From the Guidelines
The recommended treatment for injection site reactions typically involves applying a cold compress to the affected area for 15-20 minutes several times a day to reduce swelling and discomfort, as well as using over-the-counter pain relievers such as acetaminophen or ibuprofen to manage pain and inflammation. For itching or allergic reactions, an antihistamine like diphenhydramine at a dose of 25-50 mg every 4-6 hours may be helpful 1. Topical treatments including 1% hydrocortisone cream applied 2-3 times daily can reduce inflammation and itching. Most injection site reactions resolve within a few days without specific treatment. However, if the reaction is severe, spreads beyond the injection site, or is accompanied by fever, difficulty breathing, or other concerning symptoms, immediate medical attention should be sought as this could indicate a more serious allergic reaction.
Key Considerations
- Local reactions can be managed with local treatment, such as cool compresses or topical corticosteroids, or antihistamines 1.
- Systemic reactions can be mild or severe and may require epinephrine, antihistamines, and systemic corticosteroids 1.
- Patients should be taught to self-inspect injection sites and distinguish healthy from unhealthy tissue 1.
- Clinicians should monitor and record the evolution of injection site reactions and provide guidance on site rotation and needle reuse to minimize complications 1.
Treatment Options
- Cold compresses: apply for 15-20 minutes several times a day to reduce swelling and discomfort.
- Over-the-counter pain relievers: acetaminophen or ibuprofen to manage pain and inflammation.
- Antihistamines: diphenhydramine at a dose of 25-50 mg every 4-6 hours for itching or allergic reactions.
- Topical treatments: 1% hydrocortisone cream applied 2-3 times daily to reduce inflammation and itching.
From the Research
Treatment of Injection Site Reactions
The treatment of injection site reactions (ISRs) is crucial to prevent unnecessary discontinuation of treatment and to minimize complications.
- The incidence rate of ISRs with FDA-approved self-injectable biological agents is between 0.5-40% 2.
- Almost all local reactions to subcutaneously administered biological agents can be prevented by changing the injection techniques, patient education, and training 2.
- Intralesional corticosteroid injections have been used to treat various dermatological diseases, and the method of injection is critical in determining the efficacy and development of complications 3.
- Oral prednisone has been shown to be effective in treating antihistamine-resistant chronic urticaria, with nearly 50% of patients achieving remission after a single short course 4.
Prevention and Management
- Preventing ISRs can be achieved through proper injection techniques, patient education, and training 2.
- Intralesional corticosteroid injections can be an effective treatment option for various dermatological diseases, but the method of injection is crucial in determining the efficacy and development of complications 3.
- Oral prednisone can be used to treat antihistamine-resistant chronic urticaria, but the response to treatment can vary among patients 4.
- Antihistamines can cause urticaria in some patients, especially those with NSAID sensitivity, and alternative treatments such as fexofenadine may be necessary 5.