Allergy Drops

Allergy Drops in Charlotte & Monroe

Allergy Drops, also known as Sublingual immunotherapy or SLIT, is now being introduced in the United States and is an injection-free process that offers patients the freedom to treat their allergies conveniently in their own home. Previously, the only way to successfully administer allergen immunotherapy in the United States was by injections (allergy shots) at the doctor’s office.

At our clinic, we offer 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
  • A safety profile that allows the treatment to be administered at home
  • 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
  • Antigen extracts for sublingual immunotherapy are the same as those used for allergy shots
  • A safe and effective method for treating respiratory allergies caused by airborne allergens including pollen, mold, dust mites, and animal dander

What are some advantages of allergy drop compared to traditional allergy shots?

  • The patient does not have to experience repeated injections or the potential for discomfort at the injection site.
  • There is less potential for a systemic anaphylactic reaction, and there have been no reported fatalities from sublingual immunotherapy. Consequently, sublingual immunotherapy may be administered in the privacy and convenience of the patient’s home.
  •  There is very little time commitment, as the treatment is administered once a day at home in a matter of minutes, eliminating the need for travel to the doctor’s office and the 30 minute observation period that is required after allergy injections.
  • 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.

What are some disadvantages compared to traditional allergy injections?

  • Although allergy drops have been used in Europe for many years and currently account for more than half of all immunotherapy administered in the EU, it is still considered “investigational” and “off-label” in the United States and currently does not have FDA approval.
  • Although the extracts used for allergy are the same as those used for injection immunotherapy, the sublingual administration is considered “off-label” and is currently not covered by insurance plans. Therefore, the cost of sublingual immunotherapy, although comparable to the cost of injection immunotherapy, is an entirely “out-of-pocket” expense, not reimbursable by insurance.

Frequently Asked Questions

What conditions can be treated with allergy drops?

Our clinic is currently using 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 single drop from a lower concentration and gradually increasing both the drop number and the vaccine concentration over a period of 10 days. After the “build-up phase” is complete you will begin a once-a-day “maintenance” dosing regimen with 5 drops as the standard dose. This 5 drop- per-day dose will be continued for control of your allergies. If symptoms are well controlled after a year, treatment should continue. The usual treatment course is 3-5 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 3-5 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.