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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Non-Standardized Pollen Allergenic Extract [EPC]
Alnus Rubra Pollen is a non-standardized allergenic extract used for the diagnosis and treatment of Red Alder tree allergies through immunotherapy. It belongs to the class of pollen allergenic extracts and is primarily used for desensitization in patients with IgE-mediated hypersensitivity.
Name
Alnus Rubra Pollen
Raw Name
ALNUS RUBRA POLLEN
Category
Non-Standardized Pollen Allergenic Extract [EPC]
Drug Count
13
Variant Count
14
Last Verified
February 17, 2026
About Alnus Rubra Pollen
Alnus Rubra Pollen is a non-standardized allergenic extract used for the diagnosis and treatment of Red Alder tree allergies through immunotherapy. It belongs to the class of pollen allergenic extracts and is primarily used for desensitization in patients with IgE-mediated hypersensitivity.
Detailed information about Alnus Rubra Pollen
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Alnus Rubra Pollen.
Alnus Rubra Pollen, commonly known as Red Alder pollen, is a biological substance used in the field of allergy and immunology. It is classified as a Non-Standardized Pollen Allergenic Extract [EPC]. This extract is derived from the pollen of the Alnus rubra tree, a species native to western North America, particularly the Pacific Northwest. In clinical practice, this extract is utilized for two primary purposes: the diagnosis of allergic sensitivity via skin testing and the treatment of allergic rhinitis (hay fever), allergic conjunctivitis (eye allergies), and allergic asthma through a process known as allergen immunotherapy (AIT) or 'allergy shots.'
Alnus Rubra Pollen belongs to a class of drugs called allergenic extracts. Unlike standardized extracts, which are measured in Bioequivalent Allergy Units (BAU), non-standardized extracts are typically labeled based on their weight-to-volume (w/v) ratio or Protein Nitrogen Units (PNU). This classification is critical for healthcare providers to understand, as the potency can vary between different manufacturers or even different lots. The FDA has a long history of regulating these biological products, ensuring they meet specific purity and safety standards, though the 'non-standardized' label indicates that a federally recognized standard for potency has not yet been established for this specific tree species.
To understand how Alnus Rubra Pollen works, one must first understand the pathophysiology of an allergy. In a person allergic to Red Alder, the immune system mistakenly identifies the pollen proteins as a threat, producing Immunoglobulin E (IgE) antibodies. Upon subsequent exposure, these IgE antibodies trigger mast cells and basophils to release inflammatory mediators like histamine, leading to symptoms such as sneezing, itching, and airway constriction.
When used in immunotherapy, Alnus Rubra Pollen works through a process of 'desensitization' or 'immunologic tolerance.' By administering gradually increasing doses of the allergen subcutaneously (under the skin), the healthcare provider 'trains' the patient's immune system. At the molecular level, this therapy induces a shift in the T-cell response from a Th2-dominated profile (which promotes IgE and allergy) to a Th1-dominated or T-regulatory (Treg) profile. This shift leads to the production of 'blocking antibodies,' specifically IgG4. These IgG4 antibodies compete with IgE for the allergen binding sites, effectively neutralizing the pollen before it can trigger an allergic reaction. Furthermore, the treatment reduces the recruitment of eosinophils and mast cells to the mucosal surfaces of the nose and lungs.
As a biological allergenic extract consisting of complex proteins, Alnus Rubra Pollen does not follow the traditional pharmacokinetic pathways (Absorption, Distribution, Metabolism, and Excretion) of small-molecule drugs like aspirin or lisinopril.
Alnus Rubra Pollen is FDA-indicated for:
Off-label uses are rare, though it may be used as part of a multi-allergen cocktail tailored to a patient's specific geographic sensitivity profile.
Alnus Rubra Pollen is primarily available in the following forms:
> Important: Only your healthcare provider can determine if Alnus Rubra Pollen is right for your specific condition. The selection of the specific extract and the concentration must be performed by a specialist, typically an allergist or immunologist.
Dosage for Alnus Rubra Pollen is highly individualized and must be determined by an allergist based on the patient's level of sensitivity, which is usually assessed via skin testing. The treatment is divided into two distinct phases:
During this phase, the patient receives injections once or twice a week. The starting dose is usually a very dilute solution (e.g., 0.05 mL of a 1:100,000 w/v dilution). The dose is gradually increased with each subsequent injection (e.g., 0.1 mL, 0.2 mL, 0.4 mL) until the target maintenance dose is reached. This phase typically lasts 3 to 6 months.
Once the maintenance dose is reached (often 0.5 mL of a 1:10 or 1:20 w/v solution), the frequency of injections is decreased to once every 2 to 4 weeks. This phase is usually continued for 3 to 5 years to achieve long-term remission of symptoms.
Alnus Rubra Pollen is generally considered safe for use in children, typically those aged 5 years and older. Dosing protocols for children are similar to adult protocols, though the starting dose may be even more conservative depending on the child's sensitivity. It is rarely recommended for children under the age of 5 because they may have difficulty communicating the early symptoms of a systemic reaction (anaphylaxis).
No specific dosage adjustments are required for patients with renal impairment, as the proteins are not cleared via renal filtration in a way that would lead to toxicity.
No specific dosage adjustments are required for patients with hepatic impairment.
Elderly patients should be evaluated for cardiovascular stability before beginning therapy. If an elderly patient is taking beta-blockers for hypertension or heart disease, immunotherapy may be contraindicated due to the risk of refractory anaphylaxis.
If a dose is missed during the build-up phase, the next dose may need to be reduced or the previous dose repeated to maintain safety. If a dose is missed during the maintenance phase for more than 4-6 weeks, the dose is typically reduced by one or two levels. Your doctor will provide a specific 'catch-up' schedule.
An overdose of Alnus Rubra Pollen refers to an injection of a concentration higher than what the patient's immune system can currently tolerate. This can lead to immediate anaphylaxis.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or frequency without medical guidance. The safety of immunotherapy depends entirely on the precision of the dosing schedule.
Most patients receiving Alnus Rubra Pollen immunotherapy will experience some form of local reaction. These are generally not dangerous but can be uncomfortable.
> Warning: Stop taking Alnus Rubra Pollen and call your doctor immediately or seek emergency care if you experience any of these symptoms of anaphylaxis.
There are no known long-term 'toxic' effects of Alnus Rubra Pollen on organs like the liver or kidneys. The primary long-term effect is the intended modification of the immune system. However, patients should be monitored for the development of new allergies or autoimmune conditions, though no direct causal link has been established with immunotherapy.
While Alnus Rubra Pollen may not have a specific 'Black Box' on every individual vial, the class of allergenic extracts carries a general FDA-recognized warning regarding Anaphylaxis.
Report any unusual symptoms, especially those occurring more than 30 minutes after your injection, to your healthcare provider immediately.
Alnus Rubra Pollen is a potent biological agent. It is not a 'cure' in the traditional sense but a long-term immunomodulator. Patients must be committed to the schedule and the safety protocols, including the 30-minute post-injection wait time. Failure to adhere to these protocols can result in life-threatening complications.
No FDA black box warnings for Alnus Rubra Pollen specifically exist in the same format as oral medications, but it falls under the general warning for all allergenic extracts. The primary warning is that anaphylaxis can occur at any time during therapy, even in patients who have previously tolerated the same dose.
Generally, Alnus Rubra Pollen does not cause sedation. However, if a patient feels lightheaded or experiences a systemic reaction, they should not drive. It is recommended to wait until the 30-minute observation period is over and you feel completely normal before operating a vehicle.
Alcohol can cause vasodilation (widening of blood vessels), which may theoretically increase the rate of allergen absorption or worsen the symptoms of an allergic reaction. It is best to avoid alcohol for several hours after an injection.
Immunotherapy can be stopped at any time, but the benefits will likely fade if the maintenance phase (3-5 years) has not been completed. There is no 'withdrawal syndrome' associated with stopping Alnus Rubra Pollen, but your allergy symptoms will likely return to their baseline levels over time.
> Important: Discuss all your medical conditions, especially respiratory or heart issues, with your healthcare provider before starting Alnus Rubra Pollen.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, especially any new heart or blood pressure medications.
Alnus Rubra Pollen must NEVER be used in the following circumstances:
These conditions require a careful risk-benefit analysis by the allergist:
Patients sensitive to Alnus Rubra Pollen often show cross-sensitivity to other members of the Betulaceae (Birch) family, including:
If you are allergic to one, your doctor will likely test you for the others, as the proteins (like Aln g 1 in Alder and Bet v 1 in Birch) are structurally very similar.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Alnus Rubra Pollen.
Pregnancy Category C: Alnus Rubra Pollen has not been studied in pregnant women to determine if it causes fetal harm. The primary risk during pregnancy is not the extract itself, but the potential for the mother to experience anaphylaxis, which can cause fetal hypoxia (lack of oxygen).
It is generally considered safe to continue Alnus Rubra Pollen immunotherapy while breastfeeding. The large protein molecules in the extract are unlikely to pass into breast milk in any significant amount, and they would be digested by the infant's stomach even if they did. There are no known adverse effects on nursing infants.
Immunotherapy with Alnus Rubra Pollen is effective in children for preventing the 'allergic march'—the progression from allergic rhinitis to asthma.
In patients over 65, the decision to use Alnus Rubra Pollen must be balanced against the patient's cardiovascular health.
No dose adjustments are necessary. The proteins are metabolized by local tissue proteases and do not rely on renal clearance for detoxification.
No dose adjustments are necessary. The liver is not involved in the primary metabolism of subcutaneous allergenic proteins.
> Important: Special populations require individualized medical assessment and frequent monitoring during the build-up phase.
Alnus Rubra Pollen acts as an immunomodulator. The extract contains specific proteins (allergens), the most notable being Aln g 1, which is a member of the PR-10 (Pathogenesis-Related) protein family.
| Parameter | Value |
|---|---|
| Bioavailability | N/A (Subcutaneous Injection) |
| Protein Binding | Minimal (binds to IgE/IgG antibodies) |
| Half-life | Localized processing (hours to days) |
| Tmax | 15-30 minutes for systemic absorption |
| Metabolism | Proteolytic degradation in tissues |
| Excretion | Not renally excreted as intact drug |
Alnus Rubra Pollen is a Non-Standardized Pollen Allergenic Extract. It is grouped with other tree pollen extracts like Birch, Oak, and Maple. While they share the same therapeutic goal, they are not interchangeable.
Common questions about Alnus Rubra Pollen
Alnus Rubra Pollen is primarily used for the diagnosis and treatment of allergies to the Red Alder tree. In diagnostic settings, it is used in skin prick tests to confirm if a patient is sensitive to this specific pollen. For treatment, it is used in allergen immunotherapy, commonly known as allergy shots, to desensitize the immune system over time. This helps reduce symptoms like sneezing, itchy eyes, and asthma caused by Red Alder exposure. It is particularly useful for patients who do not get enough relief from standard allergy medications.
The most common side effects are local reactions at the site of the injection, including redness, itching, and swelling. These reactions occur in the majority of patients and are usually a sign that the body is responding to the allergen. Some patients may also experience mild fatigue or a temporary increase in their usual allergy symptoms. While these are generally harmless, large swellings should be reported to your doctor. Serious systemic reactions are rare but require immediate medical attention.
It is generally advised to avoid alcohol on the days you receive an Alnus Rubra Pollen injection. Alcohol can cause your blood vessels to dilate, which might speed up the absorption of the allergen into your bloodstream and increase the risk of a systemic reaction. Furthermore, alcohol can mask the early signs of anaphylaxis or make the symptoms more severe. To ensure maximum safety, wait at least several hours after your injection before consuming any alcoholic beverages. Always consult your allergist for their specific recommendations regarding your lifestyle.
Alnus Rubra Pollen is usually not started during pregnancy because of the risk of a severe allergic reaction, which could deprive the fetus of oxygen. However, if a woman is already on a stable maintenance dose and becomes pregnant, many doctors allow her to continue the treatment. The decision depends on the patient's history and the severity of her allergies. The extract itself is not known to cause birth defects, but the safety of the mother is the priority. Always inform your allergist immediately if you become pregnant or are planning to conceive.
Allergen immunotherapy is a long-term treatment and does not provide immediate relief. Most patients begin to notice an improvement in their symptoms during the first pollen season after they reach their maintenance dose, which usually takes 3 to 6 months of weekly injections. Significant and lasting benefits typically require at least one year of consistent treatment. For the best long-term results and to prevent symptoms from returning, the treatment is usually continued for three to five years. Patience and adherence to the schedule are key to success.
Yes, you can stop taking Alnus Rubra Pollen injections suddenly without experiencing withdrawal symptoms like you might with some other medications. However, stopping the treatment before the recommended 3-to-5-year period usually means that your allergy symptoms will eventually return to their original severity. If you need to stop due to side effects or life changes, discuss it with your allergist first. They may be able to adjust your dose or schedule to make the treatment more manageable. If you miss too many doses, you cannot simply restart at the same level; you will need a modified schedule for safety.
If you miss a dose of Alnus Rubra Pollen, contact your allergist's office to find out how to proceed. You should not try to 'double up' on your next dose to make up for the missed one. Depending on how many weeks have passed since your last injection, your doctor may need to repeat your last dose or even reduce the dose slightly to ensure your safety. This is because your immune system's tolerance can decrease if the time between shots is too long. Consistency is the most important factor in making the treatment effective and safe.
There is no clinical evidence to suggest that Alnus Rubra Pollen allergenic extracts cause weight gain. Unlike oral corticosteroids (like prednisone), which are sometimes used to treat severe allergies and are known for weight-related side effects, allergenic extracts are proteins that work locally and immunologically. They do not affect your metabolism, appetite, or fat storage. If you experience weight changes while on immunotherapy, it is likely due to other factors such as lifestyle changes or other medications. You should discuss any concerns about weight with your primary care physician.
Alnus Rubra Pollen can be taken alongside most common allergy medications like antihistamines and nasal steroids, which can actually help manage the local side effects of the shots. However, it can have dangerous interactions with certain heart and blood pressure medications, specifically beta-blockers and ACE inhibitors. These drugs can make an allergic reaction harder to treat or more likely to occur. It is vital that you provide your allergist with a complete list of all medications you are taking, including over-the-counter supplements, to ensure there are no safety conflicts.
The concept of 'generic' doesn't apply to allergenic extracts in the same way it does to chemical drugs. Alnus Rubra Pollen is a biological product, and different manufacturers produce their own versions of the extract. While they all contain Red Alder pollen proteins, they are not considered identical or interchangeable because they are 'non-standardized.' If you switch clinics, your new doctor will likely want to start you on a lower dose of their specific extract to ensure you tolerate it safely, even if you were at a high dose with a different brand.