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Rapid drug desensitization for immediate hypersensitivity reactions

Mariana C Castells, MD, PhD
Roland Solensky, MD
Section Editor
N Franklin Adkinson, Jr, MD
Deputy Editor
Anna M Feldweg, MD


Desensitization is a procedure that alters the immune response to the drug and results in temporary tolerance, allowing the patient with a drug hypersensitivity reaction to receive an uninterrupted course of the medication safely. Once the medication is discontinued or if treatment is interrupted for a sufficient period of time, the patient's hypersensitivity to the medication returns. Desensitization is only safe and effective for certain types of drug allergy. The terms "drug hypersensitivity" and "drug allergy" are used synonymously in this topic review.

Techniques for drug desensitization in patients with immediate hypersensitivity reactions and the proposed mechanisms underlying these techniques will be reviewed here. Desensitizations for reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are not included in this discussion but are discussed elsewhere. (See "Diagnostic challenge and desensitization protocols for NSAID reactions" and "Aspirin-exacerbated respiratory disease: NSAID challenge and desensitization".)


The World Allergy Organization (WAO) has recommended dividing drug hypersensitivity reactions into two general types [1,2]:

Immediate/acute reactions – Reactions that begin during the infusion and up to six hours after exposure to the culprit drug.

Delayed reactions – Reactions that begin after six hours or later after exposure to the culprit drug.

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Literature review current through: Nov 2017. | This topic last updated: Oct 09, 2017.
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