Sublingual Immunotherapy (SLIT) FAQ

Q: What is Sublingual immunotherapy (SLIT)?
A: SLIT is an alternative way to treat allergies. Small, incremental doses of an allergen are placed under the tongue to boost tolerance to the substance and reduce symptoms.

Q: How is SLIT administered?
A: Dailv drops of allergen extract are placed under the tongue for 1-2 minutes. Drops are administered at home after the first dose is tolerated in our office.

Q: What is the treatment period?
A: Treatment begins ~1 month prior to peak allergy season and continues through the completion of allergy season. Year-round therapy may also be considered.

Q: Is SLIT as effective as traditional allergy shots (subcutaneous immunotherapy)?
A: No, SLIT is not as effective as allergy shots. Allergy shots remain the most effective allergy treatment.

Q: Is SLIT safe?
A: Yes. Numerous studies have validated the safety of SLIT. Many people experience mild side effects. These include:

  • Lip, mouth and tongue irritation
  • eye itching, redness and swelling
  • sneezing, nasal itching and congestion

Moderate side effects have been documented (1 in about every 12,000 doses). These include:

  • nausea, vomiting, abdominal cramping and diarrhea
  • worsening asthma symptoms
  • itching of the skin, hives or swelling

Q: Who should consider SLIT?
A: SLIT offers a safe, convenient option for patients who do not tolerate allergy shots, as well as people who are unable to commit to allergy shots. Most studies on SLIT have focused on people with one type of allergy, such as grass or dust mite allergy. Those with multiple allergies (i.e pollens, pet dander and dust mite) are better candidates for allergy shots.

Q: What are the disadvantages of SLIT when compared to allergy shots?
A: SLIT is less effective than traditional allergy shots. Further studies are needed to evaluate long term benefits and optimal dosing.

Q: Is SLIT an FDA approved treatment?
A: No. The extracts used to prepare the SLIT drops are only approved for subcutaneous therapy (i.e. allergy shots). Use of the extracts for sublingual administration is "off-label."

Q: Will my medical insurance cover the costs?
A: Since SLIT is an off-label use of allergen extracts, treatment is not typically covered by insurance.

Q: What are the costs?
A: The cost is $325 for the season. Payment is due at the time of bottle receipt.


  Sublingual Immunotherapy (SLIT) Allergy Shots
Treatment period and duration March through May (co-seasonal). Treatment is administered each season. Most patients on allergy shots require 3-5 years of therapy. Shots are administered every 3-4 weeks after an initial build up phase of weekly shots for 6 months.
Ideal patient Allergic symptoms mainly due to one allergen (ie. tree pollen during spring). Allergic symptoms due to multiple allergens (various pollens, dander, dust mites, etc.)
Safety Many patients will note some irritation in the mouth and throat. More serious allergic reactions are uncommon (1 in 12,000 doses). Mild injection site reactions are common. More serious allergic reactions are estimated to occur with 1 in every 1,000 doses.
Dose administration: Home vs. Office? Home Medical office
Dose frequency Daily during allergy season (March-May). Repeated each season. Weekly for 6 months, then every 3-4 weeks for 3-5 years.
Cost $325/season Depends on insurance coverage.