Sublingual Immunotherapy

What is Sublingual immunotherapy? Sublingual immunotherapy (SLIT) is an allergy drop therapy, and has been shown to be effective against all type of allergens, including some food allergens. Because drops are very safe, they have no age restrictions and can be used at home. Drops naturally suppress the allergic part of the immune system without significant side reactions, and should be used daily for a stronger and quicker result. To begin SLIT, there is an initial “escalation” phase over the first five days, which involves a once-a-day dosing regimen. The maximum dose is five drops, which is the standard maintenance dose and will be repeated through your treatment. Each set of vials lasts approximately eight weeks. Drop therapy continues for three to five years while your immune response to allergens changes.

The Benefits of SLIT

Treats the root cause of your allergy problems by inducing a natural immunity to the allergen
Proven effective in patients with allergic rhinitis (hay fever) and other allergic disorders
Reduction in number of upper respiratory infections that require antibiotics
Reduction in use of medications to control your allergies
Improved quality of life compared to standard medical therapy
More cost effective in the long run compared to daily medication to treat allergic disorders
Avoid the discomfort of injections and associated local reactions
Allows the treatment to be administered at home, which saves you time and expense
Less potential for a systemic anaphylactic reaction, and regarded as being very safe

Administering Drops

Take your allergy drops every morning. ALWAYS stand in front of a mirror to watch the drops fall beneath the tongue. Do not eat, drink, shower, or exercise 20 minutes before/after taking your drops.

Instructions:

The first dose from the vial(s) are required to be administered in the office and you must wait for 30 minutes to watch for signs of an allergic reaction.
Record all doses including the date on the dosing log provided.
Give the vial a gentle shake.
Place drop(s) under the tongue, hold the drop in your mouth for 2 minutes, and swallow. If you sense tingling and itching in your mouth, DO NOT swallow the serum and spit out the dose.
Any adverse events associated with the dosing should be recorded in the “Remarks” section.

Missed Doses

If you miss a dose, pick up where you left off but DO NOT try to make up missed doses.
If you miss more than one week, please contact the clinic for a revised schedule.

What do the drops taste like?

Most patients report not noticing much taste at all. The allergens are normally preserved in a 50% glycerin preservative, therefore, they may have a sweet taste. Occasionally some patients report a more noticeable taste, but this is an individual response.

Side Effects

Side effects to allergy drops are minimal. You may experience some localized reaction of itchiness, slight numbness, or a tingling sensation in the mouth and under the tongue. You may also notice some stomach discomfort. If you experience side effects, call the Allergy Department for directions.

If you develop difficulty breathing, severe swelling of the mouth and/or throat, difficulty swallowing, or lightheadedness, CALL 911 and go to the nearest emergency room immediately.

Precautions for Reducing Severe Reactions

Administer the drops while somebody else is with you. Drops should be given at morning time.
Do not take drops if you have a fever of 100℉ or if you are experiencing asthmatic symptoms.
Keep Benadryl next to your SLIT bottle. A dose of 50 mg for an adult or 25 mg for a child should be taken immediately if there is any type of reaction, and please notify our office as soon as possible.
An EpiPen should always be available when taking the drops. If you experience any difficulty breathing, wheezing, swallowing, or hoarseness shortly after taking allergy drops, use the EpiPen.
Do not use any form of immunotherapy if you are currently taking a prescription beta blocker medication. Please ask if you are uncertain whether you are taking this type of medication.
If you stop using your allergy drops for multiple days, notify our office prior to resuming therapy.
If you are a woman and become pregnant, notify our office if you become pregnant.
Do not dose on days of dental procedures.

Travel and Storage

Drop vials may be kept in the refrigerator for longer potency. You may travel with drops but you must keep the vials in a safe, cool place and out of direct sunlight. Avoid extreme heat and freezing.

Call our office if you have any questions or concerns at (770) 292-3045.

Re-ordering Drops

Each allergy drop vial is to be scheduled around an eight-week supply after the first vials. The drop usage schedule provided will inform you when it is time to reorder. Drops may be reordered by calling our office, during which payment should be made. Please allow two weeks to receive your new vials. You must have two physician visits (every six months) on record for one given year to continue sublingual immunotherapy.

Comparing Allergy Shot Treatment to Allergy Drop Treatment

Type	Subcutaneous Immunotherapy (SCIT)	Sublingual Immunotherapy (SLIT)
Medication Cost	Variable based on insurance	Variable based on contents
Insurance Coverage	Yes, including deductible and copayments	No
Risk	Yes, there is a risk of an injection site localized reaction, asthma flare-up or anaphylaxis	Very minimal
Pain	May be 1-2 shots which can cause pain	None
Location of Treatment	Administered in our office only	Your home
Frequency of Administration	Once a week initially	Once a day placing drops under tongue for two minutes then swallow
Duration of Treatment	Three to five years	Three to five years
Effective	Yes	Yes
Compliance	30-50% patient dependent	80-97% patient dependent