Frequently asked questions about sublingual immunotherapy (SLIT) – Allergy Drops

Allergy drop treatment works similar to shots by delivering a slowly increasing dose of physician-prescribed antigen that over time builds the body’s tolerance. The difference is that the drops are placed under the tongue and affect the immune system through very specialized cells found under the tongue. Research shows these cells are a friendlier and effective route for long-term desensitization, making it an ideal option for patients who aren’t candidates for shots. Most patients take allergy drops each day for three to five years.
Aside from the benefits of being able to treat more patients, including children, asthmatics and others who aren’t able to tolerate shots, there are other advantages to allergy drops.
Lower cost, fewer clinic visits.
Compared to shots, allergy drops cost less and require fewer clinic visits. Most patients receiving allergy drops need only a few clinic visits the first year, and once every 6-12 months thereafter until visits are no longer needed.
More convenient, fewer medications.
You can take allergy drops at home or wherever you need to be, making it much easier to stick with treatment. And many patients find they need less medication to control symptoms after beginning allergy drops.
More healthy days.
The end benefit is simply feeling better. Our patients typically report fewer clinic visits and hospitalizations, as well as less time lost from work and school, after taking their drops consistently.
Although most people who suffer from allergies and related illnesses can benefit from allergy drops, many people aren’t aware it’s an option. For those whose allergies prevent them from living a full, productive life, allergy drops provide an effective, safe and cost effective option. Not only does this benefit patients who can’t tolerate or don’t respond to shots or other therapies, it provides tremendous benefits to employers and our entire healthcare system.
Allergy drops have been used around the world for more than 60 years, and many studies show that allergy drops are safe and effective. Dosing levels and the route of administration are safe enough to effectively treat infants, children, and people suffering from chronic conditions that previously made them unable to receive immunotherapy via shots.

In fact, the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to injection therapy.

The well-respected Cochrane Collaboration, the world’s most-trusted international organization dedicated to reviewing healthcare treatments, recently concluded allergy drop immunotherapy significantly reduced allergy symptoms and use of allergy medications.

The safety profile for sublingual immunotherapy is superior to injection based on research studies and patient treatment experience. Systemic reactions occur 3x less with sublingual, and there has never been and anaphylactic reaction (life threatening) recorded over the 30+ years of sublingual treatment.

Compliance has not been studied extensively. However, one large managed-care organization did find 50% of patients receiving allergy shots dropped out of therapy during the first year. In looking at sublingual compliance among patients in many of the studies identified previously, approximately 90% of patients complete their treatment.

Testing & Evaluation
Our first step is to confirm which allergies are present and how severe they are. Patient history plays a large role here. Skin testing is used to confirm suspected allergies. We often use intradermal skin tests to help the physician assess how severe the allergy may be. In vitro (blood) testing may be used to identify food and inhalant allergies.

Environmental Control
Once allergies are confirmed, we help patients find ways to avoid allergens by suggesting changes in diet and lifestyle when possible.

To help reduce symptoms, you might be prescribed medications, such as non-sedating antihistamines and nose sprays. As treatment continues, most patients find their need for medication decreases.

Allergy drops, customized for the patient’s specific allergies, helps alter the disease state so that eventually, allergic reactions are no longer a problem. With allergy drops, patients are able to be treated at home. Your physician will monitor your progress throughout your care. Several antigens may be in one vial. Possible treatment regimens include:

  • Preseasonal treatment. This is a quick build up of antigen weeks prior to an "allergy season." Treatment continues during the season using a maintenance dose. Common treatments are for spring grasses, trees and ragweed.
  • Threshold dosing. Allergies to dust, molds and foods require an ongoing build up of antigen, followed by a maintenance or threshold dose schedule.
  • Anaphylaxis Treatment. This is, of course a very careful and slow treatment guided by in vitro specific IgE levels (blood testing) or intradermal skin testing. Doses are increased only when we see sensitivity to the allergen decrease. To ensure your safety, the first dose is given in our office.
Unlike most allergy drugs – which treat only symptoms – sublingual immunotherapy addresses the underlying causes of allergies. Allergy drops are administered in gradually increasing dosages until the patient develops a tolerance to the allergy-causing substance.
An antigen is an allergy-causing substance. Examples include dust, pollen, mold, insect venom and specific foods such as fish, wheat, corn and eggs.
The benefit of sublingual immunotherapy is that a broad range of allergies, including those caused by dust mites, pollen, mold, animals, foods and chemicals can be treated.
Sublingual immunotherapy has been used in various parts of the world for 60-plus years. More than 100 scientific articles in peer-reviewed journals prove that sublingual treatment is both safe and effective.
Compared to traditional injection therapy, allergy drop treatment is more convenient, requires fewer clinic visits and costs less. Most importantly allergy drops are a safe, effective treatment for young children, asthmatics, the highly reactive and those with underlying medical conditions that prevent them from being candidates for injection therapy.
Some insurance plans do cover the costs of allergy drops. However many do not, check with your carrier.
Currently few US physicians offer allergy drops. Interest is growing in the allergy specialty and education and patient demand will have a positive effect. Please visit our Physician Directory to learn more.
Yes! Children from infancy on up can be treated with allergy drops. Because sublingual therapies use carefully measured frequent doses to treat allergic conditions effectively, they are able to treat children early on–enabling them to treat the root cause of the allergy before it develops into other related conditions.