What medicine is most effective for food allergies?

At present, for mild to moderate food allergies, the fastest-acting second-generation non-sedating antihistamines, such as loratadine, ebastine, and cetirizine, can generally relieve common symptoms such as skin itching, rash, and swollen mouth in 15 to 30 minutes.； If you have a severe allergic reaction such as difficulty breathing, tight throat, dizziness and unsteadiness, no oral medicine will work. The fastest way to save your life is to inject intramuscular epinephrine. There is no second option.

When I was rotating in the emergency dermatology department, when mango and crayfish were in season, I would receive more than a dozen allergic patients in one night. What left a particularly deep impression was a little girl who had just finished her college entrance examination. She ate half a plate of spicy crayfish. When she walked in, her face was so swollen that her eyes narrowed to slits, and her neck was covered in contiguous wheals, which made her shed tears from the itchiness. She was prescribed Ebastine, and she sat in the waiting area for more than 20 minutes. When she came back for a follow-up visit, most of the swelling had gone away and she no longer scratched. She said that the itching had gone away by at least 70%.

Some people also argue with me, saying that the first-generation antihistamine chlorpheniramine works faster? Yes, its onset of action is not much different from that of the second generation. The problem is that I was so sleepy after eating it that I couldn't even lift my head. I accidentally took one before my last night shift and almost fell asleep at the nurse's station. If I hadn't had a break the next day, I wouldn't have dared to touch it. If office workers or students are allergic and cannot work or attend class in the afternoon, even if the effect is quick, the price/performance ratio is too low.

Of course, not everyone can benefit from second-generation antihistamines, and individual differences are really obvious. Last week, a patient came for a follow-up visit and said that taking loratadine was of no use and that he was itching so much that he could not sleep all night long. I switched him to levocetirizine. As a result, he sent me a message in the afternoon and said that the itching disappeared within 20 minutes after taking it and he slept very soundly. So if taking a certain type of antihistamine doesn't work, don't just deny all medicines. Try changing the ingredients and it's more likely to work.

Let’s be honest, those vitamin C and calcium gluconate anti-allergies posted on the Internet are really auxiliary. Taking them alone cannot suppress acute allergies. I have seen too many people take vitamin C at home for three days and only come to the hospital after the rash grows longer and more numerous. This is purely a delay. There are other anti-allergic probiotics and herbal anti-allergic essences. Let me just say this. There is currently no evidence-based medical evidence to prove that they can quickly relieve allergic symptoms. At most, long-term consumption may have some immune-regulating effects. Taking them during acute attacks is useless.

But everyone must be careful about the severity. Not all allergies can be solved by taking medicine. Last year, there was a patient who was allergic to wheat. He accidentally took a bite of a soup dumpling during a dinner party. Within five minutes, he complained that his throat was tight and he couldn't breathe. Fortunately, he brought an epinephrine pen with him and pricked the outside of his thigh. By the time the ambulance arrived, he had recovered a lot. If you had waited to take antihistamines in this situation, you might have suffocated long ago. This is not an alarmist. The fatal time of a severe allergic reaction is only ten minutes, and you can't wait for the oral medicine to take effect.

I myself am allergic to mango peel. I accidentally got it on my face when I was peeling a mango. Half of my face immediately turned red and itchy. I just applied some calamine lotion, and it really relieved the itchiness for a while. However, within half an hour, it started to happen again. I quickly took a tablet of cetirizine to suppress it completely. Therefore, topical medicines only provide temporary relief, and oral medicines are still required.

Don't just increase the dosage casually to get better quickly, or take several antihistamines at the same time. I've seen people take three tablets of loratadine at one time. The allergy was cured, but the result was dizziness and nausea all day long, which was not worth the gain. If you have just eaten the food you are allergic to, induce vomiting first to spit out the unabsorbed food, and then take the medicine. The effect will indeed be faster. Of course, if it has been an hour or two, vomiting will be useless.

In short, the key to whether taking medicine for food allergy is quick or not is to first judge your own situation and choose the right medicine. If you are not sure whether the symptoms are serious or not, don’t just go to the hospital. It is more reliable than anything else.