What are corticosteroid (steroid) injections for allergic reactions?

From the Guidelines

Steroid shots for allergies are typically reserved for severe cases and usually contain corticosteroids like triamcinolone (Kenalog), methylprednisolone (Depo-Medrol), or betamethasone, which are powerful anti-inflammatory medications that suppress the immune system's overreaction to allergens. These injections are usually administered in a doctor's office, with dosages ranging from 40-80 mg for adults, depending on the severity of symptoms and the specific medication used. A single injection can provide relief for several weeks to months, making them particularly useful for seasonal allergy sufferers. The shots work by reducing inflammation and blocking the chemicals that trigger allergic reactions, effectively dampening symptoms like sneezing, itching, congestion, and skin reactions. While effective, these injections should be limited to 2-4 times per year due to potential side effects including elevated blood sugar, increased appetite, mood changes, and with long-term use, more serious effects like bone thinning, cataracts, and adrenal suppression, as noted in studies such as 1. Some key points to consider when using steroid shots for allergies include:

• They are most effective for severe allergies that don't respond to other treatments like antihistamines, nasal sprays, or allergy immunotherapy, as recommended by guidelines such as those outlined in 1 and 1.
• Intranasal corticosteroids are generally considered the most effective medication class for controlling symptoms of allergic rhinitis, as stated in 1.
• The combination of an intranasal corticosteroid and an intranasal antihistamine may be recommended for initial treatment of moderate to severe seasonal allergic rhinitis, as suggested in 1 and 1. It's essential to weigh the benefits and risks of steroid shots for allergies and to consult with a healthcare professional to determine the best course of treatment, taking into account the latest evidence and guidelines, such as those provided in 1, 1, 1, 1, 1, and 1.

From the FDA Drug Label

Allergic states: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions. The steroid shot for allergies is triamcinolone. It is used to control severe or incapacitating allergic conditions, including:

• Asthma
• Atopic dermatitis
• Contact dermatitis
• Drug hypersensitivity reactions
• Perennial or seasonal allergic rhinitis
• Serum sickness
• Transfusion reactions 2

From the Research

Steroid Shots for Allergies

Steroid shots, also known as corticosteroid injections, are commonly used to treat allergic reactions, including allergic rhinitis. The following points highlight the use of steroid shots for allergies:

• Steroid shots can help reduce inflammation and alleviate symptoms of allergic rhinitis, such as nasal itching, sneezing, and rhinorrhea 3.
• Intranasal corticosteroids, such as triamcinolone acetonide, are effective in reducing membrane permeability and inhibiting both early and late phase reactions to allergens 4.
• The use of nasal steroids and antihistamines can significantly decrease total oxidative stress in allergic rhinitis patients 5.
• Intranasal steroids are highly effective drugs for the treatment of allergic rhinitis and are more efficacious compared to other medications, such as antihistamines and leukotriene modifiers 6.
• A systematic review and meta-analysis found that most intranasal medications, including corticosteroids and antihistamines, are effective in improving rhinitis symptoms and quality of life 7.

Types of Steroid Shots

Different types of steroid shots are available, including:

• Triamcinolone acetonide, which is commonly used to treat allergic rhinitis 4.
• Fluticasone furoate and fluticasone propionate, which are effective in improving nasal symptoms and quality of life in patients with seasonal allergic rhinitis 7.
• Azelastine-fluticasone, which has a high probability of resulting in moderate or large improvements in nasal and ocular symptoms 7.

Administration and Dosage

The administration and dosage of steroid shots for allergies vary depending on the specific medication and individual patient needs. For example:

• The recommended maximum dose of aqueous triamcinolone acetonide in adults and children is 220microg once a day 4.
• The duration of allergy treatment with steroid shots is generally for the length of each allergy season, with a reduction of dosage to the lowest effective dose with monitoring every 3 months for risk and benefit assessment 4.