Medicinal preparations in allergology: pharmaceutical issues

7 October 2022

D. Lannoy (Lille - France)

Drug-related hypersensitivity reactions are a common cause of adverse reactions, which can even be life-threatening in the case of allergy.
By making it possible to confirm or invalidate the responsibility of one or more drug(s), allergological explorations with skin tests and oral provocation tests improve the subsequent management of patients: lifting of drug eviction in patients tested negative or diagnosis of true allergy motivating a definitive contraindication of the drug in patients tested positive.
Skin tests consist of carrying out patch tests, prick tests and intra-dermo-reaction. The continuation of the allergological exploration may require the preparation of medicinal preparations in case of reintroduction protocols and/or desensitization protocols.
Few medicinal products (batteries) in a form suitable for testing and manufactured by pharmaceutical establishments are available on the market. The preparation of allergological tests from drugs or raw materials for pharmaceutical use in a hospital pharmacy makes it possible to respond individually to the needs of the patient and to optimize and standardize the methods of preparation, while reducing cross- and microbiological contamination.
The specificities and challenges of allergological medicinal preparations must be taken into account, depending on the available data: formulation, excipients, stability of finished preparations, adaptation of pharmaceutical forms, container-content interactions, etc.
Aspects relating to the pharmaceutical circuit and organization must also be considered.

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