Do angiotensin II receptor blockers have to be withheld prior to allergy skin testing, and if so, for how long?


Thank you for your inquiry.

I am not aware of any reason to withhold angiotensin II receptor blockers prior to allergy skin testing, and could find no reference to do so in the literature. For further reference, there is a fairly recent article that investigated which drugs should be withheld prior to skin testing. The abstract is copied for you below.

Thank you again for your inquiry and we hope this response is helpful to you.

Allergy Asthma Proc. 2010 Nov-Dec;31(6):477-82. doi: 10.2500/aap.2010.31.3382.
Predicting which medication classes interfere with allergy skin testing.
Shah KM1, Rank MA, Davé SA, Oslie CL, Butterfield JH.
Author information
1Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Medications often interfere with allergy skin test interpretation. This study was performed to determine which medications interfere with allergy skin tests. We retrospectively reviewed skin-prick test results from patients who had discontinued H(1)-antagonists, tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, atypical antidepressants, antipsychotics, hypnotics, sedatives, proton pump inhibitors (PPIs), and H(2)-antagonists between 0 and 7 days before allergy skin testing. Ninety-seven subjects had taken second-generation H(1)-antihistamines within 7 days of skin testing; all patients who had stopped 3 days before testing had positive histamine controls. Two hundred sixty-eight skin tests performed on patients taking a single medication of interest showed that patients had the following percentages of a positive histamine control: TCAs, 56.5%; SNRIs, 100%; H(2)-blockers, 100%; SSRIs, 97%; PPIs, 97%; benzodiazepines, 85.7%; and atypical antidepressants/sedatives, 92.6%. The 580 patients taking multiple medications of interest showed that the odds ratio and 95% confidence intervals of a negative histamine test for patients taking TCAs were 6.33 (2.11-20.5), for H(1)-blockers were 4.95 (1.78-15.1), for benzodiazepines were 5.01 (1.72-15.80), for atypical antidepressants/sedatives were 3.11 (1.09-9.61), and for H(2)-blockers were 2.91 (0.97-9.37). The odds of a negative histamine test for SSRIs, SNRIs, or PPIs were not significantly increased. SSRIs, SNRIs, and PPIs are unlikely to interfere with skin testing. TCAs, H(1)-blockers, benzodiazepines, quetiapine, and mirtazapine should be discontinued temporarily if clinically able. H(2)-antagonists, bupropion, eszopiclone, trazodone, or zolpidem showed minimal interference with immediate hypersensitivity skin test histamine response.

Phil Lieberman, M.D.

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