which is better for eustachian tube treatment, fluticasone or azelastine sprays

Medication

Azelastine hydrochloride and fluticasone propionate nasal spray may help to reduce your nasal symptoms including stuffy nose, runny nose, itching, and sneezing. It is not known if azelastine hydrochloride and fluticasone propionate nasal spray is safe or effective in children under 4 years of age.

Procedures

Correct Use of Nasal Sprays for Eustachian Tube Dysfunction. Popping the ears in this manner, esp after nasal spray use helps to squeeze some of the medication into the eustachian tube. Do not exceed the pressure one uses as if you have mild constipation. Swallowing or yawning does not work as well in this situation.

Self-care

Lumry W, Prenner B, Corren J, et al. Efficacy and safety of azelastine nasal spray at a dose of 1 spray per nostril twice daily. Ann Allergy Asthma Immunol. 2007;99:267–72.

Nutrition

It is not known whether azelastine passes into breast milk or if it could affect in a negative way a nursing baby. Therefore, tell your healthcare provider if you are breastfeeding an infant before using the antihistamine. It is not known whether fluticasone is excreted in human breast milk and if it can affect the breastfed baby.

Does azelastine hydrochloride and fluticasone propionate nasal spray work?

How to use nasal spray correctly for eustachian tube dysfunction?

How often should I use azelastine nasal spray for nasal allergies?

Can azelastine and fluticasone be taken while breastfeeding?

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What is the best nasal spray for eustachian tube dysfunction?

1. Saline Nasal Spray. Irrigating your nose and sinuses with saline spray is a great first line of defense against eustachian tube dysfunction. Saline clears mucus out of the nose and has a mild decongestant action.

Does Flonase help blocked eustachian tubes?

The treatment for ETD is aimed at opening up the eustachian tube in the back of the nose. The main treatment is using a steroid nasal spray to help shrink the tissue where the ear drains. Nasal steroid (Flonase, Nasonex, Nasacort) – 2 sprays into each nostril twice daily.

Does fluticasone help with ETD?

Topical decongestants can be used acutely for eustachian tube dysfunction (ETD) but must be discontinued after a maximum of 5 days to prevent rebound swelling. Budesonide, fluticasone, beclomethasone, mometasone, triamcinolone, and flunisolide are steroids used in nasal sprays.

Does azelastine help with ear congestion?

Non addicting allergy nasal sprays (such as Nasocort®, Flonase® or Azelastine) are often prescribed sometimes in combination with oral anti-histamines (like Claritin®, Zyrtec® or Xyzal®) in an attempt to control allergies. Opening the eustachian tube or “popping the ears” is a very safe and effective treatment.

What is the best way to treat eustachian tube dysfunction?

Symptoms of Eustachian tube dysfunction usually go away without treatment. You can do exercises to open up the tubes. This includes swallowing, yawning, or chewing gum. You can help relieve the “full ear” feeling by taking a deep breath, pinching your nostrils closed, and “blowing” with your mouth shut.

How do you use flonase for eustachian tubes?

One sniffs as one sprays just hard enough so one can feel it in the back of the nose, but not so hard that it goes straight down into your mouth. After spray use and hourly while awake, try to pop the ear by pinching the nose and blowing gently. This milks the spray into the eustachian tube.

Do steroids help eustachian tube dysfunction?

Eustachian tube dysfunction (ETD) can be treated primarily with a combination of time, autoinsufflation (eg, an Otovent), and oral and nasal steroids (budesonide, mometasone, prednisone, methylprednisolone). The results of one study suggest that intranasal steroid sprays alone do not help eustachian tube dysfunction.

How long does flonase take to work on ETD?

NASAL STEROID SPRAYS. These sprays decrease swelling in your nose and your Eustachian tubes to help them pop open. Nasal steroid sprays must be used everyday to be effective and often take 5-7 days before you will notice their benefit. They only work on the areas they touch.

What is the best antihistamine for clogged ears?

To additionally reduce the feeling of fullness in your ear, talk to your doctor or pharmacist about an antihistamine that includes a decongestant such as:cetirizine plus pseudoephedrine (Zyrtec-D)fexofenadine plus pseudoephedrine (Allegra-D)loratadine plus pseudoephedrine (Claritin-D)

How do you clear a blocked eustachian tube?

You may be able to open the blocked tubes with a simple exercise. Close your mouth, hold your nose, and gently blow as if you are blowing your nose. Yawning and chewing gum also may help. You may hear or feel a "pop" when the tubes open to make the pressure equal between the inside and outside of your ears.

Can you use azelastine and fluticasone at the same time?

It is generally considered safe to use both Flonase and azelastine for the treatment of your allergic rhinitis. 1 Your healthcare provider may recommend this or prescribe you Dymista (azelastine hydrochloride and fluticasone propionate), a nasal spray composed of generic forms of both medications.

Is azelastine same as Flonase?

Is azelastine (nasal) the same as Flonase? Azelastine (nasal) and Flonase are two different medications. Flonase contains a steroid (fluticasone) and azelastine (nasal) contains an antihistamine (azelastine).

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What is the treatment for eustachian tube dysfunction?

Our ear, nose and throat (ENT) specialists offer a wide range of treatment options for eustachian tube dysfunction. Treatments range from nasal decongestants to surgery. We work with you to determine the most effective treatment plan that will offer a successful long-term outcome.

What is the purpose of a eustachian tube bypass?

The primary goal of surgical treatment is to bypass the eustachian tube in order to ventilate the middle ear. Surgery can restore hearing, relieve pressure sensation in the ear and reduce the tendency for middle ear infections. Types of surgery include:

What type of surgery is used to remove fluid from the middle of the ear?

Types of surgery include: Myringotomy - We make a tiny incision in the eardrum and suction out any fluid in the middle ear. In adults, the incision often stays open long enough to allow the swelling in the Eustachian tube lining to resolve.

How to get air out of the middle ear?

Make an incision in the eardrum and suction out any middle ear fluid. Insert a tiny hollow tube made of plastic or metal into the eardrum. Over time, the tube is pushed out as the eardrum heals. A pressure equalization tube usually provides middle ear ventilation for six to 12 months.

How to improve ear popping?

You may be able to improve your symptoms pinching your nose closed and “popping” your ear. This helps by forcibly air through the eustachian tube into the middle ear. You can also achieve the same effect by blowing up balloons. The pressure required to expand a balloon is usually enough to push air up the eustachian tube.

How long does it take to get a eustachian tube replaced?

If you have a more chronic condition, however, we can use longer lasting tubes. In adults, the procedure takes about five minutes and can be performed in the office using a topical anesthetic.

Why not do a nasal discharge?

Do not perform this when you have a cold or any nasal discharge because it may drive infected mucous into the middle ear and cause an ear infection.

What is the role of the Eustachian tube?

The role of the eustachian tube is to keep the pressure within the middle ear the same as the pressure in the environment. When the eustachian tube is blocked negative pressure occurs within the middle ear, ...

What happens when the eustachian tube is blocked?

When the eustachian tube is blocked negative pressure occurs within the middle ear, this can cause the eardrum to pull inwards which results in pain, pressure sensations and hearing loss. The eustachian tube also acts as a drain for mucus that is produced from the middle ear lining. A blockage can lead to fluid accumulation in ...

What is the ETD of the ear?

Eustachian tube dysfunction (ETD) occurs when there is a chronic blockage of the eustachian tube with ongoing symptoms of feeling of fullness of the ear, clicking or crackling sounds in the ear, hearing may become muffled and there may be ear pain or discomfort. The eustachian tube joins the middle ear to the back of the throat, ...

What is the best treatment for a swollen nose?

Often decongestants are useful to help reduce swelling of the nasal tissue. Further options for treatment can be sought through an otolaryngologist (Ears, Nose and Throat specialist, ENT).

What is an EUA?

An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives. Pregnancy Category.

What is a lack of accepted safety for use under medical supervision?

There is a lack of accepted safety for use under medical supervision. 2. Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.

Is abuse a low potential for abuse relative to those in Schedule 4?

Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.

How long can you use Afrin for eustachian tube dysfunction?

As a reminder, though a decongestant spray like Afrin is VERY helpful to resolve eustachian tube dysfunction, do NOT use this spray daily for more than 3 days as people do get addicted to this medication (a condition known as rhinitis medicamentosa ). Steroid and anti-histamine nasal sprays can be used indefinitely.

Where is the eustachian tube located?

Therefore, the only way medication can be delivered directly to the eustachian tube is through the nose where the other end of the eustachian tube is located (eustachian tube goes from your ear to the back of your nose).

Why don't ear drops work?

Obviously, ear drops will not work because the eardrum prevents anything administered through the ear canal from getting to the eustachian tube which is located BEHIND the eardrum.

How to pop ear after spraying?

After spray use and hourly while awake, try to pop the ear by pinching the nose and blowing gently. This milks the spray into the eustachian tube.

What to do if singulair fails?

If this method fails, your physician may give a trial of singulair and prednisone and if that fails, placement of tubes is often helpful.

What happens if the Eustachian tube is not functioning properly?

If the Eustachian tube is not functioning properly, pressure builds up in the middle ear space and the mucous secretions are unable to drain from the middle ear. Prolonged Eustachian tube dysfunction will likely lead to a middle ear infection, or otitis media.

What is the function of the Eustachian tube?

The Eustachian tube opens and closes to equalize pressure between the middle ear and nasopharynx, protects the middle ear from nasophayngeal secretions and loud sounds , as well as drain mucous secretions from the middle ear space .

What is the best nasal spray for a swollen nose?

Nasal sprays containing nasal decongestant like oxymetazoline or xylometazoline or ephedrine (1 % in adults and 0.5% in children) will help to reduce the inflamed mucosa on the lateral wall of nose as well as the turbinates by vasoconstriction locally and reopens your blocked nose.

What causes swelling in the Eustachian tube?

Allergies and/or a sinus infection can cause swelling of the tissue lining the Eustachian tube and cause dysfunction.

Where is the Eustachian tube located?

Your Eustachian tube is a small, approximately 18-36 mm length tube, that runs from the air-filled middle ear cavity to the back of the nose and throat, called the nasopharynx. There are 3 muscles connected to the eustachian tube that help open and close the tube.

Where does nasal decongestant spray work?

It appears to be a nasal decongestant spray that will do its work all over the nearby area including the entrance of the eustachian tube at the entrance of the throat.

What are the different types of drugs used for rhinitis?

These include intranasal corticosteroids, oral antihistamines, intranasal antihistamines and mast-cell stabilizers (eg, cromolyn compounds). A useful metric to compare each of these treatment modalities is the number needed to treat (NNT), which estimates the number of patients who must be treated with a particular drug in order to have one positive outcome. Obviously, drugs with low a NNT are considered more effective than those with a higher NNT. One report estimated the NNT range for oral antihistamines as 9–35, 3–6 for intranasal corticosteroids, 5–6.3 for azelastine, and 4.6 for immunotherapy (Portnoy et al 2004). However, in that study the NNT was calculated using only a single trial for each drug, and so not all of the evidence was considered. A more recent meta-analysis systematically reviewed the efficacy of azelastine nasal spray, in terms of global assessment of efficacy, versus active comparators using NNTs as the outcome measure (Lee and Pickard 2007). The active comparators included beclomethasone (Beconase®; GSK, USA) and budesonide nasal sprays (Rhinocort®; Astra Zeneca, USA), loratadine, terfenadine (Seldane®; SanofiAventis, USA), cetirizine, ebastine (Kestine®), and levocabastine. Forty-six studies were initially identified and 21 separate publications were included in the analysis. In 5 comparisons azelastine was more efficacious than placebo with a summary NNT of 5.0. No statistically significant difference was found between azelastine nasal spray and the other treatments, including intranasal corticosteroids, in terms of their efficacy in treating rhinitis. However, when the analysis was limited to studies in which an oral allergy treatment was the comparator, the point estimate of the pooled results favored azelastine nasal spray (Figure 1). The results were consistent across both SAR and nonallergic VMR, and across trials of different durations. The risk difference would have been even more favourable for azelastine if only results for azelastine at a dose of 1.12 mg/day were included in the analysis, but the small number of studies available for the meta-analysis precluded that stratification (Lee and Pickard 2007).

How long does it take to reassess corticosteroid?

A stepwise approach is advised with reassessment after 2 weeks. If symptoms are controlled and the patient is on intranasal corticosteroid, the dose should be reduced, but otherwise treatment continued. If symptoms persist and the patient is on antihistamines or cromones, a change should be made to an intranasal corticosteroid.

Is cetirizine a second generation antihistamine?

Cetirizine hydrochloride is an oral second-generation antihistamine indicated for the treatment of SAR and PR. It also has demonstrated inhibitory effects on other mediators of inflammation including leukotrienes (Cheria-Sammari et al 1995), prostaglandins (Charlesworth et al 1989), ICAM-1 expression, and eosinophil chemotaxis (Ciprandi et al 1995). The first Azelastine Cetirizine Trial (ACT 1) carried out in the autumn of 2004, examined the effectiveness and tolerability of azelastine (2 sprays per nostril) and cetirizine tablets (10 mg once daily) in 307 patients with moderate to severe SAR (Corren et al 2005). During the 2-week double-blind treatment period, azelastine nasal spray significantly (p = 0.02) improved the overall TNSS compared with cetirizine. All four symptom components of the TNSS were improved after azelastine therapy, with a significantly greater improvement versus cetirizine for rhinorrhea (p = 0.003). Differences in the TNSS between azelastine nasal spray and cetirizine were sustained throughout the study period and became more evident as the study progressed, with statistically significant differences favoring azelastine nasal spray on study days 8 through 14. In addition, compared with cetirizine, azelastine nasal spray significantly (p = 0.049) improved patients’ HRQoL as assessed by the RQLQ (Corren et al 2005).

Is azelastine better than desloratadine?

In fact, azelastine nasal spray was superior to desloratadine tablets at alleviating nasal congestion when comparing absolute scores at the end of the challenge. This result was unexpected since to date, antihistamines have been found to have little decongestant activity, whereas reduction of nasal congestion is one of the main clinical advantages of third-generation anti-histamines (Horak and Stübner 2002; Murdoch et al 2003). Significant decongestant activity has previously been reported for azelastine nasal spray, but only at the higher dosage of 2 sprays per nostril (Thomas et al 1992). Therefore, these results suggest that azelastine at a dosage of 1 spray per nostril is just as effective as 2 sprays. However, one should be reminded that the improvement in nasal congestion following azelastine therapy is a subjective one, and further objective studies, measuring nasal flow or nasal resistance, are required to confirm these findings.

Is desloratadine a sedative?

In contrast to antihistamines of earlier generations, these drugs are thought to noticeably reduce nasal congestion (McClellan and Jarvis 2001; Horak et al 2002b; Horak et al 2003), are non-se dating and do not cause cardiac side-effects. A recently published study was the first to assess the efficacy and onset of action of azelastine nasal spray (one spray per nostril) compared to desloratadine tablets (5 mg) in patients with SAR (Horak et al 2006). Results showed that azelastine nasal spray was significantly better than desloratadine tablets in reducing the symptoms of SAR including ‘nasal congestion’ induced by allergen challenge in the Vienna Challenge Chamber (VCC). Both azelastine nasal spray and desloratadine tablets significantly (p < 0.001) reduced the Major Nasal Symptom Score (MNSS; defined as the sum of scores of sneezing, rhinorrhea and nasal itching) compared to placebo (Figure 5) (Horak et al 2006), with azelastine significantly (p = 0.005) superior to desloratadine in this regard (Figure 5). In addition, the onset of action of azelastine nasal spray was 15 min. compared with 150 min. for desloratadine tablets. Regarding desloratadine tablets, the onset of action of 150 min reported by Horak et al (2006)was notably longer than that previously described (Horak et al 2002a). This may have been due to the encapsulation of desloratadine tablets for the purpose of blinding.

Is azelastine nasal spray effective?

A study in geriatric patients with allergic or non-allergic rhinitis showed that azelastine nasal spray (2 sprays per nostril twice daily; 1.1 mg) was just as effective as fluticasone propionate nasal spray 2 sprays per nostril daily; 200 μg) at improving patients’ RQLQ scores (Figure 3) and rhinitis symptoms (Figure 4) (Behncke et al 2006). Azelastine nasal spray and oral antihistamines are often used concurrently with an intranasal corticosteroid spray in patients with difficult to treat rhinitis symptoms. Several studies with oral antihistamines in combination with intra-nasal corticosteroids showed no increased clinical benefit with these drugs in combination (Weiner et al 1998; Nielsen and Dahl 2003). However, a recent proof-of-concept study showed that azelastine nasal spray and fluticasone nasal spray in combination provided a substantial therapeutic benefit for patients with SAR compared with therapy with either agent alone (Ratner and Sacks 2007). Patients were randomized to receive either azelastine nasal spray (2 sprays per nostril twice daily), fluticasone nasal spray (2 sprays per nostril twice daily), or both agents together (same dosage). All three groups had statistically significant (p < 0.01) improvement from baseline in TNSS after 2 weeks’ treatment, but the improvement was significant (p < 0.05) with the combination regimen (38%) versus either agent alone (azelastine: 25%; fluticasone: 27%) (Ratner and Sacks 2007).

Is azelastine an anti-inflammatory?

However, azelastine is more than just an anti-histamine. It exhibits a very fast and long-acting effect based on a triple mode of action, with anti-inflammatory and mast cell stabilizing properties in addition to its anti-allergic effects (Bernstein 2007; Lee and Corren 2007). For example, azelastine inhibits the activation of cultured mast cells and release of interleukin (IL)-6, tryptase, and histamine (Kempuraj et al 2002). It also reduces mediators of mast cell degranulation such as leukotrienes which are involved in the late phase allergic response (Howarth 1997), in the nasal lavage fluid of patients with rhinitis (Shin et al 1992). It does this possibly by reducing the production of leukotriene (LT)B4synthase and LTC4, inhibiting phospholipase A2and LTC4(Hamasaki et al 1996). Leukotrienes are associated with dilation of vessels, increased vascular permeability and edema which results in nasal congestion, mucus production and recruitment of inflammatory cells (Golden et al 2006). Substance P and bradykinin concentrations which are formed in biological fluids and tissues during inflammation, are also reduced by azelastine (Shin et al 1992; Nieber et al 1993; Shinoda et al 1997). These agents are associated with the AR symptoms of nasal itching and sneezing, but may also contribute to the onset of non-allergic VMR symptoms. Other anti-inflammatory properties of azelastine include inhibition of tumor necrosis factor alpha (TNFα) release (Hide et al 1997; Matsuo and Takayama 1998), reduction of granulocyte macrophage colony-stimulating factor (GM-CSF) generation, as well as a reduction in the number of a range of inflammatory cytokines including interleukin (IL)-1β, IL-6, IL-4 and IL-8 (Yoneda et al 1997; Ito et al 1998; Beck et al 2000). These cytokines perpetuate the inflammatory response (Settipane 2001). Finally, in SAR patients, azelastine nasal spray has been shown to lower neutrophil and eosinophil counts and decrease intercellular adhesion molecule-1 (ICAM-1) expression on nasal epithelial cell surfaces in both the early and late phases of the allergic reaction (Ciprandi et al 1996). It also decreases free-radical production by human eosinophils and neutrophils (Busse et al 1989; Umeki 1992) and calcium influx induced by platelet-activating factor in vitro (Nakamura et al 1988; Morita et al 1993).

How much fluticasone is in nasal spray?

Each spray contains 137 micrograms (mcg) of azelastine and 50 mcg of fluticasone.

How to use a nasal spray?

Release 1 spray and at the same time, breathe in gently through the nostril keeping your head tilted forward and down . Hold your breath for a few seconds then breathe out slowly through your mouth. Spray the opposite nostril using the same steps. Do not blow your nose after using the spray.

How to use a spray bottle for a swollen nose?

Tilt your head down, looking at your toes, and insert the tip of the nose piece into your nostril. Hold bottle upright and aim the spray tip toward the back of your nose. Close the opposite nostril with a finger.

How long do you have to prime Dymista nasal spray?

Press down fully on the top of the pump 6 times or until a fine spray comes out. Prime the spray if it has not been used for 14 days or more. Gently blow your nose before using the spray.

Can you use a saline spray on your nose?

This medicine is only used in the nose. Do not get this medicine in your eyes or mouth. If it does get on these areas, rinse it off right away with water for at least 10 minutes and call your doctor right away. Do not use this medicine for any other nose problem without checking with your doctor first. To use the spray:

How much azelastine hydrochloride is in nasal spray?

Absorption: After nasal administration of two sprays per nostril (548 mcg of azelastine hydrochloride and 200 mcg of fluticasone) of azelastine hydrochloride and fluticasone propionate nasal spray, the mean (± standard deviation) peak plasma exposure (C max) was 194.5 ± 74.4 pg/mL for azelastine and 10.3±3.9 pg/mL for fluticasone propionate and the mean total exposure (AUC) was 4217 ± 2618 pg/mL*hr for azelastine and 97.7 ± 43.1 pg/mL*hr for fluticasone. The median time to peak exposure (t max) from a single dose was 0.5 hours for azelastine and 1.0 hours for fluticasone.

How many times can you use azelastine hydrochloride?

Each bottle of Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray contains enough medicine for you to spray medicine from the bottle 120 times. After initial priming, do not use your bottle of Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray after 120 sprays.

What to do if a child swallows azelastine?

If a child accidentally swallows Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray or you use too much Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray, call your healthcare provider or go to the nearest hospital emergency room right away.

How is azelastine hydrochloride supplied?

How Supplied: Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray, 137 mcg/50 mcg (NDC 45802-066-01) is supplied as an amber glass bottle fitted with a metered-dose spray pump unit. The spray pump unit consists of a nasal spray pump with a white nasal adapter and clear plastic dust cap. Each bottle contains a net fill weight of 23 g and will deliver 120 metered sprays after priming [see Dosage and Administration ( 2.2 )]. After priming [see Dosage and Administration ( 2.2 )], each spray delivers a suspension volume of 0.137 mL as a fine mist, containing 137 mcg of azelastine hydrochloride and 50 mcg of fluticasone propionate (137 mcg/50 mcg). The correct amount of medication in each spray cannot be assured before the initial priming and after 120 sprays have been used, even though the bottle is not completely empty. The bottle should be discarded after 120 sprays have been used.

What to do if a child accidentally ingests azelastine hydrochloride?

If a child accidentally ingests Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray, seek medical help or call a poison control center immediately.

What is azelastine hydrochloride?

It is a fixed dose combination product containing an anti histamine (H 1 receptor antagonist) and a corticosteroid as active ingredients.

How much fluticasone is in nasal spray?

Nasal spray: 137 mcg of azelastine hydrochloride and 50 mcg of fluticasone propionate per spray.

What is the name of the drug that is used to treat sneezing and runny nose?

Azelastine (Astelin is the brand name) belongs to a group of medicines known as antihistamines which are used to relieve nasal symptoms, like – sneezing, runny/itching/stuffy nose, and post-nasal drip caused by allergic conditions. This drug works by blocking histamines, certain natural substances that are responsible for nasal symptoms.

Why is nasal spray used?

More importantly, this nasal spray helps prevent asthma attacks and symptoms. Important note – it is not used to relieve an asthma attack which has already started.

What is a saline solution used for?

It is used to help relieve symptoms of seasonal or perennial allergic rhinitis and vasomotor rhinitis ( inflammation of the membranes inside your nose).

What is it called when you have a nose allergy?

Nasal allergies, better known as allergic rhinitis, usually happen when allergens in the air cause uncomfortable symptoms that affect the nasal passages.

Is azelastine the same as flonase?

On the other hand, Azelastine is an antihistamine nasal spray that can treat ...

Can you use nasal spray on breast milk?

Seek immediate specialized medical attention and stop using this nasal spray if any of the following occur: hives. It is not known precisely whether this medicine is excreted in human breast milk, therefore, nursing mothers should be extra cautious when using this nasal spray.

Can you be allergic to antihistamines?

if you have ever had an allergic reaction to an antihistamine; if you wear soft contact lenses; if you are breastfeeding or pregnant. Some individuals can experience an allergic reaction, with symptoms including: swelling of the lips, face, tongue, or throat; itching; wheezing;

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