Oral drops could replace allergy shots

Posted at 8:00 AM, Feb 22, 2016
and last updated 2016-02-22 09:25:51-05

Feeling lousy from allergy symptoms — sneezing, itchy, watery eyes and runny or stuffy nose? People can suffer from allergies all year, not just in the spring and fall.

Doctors with the Christ Hospital Health Network say they’re seeing excellent results with allergy drops taken under the tongue.

Treatment with oral allergy drops is called sublingual immunotherapy, an alternative to injections for people who suffer from severe allergies.

“Sublingual immunotherapy is a safe and effective treatment for allergies that has been used for a long time in Europe but is just now becoming more popular in the United States,” said Dr. Collin Burkart, a Christ Hospital Physicians ear, nose and throat specialist.

Immunotherapy is a way to treat people who don’t get relief with over-the-counter and prescription medications.

“People who suffer from severe allergies have uncomfortable symptoms on a daily basis. It can make them miserable,” Burkart said.

For years, the gold standard treatment in the United States for people with severe allergy symptoms has been allergy shots, also known as injection immunotherapy.

“This is introducing small amounts of allergen into the person’s body so that they no longer react to the allergens,” Burkart said. “People would come in and receive a shot once a week.”

The idea is to desensitize the body’s reaction to allergens by gradually introducing small samples of the allergen so that the person’s body does not react any longer.

Burkart said good results can also be achieved without needles, through allergy drops.

“The allergen is delivered through the lining of the mouth, under the tongue, and it can be done at home on a daily basis. There are no needles involved.”


Burkart said the allergy drops are “a specific cocktail mixed for the patients, based on the results of their allergy testing.”

Depending on what the patient is allergic to, the allergy drops may consist of tree, grass, mold, dust mites, cockroach, dog or cat allergens.

“Our sublingual drops can treat multiple environmental inhalants at one time,” Burkart said.

Over time, the amounts of the allergens are varied or made more concentrated to help desensitize the patient.


One of the greatest advantages of oral allergy drops is convenience. Burkart said allergy drops and shots are equally effective, but compliance is higher with drops because there’s no need to go to the doctor’s office once a week for the injection immunotherapy.

“Sometimes it’s just difficult to come in for injections once a week. Life gets in the way,” Burkart said. “But people can do this at home on a daily basis. … It’s easy to stay consistent.”

One disadvantage is that the cost of allergy drops tends to be slightly higher.

“Insurance companies have yet to catch up with coverage for this type of treatment. Hopefully, in the future they will,” Burkart said.

The FDA has not yet approved a specific liquid formation of allergy drops. Some clinical trials are being conducted. Burkart explained that all contents in the allergy extracts, however, are FDA-approved, and doctors use them off-label.

The FDA has approved three allergy tablets that are placed under the tongue on a daily basis, but this treatment has limitations.

“We have access to sublingual immunotherapy tablets,” Burkart said, “but they treat only one allergen at a time and are limited to just grass and ragweed pollen.”


Both adults and children who suffer from severe allergy symptoms are potential candidates for allergy drops. Patients who suffer from severe asthma will need to discuss the use of sublingual therapy with their physician first.

“The first dose from each vial is always given at the doctor’s office,” Burkart said, “so that we can monitor for any potential allergic reactions.”

All patients are required to have an EpiPen at home and are taught the signs and symptoms of anaphylaxis, a severe allergic reaction.

Meanwhile, Burkart said finding an effective treatment for allergies can be life-changing.

“People feel more comfortable...They have fewer sinus infections, fewer trips to the doctor. They can exercise more and function more happily on a daily basis.”

For more information, contact The Christ Hospital Physicians — Ear, Nose & Throat at 513-421-5558.

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