Services & Treatments

Sublingual Immunotherapy (SLIT)

Sublingual immunotherapy tablets (SLIT) are an alternative to traditional allergy shots in the treatment of certain aeroallergen sensitivities. Patients receive their dose of antigen under the tongue to boost their tolerance and reduce their symptoms. The first dose is given in the allergist's office with a minimum 30 minute observation time afterward due the the risk of allergic reaction. If well-tolerated, future doses may be taken by the patient at home, generally on a daily basis.

Currently, the U.S. Food and Drug Administration (FDA) has approved four allergy tablet products: two for grass pollens, one for short ragweed, and one for dust mites. Grastek® (Merck) is a Timothy grass pollen extract approved for children 5 and up and adults. Oralair® (Greer) is a 5 grass pollen extract approved for children 10 and up and adults. Ragwitek® (Merck) is a short ragweed pollen extract approved for adults. Recently-approved Odactra® (Merck) is a house dust mite extract approved for adults. Symptom improvement is generally seen within 8-14 weeks. Patients generally start SLIT 3-4 months prior to the start of pollen season and continue through the end of the season. Tablets may be taken year-round, with studies showing reduction in symptoms for both grass and dust mite allergies when taken year-round. Patients generally remain on SLIT for 4-5 years, depending on severity of symptoms, tolerance to therapy, and other factors.

Patients with asthma that is not well-controlled or patients with eosinophilic esophagitis are not candidates for at-home SLIT.

There are no currently FDA-approved SLIT liquid (drops) formulations, and their effectiveness is still under investigation.

Most of the SLIT tablets are FDA-approved for use in patients ages 18-65 only. For younger patients, or patients with multiple aeroallergen sensitivities (more than just grass or just dust mites, for example), traditional SCIT (allergy shots) provides a more customized and all-inclusive treatment option.