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Sublingual immunotherapy (SLIT) is an alternative way to treat allergies without injections. Currently, the only forms of SLIT approved by the FDA are tablets for ragweed, northern pasture grasses like timothy and dust mites. Tablets used under the tongue boost tolerance to the substance you’re allergic to and reduce symptoms. Allergy drops are not FDA-approved and are off-label in the United States. They are not covered by most insurance, Medicare or Medicaid. An allergist can evaluate your symptoms and provide you with the best treatment options.


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How Is Treatment Administered?

An allergist must first use allergy testing to confirm your sensitivities. Once this is determined, an allergen extract is prepared in drop form or a tablet is prescribed. You will be directed to keep it under your tongue for one to two minutes and then swallow it. The process is repeated from between three days a week to as often as daily with recommendations that therapy is continued for three to five years to develop a lasting immunity. For grass and ragweed allergies, you typically take the tablet before and during the allergy season. For dust mite allergy, you take the tablet year-round. The length of your treatment is based on which tablets you are taking, and input from your allergist. See an allergist to find expert care and relief for your allergies or asthma.

Is Sublingual Immunotherapy Effective and Safe?

Most clinical trials and surveys published over at least 20 years show that SLIT is relatively safe and effective for the treatment of rhinitis and asthma caused by allergies to dust mites, grass, ragweed, cat dander, and tree pollens. Evidence is emerging that SLIT may be effective for treating the red, itchy eyes caused by pollen during hay fever season. In addition, it might prove an effective therapy for children with mild eczema and is currently being studied for its potential in treating food allergies.

Side effects among both children and adults are usually local and mild, most often occur early in treatment, and include itching in the mouth or stomach problems. These can usually be managed by dose adjustments. Very rarely, severe allergic reactions (anaphylaxis) have been reported using SLIT. Therefore, this treatment is best prescribed by an allergist.

What Are the Risks of Sublingual Immunotherapy?

For the most part, SLIT risks relate to the nature of the treatment: it is administered at home and without direct medical supervision. You should therefore receive clear guidance from your allergist on managing adverse reactions and treatment interruptions and should know when to return to your allergist for further advice.

Take back control of your life. See an allergist to learn more about this therapy option.

This page was reviewed for accuracy 4/24/2018.