What are allergy drops?

Allergy drops therapy, or sublingual immunotherapy (SLIT), is a type of allergy treatment which involves placing an allergy mixture in the mouth to treat environmental allergies.  Unlike medications which only cover up the symptoms,
allergy drops is a form of treatment  which treats the underlying cause of the symptoms. 

How is this different from allergy shots?

The allergy mixture used with allergy shots and allergy drops is the same - the difference is the manner in which it given. Instead of giving the mixture as an injection in an allergy office, it is given as drops in the mouth (under the tongue) at home.  Allergy drops are generally done for  2-5 years in order to obtain the best long term benefits.  Allergy drops have been used in Europe for a number of years, mostly for the treatment of grass allergies. Currently, allergy drops are not FDA approved in the United States for the treatment of allergies so they are considered an off label, investigational type of treatment and are unfortunately not yet covered by most medical insurance plans.

 What are the benefits of allergy drops?

Compared to placebo, they significantly decrease allergy symptoms caused by environmental allergies as well as significantly decrease respiratory symptoms caused by allergic asthma

Are the results as good than with allergy shots?

There are not many studies that directly compare allergy shots to allergy drops head to head. So far, the limited data available indicate that the drops are quite effective, but overall are probably a little bit less effecting in decreasing allergy and asthma symptoms compared to shots. It is yet unclear if allergy drops offer any long term benefits for the prevention of allergies or asthma (allergy shots cut the risk in half). Much research is being done now which should give us some better information in the next few years.

So, why might I consider allergy drops?

Allergy drops are more convenient than allergy shots because the allergy extract is administered at home instead of in the allergy office.   This means fewer clinic visits.  They are also less intrusive since there are no needles involved - making them ideal for those who do no like needles, especially children.  

What are the side effects of allergy drops?

• The most common side effect are mild and may include itching in the mouth or lip swelling, occurring in up to 40-50% of patients depending on the study.  In my experience, these type of side effects are unusual to occur.
  
• The risk of a severe allergic reaction with allergy drops appears to be quite rare (lower than allergy shots) but a few significant allergic reactions including severe asthma attacks have been reported in the literature.
  

What do allergy drops taste like?

The drops have a sweet  taste.

Who can receive allergy drops?

Children who are about 3 years of age or older, and adults can receive allergy drops    
Allergy drops are a good treatment option if you have one of the following:

• Severe allergy symptoms which significantly affect quality of life, even while taking allergy medications
  
• Significant side affects from allergy medications
  
• Have a desire to avoid using medications for the long term
  
• Have frequent ear or sinus infections
  

Allergy drops may not be suitable for individuals with heart problems, taking beta-blocker drugs, or who have uncontrolled asthma.   Individuals considering allergy drops should discuss their particular case with a board certified allergist.  

Why are allergy drops not FDA approved?

 Allergy drops have been used in Europe for over 10 years for the treatment of allergies and in1998, the World Health
Organization concluded that allergy drops were a viable, safe, and effective alternative to allergy shots.  In Europe,  
allergy immunotherapy is usually done with only a single allergen (for example, just grass) while in the United States
allergy immunotherapy typically consists of multiple allergens (grass, trees, animal dander...).   Because of this difference in treatment, it is still unclear as to exactly what the most effective dose is for allergy drops and what the full extent of side effects may be.  Because of this,  the FDA has not yet approved the use of allergy drops in the United States.  
There are a number of ongoing studies at the present time which will hopefully answer these questions soon.   Until the
FDA approves allergy drops for the treatment of environmental allergies,  they are considered off label, investigational therapy.

Did you know?

 Doctor Dauby is the first board certified allergist in the Pittsburgh / Greensburg area to offer allergy drops, and introduced this new treatment to the University of Pittsburgh and Children's Hospital allergy clinics in 2010.