An allergist will first administer the treatment in their office to ensure you don’t experience significant side effects such as anaphylaxis, a potentially fatal allergic reaction.
After that you should be able to take the tablets yourself at home. (Allergy shots are always administered under medical supervision.)
Four FDA-approved SLIT treatments are currently available. The latest is Odactra, the first to be approved for dust mite allergies, a year-round problem for millions of Americans. The others are oralair for five different grass pollens; Grastek, for allergies to timothy grass; and Ragwitek, for ragweed allergies.
All are only for people aged 65 and under. Depending on the specific SLIT treatment, younger people can start as young as 5 (for Grastek), 10 (Oralair), or 18 (Odactra and Ragwitek).
Some doctors prescribe sublingual drops instead of tablets and recommend them for a wider range of allergens, including cat dander. But this approach is still under investigation and is “off-label” – legal but not a use officially approved by the FDA.
For grasses and ragweed, it’s a good idea to start treatment three to four months before allergy season begins, says Mark S. Dykewicz, MD, Raymond and Alberta Slavin Endowed Professor in Allergy & Immunology at Saint Louis University School of Medicine.
That way, by the time grasses and ragweed are in bloom, you have built up a tolerance to the allergens and your reactions to them should be significantly reduced. (Magpie season is typically late summer to early fall; grass pollen is common in late spring or year-round in warmer areas.)
For dust mite allergies, it can take up to 14 weeks after using Odactra for symptoms to subside, according to The Medical Letter, a nonprofit journal for healthcare providers. Clinical studies have shown that it reduces allergy symptoms and the need for allergy medication by 16 to 18 percent compared to a placebo.
SLIT can cause mild side effects such as itchy or irritated mouth and throat, nausea, or abdominal discomfort. Severe reactions such as anaphylaxis seem to be quite rare.
However, guidelines published by the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recommend that people using SLIT have a prescription for an epinephrine auto-injector — and know how to use it – easy in case.
