From the Guidelines
The starting dosage for allergen immunotherapy is typically a 1,000-fold or 10,000-fold dilution of the maintenance concentrate, although a lower starting dose might be advisable for highly sensitive patients. When choosing the starting dose, most allergists/immunologists start at a dilution of the maintenance concentrate that is appropriate based on the sensitivity of the patient to the allergens in the extract, which, in turn, is based on the history and skin test reactivity 1. Common starting dilutions from the maintenance concentrate are 1:10,000 (vol/vol) or 1:1,000 (vol/vol), although more diluted concentrations frequently are used for patients who are highly sensitive, as indicated by history or skin test reactions. Some key points to consider when determining the starting dose include:
- The patient's sensitivity to the allergens in the extract
- The history and skin test reactivity of the patient
- The need to balance the risk of systemic reactions with the need to achieve a therapeutically effective dose in a reasonable number of injections. It's also important to note that the starting dose may need to be adjusted based on the patient's response to the treatment, and that the goal of the build-up phase is to reach a maintenance dose that is effective in reducing symptoms while minimizing the risk of adverse reactions 1.
From the Research
Starting Dosage for Performing
- The starting dosage for performing various medical treatments can vary depending on the specific condition being treated and the medication being used.
- For example, in the treatment of hypertension in patients with diabetes, the starting dosage of certain medications such as amlodipine can be 5 mg/day, with titration to 10 mg at week 14 if the blood pressure goal is not achieved 2.
- In the estimation of the minimum therapeutically effective dose of a compound, regression modeling and percentile estimation can be used to determine the lowest dose level that yields a therapeutic benefit to patients, on average, or to a given percentage of patients 3.
- The treatment of hypertension in type 2 diabetes mellitus involves setting blood pressure goals, choosing appropriate agents, and setting priorities in diabetes care, with target diastolic blood pressures of less than 80 mm Hg and systolic targets of 135 mm Hg or less being considered optimal 4.
- The utilization of glucose, blood pressure, and lipid-lowering medications among people with type II diabetes in the United States from 1999-2010 showed an increase in the use of metformin, angiotensin receptor blockers, beta-blockers, and statins, with metformin being the most prevalent medication during this period 5.
- The choice of starting dosage and medication depends on various factors, including the patient's medical history, current health status, and the specific goals of treatment, and should be determined by a healthcare professional based on the individual patient's needs 6, 2, 4.