What are the benefits of allergy drops?
  • Compared to placebo, they significantly decrease allergy symptoms caused by environmental allergies
  • Compared to placebo, they 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 seems to indicate that the drops are about 1/2 as good as allergy shots in decreasing allergy and asthma
symptoms.   It is 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 is itching in the mouth and lip swelling, occurring in up to 40-50% of patients
  • 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 are not 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 about 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

What are the costs of allergy drops?
Most insurance companies do not cover allergy drops since it is not FDA approved.   The cost for allergy shots is less
than $100 / month, about the same as the typical cell phone or cable bill.

Nelson HS. Allergen Immunotherapy: Where is it Now?  J Allergy Clin Immunol 2007;119:769-77.
Allergen Immunotherapy: A Practice Parameter Second Update. J Allergy Clin Immunol 2007;120:S25-S85.
Johnstone DE, Dutton A. The value of hyposensitization therapy for bronchial asthma in children - a 14-year study.
Pediatrics 1968; 42:793-802.
Blazowski et al. Anaphylactic shock because of sublingual immunotherapy overdose during third year of maintenance
dose  Allergy 2008;63:374.
Cochard et al.  Sublingual immunotherapy is not always safe alternative to subcutaneous immunotherapy.  J Allergy Clin
Immunol 2009;124:378-379.
Anthony Frew Sublingual immunotherapy NEJM 2008;358:2259-2264
Allergy Drops

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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.   The treatment starts with a very weak concentration of
allergens and over a period of about a month
the dose is gradually increased by using progressively higher doses from more concentrated vials - this is called the
buildup phase.    During this phase,  increasing amounts of drops are placed under the tongue on a daily basis until the
full dose is reached.  At this time the treatment enters the maintenance phase.  In the maintenance phase, the individual
continues to take the drops every day for a total of 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 not covered by most medical insurance plans.
Click here for a table depicting
the differences between
allergy shots and allergy drops