James Connolly, MD; Alfred Sassler, MD - AAOA PPR Commitee The past few years have seen increasing legalization of both medical and recreational marijuana across the United States. Concurrently, there has also been burgeoning use of cannabis-derived products such as…
By Dana Crosby, MD, FAAOA
WHY DO I NEED TO STOP SOME MEDICATIONS BEFORE AN ALLERGY TEST?
- When you are allergic to a substance, your body releases certain chemicals such as histamine. When these chemicals are released in the skin during a test, we see a small bump in the skin that is often surrounded by redness. Certain medications can decrease this response and cause allergy testing to look negative even if you do have allergies.
- Other medications can be dangerous to take if you are having an allergy test. Some medications can increase your chance of a life-threatening reaction to an allergy test or make treating a severe reaction more difficult.
- You only need to consider stopping medications if you are going to have a skin test for allergies. If your allergy test will be done with a blood draw from the vein no medications need to be stopped.
- It is important to review your list of medications with your ENT allergist in order to ensure the most accurate and safe outcome when you have your test.
WHAT MEDICATIONS DO I NEED TO STOP BEFORE AN ALLERGY TEST?
|Type of medication||Examples of this medication||When to stop|
|Topical Corticosteroids||aclometasone (Aclovate)amcinonide (Cyclocort)betamethasone (Diprolene, Betanate, Beta-Val)clobetasol (Clobex, Olux, Temovate)desonide (Desonate, Desowen, Lokara, Vereso)desoximetasone (Topicort)diflorasone (Apexicon)fluocinolone (Synalar)fluocinonide (Vanos, Lidex)flurandrenolide (Cordran)fluticasone (Cutivate)halcinonide (Halog)halobetasol (Ultravate)hydrocortisone (Locoid, Pandel, Westcort)mometasone (Elocon)triamcinolone (Cinalog, Kenalog, Triderm)||21 days before the test (in the area that will be tested)|
|*Tricyclic Antidepressants||amitriptyline (Elavil, Endep, Etrafon, Limbitrol, Vanatrip)amoxampine (Asendin)clomipramine (Anafranil)desipramine (Norpramin)doxepin (Adapin,Sinequan)imipramine (Tofranil)nortriptyline (Aventyl, Pamelor)protriptyline (Vivactil)trimipramine (Surmontil)||14 days before test|
|*Atypical Antidepressants & Sedatives||bupropion (Wellbutrin)eszopiclone (Lunesta)mirtazapine (Remeron)quetiapine (Seroquel)trazadone (Oleptro)zolpidem (Ambien)||14 days before test|
|Second and Third Generation Antihistamines||cetirizine (Zyrtec)desloratadine (Clarinex)fexofenadine (Allegra)levocetirizine (Xyzal)loratadine (Claritin, Alavert)||7 days before test|
|*Benzodiazepines||alprazolam (Xanax)clonazepam (Klonopin)diazepam (Valium)lorazepam (Ativan)midazolam (Versed)||7 days before test|
|*Beta-blocker (pills and eye drops)||Acebutolol (Sectral)Atenolol (Tenoretic, Tenormin)Betaxolol (Betoptic, Kerlone)Bisoprolol (Zebeta, Ziac)Carteolol (Cartrol, Ocupress)Carvedilol (Coreg)Esmolol (Brevibloc)Labetalol (Normdyne, Trandate)Levobunolol (AK-Beta, Betagan)Levobetaxolol (Betaxon)Metipranolol (OptiPranolol)Metoprolol (Lopressor)Nadolol (Corgard, Corzide)Penbutolol (Levatol)Pindolol (Visken)Propranolol (Inderal, Inderide)Sotalol (Betapace, Sorine)Timolol (Betimol, Blocarden, Ocumeter, Timolide, Cosopt, Occudose, Timoptic)||5 days before test|
|First Generation Antihistamines||azatadine (Optimine)brompheniramine (Bromax, Lodrane)carbinoxamine (Histex, Karbinal, Palgic, Pediatex)chlorpheniramine (Aller-Chlor, Chlor- Trimeton)clemastine (Allerhist, Contact, Tavist)cyproheptadine (Periactin)dexchlorpheniramine (Polarmine)diphenhydramine (Benadryl, many other cold and allergy pills)|
dimenhydrinate (Dramamine)hydroxyzine (Atarax, Rezine, Vistaril)ketotifen (Zatiden)meclizine (Antivert, Bonine)methdilazine (Tacaryl)phenindamine (Nolahist)promethazine (Chlorpromazine, Phenergan, Promethazine)pyrilamine (Nisaval)trimaparazine (Tremaril)tripelennamine (PBZ)triprolidine (Myidyl, Tripohist, Zymine)
|5 days before test|
|H2 Blockers||cimetidine (Tagamet)famotidine (Pepcid)ranitidine (Zantac)||2 days before test|
|Antihistamine Nasal Spray||azelastine (Astelin, Astepro, Patanase, Dymista)||1 day before test|
|Antihistamine Eye Drops||azelastine (Optivar)olopatadine (Patanase, Pataday, Patanol)||1 day before test|
|Immunomodulators||omalizumab (Xolair)others are unknown discuss with doctor||6 months|
WHAT MEDICATIONS CAN I CONTINUE DURING ALLERGY TESTING?
|Angiotensin-Converting Enzyme (ACE) Inhibitors||benazepril captopril enalapril lisinopril perindopril quinapril ramipril|
|Nasal Steroid Sprays||beclomethasone budesonide ciclesonide fluticasone mometasone triamcinolone|
|Decongestant, Decongestant Sprays, Expectorants||guaifenesinoxymetazoline phenylephrinepseudoephedrine|
|Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)||atomoxetinedesvenlafaxineduloxetinelevomilnacipranmilnacriprantramadolvenlafaxine|
|Proton Pump Inhibitors (PPIs)||dexlansoprazoleesomeprazole lansoprazole omeprazole pantoprazole rabeprazole|
|Selective Serotonin Reuptake Inhibitor (SSRIs)||citalopram escitalopram fluoxetine fluvoxamineparoxetinesertraline volazodone vortioxetine|
!!!!!DO NOT STOP ASTHMA MEDICATIONS OR INHALERS!!!!!
- It is critical to discuss stopping any medication for your heart, blood pressure, depression, anxiety, sleep or any medication that is required to maintain your current state of health with your ENT allergist and the physician who prescribed it to you. DO NOT stop these medications without discussing the risks first.
- It is important to continue all inhalers for asthma as uncontrolled asthma can increase the risk of testing.
- These are not firm time frames. Some doctors will tell you to stop these medications for a different length of time depending on their practice and experience.
- Many allergy doctors will tell you to stop all problematic medications at the same time (5-14 days) in advance of your testing depending on their preference to make it easier for you.
- This list does NOT include every important medication. Please discuss your medication list with your allergist. If you have questions about specific medications please do not hesitate to call to ensure accuracy and safety of the test.