From the Guidelines
Treatment for localized angioedema of the lip should prioritize the use of on-demand medications such as icatibant or sebetralstat, which have been shown to be safe and efficacious in reducing morbidity and improving quality of life 1. When considering treatment options, it is essential to distinguish between allergic and hereditary angioedema, as the latter requires specific medications such as C1 esterase inhibitor concentrates or plasma kallikrein inhibitors like sebetralstat 1.
- For immediate relief, antihistamines and corticosteroids may be considered, but their effectiveness is limited in hereditary angioedema 1.
- Cold compresses and symptomatic treatment may also be beneficial in reducing swelling and discomfort.
- If the angioedema is causing respiratory distress or significant airway compromise, immediate medical attention is required, and medications like icatibant or sebetralstat should be administered as early as possible 1.
- Identifying and avoiding triggers is crucial in managing recurrent episodes of angioedema.
- Patients should be advised that most cases of allergic angioedema resolve within 24-48 hours with appropriate treatment, but hereditary angioedema requires more specific and targeted therapy 1. Key considerations in treatment include:
- Early administration of on-demand medications to reduce morbidity and improve quality of life 1
- Distinguishing between allergic and hereditary angioedema to guide treatment decisions 1
- Symptomatic treatment and supportive care to manage discomfort and reduce swelling
- Avoiding triggers and identifying underlying causes to prevent recurrent episodes.
From the FDA Drug Label
The signs and symptoms associated with anaphylaxis include ... angioedema, swelling of the eyelids, lips, and tongue. The treatment for localized angioedema of the lip is epinephrine (IM), as it is used for emergency treatment of allergic reactions, including anaphylaxis, which may result in angioedema 2.
From the Research
Localized Angioedema of the Lip Treatment
- The treatment of localized angioedema of the lip depends on the underlying cause, which can be either histaminergic or non-histaminergic 3.
- Histaminergic angioedema is often caused by allergic reactions and can be treated with standard therapies such as epinephrine, glucocorticoids, and antihistamines 3.
- Non-histaminergic angioedema, on the other hand, is often resistant to these treatments and may require alternative therapies such as C1-inhibitor concentrates, icatibant, or ecallantide 3, 4.
- In cases of angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema, discontinuation of the causative drug is recommended, and fresh frozen plasma may be considered as a treatment option 5, 6.
- It is essential to note that bradykinin-mediated angioedema, which can be caused by ACEIs, does not respond to the same treatment as histamine-mediated angioedema 7.
- A comprehensive investigation of angioedema must include analysis of complement factors, tryptase levels, and specific allergy tests to determine the underlying cause and guide treatment 5.