Medications To Stop Before Allergy Testing - AAOA Patient Resources (2024)

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Medications To Stop Before Allergy Testing - AAOA Patient Resources (1)

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By Dana Crosby, MD, FAAOA

WHY DO I NEED TO STOP SOME MEDICATIONS BEFORE AN ALLERGY TEST?

  • When you are allergic to a substance, your body releases certain chemicals such as histamine. When these chemicals are released in the skin during a test, we see a small bump in the skin that is often surrounded by redness. Certain medications can decrease this response and cause allergy testing to look negative even if you do have allergies.
  • Other medications can be dangerous to take if you are having an allergy test. Some medications can increase your chance of a life-threatening reaction to an allergy test or make treating a severe reaction more difficult.
  • You only need to consider stopping medications if you are going to have a skin test for allergies. If your allergy test will be done with a blood draw from the vein no medications need to be stopped.
  • It is important to review your list of medications with your ENT allergist in order to ensure the most accurate and safe outcome when you have your test.

WHAT MEDICATIONS DO I NEED TO STOP BEFORE AN ALLERGY TEST?

Type of medicationExamples of this medicationWhen to stop
Topical Corticosteroidsaclometasone (Aclovate)amcinonide (Cyclocort)betamethasone (Diprolene, Betanate,Beta-Val)clobetasol (Clobex, Olux, Temovate)desonide (Desonate, Desowen, Lokara,Vereso)desoximetasone (Topicort)diflorasone (Apexicon)fluocinolone (Synalar)fluocinonide (Vanos, Lidex)flurandrenolide (Cordran)fluticasone (Cutivate)halcinonide (Halog)halobetasol (Ultravate)hydrocortisone (Locoid, Pandel,Westcort)mometasone (Elocon)triamcinolone (Cinalog, Kenalog, Triderm)21 days before the test (in the area that will be tested)
*Tricyclic Antidepressantsamitriptyline (Elavil, Endep, Etrafon,Limbitrol, Vanatrip)amoxampine (Asendin)clomipramine (Anafranil)desipramine (Norpramin)doxepin (Adapin,Sinequan)imipramine (Tofranil)nortriptyline (Aventyl, Pamelor)protriptyline (Vivactil)trimipramine (Surmontil)14 days before test
*Atypical Antidepressants & Sedativesbupropion (Wellbutrin)eszopiclone (Lunesta)mirtazapine (Remeron)quetiapine (Seroquel)trazadone (Oleptro)zolpidem (Ambien)14 days before test
Second and Third Generation Antihistaminescetirizine (Zyrtec)desloratadine (Clarinex)fexofenadine (Allegra)levocetirizine (Xyzal)loratadine (Claritin, Alavert)7 days before test
*Benzodiazepinesalprazolam (Xanax)clonazepam (Klonopin)diazepam (Valium)lorazepam (Ativan)midazolam (Versed)7 days before test
*Beta-blocker (pills and eye drops)Acebutolol (Sectral)Atenolol (Tenoretic, Tenormin)Betaxolol (Betoptic, Kerlone)Bisoprolol (Zebeta, Ziac)Carteolol (Cartrol, Ocupress)Carvedilol (Coreg)Esmolol (Brevibloc)Labetalol (Normdyne, Trandate)Levobunolol (AK-Beta, Betagan)Levobetaxolol (Betaxon)Metipranolol (OptiPranolol)Metoprolol (Lopressor)Nadolol (Corgard, Corzide)Penbutolol (Levatol)Pindolol (Visken)Propranolol (Inderal, Inderide)Sotalol (Betapace, Sorine)Timolol (Betimol, Blocarden, Ocumeter,Timolide, Cosopt, Occudose, Timoptic)5 days before test
First Generation Antihistaminesazatadine (Optimine)brompheniramine (Bromax, Lodrane)carbinoxamine (Histex, Karbinal, Palgic,Pediatex)chlorpheniramine (Aller-Chlor, Chlor-Trimeton)clemastine (Allerhist, Contact, Tavist)cyproheptadine (Periactin)dexchlorpheniramine (Polarmine)diphenhydramine (Benadryl, many othercold and allergy pills)
dimenhydrinate (Dramamine)hydroxyzine (Atarax, Rezine, Vistaril)ketotifen (Zatiden)meclizine (Antivert, Bonine)methdilazine (Tacaryl)phenindamine (Nolahist)promethazine (Chlorpromazine,Phenergan, Promethazine)pyrilamine (Nisaval)trimaparazine (Tremaril)tripelennamine (PBZ)triprolidine (Myidyl, Tripohist, Zymine)
5 days before test
H2 Blockerscimetidine (Tagamet)famotidine (Pepcid)ranitidine (Zantac)2 days before test
Antihistamine Nasal Sprayazelastine (Astelin, Astepro, Patanase,Dymista)1 day before test
Antihistamine Eye Dropsazelastine (Optivar)olopatadine (Patanase, Pataday, Patanol)1 day before test
Immunomodulatorsomalizumab (Xolair)others are unknown discuss with doctor6 months

WHAT MEDICATIONS CAN I CONTINUE DURING ALLERGY TESTING?

Angiotensin-Converting Enzyme (ACE) Inhibitorsbenazeprilcaptoprilenalaprillisinoprilperindoprilquinaprilramipril
Immunosuppressantscyclosporin
Nasal Steroid Spraysbeclomethasonebudesonideciclesonidefluticasonemometasonetriamcinolone
Decongestant, Decongestant Sprays, Expectorantsguaifenesinoxymetazolinephenylephrinepseudoephedrine
Leukotriene modifiersmontelukastpranlukastzafirlukastzileuton
Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)atomoxetinedesvenlafaxineduloxetinelevomilnacipranmilnacriprantramadolvenlafaxine
Proton Pump Inhibitors (PPIs)dexlansoprazoleesomeprazolelansoprazoleomeprazolepantoprazolerabeprazole
Selective Serotonin Reuptake Inhibitor (SSRIs)citalopramescitalopramfluoxetinefluvoxamineparoxetinesertralinevolazodonevortioxetine

!!!!!DO NOT STOP ASTHMA MEDICATIONS OR INHALERS!!!!!

PEARLS

  • It is critical to discuss stopping any medication for your heart, blood pressure, depression, anxiety, sleep or any medication that is required to maintain your current state of health with your ENT allergist and the physician who prescribed it to you. DO NOT stop these medications without discussing the risks first.
  • It is important to continue all inhalers for asthma as uncontrolled asthma can increase the risk of testing.
  • These are not firm time frames. Some doctors will tell you to stop these medications for a different length of time depending on their practice and experience.
  • Many allergy doctors will tell you to stop all problematic medications at the same time (5-14 days) in advance of your testing depending on their preference to make it easier for you.
  • This list does NOT include every important medication. Please discuss your medication list with your allergist. If you have questions about specific medications please do not hesitate to call to ensure accuracy and safety of the test.

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