Sublingual immunotherapy tablets are being used more now that the FDA has approved three forms of this product. There will be more types of sublingual immunotherapy tablets approved in the coming years ahead. Currently there are two sublingual immunotherapy grass tablets, Grastek and Oralair.
The other sublingual immunotherapy tablet approved is for Ragweed and it is called Ragwitek. All three sublingual immunotherapy tablets have shown improvement over taking a placebo, but perhaps not as well as subcutaneous immunotherapy as detailed in a blog post we wrote previously.
The convenience and time is much easier to use than the subcutaneous route where a patient needs to go to the allergists office 1-2 times a week for the build up phase.
The next sublingual immunotherapy tablet that will be approved in the future will be a dust mite tablet.
Perhaps FDA approval is taking longer because the results have been less impressive than those reported for pollen allergens. Studies are ongoing and look out for the sublingual immunotherapy tablet for dust mites in the coming year ahead.
The safety of sublingual immunotherapy tablets is superior to subcutaneous immunotherapy and the mechanism of action is similar with the production of allergen specific blocking antibodies. A question that needs to be answered in the future is whether a patient who is poly-sensitized (allergic to more than 1 allergen), can uses multiple sublingual immunotherapy tablet preparations. Most allergy doctors see patients who are allergic to more than one allergen, such as trees, grasses, weeds, molds, dust mites, cats or dogs. Currently there is not enough evidence on whether or not it is safe to take all of these tablets together.
In our practice we currently offer both sublingual immunotherapy in the allergy droplet form and the tablet form. For those patients who do not want to do subcutaneous immunotherapy (allergy shots), we prepare a mixture for them to be administered at home. The drawback though is that insurance does not cover this procedure and patients have to pay out of pocket. With conventional allergy shots, this is a covered procedure by medical insurance companies.
As always, speak to your allergist or allergy doctor and see which preparation is right for you. There are many choices now from allergy shots, allergy drops and sublingual immunotherapy tablets. You and your doctor can discuss the pros and cons of each one and begin the process of desensitization.