhinoconjunctivitis, allergic bronchial asthma. A molecular blood test should confirm the response to a major protein: Amb a 1.
Age restrictions from 18 to 65 years, but they can be changed by the treating allergist.
Contraindications
- reaction only to ragweed minor proteins;
- severe allergic reactions to previously conducted AIT;
- unstable or poorly controlled asthma (episode of severe exacerbation of bronchial asthma in the last 3 months);
- eosinophilic esophagitis;
- hypersensitivity to the substances that make up the drug;
- adrenaline intolerance;
- heart disease
- hypertension (with caution);
- upper respiratory tract infections (temporary contraindication);
- autoimmune diseases;
- inflammation and ulcers on the oral mucosa;
- beta-blocker therapy, including topical dosage forms.
Side effects
- Itching and swelling in the mouth;
- sore throat;
- dry mouth
- the appearance of ulcers on the oral mucosa;
- ear pruritus;
- itching in the eyes;
- nasal congestion;
- taste change;
- nausea;
- abdominal pain;
- vomiting
- cough;
- rash;
- hives;
- cardiopalmus;
- difficulty swallowing;
- dizziness, weakness, fatigue;
- swelling or swelling of the eyelids or around the eyes, face, lips or tongue.