wasp venom: clinical use

Prescribing considerations

• Confirm systemic IgE-mediated sting history and evidence of Vespula sensitisation.
• Treatment requires specialist supervision, trained staff, adrenaline and full resuscitation facilities.
• Assess cardiovascular disease, asthma control, autoimmune disease, malignancy, mastocytosis or raised baseline tryptase, renal impairment and interacting medicines.
• Postpone administration when clinically indicated by infection, worsening atopic dermatitis, a recent allergic reaction or poor asthma control.

Contraindications and cautions

• Hypersensitivity to an excipient.
• Active or poorly controlled systemic autoimmune disease or an immunodeficiency disorder.
• A condition in which induced anaphylaxis would create an unacceptable risk, such as severe cardiovascular disease.
• Asthma with inadequate symptom control or significant exacerbation risk.

Monitoring

• Before each injection, verify the allergen product, vial concentration and previous administration details.
• Review current health, asthma control, recent reactions and medicine changes.
• Record local and systemic reactions and reassess treatment after a large local or systemic reaction.
• Observe after administration and maintain immediate access to anaphylaxis treatment.

Clinical pharmacology

An aluminium-hydroxide-adsorbed Vespula venom extract that promotes immune tolerance through altered T-cell cytokine responses, increased IL-10 and venom-specific IgG, and reduced basophil histamine release. Adsorption provides slower release from the injection site.

Formulation and product differences

• The initial pack contains colour-coded vials of progressively increasing allergenic activity for specialist-controlled initiation.
• A separate maintenance pack contains the highest-concentration vial.
• The suspension may separate during storage and must be gently resuspended and visually inspected before use.
• ALUTARD SQ Wasp is not generally interchangeable with other venom-immunotherapy products.