I am allergic to latex, do I have to be concerned about vial stoppers in medications?

Answered by: Robert G. Hamilton,PhD Johns Hopkins University Medical School, Baltimore, Maryland

In a recent study that was just published (Primeau et al, Natural rubber pharmaceutical vial closures release latex allergens that produce skin reactions. Journal of Allergy Clinical Immunology, 107:958-962, 2001), we found latex allergen in saline that was stored in contact with natural rubber stoppers and the puncturing event increased the level of allergen as detected by intradermal skin testing of latex allergic subjects. At our institution, we are continuing to use the one stick rule to minimize any increase in levels of latex allergen in medications with vials that may contain rubber stoppers. This is done for everyone. Moreover, we have concluded that the pharmacist can not guarantee the type of material in any closure in any vial since this information is difficult to get from manufacturers. Thus, our nursing staff is increasing the extent of observation when any medication is given to a person deemed to be latex allergic by history and/or confirmatory blood or skin test. We hope that this study will

• (1) encourage the FDA to force all pharmaceuticals to be labeled at "containing natural rubber latex" if rubber is in the packaging (such as the rubber stopper) and 
• (2) encourage the pharmaceutical manufacturers to use synthetic stoppers in any new medications. 

For more information on this subject: http://www.hopkinsmedicine.org/press/2001/JUNE/010608.htm

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