Sublingual Immunotherapy (SLIT)

Posted on Monday, June 24, 2019 in Videos

Dr. Hamsa Subramanian explains sublingual immunotherapy (SLIT) - treatments for grass pollen and ragweed allergies that don't require injections. Dr. Subramanian practices at Signature Allergy and Immunology.


I'm Hamsa Subramanian and I'm an allergist and I wanted to talk to you about a new treatment that is available for allergies: sublingual immunotherapy otherwise called SLIT. Sublingual means "under the tongue."

The FDA has approved two sublingual tablets for allergy immunotherapy treatment. One is for grass pollen and the other is for ragweed.

The grass pollen medication is marketed by two different companies and the first one is approved for ages 5 to 65. It's called Grastek® and the second one is approved for ages 10 to 66 called Oralair®. The ragweed pill called Ragwitek® is approved for ages 18 through 65.

So it's a pill and that's the biggest advantage over shots because there are so many people who are deathly afraid of injections. You start preseason. We start treating patients about 8 to 12 weeks prior to the season. We treat them through the season and then once the season is over you stop the pill.

The first pill is always given in the physician's office under the supervision of an allergist and then the patient takes it home; takes it regularly every single day through the season. That's a great advantage because you don't have to take time to come to the allergist office and wait for 30 minutes as do patients who are getting injections. But the disadvantage is if you are allergic to pollens other than grass and ragweed, this is not going to help and at this time, injections are the only treatment for those patients.

Side effects are mainly local. Itching is the main side effect - local itching around your chin, tongue, mouth, and throat. Most patients qualify but there are some patients who do not. Most who do not qualify have a lot of stomach issues.

Talk to your doctor, talk to an allergist, and I'll be happy to sit down and talk to you about this treatment.