Rush Therapy

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What is Rush Immunotherapy (RIT)?

•Rush immunotherapy is a method for rapidly desensitizing patients to inhalant allergens. RIT involves giving a person multiple allergy injections over several hours in one day, achieving a near-maintenance dose in a very short amount of time.
•The procedure involves six allergy injections, with incremental increases in dose, are given in a span of 3 hours following the completion of RIT.
•After RIT, a person comes into the allergists office once a week for the next several weeks, until they reach the maintenance dose (typically about 3 months). RIT patients are able to reach maintenance dose and achieve benefit from allergy shots much faster.

Some Benefits of Rush Immunotherapy

•More rapid clinical improvement with fewer visits for injections
•Allows the patient to achieve maintenance dose more rapidly
•Allows the patient to reach monthly maintenance injections quicker

Some drawbacks or risks of Rush Immunotherapy

•Anaphylaxis (severe allergic reaction) which we help reduce with a specially designed regimen that you take before the procedure
• Premedication with corticosteroids and antihistamines has been shown to decrease the incidence of systemic reactions with RIT significantly
•If there is a systemic reaction, it is treated appropriately and RIT is stopped.
•May not be covered by all insurance companies
•Still requires patient to continue medication during build up phase
•Higher risk of reactions compared to traditional immunotherapy

Reactions to Rush Immunotherapy

•Local reactions (swelling, itching, or tenderness at the injection sites)
•Systemic reaction, which may include:
•Hives, itchy eyes, nose or throat, runny nose, nasal congestion, sneezing
•Tightness in chest and or throat, coughing and or wheezing
•Nausea and vomiting, abdominal cramps
•Lightheadedness or faintness and sometimes shock

What to do before your visit:

Premedication 2 days prior, 1 day prior and the morning of the procedure (provided in our office):

• Prednisone: 50mg once a day ( One 50mg tablet)
• Histamine (H1) Blocker: Claritin 10mg, Zyrtec 10mg, or Allegra 10mg once a day
• Histamine (H2) Blocker: Ranitidine (Zantac) 300mg once a day
• Montelukast (Singulair) 10 mg once a day
• Take all (6) pills at the same time each day if possible

Medication Time:

Time recommended Day 1   2 days before Premedication Time Day 2   1day before Premedication Time Day 3  Day of RIT Premedication Time
8:00 AM      

How long will it take:

• The RIT protocol takes 3 hours and then you must be observed for 2 more hours.
• Expect to be in the office for 5-6 hours.

What to bring on the day of the visit:

•Books, activities, light blanket
•Wear a half sleeve or sleeveless shirt
•Have a light breakfast the morning of the procedure
•We will provide snacks during RIT but you are welcome to bring food with you.

What we will do the day of the visit

•Make sure your asthma, if present, is under good control.
•Obtain baseline spirometry - FEV1 above 70%.
•No B-blockers, ACEI, or evidence of cardiovascular disease.
•Ensure we have Informed consent in chart.

What happens after RIT:

•For most patients, the final dose received during RIT will be repeated for the first post-RIT injection the week after.
•For patients who experienced a systemic reaction during RIT, the first post-RIT dose will be lowered.
•Following RIT, the regular IT schedule will be followed going forward.
•Generally if you tolerate the whole protocol you will continue on weekly injections for another 6-8 weeks, then we can proceed to every other week shots for 6 weeks, followed by every 3 week shots for 6 weeks then monthly