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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Arnica Montana, Milk Thistle, Sus Scrofa Cerebrum, Cinchona Officinalis Bark, Ginkgo Biloba Whole, Lecithin, Soybean, Lithium Carbonate, Achillea Millefolium, Phosphoric Acid, Pork Brain, Alnus Glutinosa Whole, And Rosmarinus Officinalis Flowering Top
Brand Name
N-27
Generic Name
Arnica Montana, Milk Thistle, Sus Scrofa Cerebrum, Cinchona Officinalis Bark, Ginkgo Biloba Whole, Lecithin, Soybean, Lithium Carbonate, Achillea Millefolium, Phosphoric Acid, Pork Brain, Alnus Glutinosa Whole, And Rosmarinus Officinalis Flowering Top
Active Ingredient
Achillea MillefoliumCategory
Non-Standardized Plant Allergenic Extract [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 3 [hp_X]/mL | SOLUTION | SUBLINGUAL | 58264-0225 |
Detailed information about N-27
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for N-27, you must consult a qualified healthcare professional.
Achillea Millefolium, commonly known as Yarrow, is utilized in clinical medicine as a Non-Standardized Plant Allergenic Extract for the diagnosis and treatment of Type I hypersensitivity reactions (allergies).
Dosage for Achillea Millefolium is highly individualized and must be determined by an allergy specialist based on the patient's sensitivity levels.
Achillea Millefolium extracts are generally considered safe for use in children, provided the child is old enough to cooperate with the testing and the risks of immunotherapy are outweighed by the benefits.
No dosage adjustments are typically required for patients with renal impairment, as the extract is not cleared via traditional renal pathways. However, the patient's overall health must be stable.
No dosage adjustments are required for patients with hepatic impairment. The metabolic processing of allergenic proteins occurs via cellular proteolysis rather than hepatic enzyme systems.
Caution is advised in elderly patients, particularly those with underlying cardiovascular disease. The risk of adverse reactions to epinephrine (which is required if a systemic reaction occurs) must be considered before administering Achillea Millefolium extracts.
Achillea Millefolium extracts are never for self-administration at home. They must be administered in a clinical setting equipped with emergency resuscitation equipment.
If a dose of immunotherapy is missed, do not double the next dose.
An 'overdose' in the context of allergenic extracts refers to an injection of a dose higher than the patient's current tolerance level.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or skip appointments without medical guidance.
Most patients receiving Achillea Millefolium extracts will experience some form of local reaction. These are generally not dangerous but can be uncomfortable.
> Warning: Stop taking Achillea Millefolium and call your doctor immediately if you experience any of these symptoms of anaphylaxis.
There are no known long-term 'toxic' effects of Achillea Millefolium extracts because they are biological proteins. However, the primary long-term risk is the development of new sensitivities or the rare occurrence of 'serum sickness,' although this is extremely uncommon with modern, purified extracts. The goal of long-term use is actually a positive 'side effect'—the permanent reduction of allergic symptoms.
Achillea Millefolium, like all allergenic extracts, carries a FDA-mandated Black Box Warning regarding the risk of severe systemic reactions.
Report any unusual symptoms to your healthcare provider, even if they seem minor at the time.
Achillea Millefolium extract is a potent biological agent. Its use is restricted to diagnostic and therapeutic protocols under the direct supervision of a physician. It is not a 'herbal supplement' when used in this extract form; it is a regulated drug product. Patients must be honest about their current health status, especially any respiratory or heart conditions, before each injection.
No FDA black box warnings for Achillea Millefolium? No, this is incorrect. As a member of the allergenic extract class, it does carry the standard class-wide black box warning. The warning emphasizes that Achillea Millefolium can cause anaphylaxis, which may be fatal. It must be administered in a facility equipped with oxygen, IV fluids, and epinephrine. Patients must be monitored for 30 minutes post-injection.
Achillea Millefolium generally does not cause drowsiness. However, if a patient experiences a systemic reaction or receives epinephrine, they should not drive until cleared by a physician.
Alcohol should be avoided for several hours before and after an injection. Alcohol causes vasodilation (widening of blood vessels), which can increase the rate of allergen absorption and potentially increase the risk or severity of a systemic reaction.
If immunotherapy is discontinued, the patient will slowly lose the immunological tolerance they have built up. There is no 'withdrawal syndrome,' but allergic symptoms will likely return to their baseline levels over several months.
> Important: Discuss all your medical conditions with your healthcare provider before starting Achillea Millefolium.
While there are few absolute contraindications for other drugs, the following combinations create extreme risk:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Achillea Millefolium extract must NEVER be used in the following circumstances:
These conditions require a careful risk-benefit analysis by the physician:
Patients who are allergic to Achillea Millefolium are highly likely to be cross-sensitive to other members of the Asteraceae family. This includes:
If you have had a severe reaction to any of these plants, you must inform your doctor before Achillea Millefolium testing.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Achillea Millefolium.
Achillea Millefolium is categorized similarly to other allergenic extracts (FDA Category C). There are no adequate and well-controlled studies in pregnant women.
It is not known whether the allergenic components of Achillea Millefolium are excreted in human milk. However, because these are large proteins and administered in minute quantities, it is highly unlikely they would be absorbed intact by the nursing infant. The risk-benefit ratio is generally favorable for continuing immunotherapy while breastfeeding.
Achillea Millefolium is used in children as young as 5 years old.
In patients over 65, the decision to use Achillea Millefolium must be made cautiously.
No specific studies have been conducted in patients with renal impairment. However, since the proteins are degraded by local and systemic proteases into amino acids, renal function does not significantly impact the drug's safety or efficacy.
No adjustments are required. The metabolic pathway for allergenic extracts does not involve the liver's cytochrome P450 system.
> Important: Special populations require individualized medical assessment and close monitoring.
Achillea Millefolium allergenic extract acts as a specific antigen challenge. At the molecular level, the extract contains various proteins (antigens) from the Yarrow plant. When these antigens enter the body of a sensitized individual, they bind to IgE antibodies that are already attached to the high-affinity IgE receptor (FcεRI) on mast cells and basophils. This binding causes the receptors to cluster (cross-link), which activates an intracellular signaling cascade involving tyrosine kinases (like Syk). This results in the rapid release of pre-formed mediators (histamine) and the synthesis of new mediators (leukotrienes) that cause the allergic response.
| Parameter | Value |
|---|---|
| Bioavailability | N/A (Administered locally/subcutaneously) |
| Protein Binding | Primarily binds to IgE and IgG4 antibodies |
| Half-life | Proteins are degraded within hours/days by proteases |
| Tmax | 15-20 minutes for skin reaction |
| Metabolism | Cellular proteolysis |
| Excretion | Not excreted as an intact drug |
Achillea Millefolium is a Non-Standardized Plant Allergenic Extract. It belongs to the broader class of Immunotherapy Agents. Related medications include extracts for Ragweed, Timothy Grass, and various tree pollens used in the same diagnostic and therapeutic manner.
Common questions about N-27
Achillea Millefolium extract is used in clinical allergy practice for two primary purposes: diagnosis and treatment. In diagnosis, it is applied to the skin to identify if a patient has a specific allergy to Yarrow plant proteins, which often cause seasonal hay fever. In treatment, it is used in allergen immunotherapy (allergy shots) to gradually desensitize the patient's immune system. This process involves giving small, increasing doses of the extract over several years. The goal is to reduce or eliminate the patient's allergic symptoms when they are naturally exposed to Yarrow pollen in the environment.
The most common side effects are localized to the site where the extract was administered. Patients frequently experience redness, itching, and a raised bump (wheal) at the injection or skin-test site. These reactions are usually mild and resolve within a few hours to a couple of days. Some patients may also experience a 'late-phase' reaction where the area becomes swollen and warm several hours later. While these local effects are common, they are generally not dangerous and can be managed with cold compresses or over-the-counter antihistamines if approved by your doctor.
It is strongly recommended to avoid alcohol for several hours before and after receiving an Achillea Millefolium injection. Alcohol causes your blood vessels to dilate (expand), which can increase the speed at which the allergen is absorbed into your bloodstream. This rapid absorption can increase the risk of a systemic allergic reaction or make a reaction more severe if it occurs. Additionally, alcohol can sometimes mask the early symptoms of an allergic reaction, such as lightheadedness or flushing. Always wait until the observation period is over and you feel completely normal before consuming alcohol.
Achillea Millefolium is generally not started as a new treatment during pregnancy. The main concern is not the extract itself, but the risk of a severe allergic reaction (anaphylaxis) in the mother, which could deprive the fetus of oxygen. However, if a patient is already on a stable 'maintenance' dose of allergy shots and becomes pregnant, many allergists will continue the treatment because the risk of a reaction is much lower at that stage. You must inform your allergist immediately if you become pregnant so they can adjust your treatment plan. Decisions are made on a case-by-case basis to ensure the safety of both mother and baby.
When used for diagnostic testing, Achillea Millefolium works almost immediately, with results visible within 15 to 20 minutes. However, when used for immunotherapy (allergy shots), the process is much slower. Most patients begin to notice a reduction in their allergy symptoms during the first year of treatment, usually once they reach their 'maintenance dose.' For the best and most lasting results, the treatment usually continues for three to five years. This long-term approach is necessary to fundamentally retrain the immune system to tolerate the allergen.
Yes, you can stop taking Achillea Millefolium shots suddenly without experiencing physical withdrawal symptoms like those seen with some other medications. However, stopping treatment prematurely means your immune system will likely revert to its previous allergic state. This means your hay fever or allergy symptoms will probably return over the following months. If you are finding the schedule difficult or are concerned about side effects, talk to your allergist. They may be able to adjust your dose or frequency rather than stopping the treatment entirely.
If you miss a scheduled allergy shot, do not attempt to 'make it up' by taking a higher dose later. Contact your allergist's office as soon as possible to reschedule. Depending on how long it has been since your last shot, your doctor may need to repeat your last dose or even reduce the dose slightly for safety. This is because your level of tolerance can decrease if there is too much time between injections. Following a consistent schedule is the most effective way to reach your treatment goals safely.
There is no clinical evidence to suggest that Achillea Millefolium allergenic extract causes weight gain. The extract consists of natural proteins and is administered in very small quantities that do not affect your metabolism or appetite. If you experience weight changes while on this treatment, it is likely due to other factors such as lifestyle changes, other medications (like oral steroids sometimes used for allergies), or an underlying health condition. Always discuss significant weight changes with your primary care physician.
Achillea Millefolium can be taken with many medications, but there are critical exceptions. You must avoid beta-blockers (often used for heart conditions or blood pressure) because they can prevent life-saving epinephrine from working if you have a severe reaction. Additionally, you must stop taking antihistamines several days before a skin test, as they will block the reaction and lead to incorrect results. Always provide your allergist with a complete list of all prescriptions, over-the-counter drugs, and herbal supplements you are using to ensure your safety.
Achillea Millefolium is a biological product rather than a synthetic drug, so the term 'generic' is not used in the traditional sense. Instead, different biological manufacturers produce their own versions of Yarrow allergenic extract. While these extracts are all derived from the same plant, they are 'non-standardized,' meaning the exact potency can vary between different manufacturers. For this reason, allergists usually prefer to keep a patient on the extract from the same manufacturer throughout their treatment to ensure consistent dosing and safety.
Other drugs with the same active ingredient (Achillea Millefolium)