Do beta-blockers really enhance the risk of anaphylaxis during immunotherapy?
Both beta-blockers and allergen immunotherapy are frequently prescribed, and allergy/immunology physicians commonly encounter patients who are candidates for immunotherapy and are receiving beta-blockers. The evidence in the medical literature indicates that although anaphylaxis does not appear to be more frequent, beta-blocker exposure is associated with greater risk for severe anaphylaxis, and for anaphylaxis refractory to treatment. Use of beta-blocker suspension merits consideration to reduce risk for untoward outcomes, while supplanting the beta-blocker medication with an equally efficacious non-beta-blocker alternative. For patients who require a beta-blocker for an indication for which there is no equally effective substitute, a management decision by the physician prescribing allergen immunotherapy should be approached carefully from an individualized risk-benefit standpoint.
Lang
David M
DM
Cleveland Clinic, 9500 Euclid Avenue, Desk C22, Cleveland, OH 44195, USA. LANGD@ccf.org
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000707:Anaphylaxis / Q000209:etiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003888:Desensitization, Immunologic / Q000009:adverse effects*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000276:immunology / Q000628:therapy*
D000319:Adrenergic beta-Antagonists