Anaphylaxis Due to Poloxamer 238

Carbonell, A; Escudero, Alejandro; Miralles, J C; González, A; Navarro, Carlos; Cardona, Porfirio Nordet; Jimeno, L; Pineda, Fernando

doi:10.18176/jiaci.0298

Cited by 9 publications

(3 citation statements)

References 6 publications

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“…SPT and IDT (1:1000) with poloxamer 238 were positive and negative in 5 controls. A histamine release test was also positive [ 102 ]. As poloxamers are block copolymers of PEG and polypropylene glycol, cross-reactivity between poloxamers and macrogols could potentially occur.…”

Section: Poloxamer 238mentioning

confidence: 99%

New Challenges in Drug Allergy: the Resurgence of Excipients

Díaz

Oribe

Torrence

et al. 2022

Curr Treat Options Allergy

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Purpose of Review Allergy to excipients is a cause of multidrug allergy and if it is not taken into account, it can lead to unexpected severe reactions. If an excipient allergy is suspected, an accurate examination followed by algorithms is very important for a correct diagnosis and to give patients detailed information in order to avoid future reactions. Recent Findings In recent times, due to allergy COVID vaccine reactions, interest in excipients as polyethylene glycol derivatives (PEGs) has increased as a possible cause of drug and vaccine hypersensivity. In addition to PEGs many other excipients as gelatin, alpha-gal, protamine, benzalkonium chloride, and benzyl alcohol have been described as a cause of allergy to drugs and vaccines. For most excipients, the dilutions used for skin testing (ST) are not standardized and proper algorithms to reach a diagnosis are not available. Summary The purpose of this article is to review the excipients that may produce inmediate hypersensitivity drugs and vaccine reactions and update diagnostic procedures to reach an accurate diagnosis. We highlight the in vivo and in vitro diagnostic tests used in published reports and detail the dilution used for each excipient to perform ST in order to confirm this vital pathology and to prevent new reactions.

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Section: Poloxamer 238mentioning

confidence: 99%

New Challenges in Drug Allergy: the Resurgence of Excipients

Díaz

Oribe

Torrence

et al. 2022

Curr Treat Options Allergy

View full text Add to dashboard Cite

show abstract

“…Of the 17 case reports found, six were due to an adverse effect to a surfactant [12][13][14][15][16][17]. These include an 80-year-old female patient who developed an injection site reaction due to polysorbates in PCSK9i formulations [14].…”

Section: Plos Onementioning

confidence: 99%

Biologic excipients: Importance of clinical awareness of inactive ingredients

Ionova

Wilson

2020

PLoS ONE

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Due to the complexity and fragility of biological drug products, several challenges exist in their formulation development. Excipients are added to increase product stability, maintain tonicity, and facilitate drug delivery. The potential implications of these additive substances merit clinical consideration. We assessed the safety risk of excipients on the basis of their type and variability through an assessment framework, which quantifies excipient complexity in 230 biological formulations, and identifies excipient-related adverse events through published case reports. A biologic on average contained 4.45 excipients, half of that found in oral medications. The frequency distribution was heavily skewed towards the most commonly occurring excipients: water (40.4%), sodium chloride (38.3%), polysorbate 80 (28.7%), sucrose (24.4%), and mannitol (20.9%), with 44.4% of formulations not listing the concentration of the most commonly occurring inactive ingredients. A literature search revealed only 17 case reports of excipient-related adverse events, suggesting the need for more clarity for clinicians on the safety of chemical additives. These cases included injection site reactions, anaphylaxis, hyperglycemia, and acute renal failure. With the expansion of the biopharmaceutical market, it is important to consider the safety data of biologic excipients, so that therapy can be tailored appropriately for a specific patient.

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“…Anaphylaxis occurred after intravenous administration of Nanocoll [100]. SPTs and IDTs to poloxamer 238 were positive.…”

Section: Radiopharmaceuticalsmentioning

confidence: 99%

Immediate Hypersensitivity Reactions Caused by Drug Excipients: A Literature Review

Caballero¹,

Quirce²

2020

J Investig Allergol Clin Immunol

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The European Medicines Agency defines excipients as the constituents of a pharmaceutical form apart from the active substance. Immediate hypersensitivity reactions (IHRs) caused by excipients contained in the formulation of medications have been described. However, there are no data on the prevalence of IHRs due to drug excipients. Clinical manifestations of allergy to excipients can range from skin disorders to life-threatening systemic reactions. The aim of this study was to review the literature on allergy to pharmaceutical excipients and to record the IHRs described with various types of medications, specifically reactions due to the excipients contained in their formulations. The cases reported were sorted alphabetically by type of medication and excipient in order to obtain a list of the excipients most frequently involved for each type of medication.

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Anaphylaxis Due to Poloxamer 238

Cited by 9 publications

References 6 publications

New Challenges in Drug Allergy: the Resurgence of Excipients

New Challenges in Drug Allergy: the Resurgence of Excipients

Biologic excipients: Importance of clinical awareness of inactive ingredients

Immediate Hypersensitivity Reactions Caused by Drug Excipients: A Literature Review

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