Allergy shots (subcutaneous immunotherapy) are administered on a weekly basis in the office. After each injection the patient must remain in the office for 30 minutes to monitor for any signs of an allergic reaction to the injection. During the initial “build up phase” of immunotherapy gradually increasing doses of the offending allergens are administered until the patient reaches a maintenance concentration or the maximum concentration at which the patient tolerates the injections without an adverse reaction. The “build up phase” of allergy immunotherapy with allergy shots typically takes 6-8 months. Once a maintenance concentration is reached patients are continued on weekly allergy injections. The typical treatment period is 3-5 years and the frequency of injections may be gradually decreased to once every two weeks or once every month based on your symptoms and the discretion of your treating physician.
Before proceeding with allergy shots our physicians will review the medications that you are taking. We do not recommend that you that you receive allergy shots if you are taking an oral or topical beta-blocker medication (which may be prescribed for high blood pressure, cardiac conditions, glaucoma, etc) because they may hinder the effectiveness of treating generalized allergic reactions (anaphylaxis) to immunotherapy.
Patients will typically notice an improvement in their symptoms within 6-8 months of starting allergy shots. Maximum improvement in symptoms may not be achieved until they have been receiving their maintenance concentration for a period of 6-12 months.
After receiving an allergy shot it is normal to develop some irritation and redness around the injection site. These reactions typically disappear within hours after administration of the allergy shot and topical hydrocortisone cream can be applied as needed for itching.
While receiving allergy shots it is possible to develop more significant local skin reactions (redness and swelling) from the injections and more rarely a generalized allergic reaction (anaphylaxis). A generalized allergic reaction (anaphylaxis) will usually occur within 30 minutes of injection but can occur hours later in some cases. Symptoms of anaphylaxis can include difficulty breathing, shortness of breath, wheezing, hives/generalized itching, skin flushing, throat or tongue swelling, heart palpitations, nausea, and abdominal cramping. Anaphylaxis can be life-threatening and may require immediate medical attention including evaluation in an emergency room or hospital setting. 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.