Acarizax treatment for patients with severe house dust mite allergy

Acarizax is a treatment for house dust mite allergy. It is used only for severe symptoms that have not responded to usual treatments. Acarizax reduces allergic symptoms by giving you a regular fixed amount of house dust mite allergy extract, allowing your immune system to build up a natural tolerance to house dust mite allergy. This process is called desensitisation or immunotherapy.

Procedure

Acarizax is a tablet that is taken daily. Treatment should be continued all year round for a total of three years.

One to two hours before taking Acarizax you should have taken an antihistamine such as Cetirizine 10mg. The Acarizax tablet should be carefully removed from the blister card, using dry fingers, and placed directly under the tongue. It will dissolve within seconds.

The first Acarizax tablet will be administered in the hospital’s allergy clinic by a doctor or nurse. This is to ensure that the tablet is taken correctly, to monitor any side effects and give you the opportunity to discuss possible side effects with the doctor. Before taking the first tablet, you will be asked to complete a consent form, and we will check your pulse, blood pressure and peak expiratory flow rate (PEFR), which is the volume of air forcefully expelled from the lungs in one quick exhalation – it is a reliable indicator of ventilation adequacy as well as airflow obstruction.

You should avoid swallowing for one minute and avoid food and drink for five minutes after taking the tablet. You will be asked to remain in the department for at least one hour under observation. On the second or third day after starting the medication you will be asked to phone or email the allergy department to report any side effects or symptoms. After that you will be reviewed annually by the allergy team. Your GP (general practitioner) will continue to prescribe the medication and review you in the interim.

Side effects

The most common side effect of treatment with Acarizax is itching and swelling of the mouth. These symptoms should be expected and are more common in the first few weeks of treatment. Therefore we advise you to take regular antihistamines during the first month of treatment to prevent these symptoms. Some patients also experience tiredness in the first few weeks. More serious reactions are less common but include swelling of the throat, generalised itchy rash, difficulty in breathing, abdominal pain and vomiting. If any of these symptoms occur you should seek medical advice immediately.

Contraindications

Acarizax should not be taken if you have cancer / malignancy, severe asthma or severe inflammation of the mouth (for example cuts or sores). Acarizax contains fish-derived gelatine and although there does not appear to be an increased risk of allergic reactions in patients with fish allergy, you should inform your allergy doctor if you are aware that you suffer from this.

Special care

Special care is required if you have had recent dental surgery, you have a severe allergy to fish or you have experienced severe allergic reactions to house dust mite immunotherapy injections previously. Please contact the allergy clinic for advice if any of these apply to you.

Vaccinations may be given without interrupting treatment with Acarizax after medical evaluation of your general condition. Please inform the allergy clinic if you have any vaccinations planned.

Pregnancy and breastfeeding

Pregnancy

There is no data on the clinical experience of the use of Acarizax in pregnant women. Animal studies do not indicate increased risk to the foetus.

Treatment with Acarizax should not be initiated during pregnancy. If pregnancy occurs during treatment, the treatment may continue after evaluation of the general condition (including lung function) of the patient and reactions to previous administration of Acarizax. For those patients with pre-existing asthma, close supervision during pregnancy is recommended.

Breastfeeding

No clinical data is available for the use of Acarizax during lactation. No effects on the breastfed infants are anticipated.

Fertility

There is no clinical data with respect to fertility for the use of Acarizax. In a repeat dose toxicity study in mice, no effects were observed in the reproductive organs of either genders.

Contacts/ further information

If you have any questions regarding any aspect of your treatment, please do not hesitate to contact the allergy nurses on 01223 348112.

After you commence treatment, please email the allergy secretaries.