Steps to Avoid a Serious Allergic Reaction

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Long-Term Therapies for Anaphylaxis

Certain medical treatments may reduce your risk of anaphylaxis, or reduce the severity of a reaction if you can’t avoid exposure to an allergen.

These preventive treatments must be used continually, as directed by your doctor. The goal is to prevent a serious reaction that would require epinephrine or other emergency responses after the fact. You’ll still need to avoid any known triggers to the best of your ability.

Food Allergy Medications

In February 2024, the U.S. Food and Drug Administration (FDA) approved the first-ever medication to reduce severe allergic reactions linked to a range of common food triggers, including peanuts, milk, eggs, and wheat.

The approved drug, omalizumab (Xolair), is an injectable medication that has been in use for asthma for over two decades. Xolair is approved as a preventive therapy for food allergies caused by accidental exposure in most adults and children over age 1. It works by binding to an antibody (immune system protein) involved in allergic reactions.

If you and your doctor decide this approach is right for you, you’ll need to stay on the medication indefinitely while continuing to carry an epinephrine auto-injector and avoiding any known triggers. It’s also worth noting that in clinical trials, about 17 percent of people treated with Xolair showed no meaningful improvements. Xolair also carries a small risk for anaphylaxis from the drug itself.

The cost of Xolair varies depending on your insurance coverage, and the companies behind the drug offer financial assistance options.

For people who have a peanut allergy, in 2020, the FDA approved the peanut allergy treatment Palforzia. It works by gradually desensitizing your immune system to peanut proteins, and comes as a powder that you mix with food. You’ll increase your intake of the drug over several months, then take a maintenance dose indefinitely.

While Palforzia does not cure peanut allergies, it does reduce the likelihood of severe and fatal reactions from accidental exposure. People taking the drug must continue to avoid peanuts.

The out-of-pocket cost of Palforzia depends on your insurance coverage. A copay savings program is available.

Allergy Shots

In cases where you may not be able to totally avoid an allergen — such as insect (bee, wasp, hornet, or fire ant) venom, allergen immunotherapy, also known as allergy shots, may be helpful.

For this therapy, you’ll be given a series of shots (injections) that contain increasing doses of the allergen to make your immune system less sensitive to it. Variations of this therapy are available for certain indoor and outdoor allergens, as well as insect venom — but not for food allergies.

Injections for allergy shots are usually given as a series lasting three to five years. Because of the risk of an allergic reaction, you’ll need to stay at your doctor’s office for at least 30 minutes after each allergy shot.

Allergy shots typically cost between $1,000 and $4,000 per year, depending on the type of treatment you’re receiving. With insurance coverage, you may pay less than this out-of-pocket.

The Takeaway

To prevent anaphylaxis, the most important step is avoiding any known allergens. Carry epinephrine and any other recommended treatments with you at all times. For certain allergies, long-term treatments are available that can reduce your anaphylaxis risk.

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