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EpiPen Update! Have you heard about AUVI-Q?

EpiPen Update! Have you heard about AUVI-Q?

December’s EpiPen Update for children allergies

The Epipen shortage continues to have many allergy sufferers in a panic, including parents who need to provide emergency allergy supplies to their school children. But the Epipen is not the only medicine capable of preventing anaphylactic shock (see our page here for info on what  life-threatening anaphylaxis is).

AUVI-Q is one alternative to Epipen

Walgreens has responded to the Epipen shortage by stocking up on this alternative. They’re stepping up in more ways than one. According to a recent press release, Walgreens will be providing this vital medication free of charge to anyone who has an eligible insurance plan. This even applies to high-deductible plans which historically do not cover very much. This does not include any AHCCCS plans. Those who don’t have insurance may receive assistance obtaining AUVI-Q at an affordable cost by taking advantage of kaléo’s patient assistant program. The kaléo company manufactures AUVI-Q.

AUVI-Q is pretty similar to an Epipen. It's smaller, which makes it easier to carry.

  • AUVI-Q is pretty similar to an Epipen. It’s smaller, which makes it easier to carry. If you need to administer a dose you place it against your thigh and hold it in place for 5 seconds. It has a fully retractable needle, a safety measure intended to keep a needle from getting embedded in the leg. In this regard, it may be an even safer alternative for kids than the Epipen.
  • AUVI-Q has another innovation: verbal instructions. As soon as you remove the plastic case on the outside in preparation to use the device you’ll hear the instructions playing. This can be nice if you’re trying to administer the injection to yourself. You won’t have to worry that you’ve forgotten something while you’re busy struggling to breathe.
  • The medication inside the AUVI-Q device is the same as the Epipen: epinephrine. The only real difference is in the delivery method. But the delivery method is enough to mean pharmacists can’t just swap out the two devices. You will need to stop by our office to get a prescription for AUVI-Q if you want to take advantage of this generous offer.

Dr. Habib’s and Dr Alasaly’s thoughts:

There are very few instances where we wouldn’t approve such a change. If you’re struggling to obtain life-saving epinephrine please give our offices a call to make the switch today. But before we ever truly endorse or recommend a medicine for you or your child, you should meet with us in person in order to screen you to make sure you don’t have any of the medical conditions or drug interactions which might make AUVI-Q an unsafe alternative

About Our Allergy Clinic:

For more information about our pediatric and adult allergy services, you can book at any of our 5 allergy and asthma clinics in the Phoenix Metro area or on our  ZocDoc site  for an appointment


2018 Allergy and Asthma Check up Season before Fall Arrives

2018 Allergy and Asthma Check up Season before Fall Arrives

Phoenix Allergies are on the Rise Right Now

With summer heat moving on and our Arizona “cool” fall is approaching, another allergy season is soon be upon us!

Unfortunately, spring is not the only time when asthma and allergies are on the rise. Our late summer rain in July and August means more grasses and weeds and, consequently, an increased pollen count this fall and winter. Moreover, temperature inversions contribute to air pollution, another factor that affects allergies like the common hay fever. At the same time, there’s an increase in asthma symptoms that coincides with our children going back to school.

Allergies and asthma have undoubtedly become more prevalent during the last few years. Major cities are turning into allergy hot spots, and Phoenix is no exception. In fact, in extensive study of allergies across the country in 2011, Phoenix ranked the second worst city for allergen sensitizations, right after Dallas. The allergens examined included food, the common ragweed, house dust mites, mold, and pets.

Why an Allergy and Asthma Check Up is so Important Now

When it comes to allergies and asthma, being proactive is crucial. It’s important to remember that allergies are not static-they evolve over time and are greatly influenced by lifestyle changes and age. Nevertheless, with the right preparation, you will be able to treat your symptoms effectively or prevent them altogether in some cases.

Visiting your allergist right now will give you a chance to:

1) evaluate the effectiveness of your treatment,

2) adjust your medication if necessary, and

3) update your medical history.

Children can also benefit from a check up right as school is starting

Finally, this is a great time for first visits if you suspect you have an allergy that will trouble you as soon as allergy season hits!

How to Prepare for Your Visit to the Allergist’s Office

Before your appointment, talk to your doctor about any medication you might be taking. ALERT: Antihistamines interfere with allergy testing, so the general recommendation is to avoid them for seven days prior to testing. However, this may vary for specific medicines, so remember to follow your doctor’s specific instructions.

Psychiatric medications are another category that might affect skin tests. However, you should never stop taking your prescription without your psychiatrist’s permission. Finally, if you take beta-blockers, which might make testing riskier, your allergist will consult your cardiologist to have you stop them for a few days right before your visit.

There are no special preparations for the actual visit, however, it’s a good idea to wear comfortable clothing to make skin testing on your arm or back easier. Remember to provide your doctor with as much information as possible about changes to your symptoms, the effectiveness of your medication, or anything else relevant. Also, think about any questions you might have and prepare them beforehand. Don’t hesitate to ask for additional information or any educational materials that might be available for patients (which a good allergy specialist should provide).

What to Expect at the Allergist’s Office

Your first visit to a certified Arizona allergist will include a physical examination and communicating your complete medical history. This is a crucial step and you should try to be as thorough as possible. Remember to bring any relevant medical documents with you. Be sure to mention any childhood allergies, your current symptoms, as well as any medication you might be taking. A detailed picture of your condition will help your doctor determine which allergens may be responsible and test you specifically for them.

Allergy tests are suitable for people of all ages, including children. Skin tests are by far the most common. They are reliable, and provide fast results. Examples include the skin prick test, the intradermal, and the patch test. Blood tests are also available for investigating allergies, but these are more expensive and you will have to wait several days for your results. Nonetheless, blood testing is useful occasionally. When allergen exposure during a skin test could result in a severe reaction, when a patient suffers from a severe skin condition like eczema, or they cannot stop taking medication prior to testing, blood tests are a good alternative.

Why Repeating Your Allergy Test is Important

Your doctor may recommend retesting in some cases. If, for example, you are on medication and your symptoms return, change or worsen, or if you develop symptoms in a new season, you will most likely need to repeat your tests. Furthermore, people often develop new allergies over time, so it is necessary to identify these new triggers and pick up anything that previous tests might have missed. Another appropriate time for retesting is before beginning an immunotherapy plan. Your doctor will most likely want to check again for specific allergens before administering allergy shots.

Dealing with allergies and asthma is not just about treating the symptoms. A well-thought plan designed by you and your doctor will keep you one step ahead of your allergies. With the right preparation, you will be able to deal with this fall’s allergies and improve your quality of life significantly. So, don’t delay your appointment with your allergist this summer.

WATCH – Why allergy season gets worse every year


“Allergy and Asthma in the Southwestern United States”., University of Arizona, Health Sciences Center, Sept. 2012, Accessed 5 July 2018.

“Allergy Testing”., American College of Allergy, Asthma & Immunology, Accessed 5 July 2018.

“Allergy Testing”., Health Union, Accessed 5 July 2018.

“Allergy Tests and Asthma”., Webmd, Accessed 5 July 2018.

“How often should I be retested for allergies?”., American College of Allergy, Asthma & Immunology, Accessed 5 July 2018.

Nath, Ishani. “How to Prepare For Your First Visit to the Allergist”., Allergic Living, 4 May 2017, Accessed 5 July 2018.

Quest Diagnostics Health Trends. Allergies Across America: The Largest Study of Allergy Testing in the United States, 2011 [online], Accessed 5 July 2018.

“Will my medication affect the results of my skin test?”., American College of Allergy, Asthma & Immunology, Accessed 5 July 2018.


Will the EpiPen Shortage Create a 2018 Back-to-School Challenge for Your Family?

Will the EpiPen Shortage Create a 2018 Back-to-School Challenge for Your Family?

EpiPen Shortage Update for Families suffering from Allergies

When Back-to-School time rolls around every year we always remind the parents of kids with asthma and allergies to stock up on more than notebooks and tissue. It’s a good time to make sure you’ve got the inhalers and EpiPens your child needs to get through the school year safely, too.

Parents of kids with allergies typically need two boxes, or four pens, to make it through the year. Two for the school nurse’s office, and two for home.

Unfortunately, a 2018 EpiPen shortage may make this task difficult for parents this year.

According to Pfizer, the manufacturer of EpiPens, the company is experiencing “manufacturing constraints” that are making distribution at some pharmacies “iffy.” Generic EpiPens have been approved by the FDA but haven’t made it to market yet, making these distribution problems even more of a challenge for parents who may already have been challenged by the high price of epinephrine.

Epi-pens expiration date

In response to the shortage, the FDA has reviewed certain lots of EpiPens and has chosen to extend the expiration dates on some pens. Thus, the first step for your child will be reviewing your current EpiPen lot to see if your current pens will tide them over until supplies stabilize. You can call our offices if you need help with this.

You can view the list of lots and the new expiration dates here. You will typically find the lot number on the top of the box your pens came in. Your pharmacy can also help if you’re having trouble finding your lot number.

What if your current batch of EpiPens is not part of the extension?

If that’s the case, we may be able to help you locate a pharmacy that currently has a sufficient supply to fill your prescription. With five locations throughout the state we sometimes have access to information other clinics won’t have. While receiving your pens may require a bit of a drive it’s worth it to know your child will have the lifesaving EpiPen on hand should he or she need it.

Mylan, the company that markets EpiPens, has also offered a hotline for parents looking for a place to fill their prescription. You can reach this hotline by dialing 1-800-796-9526.

Another option may be to explore whether your child can use one of the Epi alternatives out there, like Adrenaclick or Auvi-Q. You may have to speak to your insurance company about whether they’ll cover these alternatives. Even if your insurer doesn’t cover these alternatives normally some have been making one-time exceptions in response to the EpiPen shortage.

It doesn’t hurt to ask!

If you’re lucky enough to have an EpiPen that won’t expire for a few months anyway, we here at the Adult and Pediatric Allergy Associates would like to encourage you to wait on your refills. You’ll really help parents who have an emergency situation now. By the time your pens actually expire you might have managed to wait this shortage out.  And at the very least, you won’t contribute to the current problem by replacing pens that don’t need to be replaced yet.

About Us

For more information about our allergy testing or clinic, you can book at any of our 5 allergy and asthma clinisc in the Phoenix Metro on our  ZocDoc site  for an appointment!


Can Antihistamines Used for Treating Allergies Actually CAUSE Allergies?

Can Antihistamines Used for Treating Allergies Actually CAUSE Allergies?

What are antihistamines

Antihistamines for allergies are often purchased over the counter by customers who want relief from allergy or cold symptoms. Many symptoms are so severe that they can affect how a person sleeps or make it difficult to make it through the day. Using an antihistamine can relieve their symptoms and allow them to sleep peacefully.

How Antihistamines for Allergies Work

Antihistamines provide relief for a wide variety of symptoms including the following:

  • Nasal congestion
  • Runny nose
  • Sneezing
  • Skin rashes, hives, inflammation
  • Red, itchy, watery eyes

Antihistamines for allergies come in varying strengths that last for different lengths of time, including 4-6 hours, 12 hours, or extended release that can last up to 24 hours. Some examples of kinds Flonase, Zyrtec, Claritin, etc.

More potent doses may require a prescription, but in general, most can be found at a grocery or drug store. As you will read in our Flonase vs Zyrtec blog, each medicine has different purposes. So, it’s important that you discuss your options with a board certified allergy specialist, like Dr Habib or Dr Alasaly to make sure you get only the dose you need, but also the correct one for the symptom.

relief allergy/cold symptoms

Do Antihistamines for Allergies Have Side Effects?

For as helpful as they are, antihistamines for allergies do have side effects. Each person reacts different to the medication and they are considered to be extremely safe for adults.

Most doctors and pharmacists recommend that you take an antihistamine and find out how you react to it before taking on any major task or getting behind the wheel of a vehicle. Children with allergies who take antihistamines may have trouble concentrating during class, so it’s extremely important that you monitor them while they are taking the medication.

A few of the most common side effects that have been reported during antihistamine use include:

  • Drowsiness
  • Dizziness
  • Blurry vision
  • Reduced appetite
  • Nervousness, irritability or overly excited

If you begin to experience heavy nosebleeds or your symptoms continue to worsen, contact your doctor as soon as possible.

What Are Other Names Associated With Antihistamines for Allergies?

Antihistamines and decongestants are not one and the same, although they are often included in the same medication. The active ingredient in the majority of antihistamines is Diphenhydramine Hcl. This is one of the most common medications used in the treatment of colds and allergies. While there are more than a hundred different brand names to choose from, it’s important to look at the amount of Diphenhydramine in each dose, how often the doses are to be taken, and what other medications are included in the product.

If you live in or near Avondale, Glendale, Phoenix or Scottsdale, Arizona and suffer from allergies, you can find the relief you need at Adult & Pediatric Associates, PC. When you have questions concerning antihistamines for allergies, you need a doctor you can trust. The professional staff have many years of experience and offer the best possible care to each of their patients. 

And did you know that other doctors in the area often refer their patients to Adult & Pediatric Associates?   For over 2 decades, physicians and patients have been highly recommending the staff and doctors because of their level of care and ultimate professionalism!

Call and schedule your appointment today!


10 Common Myths about Allergies and Asthma

10 Common Myths about Allergies and Asthma

Allergies and asthma are becoming increasingly common and affect a substantial portion of the population around the globe, and especially in Arizona. Even in cases of a mild allergy, proper diagnosis and management are essential. Unfortunately, the prevalence of specific misconceptions prevents many people from getting the care they need.

Here are 10 common myths about asthma and allergies you might have thought were true.


1. Allergies are harmless

Allergies are a serious problem that has become more prominent in recent years. No fewer than one in five people will develop an allergy at some point during their lifetime. If left untreated, allergies can have a very negative impact on quality of life. Allergic rhinitis, for instance, causes fatigue, sleepiness, and irritability. Sufferers often find it hard to concentrate, and this, in turn, affects their work or school performance. Furthermore, allergies to foods, drugs, and insects can cause anaphylaxis. This systemic allergic reaction can potentially be life-threatening.

2. Asthma is not fatal

Unfortunately, this is not the case. Asthma deaths have been on the increase recently. According to the Asthma and Allergy Foundation of America, 10 people die of asthma each day in the country. Adults are four times more likely to have a fatal asthma attack than children. In 2015, asthma accounted for 3,615 deaths, many of which proper care and treatment could have prevented.

3. Asthma is a strictly emotional disorder; it’s “all in your head”

Acute emotional stress can trigger an asthma attack. That is not, however, the real cause of the condition. An asthmatic person has hyperactive airways, which become highly sensitive to environmental changes or stimuli. Some scientists believe that these triggers cause an abnormal reaction to sensory nerves in the lungs, which results in coughing and wheezing. The airway muscles contract and swell as the attack progresses.

4. Asthma does not require any medical treatment.

Close monitoring and regular follow-ups with a specialist are crucial, even if the symptoms are mild. The right medication will also prevent inflammation and damage to the lungs. Prevention is the most effective medicine, however, and drugs could be unnecessary in the mildest of cases or when the asthmatic person avoids the triggers that cause asthma, such as pollen, pets, or cold air. These preventive measures are often too restrictive or even impossible to adopt.

5. Allergies and asthma are curable

While there are several useful treatments available, there is not, at the moment, any permanent cure for allergies or asthma. Immunotherapy (allergy shots) is an effective way to treat specific allergies, such as allergic rhinitis (hay fever), asthma, and stinging insect allergy. However, not every allergic person responds to immunotherapy, and there is the possibility of relapse after the end of the treatment. Moreover, this type of therapy cannot treat food allergies yet.

6. All children will eventually outgrow their allergies and asthma

For some children, their asthma symptoms improve or even disappear during puberty, the most severe cases, however, can last for many years, well into adulthood. A large percentage of children with atopic dermatitis (eczema) also improve as teenagers, although they may have lifelong issues with soap and skincare products. In the case of allergic rhinitis, an 80 percent of the children still have symptoms 10 years later. Seasonal allergies are hard to outgrow, but a person’s symptoms may lessen with time.

7. If you relocate, your allergies and asthma will disappear

Moving to another climate might offer relief to some allergy sufferers. If high humidity, molds or cold air trigger your allergy, you may benefit from a warm, dry environment. The air quality in your area is also relevant. Pollution has a negative impact on allergies and could even set off an asthma attack. The bad news is, even if you relocate, your immune response will not change. You might still be exposed and react to new triggers. Allergic people tend to develop new allergies, so a new environment comes with its own risks.

8. Asthmatics should not do any form of exercise or participate in sports

Exercising is essential for everyone’s health and well-being, including people who have asthma. Physical activity strengthens your heart and respiratory system, improves your immunity, and battles stress and anxiety. Because asthmatics greatly benefit from the right kind of exercise, they should engage in it regularly; however it is true that exercise can create an asthma attack.

9. If you are continuously exposed to animals, you will become desensitized to them

In reality, if you are allergic to individual animals and your exposure increases, it is likely that your sensitivity will worsen. In some cases, if you already have an allergy and come in regular contact with indoor pets, you eventually become allergic to them as well. The best solution for relieving your symptoms would be avoiding contact with said pets altogether.

10. Some pet breeds are better for people with allergies

While the amount of allergens that a specific animal can produce varies, all members of a species can potentially be allergenic but some pets are none to be less allergen producing than others (Read this blog for details). In the case of cats, most of the allergen comes from the sebaceous glands in their skin. Dog allergens, on the other hand, are mainly found in the animal’s saliva. Even if a pet doesn’t shed hair, the allergens could still be carried into the house by dust particles. Most specialists agree that people with pet allergies shouldn’t keep them in their homes. Other animals, such as guinea pigs, mice, horses, and even exotic pets like iguanas can also trigger allergies, so there is no genuinely hypoallergenic pet.

When it comes to allergies and asthma, myths, misconceptions, and half-truths abound. It is essential for everyone, and especially for allergic people and their families to get reliable information from reputable sources, such as official allergy organizations and specialists. This will help you separate the scientifically proven from the disproven facts, and possibly improve your quality of life it the long run.

Related: Asthmatic Allergy


“Asthma Facts and Figures.”, AAFA (Asthma and Allergy Foundation of America), February 2018, Accessed 18 March 2018.

“Common Myths About Allergy and Asthma Exposed.”, ASCIA (Australasian Society of Clinical Immunology and Allergy), Accessed 18 March 2018.

Gupta, Sanjay. “Myths and Facts About Allergic Asthma.”, Ziff Davis, LLC, 27 Feb. 2014. Accessed 18 March 2018.

Lipkowitz, Myron A., and Tova Narava. The Encyclopedia of Allergies. Facts on File, Inc., 2001 (second edition), pp. 35, 179-180.