Allergy Drops (Sublingual Immunotherapy or SLIT): FAQ

by Dr. Christopher Chang, last modified on 5/21/21.

NOTE: Treatment will be provided ONLY with an office visit.We also do not treat patients with severe asthma. We are an ENT allergy practice and as such, deal only with problems above the shoulders which excludes the lungs and asthma.

Who should take allergy drops?
Although most allergy sufferers can benefit from allergy drops, they’re especially ideal for people who can’t tolerate or don’t respond to allergy shots, as well as people who are unable to commit to allergy shot therapy. These people include:

Children
Asthmatics (of note, our practice does not treat this patient population at this time)
Highly sensitive people (especially those with a history of anaphylaxis during skin testing or during allergy shots)
Those with chronic conditions including sinusitis
People with multiple allergies including dust, pollen, mold, animals

Allergy drops have a sweet, minty taste to them and are tolerated well by children.

What are the advantages of allergy drops?
In addition to being able to treat patients of all ages safely and effectively, 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. You can take allergy drops at home or wherever you need to be, making it much easier to stay with your treatment.
Less medication. Our patients report, and research confirms, that most patients report needing less medication to control symptoms after beginning allergy drops.
Enjoy healthier days. The end benefit? Feeling better. Patients typically report fewer clinic visits, hospitalizations, and less lost time from work and school after taking drops consistently.

Are allergy drops safe? Is there research validating their effectiveness?
Allergy drops have been used around the world for more than 60 years, and numerous studies validate both the safety and effectiveness. In fact, the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to injection therapy. The 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.

How long will I need to take my drops?
Most patients take allergy drops each day for three to five years, but it varies according to the severity of your allergies and the seasonality. Many patients report improvement within a few months.

How long can I expect the effects of allergy drops to last?
A benefit of immunotherapy—whether it’s allergy shots or allergy drops—is that it can alter the course of allergic disease by treating the root cause, not just the symptoms. Key studies have already been conducted to explore the long-lasting effect of allergy drops, including a 10-year prospective study on children with asthma that demonstrated drops maintained effectiveness long after treatment had stopped.

The key to ensuring the effects last is compliance, which is an additional benefit of allergy drops. Studies show that patients taking allergy drops tend to stay with their treatment 90 percent of the time, which is significantly higher than with other routes of treatment. Why is compliance so much higher? Patients appreciate the convenience of being able to take their drops wherever they are, eliminating the need to make frequent clinic visits and the savings in time and money that result. They also tend to see improvement within one to three months, which motivates them to continue a treatment that leaves them continuing to feel better.

But even the best treatments won’t work if you don’t stay with them. Like allergy shot treatment, it’s important to stay with allergy drop treatment until your doctor has determined treatment can be discontinued. A typical patient will continue treatment for three to five years, depending upon the severity of allergic problems.

Continuing with your treatment will help you reap the long-term rewards. A recent study showed that the use of allergy drops with children can significantly lessen the development of asthma later in life—as much as an 80 percent decrease than found in patients who haven’t had immunotherapy. These findings are consistent with the Pediatric Asthma Treatment study done by leading European researchers who found similar results with injection therapy.

I’ve heard that allergy drops are not approved by the FDA. Is that safe?
First, it’s important to understand that the antigens used in allergy drops are the same physician prescribed antigens used in allergy shots. They’re also prepared in the same way as allergy shots. The difference is the route of administration—a dropper that delivers the antigen under the tongue versus a syringe injecting antigen into tissue.

Currently, antigens are labeled by the FDA for use through injections. Using them for sublingual immunotherapy is an off-label use of an FDA-approved biologic, which is both legal and highly common. Most physicians prescribe “off-label” use of a myriad of drugs today, for example, the use of blood pressure medications for migraines, aspirin for heart conditions, or the use of arthritis drugs for the treatment of shingles.

If drops are so effective, why don’t more patients receive them?
Allergy drops are widely accepted as an effective treatment throughout the world. In fact, 50-75 percent of allergy sufferers in southern Europe are treated with allergy drops. That acceptance is growing throughout the world, and is beginning to grow in the United States as the treatment becomes more widely available.

How much will it cost me?
Please note that insurance does not cover allergy drops at this time and will be an out-of-pocket expense. The current cost can be found here.

More frequently asked questions for patients beginning allergy drops can be found here.

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Allergy Drops (Sublingual Immunotherapy or SLIT): FAQ

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