June 2, 2014
Peter B. Boggs, MD – BreatheAmerica Shreveport
SOMETHING NEW FOR THE 4.5 MILLION RAGWEED ALLERGY SUFFERERS!
…IT IS HERE AND READY FOR USE NOW!
WHAT IS RAGWITEK?
MEET RAGWITEK! The first FDA approved tablet (YES, TABLET!) for immunotherapy for adult short-ragweed pollen sufferers age 18-65 years. If you have nasal symptoms (stuffy nose, runny nose, sneezing, itching, drainage) and/or eye symptoms (red eyes, watery eyes, itchy eyes, eyelids that swell, mucous accumulation, or bubbling of the white part of the eyes) caused by allergy to short-ragweed pollen, this new tablet may be just what you need.
WHAT IS SHORT RAGWEED?
Short-ragweed is one name for common ragweed. Other names include giant ragweed, western ragweed, and false ragweed. It cross-reacts with most other common fall weed allergens (cocklebur, lamb’s quarters, rough pigweed, marshelder, and goldenrod) so should provide a wide range of protection to those sensitive to fall weed pollens.
WHEN IS RAGWEED SEASON?
While there are regional variations, in most areas of the United States ragweed pollen season begins in mid-August and can last until November. In Louisiana it is almost always gone by the end of the first week of November.
FOR WHOM IS THIS PILL INTENDED?
Anyone 18-65 years of age who has short-ragweed pollen induced nasal and/or ocular symptoms confirmed by a positive skin or serum test for pollen-specific IgE antibodies to short ragweed. It is not yet available in a dosage form for children.
Yep, it is a tablet. It is taken once-a-day: placed in the mouth, under the tongue, and allowed to dissolve. It impacts the immune system and works to reduce the reactivity to ragweed pollen.
DO YOU TAKE IT ALL YEAR, LIKE ALLERGY SHOTS/DROPS?
No. The current recommendation is to begin this at least 12-weeks before the ragweed season begins in your area and continue it until the season is over. Then stop, restarting the next year 12-weeks before the season begins. In Louisiana, this means the latter half of May is the ideal time to begin Ragweitek.
DOES IT WORK?
Studies proving that it works are required by the FDA before it can gain approval and these have been done. The studies so far have been limited to adults, but pediatric studies are underway and it is highly likely that a form for children will be available in the near future. The general assessment is that it works about as well as traditional allergy injections, but with the advantage of less risk of adverse reactions.
IS IT DANGEROUS?
Like any form of immunotherapy, serious reactions can occur. However, the likelihood is sufficiently low to permit dosing at home once the first dose is given in a physician’s office and shown not to cause any adverse reaction.
As with all forms of immunotherapy, all patients receiving RAGWITEK tablets should also be prescribed and taught the use of an epinephrine auto-injector (Epi Pen, Auvi-Q, etc.) in case of an adverse reaction. The most common adverse reactions are mild and include throat irritation, oral itching, ear itching, and numbness-tingling in the mouth. These are annoying, and usually need no treatment other than perhaps Benadryl.
WHAT IS A SERIOUS REACTION THAT WOULD REQUIRE EPINEPHRINE?
Like other forms of immunotherapy, serious reactions are possible and include generalized hives, swelling of the lips, tongue, and throat, trouble breathing, reduced blood pressure, and passing out. These reactions are rare, but can be life threatening, hence patients using this form of immunotherapy, like those who take allergy shots, must always have their Epi Pen, Benadryl, and Pepcid/Zantac available for immediate use. Of course, should a truly serious reaction ever begin, the Epi Pen should be administered first and 911 called. Then one can take the Benadryl and Pepcid/Zantac.
WHO SHOULD NOT TAKE THIS PILL?
Just as with conventional immunotherapy the following persons should not receive RAGWITEK:
- Severe or unstable asthma
- A past history of any systemic allergic reaction (anaphylaxis)
- Those with eosinophilic esophagitis or those who appear to have developed eosinophilic esophagitis during treatment with RAGWITEK
- Hypersensitivity to ingredients included in the tablet other than the ragweed protein (mannitos or sodium hydroxide)
- Persistent or escalating reactions in the mouth or throat area after taking the tablets
- Those currently receiving allergen immunotherapy (shots or drops) for other allergies
- Inflammatory conditions in the mouth (treatment should not be given or stopped until these problems heal)
- Recipients of beta-blockers for hypertension, heart rhythm problems, migraine, etc.