Adjunctive medications for food-induced anaphylaxis

Intramuscular epinephrine is the first-line treatment for anaphylaxis, including anaphylaxis caused by food allergy. Antihistamines and glucocorticoids are considered second-line treatments for anaphylaxis due to slow onset of action and inability to reverse life-threatening cardiovascular and pulmonary symptoms. Antihistamines can help with cutaneous symptoms while glucocorticoids can reduce inflammatory mediators. The role of these drugs in preventing biphasic anaphylaxis is unclear. Nebulized adrenaline, glucagon, and beta-2 agonists in some cases are helpful as adjunctive medications in managing the symptoms of anaphylaxis. Following anaphylaxis, patients should receive education on how to identify signs of anaphylaxis and treat it with an epinephrine auto-injector, a prescription for an epinephrine auto-injector, an anaphylaxis management plan, and a referral to an Allergist and Immunologist. Strict avoidance of the allergen(s) remains the only strategy to prevent anaphylaxis.