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Sublingual Immunotherapy

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Sublingual Immunotherapy, Grastek, Oralair, Ragwitek

  • Indications
  1. Allergy Immunotherapy
    1. For allergic symptoms refractory to standard allergy medications
  • Precautions
  1. Not to be used without formal Allergy Testing first
  2. Observe in office for first sublingual dose
  3. All patients should receive Epinephrine auto-injector in case of Anaphylaxis reaction
  • Preparations
  1. Grass allergies
    1. Grastek
    2. Oralair
  2. Ragweed allergy
    1. Ragwitek
  • Dosing
  • Protocol
  1. Start medication 3-4 months prior to allergy season and continue throughout the season
  2. Have Epinephrine auto-injector readily available in case of Anaphylaxis reaction
  • Advantages
  1. More convenient, possibly safer, and without the pain of standard allergy Immunotherapy injections
  2. Efficacy approaches that of standard allergy Immunotherapy injections
  • Disadvantages
  1. More expensive than standard allergy Immunotherapy injections
  • References
  1. (2014) Presc Lett 21(6):35
  2. Koberlein (2013) Immunotherapy 5(1):13-21 [PubMed]
  3. Maloney (2014) Ann Allergy Asthma Immunol 112(2):146-153 [PubMed]
  4. Nolte (2013) Ann Allergy Asthma Immunol 110(6):450-456 [PubMed]