Allergy Drops (Sublingual Immunotherapy or SLIT)

Sublingual immunotherapy, or SLIT, is a comprehensive term for tablets or drops placed under the tongue as part of an immunotherapy program to desensitize patients to common allergens. SLIT is safe and effective and does not require injections like allergy shots. These therapies can effectively treat allergies caused by dust, pet, dander, pollen, and other environmental allergens, amongst other allergies. Much like any immune therapy, including allergy shots or allergy tablets, it takes time for these sublingual options to work, and patients may start noticing improvement in symptoms after a few months. It is worth noting that allergy drops are formulated specifically for the patient and are not FDA-approved. Four tablets for single allergens, on the other hand, are FDA-approved.

The Safety of Sublingual Allergy Treatment

Immunotherapy is very safe and can help avoid the most severe reactions to allergens. This therapeutic intervention can be considered for any well-selected patient, whether administered as a shot, a sublingual tablet, or a drop. When comparing safety profiles, it’s worth noting that while allergy shots have caused severe reactions and even death in the past, we do not know of any fatalities associated with allergy drops.

How Effective Are Allergy Drops?

The drops we use for sublingual allergy treatment are very effective in selected patients, highlighting the importance of working with an experienced provider like Dr. Boger. Depending on the formulation, sublingual allergy drops are effective, and about 80% of patients in our practice experience relief from their allergies. Typically a 6-12 month trial is recommended before abandoning treatment for non-response.

When and How to Take Allergy Drops

Allergy drops are a daily therapeutic intervention, and most patients will be directed to take one drop in the morning, one drop around lunchtime, and one later in the evening. If this schedule does not fit your lifestyle, we can modify it slightly, combining the midday drop with the morning or evening drop. What you consume by mouth may interfere with the function of the drop; therefore, patients mustn’t eat or drink anything for about 20 to 30 minutes after their drop. Taking antihistamines and nasal sprays alongside your allergy drops is typically fine, and Dr. Boger will offer guidance to that end.

How Long Do You Have to Stay On Allergy Drops?

As with any other immunotherapy, allergy drops require long-term adherence. You will take allergy drops for up to five years and possibly longer. However, you will experience incremental improvements as your body and immune system adapt. You will have periodic follow-up appointments with Dr. Boger to evaluate progress and adjust as necessary.

Costs and Insurance of Drops

Unfortunately, commercial insurance, as well as Medicare and Medicaid, does not cover the cost of allergy drops, and patients must pay out-of-pocket. However, the cost of these drops can be very reasonable, and our office will guide you on how to find the best prices. As a rough guide, single-allergen lozenge therapy may cost around $40 per month, while a multi-allergen drop program may cost $75-150 per month. Bear in mind that you will have much fewer office visits than with allergy shots, and therefore, the overall cost may be lower despite the lack of insurance coverage because you will not be paying co-pays, coinsurances, taking time off work, etc.

Remembering to Take Your Drops

Because allergy drops do not immediately improve symptoms, many patients have trouble remembering to take their medications after a few weeks to months. For this, we recommend habit stacking, which is to say that you should take your drops in conjunction with another daily activity. For example, if you drive the kids to school at a particular time every morning, take the drop at that time. Some patients keep their drops near their toothbrush to remind them to take the drops morning and night after they brush their teeth. You can find similar activities at midday to remind you. Of course, there’s also the option to set an alarm. If you miss a day of allergy drops here and there, it’s unlikely to affect your overall treatment plan. How quickly you get relief and the efficacy of the drops depends on your diligence in taking them.