Allergy Drops Instructions

Administration of Sublingual Drops

  1. Dosing should occur at the same time each day, preferably in the morning. 
  2. Record all doses and dates on the Treatment Record form provided to you. 
  3. Prior to dosing, review the Pre-Dose Health Screen on the Treatment Record form. If the Health Screen questions are answered “no”, check the Health Screen box and proceed with dosing. If answered with “yes”, call our office and ask to speak with one of our allergy staff before dosing. 
  4. Drops should be placed under the tongue and held there for 2 minutes, then swallowed. For multiple vial sets, drops from each vial may be added together under the tongue all at once. If mouth itching occurs and is uncomfortable, then spit out the dose and do not swallow. 
  5. If mouth itching persists for more than 5 minutes after dosing, take an oral antihistamine. If mouth itching persists for more than 30 minutes after taking the antihistamine, call our office immediately.
  6. If any suspected systemic allergic symptoms occur, follow the instructions outlined below for adverse allergic reactions and reference the patient instructions for adverse reactions for symptoms of generalized allergic reactions (anaphylaxis)
  7. When dosing is completed, check the appropriate boxes on the Treatment Record form.
  8. Record any adverse reactions associated with dosing in the “Remarks” section on the Treatment Record form.
  9. If you are unsure of any dosing instructions, call our office before proceeding. (See phone number below). 


  1. Always be certain that your epinephrine auto-injector (EAI) and oral antihistamines are available at the time of dosing.
  2. Prescription vials should be kept refrigerated for optimum maintenance of potency. However, studies have shown that the extracts are stable at room temperatures for 30 days. Avoid extreme heat or freezing of the extract vials. 
  3. Always check the vial labels before dosing to be certain that you have the correct vial. 
  4. Do not take drops if you are running a fever higher than 99.5°, if you have active asthma symptoms and are wheezing, or if you have any open sores or wounds in the mouth. 
  5. Do not dose on days of dental procedures. 
  6. Dose adjustments based on missed days or adverse reactions are outlined below. 
  7. Do not take allergy drops if you are also taking a prescription beta-blocker medication. 
  8. Do not administer doses from expired vials. 
  9. For women of childbearing age, immediately notify our office if you become pregnant.

Adjustments Based On Interval Between Dosings

Missed Days

1-7 days

Dosage adjustment

Continue advancement if during the build-up phase or continue with the maintenance dose if on maintenance.

8-14 days

Repeat the last 3 doses (if during the build-up phase).

If at the maintenance phase, resume a 3-day advancement.

  • Day 1 – take 1 drop
  • Day 2 – take 2 drops
  • Day 3 – take 3 drops

then return to scheduled

> 14 Days

Call our office for instructions – 704-752-7575

Instructions For Adverse Allergic Reactions


Itching of mouth


Take an oral antihistamine as needed.*

Swelling lips or tongue

Take an oral antihistamine as needed; return to
last previously tolerated dose (if on maintenance decrease to 2 drops), repeat for 2 doses; then continue with scheduled dosing.*


Take an oral antihistamine. If symptoms persist, use EAI, call 911, and contact our office. Do not take further doses without our direction.


Use your EAI, take an oral antihistamine, call 911, and call our office. Do not take further doses without our direction.

Throat tightness or wheezing

Use your EAI, take an oral antihistamine, call 911, and call our office. Do not take further doses without our direction.

* Call us if symptoms do not improve or worsen.