Everything You Need to Know Before Taking Oralair

What is Oralair?

Oralair is a form of sublingual immunotherapy. It is indicated for the treatment of grass allergies including hay fever symptoms caused by the following types of grass: Sweet Vernal Grass, Orchard Grass, Perennial Rye, Timothy Grass, and Kentucky Blue Grass. It was the first medication approved for this use (sublingual immunotherapy) in the United States. Sublingual immunotherapy is a treatment for allergies that works in a similar manner to allergy shots.

An individual with a specific allergy is given minute amounts of the allergen which causes their symptoms in an effort to desensitize their immune system. In this manner some individuals experience a permanent or long lasting decrease in their allergy symptoms after undergoing this treatment.

How is Oralair Taken?

Oralair comes in a tablet form which is dissolved under the tongue for a period of one minute. You should not eat or drink for a full five minutes after the tablet is completely dissolved. Individuals ages 10-17 years of age are started on a low dose of the medication which is then gradually increased over a period of 3 days. Individuals over the age of 17 are started out on a full strength dose. The first dose of Oralair should be taken in a healthcare providers office and you should be monitored for at least 30 minutes after taking your first dose. Following the first dose of Oralair, subsequent doses may be taken at home.

Treatment with Oralair should be initiated at least 4 months before the onset and continue throughout the grass allergy season.

Due to the risk for a severe allergic reaction (discussed further below), all individuals who take Oralair should also be given a prescription for auto-injectable epinephrine and instructed on how to use this medication in the event of a severe allergic reaction or anaphylaxis.

Who Can Take Oralair?

Oralair is only effective for individuals with confirmed allergies to Sweet Vernal Grass, Orchard Grass, Perennial Rye, Timothy Grass, or Kentucky Blue Grass. This should be confirmed either via skin testing or in vitro (blood testing).

Oralair is approved for use in individuals aged 10-65 years old. It should not be given to individuals with the following health conditions: severe or unstable asthma, a history of eosinophilic esophagitis, individuals who are taking beta blockers, or individuals with a history of severe allergic reaction or anaphylaxis.

Notify your doctor if you are pregnant or breastfeeding before starting treatment with Oralair. You should also notify your doctor of any other health conditions you have, and any medications you are taking.

Side Effects

During clinical trials the most commonly reported side effects of Oralair were: itching of the ears, mouth and tongue, mouth edema, cough, oropharyngeal pain, and throat irritation.

Other less commonly reported side effects included: lip edema, abdominal pain, dyspepsia, skin itching, stomatitis, oral paraesthesias (mouth numbness).

While rare, the most serious side effect of any sublingual immunotherapy is severe allergic reaction or anaphylaxis. Anaphylaxis is an extreme allergic reaction that can be life threatening. Signs of an anaphylactic reaction include: swelling of the face and tongue, flushing, difficulty breathing, difficulty swallowing, wheezing, dizziness, rapid heartbeat, and slurred speech. In the event you experience these symptoms while undergoing sublingual immunotherapy with Oralair you should use auto-injectable epinephrine as instructed and call 911 or go to your nearest emergency medical center.


FDA.gov. Oralair Prescribing Information (Package Insert). Accessed: May 30, 2015 from http://www.fda.gov/downloads/BiologicsBloodVaccines/Allergenics/UCM391580.pdf

Oralair.com. Oralair (Official Patient Prescribing Information). Accessed: May 30, 2015 from http://oralair.com/

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