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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Verbascum Thapsus
Brand Name
Verbascum Thapsus
Generic Name
Verbascum Thapsus
Active Ingredient
Verbascum ThapsusCategory
Non-Standardized Plant Allergenic Extract [EPC]
Variants
10
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 6 [hp_C]/1 | PELLET | ORAL | 37662-1630 |
| 30 [hp_C]/1 | PELLET | ORAL | 37662-1632 |
| 30 [hp_C]/30[hp_C] | PELLET | ORAL | 0220-5243 |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Verbascum Thapsus, you must consult a qualified healthcare professional.
| 100 [hp_C]/1 | PELLET | ORAL | 37662-1633 |
| 12 [hp_C]/1 | PELLET | ORAL | 37662-1631 |
| 500 [hp_C]/1 | PELLET | ORAL | 37662-1635 |
| 6 [hp_C]/6[hp_C] | PELLET | ORAL | 0220-5242 |
| 1 [hp_M]/1 | PELLET | ORAL | 37662-1636 |
| 200 [hp_C]/1 | PELLET | ORAL | 37662-1634 |
| 1 [hp_Q]/1 | PELLET | ORAL | 37662-1637 |
Detailed information about Verbascum Thapsus
Verbascum Thapsus is a non-standardized plant allergenic extract used primarily in diagnostic testing and immunotherapy. It belongs to the class of Non-Standardized Plant Allergenic Extracts and exhibits ammonium ion binding activity.
For diagnostic purposes, the dosage of Verbascum Thapsus is not measured in milligrams but in volume and concentration.
Verbascum Thapsus extracts are approved for use in children; however, extreme caution is required. Pediatric dosing follows the same escalation protocol as adult dosing, but the starting concentration may be further diluted based on the child's sensitivity level. Children under the age of 5 require careful monitoring due to the difficulty in communicating early symptoms of systemic reactions.
No specific dose adjustments are required for skin testing in patients with renal impairment. However, for immunotherapy, patients with severe renal disease should be monitored for their ability to clear the metabolic byproducts of the inflammatory response triggered by the injection.
Because Verbascum Thapsus possesses Ammonium Ion Binding Activity, patients with hepatic impairment (liver failure) may actually benefit from its metabolic properties, but the allergenic use remains standard. No specific adjustments for skin testing are documented.
Elderly patients may have reduced skin reactivity (anergy). Therefore, a negative skin test in a patient over 65 may require further validation. Additionally, elderly patients on beta-blockers for hypertension are at higher risk if a reaction occurs.
Verbascum Thapsus allergenic extracts are strictly for professional administration.
In immunotherapy, if a dose is missed:
An overdose of Verbascum Thapsus extract usually manifests as a systemic allergic reaction. Signs include hives (urticaria), swelling of the throat (angioedema), wheezing, and a drop in blood pressure. Emergency treatment with epinephrine (Adrenalin) is required immediately.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or frequency of immunotherapy without medical guidance.
Most patients receiving Verbascum Thapsus for diagnostic or therapeutic purposes will experience localized reactions.
Verbascum Thapsus extract is a potent biological substance. It must never be self-administered by the patient. Safety depends on the accuracy of the dilution and the technique of administration. Patients must be screened for current health status before every dose; for example, if a patient is currently experiencing an asthma flare or has a fever, the dose should be withheld.
Verbascum Thapsus must NEVER be used in the following circumstances:
Verbascum Thapsus is classified in FDA Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Animal reproduction studies have not been conducted. The primary concern is not the extract itself, but the potential for a systemic reaction in the mother, which can cause uterine contractions and fetal distress. Maintenance immunotherapy may be continued during pregnancy if the mother is tolerating it well, but doses are typically not increased during this time.
It is not known whether the antigens in Verbascum Thapsus are excreted in human milk. Because most of the components are proteins that would be digested in the infant's stomach, the risk to a nursing infant is considered low. However, the decision to continue immunotherapy while breastfeeding should be made after a risk-benefit discussion with a healthcare provider.
Verbascum Thapsus is safe and effective for diagnostic testing in children as young as infants, though it is rarely performed before age 2. For immunotherapy, the American Academy of Allergy, Asthma & Immunology (AAAAI) suggests that children under age 5 may be difficult to treat because they cannot communicate early symptoms of a reaction. Growth and development are not known to be affected by allergenic extracts.
Verbascum Thapsus operates through a dual-action pharmacological pathway. First, as an allergenic extract, it introduces specific protein antigens (such as Ver t 1) to the immune system. In sensitized individuals, these proteins bind to IgE antibodies on mast cells, causing the release of histamine. In immunotherapy, repeated exposure induces the production of 'blocking' IgG4 antibodies and regulatory T-cells (Tregs), which eventually suppress the allergic response.
Second, the extract functions as a Nitrogen Binding Agent [EPC] through Ammonium Ion Binding Activity [MoA]. It acts as a molecular sieve or chemical binder that sequesters ammonium ions (NH4+). This reduces the concentration of nitrogenous waste products in the blood, which is a critical mechanism for preventing ammonia toxicity in metabolic disorders.
Common questions about Verbascum Thapsus
Verbascum Thapsus, also known as Mullein, is primarily used as a diagnostic tool to identify patients who are allergic to its pollen. In a clinical setting, an extract of the plant is applied to the skin to see if it triggers an allergic reaction, which helps doctors diagnose hay fever or allergic asthma. Beyond diagnosis, it is used in allergen immunotherapy, commonly known as allergy shots, to help desensitize the patient's immune system over time. Additionally, it has a specialized pharmacological role as a nitrogen binding agent, which can help manage ammonium levels in specific metabolic conditions. Always consult an allergist to see if this extract is necessary for your diagnostic workup.
The most frequent side effects of Verbascum Thapsus are localized to the site where the extract was applied or injected. Patients typically experience a 'wheal and flare' reaction, which is a raised, itchy red bump similar to a mosquito bite. This is actually the intended result during a skin test to confirm an allergy. Other common effects include localized itching, redness, and minor swelling that usually resolve within an hour or two. In some cases, a delayed reaction may occur several hours later, causing the area to feel warm or tender. While these are common, any signs of a body-wide reaction like hives or trouble breathing must be treated as an emergency.
It is generally recommended to avoid alcohol on the days you receive Verbascum Thapsus injections for immunotherapy. Alcohol acts as a vasodilator, meaning it widens your blood vessels, which can cause the allergenic extract to be absorbed into your bloodstream more quickly than intended. This rapid absorption increases the risk of a systemic allergic reaction or anaphylaxis. Furthermore, alcohol can mask the early symptoms of an allergic reaction, such as lightheadedness or flushing, making it harder for you or your doctor to recognize an emergency. To ensure your safety, wait at least 24 hours after your injection before consuming alcoholic beverages.
The safety of Verbascum Thapsus during pregnancy has not been established through rigorous clinical trials, placing it in FDA Category C. Most doctors advise against starting a new course of immunotherapy while pregnant because of the risk of anaphylaxis, which can deprive the developing fetus of oxygen. However, if a woman is already on a maintenance dose and is tolerating the injections well, her allergist may decide to continue the treatment at the same or a reduced dose. The primary goal is to avoid any severe reactions that could cause uterine contractions or other complications. If you are pregnant or planning to become pregnant, discuss the risks and benefits of continuing your allergy treatment with your healthcare provider.
The timeframe for Verbascum Thapsus to 'work' depends on whether it is being used for diagnosis or treatment. For diagnostic skin testing, the results are almost immediate, with the skin reaction peaking within 15 to 20 minutes. For therapeutic immunotherapy, the process is much slower and requires patience. Most patients begin to notice a reduction in their allergy symptoms after 3 to 6 months of consistent weekly injections as they reach their maintenance dose. The full benefits, which can include long-term remission of allergy symptoms, typically require a treatment course lasting 3 to 5 years. Your doctor will monitor your progress to determine the optimal duration of therapy.
If you are receiving Verbascum Thapsus for diagnostic testing, it is a one-time procedure, so discontinuation is not an issue. However, if you are undergoing immunotherapy, stopping the injections suddenly will not cause a physical withdrawal syndrome like some other medications. The main consequence of stopping abruptly is that your allergy symptoms are likely to return, and the progress you made in desensitizing your immune system may be lost. If you miss too many doses and then try to restart at the same level, you may be at a higher risk for a severe allergic reaction. Always talk to your allergist before deciding to stop your immunotherapy schedule.
If you miss a dose of Verbascum Thapsus immunotherapy, you should contact your allergist's office as soon as possible to reschedule. Missing a single week usually does not require a change in your treatment plan, but missing two or more weeks may require your doctor to reduce the dose for your next injection to ensure safety. This is because your body's tolerance to the allergen can decrease if there is too much time between doses. Never attempt to 'double up' on a dose to make up for a missed one, as this significantly increases the risk of a life-threatening allergic reaction. Your healthcare provider will have a specific protocol for getting you back on track based on how many doses were missed.
There is no clinical evidence to suggest that Verbascum Thapsus allergenic extracts cause weight gain. Unlike systemic corticosteroids, which are sometimes used to treat severe allergies and are well-known for causing weight changes, allergenic extracts work by modulating the immune system's response to specific proteins. The amount of the extract administered is very small and does not affect the metabolic processes associated with fat storage or appetite. If you experience unexpected weight gain while undergoing immunotherapy, it is likely due to other factors such as lifestyle changes, other medications, or an underlying health condition. You should discuss any significant weight changes with your primary care physician.
Verbascum Thapsus can interact with several types of medications, some of which can make the treatment dangerous. The most critical interaction is with beta-blockers, which are often used for heart conditions and high blood pressure; these drugs can prevent epinephrine from working if you have a severe allergic reaction. Antihistamines and certain antidepressants must also be stopped before diagnostic testing because they can block the skin's reaction, leading to inaccurate results. Other medications like ACE inhibitors may increase the risk of swelling. It is vital to provide your doctor with a complete list of all prescriptions, over-the-counter drugs, and supplements you are taking before starting Verbascum Thapsus.
Verbascum Thapsus is a biological product rather than a traditional chemically synthesized drug, so the term 'generic' does not apply in the same way. Instead, it is produced by several different manufacturers as a 'non-standardized extract.' While these extracts from different companies (such as Greer, HollisterStier, or ALK) contain the same mullein pollen antigens, they are not considered exactly identical or interchangeable because their manufacturing processes may vary. Your allergist will usually stick with one manufacturer's extract for the duration of your treatment to ensure consistency in dosing. These extracts are generally covered by most insurance plans under the category of diagnostic or therapeutic biologicals.
> Warning: Stop taking Verbascum Thapsus and call your doctor immediately if you experience any of these symptoms of anaphylaxis.
With prolonged immunotherapy (3–5 years), the primary long-term effect is the development of immunological tolerance. However, rare cases of serum sickness (an immune complex reaction) have been documented with high-dose, long-term allergenic extract therapy, manifesting as joint pain, fever, and rash.
While Verbascum Thapsus specifically may not have a unique black box warning, all allergenic extracts of this class carry a general warning regarding Anaphylaxis.
Report any unusual symptoms to your healthcare provider immediately.
Generally, Verbascum Thapsus does not cause sedation. However, if a patient experiences a vasovagal reaction (fainting) or a mild systemic reaction, they should not drive until symptoms have completely resolved and they have been cleared by a physician.
Alcohol consumption should be avoided on the day of an immunotherapy injection. Alcohol can cause vasodilation (widening of blood vessels), which may increase the rate of absorption of the allergen and potentially increase the severity of a systemic reaction.
Discontinuation of Verbascum Thapsus immunotherapy does not require a tapering period. However, the protective effects against allergies will gradually diminish over months or years if the maintenance course is not completed (typically 3–5 years).
> Important: Discuss all your medical conditions with your healthcare provider before starting Verbascum Thapsus.
There are no direct food-drug interactions with Verbascum Thapsus. However, patients with 'Oral Allergy Syndrome' may experience cross-reactivity between certain fruits and Mullein pollen. It is advised not to eat a heavy meal immediately before an injection to avoid confusion between food-related distress and a systemic reaction.
Verbascum Thapsus administration will increase the levels of allergen-specific IgG antibodies and may temporarily increase specific IgE levels. It does not typically interfere with standard blood chemistry or hematology panels, except for the specific ammonium ion binding activity which may lower serum ammonia levels in laboratory results.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Patients allergic to other members of the Scrophulariaceae (Figwort) family may show cross-sensitivity to Verbascum Thapsus. Additionally, there is documented cross-reactivity with certain grass pollens and other weeds in the same ecological niche.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Verbascum Thapsus.
Clinical studies of Verbascum Thapsus did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, elderly patients have a higher prevalence of comorbid conditions (like heart disease) and are more likely to be on medications (like beta-blockers) that increase the risk of immunotherapy.
In patients with renal impairment, the clearance of inflammatory mediators may be delayed. While no specific dose adjustment is required for the extract, the patient's overall health and ability to tolerate a systemic reaction must be considered.
Given the Ammonium Ion Binding Activity of Verbascum Thapsus, patients with hepatic impairment (e.g., Child-Pugh Class B or C) should be monitored. While the extract is used for allergy, its metabolic effects on nitrogen levels should be noted in the context of liver-related hyperammonemia.
> Important: Special populations require individualized medical assessment.
| Parameter | Value |
|---|---|
| Bioavailability | Low (Localized administration) |
| Protein Binding | High (to IgE and IgG4) |
| Half-life | 2–12 hours (systemic components) |
| Tmax | 15–30 minutes (local reaction) |
| Metabolism | Proteolytic degradation |
| Excretion | Renal (primary) |
Verbascum Thapsus is a member of the Non-Standardized Plant Allergenic Extract class. It is related to other weed extracts like Ambrosia (Ragweed) and Artemisia (Sagebrush).