To further what rebekah said - I'm on atrovent.  No where in any of my patient information or on the box does it list soy or peanuts as an ingredient, and it has now mention of worries for the peanut or soy allergic.  I'm guessing that the soy lecithin was phased out when they made the switch to HFA propellant.



Combivent inhalers do have a warning for PA and soy allergies - you can find it on the front page of their website: http://www.combivent.com/  For those unfamiliar, a Combivent inhaler is albuterol and ipratorium bromide (atrovent) in one inhaler.  If you are PA or soy allergic and asthmatic, you should keep this in mind.  Generic combivent nebulizer solution is safe (at least the kind that my doc uses), and luckily, if you are in the hospital, you are probably more likely to get that.

Reading the ingredients for the current Atrovent inhaler, there is no soy listed and no mention of peanut or soy allergies in the contraindications section.  Since soy was listed in the ingredients before as well as a warning against using if peanut or soy allergic, it would seem that when the inhalers were reformulated they removed the soy component but I can find no specific reference to it's removal - just the labeling changes.

Yes, but remember that major formulation changes have occurred since that time.

The question at this point is--

is this STILL a problem?

Here is a link to some information about Atrovent and Soy/Peanut Allergies.  This was written in 1998, so more doctors should be aware of this!
http://www.ismp.org/newsletters/acutecare/articles/19981021.asp

Quote from: rebekahc on November 07, 2011, 01:14:02 PM
That's what I can't seem to find out.  I've searched and all the mention I can find is of people with confirmed PA - nothing said about soy allergy, but I presume that if they were known to be soy allergic their soy allergy would have been blamed for the reactions rather than their PA.

Most of the references I can find WRT Atrovent and peanut allergy date from 1998-2002.  It may be that when inhalers were redesigned a few years ago to eliminate CFCs, that they removed the soy component.  I found the pharmacist insert from Atrovent Inhalation Aerosol dated 2002 that lists soya lecithin as an ingredient.  All the "new" info I can find is for Atrovent HFA (post-CFC removal??) and there is no mention of soy in the ingredients (dated 2008) nor is peanut allergy listed in the contraindications section as it was on the 2002 insert.

They could be PA folks like my DD who tests postive (both SPT and RAST) to soy but who is not allergic to soy.  She eats it (though she's not had tofu or edamame).  She tests positive because she tests so highly for peanut.  Dr. Wood said that he's found in his practice that PA folks who test highly and also test positive for soy are not allergic if the difference in the RASTS between peanut and soy is greater than 50 (which it is in DD's case).  It's a cross-reactivity in the testing.

That's what I'm thinking, too, R.

It's still listed in DD's Medic-Alert file, just as it has been since 2002, but I doubt that it's relevant info at this point in time.

I concur that the problem was with inhalers. 
A couple years ago, they wanted to give my ds atrovent via nebulizer in the er when he had pneumonia, but I wouldn't let them.  I spoke with allergist and did some research and realized the problem was inhaler, not nebulizer solution. 

nutless, Atrovent Inhalation Aerosol is listed on the unusual or unexpected peanut list. 

I'm not sure we need to add anything more to the specific allergy section because I'm not convinced it's still a problem.  It looks as if they have replaced the Atrovent Inhalation Aerosol (inhaler) with Atrovent HFA (inhaler) which does not have a peanut warning and does not contain soy.  The Atrovent Inhalation Solution (nebulizer med) has always been safe.

ETA:  Looks like all CFC propellant inhalers were phased out at the end of 2008.  After December 31, 2008, only HFA inhalers were allowed by the FDA.  So, there shouldn't be any Atrovent Inhalation Aerosol (with soy lecithin) left on the market now almost three years later.

Wow, that is really scary. I know it took me years to even think about pn being in medicine. Should this thread go in the specific food allergy section too? I would hate to see it buried and for someone to get sicker!!!

I am only soy allergic, not PA, but I take an Atrovent inhaler pretty regularly and have never had any problems.  My newest box says nothing about soy in the inactive ingredients.  Note: My soy allergy is mild, and I can eat soy lecithin.

However, there is a recommendation that I could find online to avoid using a Combivent inhaler (albuterol and ipratorium bromide - the active ingredient in Atrovent) for people with PA and soy allergies.  However, I can't find any warnings regarding Combivent nebulizer solution.

That's what I can't seem to find out.  I've searched and all the mention I can find is of people with confirmed PA - nothing said about soy allergy, but I presume that if they were known to be soy allergic their soy allergy would have been blamed for the reactions rather than their PA.

Most of the references I can find WRT Atrovent and peanut allergy date from 1998-2002.  It may be that when inhalers were redesigned a few years ago to eliminate CFCs, that they removed the soy component.  I found the pharmacist insert from Atrovent Inhalation Aerosol dated 2002 that lists soya lecithin as an ingredient.  All the "new" info I can find is for Atrovent HFA (post-CFC removal??) and there is no mention of soy in the ingredients (dated 2008) nor is peanut allergy listed in the contraindications section as it was on the 2002 insert.

Quote from: rebekahc on November 07, 2011, 08:41:55 AM
Yes, twinturbo, that's what I've always heard.  For some reason the soy component in the Atrovent inhalers has caused reactions in some PA people.   

So it has caused reactions in pa people who are also allergic to soy or in pa people who are not allergic to soy? 

Yes, twinturbo, that's what I've always heard.  For some reason the soy component in the Atrovent inhalers has caused reactions in some PA people.   

QuoteIpratropium and ipratropium/albuterol metered dose inhalers (Atrovent and Combivent); contain the phospholipid soya lecithin, a legume related to peanuts, as a suspending agent. Anaphylactic reactions have occurred in patients with allergies to peanuts or soybeans who have received Atrovent. Soya lecithin is only used in the Atrovent and Combivent inhalers; the nasal spray and nebulized solution do not contain phosphatidylcholine, phosphatidylethanolamine, and phosphotidylinositol.(the phospholipids extracted from soybean oil that formulate Soya Lechtin)

Is this what it's based on? If so, then it's overlapping soy lecithin to peanut because it's a related legume. I don't know fwiw, I'm asking.

Hello, everybody, I am new here. 

I can't comment on the Atrovent but I have suspected for a while that the Albuterol nebulizer does produce color changes in my DS (now 23 mos).  I've seen flushing and paleness.  The color changes will go on throughout the day - not just right after the neb. It also gives him a racing heart and makes him a little shaky if he's been on it for a few days.  But he doesn't seem bothered by any of it. 

I am really sorry to hear of your night trip to the ER.  Those are really not fun at all. I hope your son's Bronchitis clears up and never comes back.