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Q: While at the pharmacy recently, I was asked if I had any allergies. Why should that matter?

A: Lots of confusion surrounds the term “allergy.” The term can be used to describe seasonal allergies with symptoms of sneezing and itchy, watery, red eyes experienced during certain times of the year. It can also be used to define food or medication allergies, which could include a rash or even life-threatening reactions.

First, what is an allergy? According to the American Academy of Allergy, Asthma and Immunology, an allergic reaction occurs when the immune system reacts to a normally harmless substance. This substance is called an allergen.

Exposure to an allergen causes production of antibodies. Antibodies can be compared to an alarm that alerts the body to something present that should not be there.

These antibodies, or alarm signals, travel throughout the body telling cells to release chemicals to attack the allergen. This chemical release causes symptoms that can include many different body reactions, some minor and some severe.

Allergy symptoms can include hives, red or itchy skin, swelling, throat tightness, wheezing, trouble breathing, and sometimes tingling in the hands, feet, lips or scalp.

The most severe presentation of an allergic reaction is anaphylaxis, which involves multiple parts of the body and requires immediate medical treatment.

Allergens in drugs

Drug allergies are seen after being exposed to a particular medication. The most common drug allergies are to antibiotics, aspirin, nonsteroidal anti-inflammatory medications and anticonvulsants.

At the pharmacy, not only do allergies to medications need to be considered. There is also the possibility for an inactive ingredient in a medication to be an allergen. Some inactive ingredients can trigger food allergies if they contain the specific proteins found in that food item.

According to a review published by the American Journal of Allergy and Clinical Immunology, food allergy symptoms are rarely caused by taking medications because not enough protein from the allergen is present to trigger a reaction. However, for many patients with severe allergies, specifically those patients who experienced anaphylaxis, it is best to avoid their allergens even in small quantities.

Allergies can change with age

With food and drug allergies, the severity of the reaction can change as a person ages. Some people can even outgrow an allergy altogether or develop a new allergy later in life.

The table below lists some medications that could contain potential food allergens for the most common food allergies in the United States, according to the Centers for Disease Control (CDC):  milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts and tree nuts.

Filling out your patient history questionnaires to the best of your ability is crucial so your healthcare providers can provide you the best care possible.

Allergic reactions, especially reactions that result in anaphylaxis, are a serious concern at the pharmacy. Keeping an up-to-date record of allergies to both medications and food can help you avoid any accidental exposures due to the inactive ingredients in medications.

Kayla Lucas is a fourth-year Doctor of Pharmacy candidate at VCU School of Pharmacy. Originally from Roanoke, she completed her prerequisites at Roanoke College while working at her family’s independent pharmacy, DownHome Pharmacy. Her career interests include ambulatory care, compounding pharmacy and independent community pharmacy.

Food allergies with potential triggers found in medications