How to get allergy shots without needles

For those who receive or are thinking of receiving allergy shots for allergies such as those related to grass pollen, ragweed, or dust mites, there is an alternative that has been deemed effective by the American College of Asthma, Allergy, and Immunology. Unlike allergy shots, or subcutaneous immunotherapy, which involves injections, the alternative, called sublingual immunotherapy, or SLIT, involves simply placing a tablet under the tongue and letting it dissolve.

Immunotherapy is a strategy that involves exposing an allergy patient to tiny doses of the substance to which the patient is allergic, and increasing the exposure dose over time. This approach works in treating allergies because it trains the patient’s immune system to understand that the allergen is not dangerous. Indeed, allergies represent the immune system’s mistaken interpretation of

Whereas subcutaneous immunotherapy, which means immunotherapy under the skin, can be painful for patients and cause anxiety, sublingual immunotherapy – i.e. immunotherapy under the tongue – is non-invasive and a preferable alternative for many patients, particularly children and those afraid of needles.

In Europe, SLIT has been used for decades for a number of allergens. In the U.S. the Food and Drug Administration (FDA) has approved SLIT for some – but not all – allergens. Currently, patients have been able to get SLIT for some grass pollens and ragweed for years, and more recently, patients have been able to get SLIT for dust mites. Oralair is the SLIT that works against five distinct grass pollens, and Grastek works for certain grass and ragweed allergies. The newest SLIT treatment for dust mites, called Odactra, became available a couple of months ago.

Age is still one limitation with SLIT approaches. For instance, patients must be 5 years old to start Grastek, 10 years old to start Oralair, and 18 to stair Odactra. For patients who are particularly young, sublingual immunotherapy may work better as drops rather than tablets. Cat dander is one allergy for which doctors recommend sublingual drops more than tablets.

Some people should not use sublingual immunotherapy, however. These people include those with uncontrollable asthma, immune disorders, and eosinophilic esophagitis disorder. The risks of serious allergic reactions with SLIT, however, are far lower than those with allergy shots. However, it is generally recommended that those who use SLIT as their form of therapy also carry an EpiPen in case of emergencies.

Author
Dr. Summit Shah

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