Advanced Allergy Drop Treatment

Until recently, the only way to successfully administer allergen immunotherapin the United States was by injections (allergy shots) at the doctor’s office. Allergy Drops (Sublingual immunotherapy or SLIT), are an injection-free allergy treatment that offers patients the freedom to treat their allergies conveniently in their own home. Callahan ENT now offers allergy drops and follow the guidelines of the American Academy of Otolaryngic Allergy (AAOA).

Facts About Allergy Drops

• Drops under the tongue replace weekly shots in the office
• Convenient at-home treatment
• A great option for children and busy working adults
• Patients will be seen in the office every 6 to 12 months to monitor their progress
• A safe and effective method for treating respiratory allergies caused by airborne allergens including pollen, mold, dust mites, and animal dander

Advantages of Allergy Drops Compared to Traditional Allergy Shots

• Patients are freed from repeated injections or the potential for discomfort at the injection site.
• Sublingual immunotherapy may be administered in the privacy and convenience of the patient’s home because there is less potential for an anaphylactic reaction.  There have been no reported fatalities from sublingual immunotherapy.
• Frequent travel to the doctor’s office and the 30 minute observation period that is required after allergy injections is eliminated.  SLIT is administered once a day at home in a matter of minutes.
• For patients living a great distance from the doctor’s office or for patients who travel frequently, allergy drops offer the convenience of being able to administer the treatment wherever the patient happens to be.

Disadvantages of Allergy Drops Compared to Traditional Allergy Injections

• Allergy drops have been used in Europe for many years and currently account for more than half of all immunotherapy administered in the EU.  In the US, however, allergy drops lack FDA approval.  They are still considered "off-label" use.
• Because sublingual allergy drop immunotherapy is still considered “off-label” by the FDA, most insurance plans do not cover it. Therefore, the cost of sublingual drops is an “out-of-pocket” expense for patients.  Check with your insurance carrier to see if they provide coverage or reimbursement.

FAQs About Allergy Drops

What conditions can be treated with allergy drops?

We currently use sublingual immunotherapy for the treatment of respiratory allergies secondary to airborne allergens such as trees, grasses, weeds, mold, dust mites, and animal dander.

How quickly will I see relief of my allergy symptoms?

Although treatment success varies from patient to patient, we anticipate improvement within the first few months of treatment. Maximum benefit may not be noted until one year of therapy has been completed.

Is there a minimum age for use of SLIT?

There are no age restrictions for sublingual immunotherapy, although it is rare to begin any form of immunotherapy prior to age two years.

How will the dosing proceed?

There is an initial “build-up phase” that involves once-a-day dosing, beginning with a few drops from a lower concentration and gradually increasing both the drop number and the vaccine concentration over a period of several months. After the “build-up phase” is complete, you will begin a once-a-day dosing regimen with 3 drops as the standard maintenance dose. This 3 drop- per-day dose will be continued for control of your allergies. The usual treatment course is 4 years, at which time re-evaluation will be recommended. If you are doing well on maintenance immunotherapy, our physicians will want to see you in the clinic about every 6-12 months for a brief follow-up visit.

How will the drops be administered?

The allergen extract is provided in bottles with a dropper mechanism that allows easy dosing under the tongue. Dosing should be done in the morning. Drops are placed under the tongue and held there for 2 minutes, then swallowed. We recommend no food or water for a period of 5 minutes after dosing. After that, there are no restrictions for eating or drinking. Also, there are no restrictions for eating or drinking prior to taking the drops.

Do the drops have any taste?

Due to the glycerin additive mixed with the extract, there is a slight sweet taste. However, since there are no taste buds under the tongue, most patients experience very little taste sensation.

How often do I take the drops?

The drops are taken once a day, every day, for 4 years. Treatment duration varies from patient to patient, depending on the response to treatment and the need for continued symptom control.

Are there any medications that could interfere with my sublingual immunotherapy?

As with subcutaneous (injection) immunotherapy, we do not recommend that you receive sublingual immunotherapy if you are taking a beta-blocker medication (usually used for high blood pressure or glaucoma).

What are the potential side effects of allergy drops?

Reported reactions to sublingual immunotherapy include itching of the tongue or lips (the most common reaction), gastrointestinal symptoms such as nausea and cramping, skin rashes including hives, and very rarely headaches. Systemic reactions (anaphylaxis) have been reported and may include symptoms such as difficulty breathing, shortness of breath, wheezing, hives and generalized itching, skin flushing, throat or tongue swelling, heart palpitations, nausea, and abdominal cramping. These systemic reactions are extremely rare and there has never been a reported incidence of a fatal reaction to sublingual immunotherapy. However, we recommend that you always have an oral antihistamine available for mild local reactions, as well as an epinephrine auto-injector (EpiPen), which we will prescribe, to have available for systemic reactions.