Shellfish allergy and Pepcid? Heard of this?

[shortbun]

A friend was talking about her allergies yesterday and said she always takes a Pepcid prior to going into a restaurant just in case of accidental shellfish contamination of her food. She swears a nurse told her to do this. I tried googling and came up with vague references but nothing firm. Anyone know?

 

[Christine]

Pepcid AC is an H2 histamine blocker. So, while it is a stomach remedy, it does have some allergy benefits, but certainly not first line. I think it's pretty reckless.

 

[disfan07]

I've never heard of that. But I do know that my allergist had me take Zantac every week before allergy shots last spring.

From what I understand Zantac is also supposed to be prescribed after an allergic reaction.

Every time I have a reaction I always take 1-2 Benadryl, 10-20mg of prednisone and 150mg of Zantac right after it happens. Unless its anaphylaxis and then its epi pen and prednisone.

So I don't know if she had me take it as a preventive because I have severe GERD and/or because I was an extremely high risk patient doing cluster shots but it's what she told me to do.

But she's never told me to take it before going out to eat.

 

[KristaTX]

Pepcid AC is an H2 histamine blocker. So, while it is a stomach remedy, it does have some allergy benefits, but certainly not first line. I think it's pretty reckless.

It's reckless for her friend to go out to eat at any and all restaurants who serve any shellfish? Sounds like she isn't ordering foods she's allergic to, but just trying to avoid the risk of cross-contamination.

Reckless would be to not take an Epipen with her everywhere she goes. Taking Pepcid AC "just in case" isn't reckless.

 

[twinboysmom]

I am a nurse and it's the Same advice I have given my father and mil who have shellfish allergies. It's hardly reckless advice. Neither my father or my mil experience severe enough reactions to require an epi pen. For allergic reactions in the ERs that I have worked we give an iv combo of Benadryl and usually Pepcid and a steroid. I have subbed Zantac but Pepcid is an easier iv drug to give.

 

[shortbun]

I am a nurse and it's the Same advice I have given my father and mil who have shellfish allergies. It's hardly reckless advice. Neither my father or my mil experience severe enough reactions to require an epi pen. For allergic reactions in the ERs that I have worked we give an iv combo of Benadryl and usually Pepcid and a steroid. I have subbed Zantac but Pepcid is an easier iv drug to give.

Interesting. My friend carries her epipens. She doesn't order food that contains shellfish. She simply knows that any restaurant that serves shrimp or crab might have those things on a surface where there is other food or fryers might deep fry shrimp AND chicken. She actually doesn't order deep fried food where there's shrimp being fried. She just knows that the first symptoms of shellfish allergy is stomach pain, therefore the Pepcid might slow the reaction allowing her to get help IF she needs it without as much stress or fear of a fatal reaction.
Reason I'm interested is that my son had his first shellfish reaction last year and it was a bad one-bad. Anaphylactic reactions are scary; if you're a teen ager and you're carrying around epipens, it's nice to know there's something that gives you an edge. Pepcid will be in my son's epi bag from now on and in my purse. I keep them around anyway for reflux/GERD.

 

[disfan07]

Interesting. My friend carries her epipens. She doesn't order food that contains shellfish. She simply knows that any restaurant that serves shrimp or crab might have those things on a surface where there is other food or fryers might deep fry shrimp AND chicken. She actually doesn't order deep fried food where there's shrimp being fried. She just knows that the first symptoms of shellfish allergy is stomach pain, therefore the Pepcid might slow the reaction allowing her to get help IF she needs it without as much stress or fear of a fatal reaction.
Reason I'm interested is that my son had his first shellfish reaction last year and it was a bad one-bad. Anaphylactic reactions are scary; if you're a teen ager and you're carrying around epipens, it's nice to know there's something that gives you an edge. Pepcid will be in my son's epi bag from now on and in my purse. I keep them around anyway for reflux/GERD.

If you want an edge....prednisone. My allergist has me keep a stash of prednisone so that I can use my epi and then take prednisone and benadryl right away. When I went into anaphylaxis in her office I had 2 epis and 2 doses of decadron....never had Zantac or Pepcid. And one of my primary anaphylaxis symptoms is GI pain.

..I don't think Zantac or Pepcid would really do anything to help lessen a severe reaction. The only thing I could think of in addition to epi would be steroids and Benadryl.

But there's no alternative for immediate injection of epi if it's that severe.

Also....if you want to decrease the risk of a fatal reaction, make sure that the person having the reaction lies down (with feet propped up if possible) right after injection until paramedics get there. One of the leading causes of death from anaphylaxis actually occurs even with epi injection because patients don't know they shouldn't sit up right after epi....it has something to do with blood flow and the brain.

But I may be missing some information. This is just what my allergist has told me (and she is extremely overprotective of me!)

 

[njmom47]

I've never heard of Peptid, but I have taken a Benadryl or two when I thought I might come into contact with cross-contaminated food. I haven't eaten shellfish in years but joke that with Benadryl, I will. My family always says "NO WAY!" Three ER trips was enough for me! Maybe I should have an Epi pen...hmmmm.

 

[Christine]

It's reckless for her friend to go out to eat at any and all restaurants who serve any shellfish? Sounds like she isn't ordering foods she's allergic to, but just trying to avoid the risk of cross-contamination.

Reckless would be to not take an Epipen with her everywhere she goes. Taking Pepcid AC "just in case" isn't reckless.

No, it's not reckless to eat at restaurants that serve shellfish. My son has a shellfish allergy and he eats in the mall the time.

It's reckless to rely on Pepcid as protection. Sure, it provide some protection as an H2 antagonist, but it's probably a #3 choice for allergic reactions. Meaning, we've been told we could use it if there's nothing else around.

If you have a food allergy it can become serious at anytime in your life--whether it's accidental cross contamination of a small particle or not. If you know you have food allergy, I'd be going along to a restaurant with more than Pepcid.

I will rephrase my statement: it's not reckless to take Pepcid. It's reckless to depend on it keep you out of trouble should an accidental ingestion occur.

 

[tink_n_pooh]

I have never heard of this before but now I will be doing a bit of investigating. Thank you.

 

[MrsToad]

On a recent trip to the ER for a nasty case of hives, I was given Benedryl, Prednisone, and Pepcid, though Epi was needed an hour later when the hives were still increasing. They even sent me home with prescriptions for 3 days of Prednisone, Pepcid, and Claritin. It was the first I'd heard of Pepcid for allergic reactions.

 

[shortbun]

No, it's not reckless to eat at restaurants that serve shellfish. My son has a shellfish allergy and he eats in the mall the time.

It's reckless to rely on Pepcid as protection. Sure, it provide some protection as an H2 antagonist, but it's probably a #3 choice for allergic reactions. Meaning, we've been told we could use it if there's nothing else around.

If you have a food allergy it can become serious at anytime in your life--whether it's accidental cross contamination of a small particle or not. If you know you have food allergy, I'd be going along to a restaurant with more than Pepcid.

I will rephrase my statement: it's not reckless to take Pepcid. It's reckless to depend on it keep you out of trouble should an accidental ingestion occur.

No one is relying on Pepcid, my friend takes on prior to eating in case she gets a cross contamination. She also has an epi. She first learned of this issue when she was in the hospital and they couldn't completely stop her reaction. The nurse suggested Pepcid because she obviously still had the shellfish in her digestive track and it worked. Anyone who's had or witnessed one of these reactions knows that the epis and steroids have to be followed by further treatment for a couple of days-either Benedryl or more steroids. But first, they have to get the reaction stopped.

 

[Christine]

No one is relying on Pepcid, my friend takes on prior to eating in case she gets a cross contamination. She also has an epi. She first learned of this issue when she was in the hospital and they couldn't completely stop her reaction. The nurse suggested Pepcid because she obviously still had the shellfish in her digestive track and it worked. Anyone who's had or witnessed one of these reactions knows that the epis and steroids have to be followed by further treatment for a couple of days-either Benedryl or more steroids. But first, they have to get the reaction stopped.

Excellent. I did not get that from your very first post. It just sounded kind of easy-breezy to me like maybe that was all she was using to avoid a reaction.

So, having said that--nope, using Pepcid doesn't surprise me. It is an H2 antagonist and works on histamines in a specific way. For what it's worth, I took Pepcid for years for reflux and it didn't do a DARN thing for my allergies!!! But I can see where it would be a "cover all the bases" augmentation if you were using other meds too.

 

[disfan07]

My allergist had me on 20mg of prednisone as a precaution while we were at WDW. Since I have so many severe allergies and we know my anaphylaxis reactions require high doses of epi and steroids (2 epis and 2 5mg doses of decadron IM within 10 minutes....spent another 24 hours receiving epi and steroids last time,) she wanted steroids in my system. But she never recommended Zantac....but that might also be because I am already on Prilosec everyday and zantac as needed.

Oh...and just as another PSA....most of you probably always know this but you should always carry at least 2 epi pens with you. For 2 reasons...
First- the first dose doesn't always work (learned that the hard way!) and the EMTs/ paramedics might not be there fast enough if you need more epi (and I learned that not all paramedics/EMTs carry epi)
Second- an epi pen might fail. I have seen this happen at the camp I worked at. Luckily we had an extra epi pen jr. But if we hadn't had one, it would have been bad. My allergist said she has heard of this before...the needle can get stuck.

I personally carry 3 or 4 with me at all times.