Drug provocation tests
Placebo-controlled single blinded DPT with the culprit drug was only
done in mild NIDHRs with negative ST and after a careful risk-benefit
assessment.8,33 The DPT was sequential and additive
when symptoms remitted and laboratory parameters became normal, not
earlier than 4 weeks. Initially 1/100 of the therapeutic dose was
administered. If tolerated, a dose of 1/10 was given 3 days to 1 week
later, depending on the drug and the time interval between drug intake
and the reaction. If tolerated, the full therapeutic dose was given
after the same interval. If symptoms suggestive of NIDHR appeared, the
procedure was stopped and the symptoms were evaluated and treated.
Medications were stopped before DPT according to international
guidelines.33