A. The first day procedure will take about 3 hours. Visits 2 and 3 will be about 2 hours, with subsequent visits about an hour. If there are no problems during the escalation phase, the patient will be eating a full serving of the allergenic food in 4-5 months.
A. No. Patients should take all routine medications as they normally would during OIT.
A. There must be a minimum of 7 days between dose increases (7 doses given), but patients may decide to go longer between dose increases if they so choose.
A. Doses should be given 21-27 hours apart.
A. No. Your child must be up-to-date on all scheduled immunizations before starting any of the oral immunotherapy programs.
A. Children should be observed for at least one hour after the dose is given. They should not be allowed to sleep during this time.
A. There should be at least 21 hours and no more than 27 hours between doses. NEVER increase the dose at home. If the updose office visit is scheduled more than 27 hours since the last dose, give one additional dose about 12 hours before the scheduled updose visit.
A. Treat the reaction the same way you would any food reaction; antihistamine if there is just rash/hives, Epi-pen or Auvi-Q if there are other symptoms of anaphylaxis. If there are only mild hives or oral itch, DO NOT give antihistamine for the first hour to see if the reaction progresses. If the hives/oral itch are increasing, give antihistamine.
Please see the additional information sheets regarding fever, nausea, and vomiting. Call us after the appropriate immediate intervention. We will give instructions on future dosing.
A. Do not administer the dose less than one hour before boarding and do not administer the dose while flying.
A. When dosing with whdiv id="accordion-tabs>e foods. Specific brand and type recommendations will be given.
A. If there is a gap of more than 27 hours between doses, call before giving the next dose. If it is less than 27 hours, pick up on the standard dosing schedule.
A. Taste is personal; experiment. Try drink powder (Kool-Aide, Crystal Light), chocolate or another beverage. The food powder could be mixed with a small amount of a semi-solid food such as apple sauce or mashed potato. Try to give the dose in one bite to ensure that the entire dose of oral immunotherapy mixture is taken. If the total amount gets too large, it will be hard to get it all down.
A. Egg Beaters are not permitted because they are not complete eggs.
A. Foods containing the allergenic food may be introduced into the diet at the end of the entire oral immunotherapy escalation process as instructed by your provider.
A. The number one goal is safety; to allow the patient to ingest the allergenic food and foods that contain the allergenic food without thinking about it.
A. When the full dose has been reached, there is a follow-up at 1 month (with lab) and then every 6 months. Food specific IgE levels should be drawn yearly on maintenance dosing.
A. Time of day is not important but the amount of time between doses is important. We have achieved a delicate balance that depends on a certain amount of the allergenic protein being in their system at all times. You should try to give the once a day dose at the same time every day (21-27 hours between doses). We recommend morning dosing.
A. Exercise should be avoided for at least two hours after dosing and doses should not be given immediately following exercise. Exercise around the time of dosing increases the chance of a reaction. Exercise restriction applies to both escalation and maintenance dosing.
A. In most cases the food may be freely added to the diet after reaching the maintenance phase of Food OIT treatment.
Cashew, Hazelnut, Almond, Pistachio, Macadamia, and Peanut: 8 nuts
Walnut and Brazil nut: 3 ½ nuts
Pecan: 7 pecans
Egg: 2 tsp egg white powder or 2 T of liquid egg white
Milk: 240ml (8 oz) whole or 2% milk
Wheat: 75 Wheat Chex (3/4 cups) or 1 slice of whole wheat bread
Chickpea: 16 chickpeas
Soy: 240ml (8 oz) soy milk
Sesame: 5.6 grams of sesame seeds
Sunflower seed: 8 grams of sunflower seeds or 7 grams of Sunbutter.
If the time comes when the frequency of the maintenance dose changes, we will let you know. Until then, the patient should continue the daily maintenance dose as directed.
A. May do a food challenge for a different food 1 week after completing oral immunotherapy.
A. Each Food OIT Program is food specific. Completing one program does not treat other food allergies. Ask your provider for more specific information for treating multiple food allergies.
A. Your child may begin a second oral immunotherapy program after he/she has been stable on a maintenance dose for one month.
A. The first 3 visits/procedures will be billed as an Oral Challenge and visit. Subsequent dosing office visits are billed as an office visit. The actual reimbursement varies by insurance plan. As this procedure is not FDA approved your insurance will not cover the actual materials and time used to make the capsules. Out of pocket expense for this portion of treatment will vary based on the number of food allergies being treated.