Sublingual Immunotherapy (Allergy Drops)

Sublingual immunotherapy, also known as allergy drops, has been used in the U.S. for more than 35 years, with research dating back 40 years. Its uses dates approximately 100 years in some parts of the world; yet many allergy sufferers have heard little about this treatment option. Thanks to an increase in European research over the past decade and tremendous growth in the use of allergy drops worldwide, we now have valid scientific evidence that corroborates what many have known for decades – allergy drops are both safe and effective. Sublingual immunotherapy will likely prove to be one of the most important innovations in allergy treatment in the past century.

Until allergy drops are more widely available in the U.S. and more resources are dedicated to educating providers and patients about allergy drops, it’s important to understand the facts about this treatment to help you determine whether it’s the right course of treatment for you.

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Frequently asked questions about sublingual immunotherapy.

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:

  • Infants and children*
  • Asthmatics
  • Highly sensitive people
  • Those with chronic conditions including sinusitis
  • People with food and mold allergies
  • People with multiple allergies including dust, pollen, animals

*allergy drops have proven especially helpful for children with eczema and recurrent ear infections, which often have underlying allergic causes. Research shows that many children with untreated eczema and allergies often develop asthma and other chronic conditions later in life, so treating them early can have life-long benefits.

What are the benefits 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 and fewer clinic visits. Compared to shots, allergy drops cost and required fewer clinic visits. Most patients receiving allergy drops need only a few clinic visits the first year, and once every 6-12 month 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 drops.
  • Enjoy healthier days. The end benefit? Feeling better. Patient typically report fewer clinic visits, hospitalizations, and less lost time work and school after taking drops consistently.

Are allergy shots 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 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.

I’ve heard that allergy drops are not approved by the FDA. Is that safe?

First, it’s important that the antigens used in allergy drops are the same physician prescribed antigens used in allergy shots. They’re prepared in the same way as allergy shots. The difference is the route of administration – a dropper that delivers the antigens 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 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 used throughout the world. In fact, 50-75 percent of allergy sufferers in southern Europe are treated with allergy drops. Acceptance is growing throughout the world, and is beginning to grow in the United States as the treatment becomes more widely available.

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 weeks to a month.

How long can I expect the effects of allergy drops to last?

A benefit of immunotherapy – whether its 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 that drops maintained effectiveness long after treatment stopped.

The key to ensuring the effects last is compliance, which is an additional benefit of allergy drops. Studies show that patients with 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 saving in time and money that results. 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 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 that 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.

Are allergy drops covered by insurance?

Allergy drops are not typically a covered benefit under insurance coverage;  however, patients can submit reimbursement requests through their medical flexible spending accounts, when applicable.