Sublingual Immunotherapy Overview

About Sublingual Immunotherapy for the Treatment of Allergies

Samples for allergy testing, Santa Fe, New Mexico, USA
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Immunotherapy is the medical term for a type of treatment that alters the way the immune system functions. For the treatment of allergies, allergy shots (subcutaneous immunotherapy) are a common form of immunotherapy. Sublingual immunotherapy works the same way as allergy shots but without the pain of an injection, and the frequent trips to your doctor's office.

How this Treatment Works

Both allergy shots and sublingual immunotherapy work by giving a person small doses of an allergen (the substance that they are allergic to).

In this manner, it is possible to desensitize some people's immune system to that allergen. For many people, immunotherapy can reduce the severity and duration of their allergy symptoms. Occasionally, some allergies can be cured with immunotherapy.

Sublingual immunotherapy is commonly used in many parts of the world but has not been widely used in the United States. However, it is becoming more popular in the U.S. and in 2014 the FDA approved Ragwitek, a form of sublingual immunotherapy for the treatment of ragweed allergies. Two other medications have also been approved for the treatment of grass allergies, Oralair and Grastek.

Prior to sublingual immunotherapy for the treatment of allergies, the exact cause of your allergies must be identified. There are two types of tests that are commonly used to identify allergies, a skin test or a blood test that looks for specific antibodies. If you are interested in sublingual immunotherapy, visiting a doctor who specializes in the testing and treatment of allergies, called an Immunologist, is usually the best way to go.

Sublingual immunotherapy differs from allergy shots in that the allergen is given in tablet form. The tablet is dissolved beneath the tongue. While the first dose should be given in your doctor's office, subsequent doses can often be taken at home, unlike allergy shots which require frequent visits to your doctor's office for injections.

Benefits and Drawbacks

Since immunotherapy involves giving you a dose of a substance you are known to be allergic to, there is always a risk that you will have an allergic reaction to the medication. Even severe life-threatening anaphylaxis can occur. For this reason, you need to be monitored in your doctor's office for about 30 minutes after the first dose. Some sources suggest that sublingual has a higher safety record than allergy shots which in addition to its tablet form makes it possible to be taken at home. Your doctor may give you a prescription for auto-injectable epinephrine and instruct you how to use this medication if you have symptoms of a serious allergic reaction. For more information on this read: What is Anaphylaxis?.

Closing Thoughts

Sublingual immunotherapy is typically appropriate for use in healthy adults who do not have underlying medical problems which might impair their ability to survive a life-threatening allergic reaction. For example, individuals with uncontrolled or severe asthma are not typically good candidates for sublingual immunotherapy.


American Academy of Allergy Asthma and Immunology. Sublingual Immunotherapy Treatment (Allergy Tablets) for Allergic Rhinitis Nothing to Sneeze About. Accessed: April 30, 2015 from

American College of Allergy Asthma and Immunology. Sublingual Immunotherapy (SLIT). Accessed: April 30, 2015 from

The Asthma Center. Sublingual Immunotherapy: Controversies and Issues. Accessed: April 30, 2015 from

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