Anaphylaxis to trometamol excipient in gadolinium-based contrast agents for clinical imaging

Adverse reactions to COVID‐19 vaccines: A practical approach

“…It is present in enteral and parenteral drugs: cotrimoxazole iv, Humalog insulin, Menitorix (Haemophilus type b and meningococcal group C conjugate) vaccine, midazolam, oxaliplatin as well as MRI and CT radiocontrast media. 30 The allergenic potential of other excipients: 1,2-distearoyl-sn-glyce ro-3-phosphocholine (DSPC) and EDTA needs to be considered. 31 However, testing faces the same challenges as for PEG, due to the lack of standardized, commercially available test solutions.…”

“…The Moderna vaccine, in addition to PEG, contains trometamol (tromethamine) known to cause not only contact dermatitis but also immediate hypersensitivity reactions. It is present in enteral and parenteral drugs: cotrimoxazole iv, Humalog insulin, Menitorix (Haemophilus type b and meningococcal group C conjugate) vaccine, midazolam, oxaliplatin as well as MRI and CT radiocontrast media 30 . The allergenic potential of other excipients: 1,2‐distearoyl‐sn‐glycero‐3‐phosphocholine (DSPC) and EDTA needs to be considered 31 .…”

COVID‐19 vaccines and the role of other potential allergenic components different from PEG. A reply to: “Other excipients than PEG might cause serious hypersensitivity reactions in COVID‐19 vaccines”

“…The reaction was induced shortly after the injection of GBCA and an IgE-mediated mechanism against trometamol could be detected. 4 Although both BNT162b2 and mRNA-1273 vaccines are mRNA vaccines containing PEG-2000, the excipient tromethamine can only be found in the latter (Figure 1). with medicines containing this excipient and only a few cases of allergy to vaccines due to polysorbates have been reported.…”

Delving Into COVID-19 Vaccination–Induced Anaphylaxis: Are mRNA Vaccines Safe in Mast Cell Disorders?

“…Besides PEG, the mRNA-1273 vaccine contains tromethamine, which is present in contrast media and other healthcare and cosmetic products and has been recently involved in an allergic reaction to gadolinium-based contrast media [7,8]. Thus, to assess whether a patient can safely receive one of these vaccines, a thorough clinical history including previous allergic reactions to drugs and self-care products is mandatory.…”