Once your allergy testing results have come back, our allergists can recommend treatment methods. Depending on the allergen, our allergists may recommend immunotherapy in the form of sublingual drops or allergy shots. Avoidance of the allergy may also be recommended.


ALLERGY SHOTS (IMMUNOTHERAPY)

One method of allergy treatment employed by the allergists at Charlotte Eye Ear Nose & Throat Associates is allergy shots (also called immunotherapy). Allergy shots are given regularly in gradually-increasing doses to increase your tolerance to allergens. Allergy shots will not cure you of your allergies, but they will reduce your symptoms. Allergy shots are effective in treating allergies such as insect venom, pollen, mold, pet dander and dust mites, but they are not an effective treatment method for food allergies.

What is involved?

Allergy shots involve injecting substances under the skin to which you are allergic. It requires a build-up phase during which the strength of the shots is gradually increased. During the build-up of your shots, you will need to come to one of our offices or to another physician’s office at least every two weeks and as often as twice a week. In order that we can promptly treat any systemic reaction, you must wait in our office 30 minutes after every build-up shot. On average, 30 or more visits over a few months time are required to complete build-up. Once maintenance immunotherapy starts, you will continue to receive injections at that dose every 1-4 weeks for the next 3-5 years. Although you can continue to receive your shots in our office, you may do maintenance immunotherapy at home as long as you do not have severe asthma or a history of anaphylaxis.

What are the advantages?

Allergy shots have been around the longest and are the method that has been studied the most. It is likely more effective and reliable than sublingual immunotherapy. Numerous inhalant allergens can be treated, including pollens, dust mites, animal dander, molds and cockroaches. The injections are FDA approved and covered by most insurance plans.

What are the disadvantages?

Allergy shots are not as safe as sublingual immunotherapy. Although still rare, the risk of a systemic reaction is greater with allergy shots. In addition to safety issues, subcutaneous immunotherapy is less convenient and more painful.

SUBLINGUAL ALLERGY DROPS

Sublingual allergy drops, like allergy shots, are a form of immunotherapy. Unlike allergy shots, however, sublingual allergy drops are not injected but instead are usually placed under the tongue. These allergy drops are often referred to as "sublingual immunotherapy" or "SLIT". Sublingual drops are usually taken at home, as they are usually used several times in a week. The drops can be used to treat inhalation allergies (as mentioned above) as well as food allergies.

What is involved?

Allergy drops are made from the same liquids used for allergy shots. Instead of being injected, they are held under the tongue for two minutes and then swallowed. Only the first dose is administered in the office and the rest are done at home. The inhalant allergens that can be treated include everything that subcutaneous immunotherapy treats except for mold, cockroaches and certain animals. As with allergy shots, each vial is custom-made to match your sensitivities. Unlike with sublingual tablets, the drops are used year-round.

What are the advantages?

Allergy drops at the proper dose may be nearly as effective as allergy shots but without the discomfort and inconvenience. They are also safer than allergy shots. Drops can treat more allergens than prescription tablets.

What are the disadvantages?

The proper dose of allergy drops has not been as well established as with allergy shots and tablets; therefore, their efficacy is less certain than the other methods. Dosing issues often limit the number of your allergens that can be treated. Finally, the liquid being used is approved by the FDA to be injected under the skin but not to be placed under the tongue. Since sublingual allergy drops are not FDA-approved and are considered to be investigational, insurance companies do not pay for them. Payment is out-of-pocket and may be up to $100 each month.

ALLERGY TABLETS (SUBLINGUAL pRESCRIPTION TABLETS)

What is involved?

Allergy tablets are obtained from your pharmacy like other prescription medicines. Currently, tablets are available for grass pollen (summer season) and ragweed pollen (fall season). You begin using them on a daily basis 3-4 months before that pollen season and continue during that season for a total of approximately 6 months out of the year.

What are the advantages?

Tablets are an especially good option if your symptoms are substantially worse in the summer or fall. They have been studied in well-designed trials and the proper dose has been determined. They are FDA-approved and covered by most insurance plans. No buildup is required. Systemic reactions are exceedingly rare. Only the first dose is administered in the office and the rest are done at home.

What are the disadvantages?

Tablets are only available for grass pollen and ragweed pollen at this time. The other things to which you are allergic will not be treated. Furthermore, the cash price for the tablets is expensive. Although covered by most insurance plans, the copay may be high.


Avoidance

Sometimes there may be no effective treatment methods for an allergy, as is the case with many food allergies. When there is no sufficient treatment available, it is best to avoid the allergen altogether. Once your allergy test results have identified the specific things you are allergic to, you can then determine how best to avoid them. With food allergies, this would involve eliminating the allergen from your diet. With seasonal allergies, it might involve keeping your home's windows and doors shut tight and using a allergen reducing air filter.

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