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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Non-Standardized Food Allergenic Extract [EPC]
Levisticum Officinale Root, commonly known as Lovage, is a botanical substance utilized primarily as a Non-Standardized Food Allergenic Extract for diagnostic testing and immunotherapy in patients with suspected hypersensitivity to the Apiaceae family.
Name
Levisticum Officinale Root
Raw Name
LEVISTICUM OFFICINALE ROOT
Category
Non-Standardized Food Allergenic Extract [EPC]
Drug Count
4
Variant Count
4
Last Verified
February 17, 2026
About Levisticum Officinale Root
Levisticum Officinale Root, commonly known as Lovage, is a botanical substance utilized primarily as a Non-Standardized Food Allergenic Extract for diagnostic testing and immunotherapy in patients with suspected hypersensitivity to the Apiaceae family.
Detailed information about Levisticum Officinale Root
References used for this content
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Levisticum Officinale Root.
Levisticum Officinale Root, derived from the perennial herb commonly known as Lovage, is a botanical substance that serves multiple roles in both traditional medicine and modern clinical immunology. Within the framework of the United States Food and Drug Administration (FDA) pharmacological classification, it is categorized as a Non-Standardized Food Allergenic Extract [EPC]. This classification indicates that while the extract is used for medical purposes—specifically in the diagnosis and treatment of allergic sensitivities—it has not undergone the rigorous standardization process that defines the exact potency of specific allergens within the solution, unlike 'standardized' extracts such as certain grass pollens or dust mites.
Levisticum Officinale belongs to the Apiaceae (or Umbelliferae) family, which also includes celery, carrots, parsley, and fennel. In clinical practice, healthcare providers utilize this extract to identify patients who may have developed IgE-mediated hypersensitivity (allergic reactions) to lovage or through cross-reactivity with other members of the Apiaceae family. The FDA approval history for allergenic extracts like Levisticum Officinale Root dates back several decades, falling under the regulatory purview of the Center for Biologics Evaluation and Research (CBER). These products are essential tools for allergists to confirm a patient's sensitivity profile and, in some cases, to formulate subcutaneous immunotherapy (SCIT) to desensitize the patient over time.
When used as a diagnostic tool, Levisticum Officinale Root extract works by interacting with the patient's immune system at a localized level. In a skin prick test (SPT), a minute amount of the extract is introduced into the epidermis (the outermost layer of the skin). If the patient is sensitized to Levisticum Officinale, specific Immunoglobulin E (IgE) antibodies bound to the surface of mast cells in the skin will recognize the proteins (allergens) in the extract. This recognition triggers the degranulation of mast cells, leading to the release of inflammatory mediators such as histamine, leukotrienes, and prostaglandins. This physiological cascade results in a 'wheal and flare' reaction—a raised, itchy bump surrounded by redness—which the clinician measures to determine the degree of sensitivity.
In the context of immunotherapy (allergy shots), the mechanism is more complex and involves a long-term shift in the immune response. By administering gradually increasing doses of the Levisticum Officinale Root extract, the body is encouraged to move away from a Th2-biased (pro-allergic) immune response toward a Th1-biased or regulatory T-cell (Treg) response. This process stimulates the production of 'blocking antibodies,' specifically IgG4, which can intercept the allergen before it reaches the IgE on mast cells, thereby reducing the severity of allergic symptoms upon future exposure.
As an allergenic extract administered via the skin or subcutaneous tissue, the traditional pharmacokinetic parameters (Absorption, Distribution, Metabolism, and Elimination) differ significantly from oral or intravenous medications.
The primary clinical indications for Levisticum Officinale Root extract include:
Levisticum Officinale Root is typically available in the following pharmaceutical forms:
> Important: Only your healthcare provider can determine if Levisticum Officinale Root is right for your specific condition. Diagnostic testing must always be performed in a clinical setting equipped to handle potential systemic reactions.
Dosage for Levisticum Officinale Root extract is highly individualized and depends entirely on whether the extract is being used for diagnostic purposes or therapeutic desensitization.
For a Skin Prick Test (SPT), a single drop of the concentrated extract (often 1:10 or 1:20 w/v) is applied to the skin, followed by a prick through the drop. For Intradermal Testing, if the SPT is negative but clinical suspicion remains high, a much more dilute solution (ranging from 1:100 to 1:1000) is injected (0.02 to 0.05 mL) to create a small bleb.
If used in Subcutaneous Immunotherapy (SCIT), the dosage follows a 'Build-up Phase' and a 'Maintenance Phase':
Levisticum Officinale Root extract is not specifically contraindicated in children; however, its use must be managed with extreme caution by a pediatric allergist. Dosing for children is generally the same as for adults in terms of concentration, but the volume administered during the build-up phase may be adjusted based on the child's weight and the clinician's assessment of sensitivity. It is generally not recommended for children under the age of 5 due to the difficulty of monitoring for early signs of systemic reactions.
No specific dose adjustments are required for patients with renal impairment, as the systemic protein load is minimal. However, patients with severe renal disease may have altered skin reactivity, potentially leading to false-negative diagnostic results.
There are no known requirements for dosage adjustment in patients with hepatic impairment. The metabolism of allergenic proteins does not rely on hepatic enzyme pathways.
In patients over 65, skin reactivity may be diminished (atrophy of the skin), which can affect the interpretation of diagnostic tests. Clinicians may need to use a positive control (histamine) more rigorously to validate the test results.
Levisticum Officinale Root extract is never self-administered by the patient at home. It must be administered by a qualified healthcare professional (usually an allergist or immunology nurse) in a clinical setting.
In the context of immunotherapy, a missed dose can disrupt the desensitization process. If a dose is missed by more than one week, the clinician may need to 'step back' to a lower dose to ensure safety before resuming the build-up. If several weeks are missed, the entire protocol may need to be restarted.
An overdose of Levisticum Officinale Root extract usually manifests as a severe systemic allergic reaction. Signs include generalized hives (urticaria), swelling of the throat (angioedema), wheezing, shortness of breath, and a drop in blood pressure (hypotension). Emergency treatment requires the immediate administration of epinephrine (Adrenaline), followed by antihistamines, corticosteroids, and supportive care.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
The most frequent side effects associated with Levisticum Officinale Root extract are localized to the site of administration. These are generally expected as part of the diagnostic or therapeutic process.
> Warning: Stop taking Levisticum Officinale Root and call your doctor immediately if you experience any of these.
There are no documented long-term adverse effects of Levisticum Officinale Root extract on organ systems (such as the liver or kidneys). The primary long-term 'effect' is the desired modification of the immune system. However, repeated injections over several years can occasionally cause localized thickening of the skin or subcutaneous tissue at the injection sites.
While Levisticum Officinale Root extract may not have an individual 'Black Box' warning unique to the plant, it falls under the General Class Warning for Allergenic Extracts. This warning states:
Report any unusual symptoms to your healthcare provider.
Levisticum Officinale Root extract is a potent biological substance that must be handled with the same level of caution as a vaccine or a high-alert medication. Because it contains the very proteins a patient is allergic to, the risk of triggering the very symptoms the clinician is trying to diagnose or treat is inherent to the product.
As noted in the side effects section, the FDA requires a general warning for all non-standardized allergenic extracts. This includes the requirement that the product only be administered by clinicians trained in the management of anaphylaxis and that the facility be equipped with oxygen, IV fluids, and intubation equipment.
Generally, Levisticum Officinale Root does not affect the ability to drive. However, if a patient experiences a vasovagal reaction (fainting) or a mild systemic reaction requiring antihistamines (which can cause drowsiness), they should not drive until symptoms have fully resolved.
Alcohol should be avoided on the day of an immunotherapy injection or skin test. Alcohol can cause vasodilation (widening of blood vessels), which may theoretically increase the rate of allergen absorption and increase the risk of a systemic reaction.
Discontinuing Levisticum Officinale Root extract does not require a tapering period. However, stopping immunotherapy prematurely will likely result in the return of the patient's original allergy symptoms. If the treatment is stopped due to a severe reaction, the clinician will perform a detailed risk-benefit analysis before considering a restart at a much lower dose.
> Important: Discuss all your medical conditions with your healthcare provider before starting Levisticum Officinale Root.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Patients with a known allergy to Celery (Apium graveolens) have a very high likelihood of cross-reacting with Levisticum Officinale Root. This is due to the presence of highly conserved proteins across the Apiaceae family. Caution should also be exercised in patients with 'Birch-Mugwort-Celery' syndrome, as they are often sensitized to the profilin proteins found in these botanicals.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Levisticum Officinale Root.
Levisticum Officinale Root extract is classified as Pregnancy Category C. This means that animal reproduction studies have not been conducted, and it is not known whether the extract can cause fetal harm. The primary concern during pregnancy is not the extract itself, but the potential for a systemic allergic reaction (anaphylaxis) in the mother. Anaphylaxis causes a sudden drop in blood pressure, which can lead to decreased uterine blood flow and fetal distress or death. Consequently, healthcare providers typically do not initiate new immunotherapy or perform skin testing during pregnancy. If a patient is already on a stable maintenance dose and is tolerating it well, the clinician may choose to continue the dose without further increases.
It is not known whether the allergenic components of Levisticum Officinale Root are excreted in human milk. However, since the allergens are proteins that would be digested in the infant's stomach, the risk to a nursing infant is considered extremely low. Breastfeeding is generally not considered a contraindication for either diagnostic testing or immunotherapy.
While effective in children, the use of Levisticum Officinale Root extract in patients under the age of 5 is often avoided. Young children may be unable to articulate the early symptoms of a systemic reaction (such as an itchy throat or a sense of 'doom'), making treatment more dangerous. In older children, the extract is used similarly to adults, though the psychological impact of repeated injections must be considered.
Clinical studies of allergenic extracts generally do not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently than younger subjects. In elderly patients, the presence of co-morbidities such as cardiovascular disease or the use of medications like beta-blockers significantly increases the risk profile of the treatment. Furthermore, age-related thinning of the skin can lead to less distinct results in diagnostic testing.
In patients with chronic kidney disease (CKD), the clearance of degraded peptide fragments may be slowed. However, because the total mass of protein administered is so small, this is rarely clinically significant. The main concern is the patient's overall physiological resilience in the event of a systemic reaction.
There are no specific guidelines for the use of Levisticum Officinale Root in patients with hepatic impairment. Since the proteins are not processed by the liver's metabolic enzymes, no dose adjustment is typically required based on Child-Pugh classification.
> Important: Special populations require individualized medical assessment.
Levisticum Officinale Root extract contains a complex mixture of proteins, glycoproteins, and polysaccharides. In diagnostic use, these allergens cross-link IgE antibodies on the surface of mast cells and basophils. This cross-linking triggers a signal transduction pathway involving tyrosine kinases, leading to the influx of calcium ions and the subsequent release of pre-formed mediators like histamine.
In therapeutic use (immunotherapy), the mechanism involves the induction of immune tolerance. This is characterized by the expansion of T-regulatory (Treg) cells that produce IL-10 and TGF-beta. These cytokines suppress Th2-driven allergic inflammation and signal B-cells to switch production from IgE to IgG4, which acts as a 'decoy' antibody.
| Parameter | Value |
|---|---|
| Bioavailability | Low (Subcutaneous/Dermal) |
| Protein Binding | Minimal (Systemic) |
| Half-life | Hours (Proteins) |
| Tmax | 15-30 mins (Local) |
| Metabolism | Proteolysis (Non-CYP) |
| Excretion | Renal (Peptides) |
Levisticum Officinale Root belongs to the class of Allergenic Extracts. It is specifically grouped with food-derived extracts used for the management of Type I hypersensitivity reactions.
Medications containing this ingredient
Common questions about Levisticum Officinale Root
Levisticum Officinale Root extract is primarily used by allergists as a diagnostic tool to identify if a patient has a specific allergy to lovage or related plants in the Apiaceae family, such as celery or carrots. It is also used in allergen immunotherapy, a process where small, increasing doses are given to a patient to help their immune system become less sensitive to the allergen over time. This is particularly important for patients who may experience severe reactions from accidental food exposure. The extract helps confirm the presence of IgE antibodies that trigger allergic symptoms. It is not used to treat the symptoms of an active allergic reaction but rather to diagnose the underlying cause.
The most common side effects are localized reactions at the site of the skin test or injection, including redness, itching, and a raised bump known as a wheal. These reactions are typically mild and resolve on their own within a few hours. Some patients may also experience a 'late-phase' reaction where swelling appears several hours after the injection. While these local effects are common, they are generally not dangerous. However, they must be monitored by a healthcare provider to determine the safety of future doses. If the swelling is excessively large, the next dose of immunotherapy may need to be reduced.
It is generally advised to avoid alcohol on the days you receive a Levisticum Officinale Root injection or undergo skin testing. Alcohol can cause your blood vessels to dilate, which might speed up the absorption of the allergen into your bloodstream, potentially increasing the risk of a systemic or 'whole-body' allergic reaction. Furthermore, alcohol can sometimes mask the early symptoms of an allergic reaction or make them more difficult to treat. To ensure the highest level of safety during your treatment, it is best to abstain from alcohol for at least 24 hours around your appointment. Always follow the specific instructions provided by your allergy clinic.
Levisticum Officinale Root is generally not started during pregnancy because of the risk of anaphylaxis, which can be dangerous for both the mother and the developing fetus. If a woman is already on a stable maintenance dose of immunotherapy and becomes pregnant, her doctor may decide to continue the treatment but will usually not increase the dose. Skin testing for diagnostic purposes is typically postponed until after delivery. The main goal is to avoid any reaction that could cause a drop in blood pressure or oxygen levels. If you are planning to become pregnant or find out you are pregnant while on this treatment, notify your allergist immediately.
When used for diagnostic skin testing, the results are visible within 15 to 20 minutes. However, when used for immunotherapy to reduce allergy symptoms, the process is much slower. Most patients begin to see a reduction in their allergic sensitivity after 6 to 12 months of consistent weekly injections during the 'build-up' phase. The full benefit of the treatment is often not realized until the patient has been on a 'maintenance' dose for one to two years. A complete course of immunotherapy typically lasts between three and five years to provide long-lasting protection. Patience and consistency are key to the success of this treatment.
Yes, you can stop the treatment suddenly without experiencing withdrawal symptoms, as it is not a physically addictive medication. However, stopping immunotherapy before the recommended three-to-five-year course is finished usually means that your allergy symptoms will eventually return. The immune system requires long-term exposure to the extract to maintain the 'tolerance' that prevents allergic reactions. If you stop because of side effects or other concerns, it is important to discuss this with your doctor first. They can help you weigh the risks and benefits or perhaps adjust your schedule to make the treatment more tolerable.
If you miss an immunotherapy injection, you should contact your allergy clinic as soon as possible to reschedule. Do not attempt to 'double up' on your next dose or take an extra dose later. Depending on how long it has been since your last injection, your doctor may need to reduce your next dose to ensure you don't have a reaction. If too much time has passed (usually several weeks), you might need to restart the build-up process from a lower concentration. Consistency is vital for the treatment to be effective and safe, so try to keep your appointments as scheduled.
There is no clinical evidence to suggest that Levisticum Officinale Root extract causes weight gain. The extract consists of proteins and glycoproteins administered in very small amounts, which do not have the metabolic or hormonal effects associated with weight changes. Unlike some other medications used for allergies, such as oral corticosteroids (like prednisone), allergenic extracts do not increase appetite or cause fluid retention. If you notice unexpected weight changes while undergoing treatment, you should discuss them with your healthcare provider to identify other potential causes. Your allergy treatment is unlikely to be the culprit.
Levisticum Officinale Root can interact with several types of medications, particularly those that affect your heart or your body's response to adrenaline. Beta-blockers and ACE inhibitors are of particular concern because they can make an allergic reaction more severe or harder to treat. Additionally, you must stop taking antihistamines several days before a skin test because they will block the reaction and lead to inaccurate results. Always provide your allergist with a complete list of all medications, including over-the-counter drugs and herbal supplements. This allows them to safely plan your testing and treatment protocol.
Levisticum Officinale Root extract is a biological product rather than a traditional chemical drug, so the term 'generic' does not apply in the same way. However, it is produced by several different specialized laboratories that manufacture allergenic extracts. While the brand names may differ, the extracts are generally considered comparable for diagnostic purposes if they are prepared using similar weight-to-volume ratios. Because these are 'non-standardized' extracts, your allergist will usually stick with the same manufacturer's product throughout your treatment to ensure consistency in potency and to minimize the risk of reactions when switching vials.