Administering pharmaceuticals to latex-allergic patients from vials containing natural rubber latex closures

Natural rubber latex derived from the Hevea brasiliensis tree is widely used in the manufacturing of packaging for pharmaceuticals and medical products because of its excellent elasticity and durability. In 1991, the Food and Drug Administration (FDA) issued a medical alert on natural rubber latex allergy.1 From that point forth, latex allergy has remained an established health problem, with a reported frequency in the 1990s of 1–6% in the general population,2,–4 8–16% in health care workers,5,6 and up to 50% in children with spina bifida.7 In recent years, the number of new cases of latex allergy has decreased due to improved diagnostic methods, more extensive education, accurate labeling of medical devices containing natural rubber latex, and use of medical devices with reduced latex-allergen content. Individuals sensitized to allergenic proteins released from natural-rubber-containing consumer (e.g., toy balloons, condoms) and medical products (e.g., medical examination and surgeon gloves, manual resuscitators, rubber dental dams) have a broad range of allergic reactions, from mild local cutaneous reactions to generalized urticaria, angioedema, allergic rhinitis, respiratory symptoms, and life-threatening or fatal anaphylaxis. The epidemiology, diagnosis, and natural history of latex allergy are more extensively discussed elsewhere in a primer for the pharmacist.8