How Allergy Drops Can Work When Shots Can’t

Allergy shots were the OG of allergy treatment, but, in the words of Bob Dylan, “the times they are a-changin’.” In the mid-1980s, a new form of allergy immunotherapy, known as sublingual immunotherapy (SLIT), was developed. In Europe, SLIT is now prescribed at least as often as shots for allergy remediation, and the treatment is rapidly gaining traction in North America as well.

As with allergy shots, SLIT starts with antigens that are dosed regularly to help the body develop immunity to allergens in the environment. But instead of being injected, these antigens are dispensed under the tongue as liquid drops. The drops absorb into the bloodstream through specialized cells in the mouth and work their magic with the immune system.

Allergy Drops

(ddimitrova / pixabay)

Allergy drops are gaining traction for a number of reasons. First, they are highly effective. If you look at the sublingual immunotherapy research page on our website, you’ll see plenty of data to verify the effectiveness of this shot-free therapy:

Here’s a sampler:

  • The World Health Organization affirms SLIT as a viable alternative to injection immunotherapy.
  • The Cochrane Collaboration, which is recognized worldwide as the gold standard in evidence-based medical care, reviewed 22 studies involving nearly 1,000 patients undergoing sublingual immunotherapy. The review concluded that SLIT is a safe treatment “which reduces symptoms and medication requirements in allergic rhinitis.”
  • This article in the Journal of Environmental and Public Health found that when comparing subcutaneous injection immunotherapy and sublingual immunotherapy, “Both treatment modalities were found to be of similar efficacy.”
  • This article in the Journal of Biological Regulators and Homeostatic Agents found that “SLIT is now recognized as a viable alternative to the classical injection route” and one that is “particularly attractive for children since it is completely pain-free.”
  • This article in the Official Journal of the American Academy Pediatrics shows that “evidence supports the efficacy of both SLIT and SCIT for the treatment of asthma and rhinitis in children.”

In addition to being effective, drops are safer than shots. Sublingual immunotherapy was developed by scientists looking for a safer allergy treatment after a string of anaphylactic reactions to shots. Serious reactions to SLIT are very rare, and there has never been a reported fatality from SLIT.

And finally, SLIT works for populations who are not well served by allergy shots. Here’s a closer look at three of these populations:

Children under age 7. Allergy shots are not typically prescribed for children under age 7. This is not because their risk for an anaphylactic reaction is necessarily higher, but because they may not be able to identify or articulate the symptoms of an anaphylactic reaction should one occur.

Allergy drops have not been associated with the same degree of risk for an anaphylactic reaction that shots have. One of the reasons for this is that the cells located beneath the tongue are hard-wired for allergic tolerance.

Allergy drops present a “way out” for young children whose lives are dominated by allergic misery—whether it be the toddler who has spent her life in the throes of what feels like a continuous cold (a manifestation of chronic allergic rhinitis) or the four-year-old with itchy, painful eczema all over his body. And since research now shows that treating allergies young can help decrease risks for recurring allergy-related illnesses, surgeries and chronic allergic disease as children grow, allergy drops are all the more important. Check out our blog on the atopic march to learn more on this topic.

People with severe allergies or asthma. If you have severe allergies or uncontrolled asthma, you may be turned away from a traditional shot program because your risk for an anaphylactic reaction may be too high. In fact, there is a correlation between uncontrolled asthma and death from allergy shots. This presents a Catch 22, because even though it’s unsafe for these patients to get allergy shots, they desperately need immunotherapy.

This is where drops can be a lifesaver. Because drops have a higher safety profile than shots, research shows that they can be a safe course of treatment for those with severe allergies and asthma.

People on the go. Shots can be almost impossible for the jet-set crowd to maintain because of the requirement to visit the doctor’s office for shots (usually a couple of times per week). This is not easy to comply with if you travel frequently for business, are deployed with the military or have an extremely busy schedule that doesn’t afford time to visit the doctor during regular business hours. Allergy drops allow people to maintain consistency with their immunotherapy because they can be administered anywhere at any time.

Allergy immunotherapy is the only treatment that has been shown to change the underlying allergy—not just its symptoms. That’s why it’s a better long-term solution than simply taking allergy pills, nasal sprays or steroids. It can help people achieve ongoing relief from the allergies that are weighing down their quality of life. And with the option of sublingual immunotherapy, lasting allergy treatment is now available to many more people.

About The Author

Stuart H. Agren, M.D.

Stuart H. Agren, M.D. completed his undergraduate studies at the University of Utah and went on to earn his Doctor of Medicine from Tulane University School of Medicine in 1974. He completed additional training at L.D.S. Hospital in Salt Lake City, Utah and then established his private medical practice starting in 1975. Dr. Agren completed a mini-residency in Industrial Medicine at the Robert Johnson School of Medicine at Rutgers University and also completed training to become a certified Medical Review Officer.

Dr. Agren was the Medical Director at TRW and McDonnell Douglas in Mesa, Arizona and at Stauffer Chemical and Kennecott Copper in Salt Lake City, Utah. He also served as an adjunct faculty member at Arizona State University.

In his private medical practice, Dr. Agren specialized in family practice and allergy. In his work as a private practice allergist, he was one of the first doctors in the country to prescribe sublingual immunotherapy to his patients as an alternative to subcutaneous immunotherapy (allergy shots). He has also been a trailblazer in the field of food allergy treatment and research, developing a program to treat multiple food allergies simultaneously using sublingual immunotherapy. Dr. Agren has been featured on local CBS, NBC, and ABC news affiliates and won the peer-nominated “Top Doc” award from Phoenix Magazine.

After 20 years in private practice, Dr. Agren became the Founder and President of AllergyEasy, which helps primary care physicians around the country offer allergy testing and sublingual immunotherapy treatment to their patients. Over 200 physicians in over 32 states use the AllergyEasy program to help their patients overcome environmental and food allergies and asthma.