Sublingual Immunotherapy

How does sublingual immunotherapy work?

The immune system of the gastrointestinal tract tends to “tolerate” foreign substances, meaning that it does not respond in an over-active way to swallowed material.

When sublingual immunotherapy is administered into the gastrointestinal tract, the immune system tolerates the allergen, instead of causing an over-reactivity of the immune system, such as with allergic disease.  This results in less allergy symptoms when the body is exposed to the allergy source, such as airborne pollen or pet dander.

Reaction to sublingual immunotherapy

Sublingual immunotherapy is a very safe allergy treatment for both adults and children.  Numerous published scientific studies have confirmed sublingual immunotherapy is both safe and effective for the treatment of allergic rhinitis and asthma caused by allergies to dust mites, grass, ragweed, cat dander and tree pollens.  Evidence is emerging that sublingual therapy may be effective for treating red, itchy eyes caused by pollen during hay fever season.

Additionally, it has shown signs of being an effective therapy for children with mild atopic dermatitis (eczema) and is currently being studied for its potential in treating food allergies.

The safety of sublingual immunotherapy is well documented, and serious reactions are very rare.  Mild reactions, such as an itchy mouth, occur in the majority of people and tend to resolve over time.  The following is a review of reactions:

  • There is a small chance of having an anaphylaxis reaction, but reactions are usually mild with sublingual immunotherapy.  All sublingual immunotherapy patients are prescribed an Epi-Pen in case of an anaphylaxis reaction.
  • At the present time, there have been no fatalities reported from sublingual immunotherapy treatment.
  • Patients may have swelling of the tongue or lips. If this occurs, an over-the-counter antihistamine usually resolves this reaction.
  • Itching of the mouth may occur temporarily.
  • Mild gastrointestinal discomfort may occur.

If you experience mild reactions to sublingual immunotherapy, an antihistamine, such as Benadryl, may be taken.  If symptoms worsen, call 911.

Benefits and Drawbacks of Sublingual Immunotherapy


  • Sublingual immunotherapy has been shown in multiple studies to be effective in treating allergic rhinitis in both adults and children.  Other countries have been using this therapy to treat allergic rhinitis for many years.
  • Sublingual immunotherapy has been shown to be helpful in asthma and in preventing the development of new sensitivities to allergens.
  • Sublingual immunotherapy is very safe. If a reaction occurs, it is usually very mild.
  • Sublingual immunotherapy does not involve the use of needles.
  • Sublingual immunotherapy allows for administration to be performed at home, so frequent, time-consuming clinic visits are not required.


  • It takes approximately 3-6 months to experience benefits.
  • Insurance companies generally do not cover sublingual immunotherapy.

Click links below for additional resources

Sublingual Immunotherapy Brochure

Sublingual Immunotherapy FAQ

Anaphylaxis Information/EpiPen Instructions

Instructions for 2 month vial

Instructions for 3 month vial

Consent Form

Click the links below for more information regarding sublingual immunotherapy

Sublingual Immunotherapy: World Allergy Organization Position Paper

Long-term clinical efficacy of grass pollen immunotherapy

Efficacy of sublingual immunotherapy in asthma: Systematic review of randomized clinical trials using the Cochrane Collaboration method

Preventive effects of sublingual immunotherapy