AAO-HNSF Primary Care Otolaryngology Handbook

ALLERGY

More recently sublingual immunotherapy (SLIT) has been popularized because of its reduced time commitment and risk profile, and the avoid- ance of needles. Grass, ragweed, or dust mite tablets placed under the tongue are the only form of immunotherapy approved by the U.S. Food and Drug Administration (FDA). Sublingual drops, which are not FDA approved, are administered under the tongue with very rare local or systemic reactions. SLIT may be more cost-prohibitive than SCIT, depending on insurance and out-of-pocket costs. Allergy skin testing and immunotherapy have the potential to cause severe or fatal anaphylaxis . Both should be undertaken with caution in a setting where emergency supplies, equipment, and trained personnel are immediately available. Since poorly controlled or worsening asthma is the main risk factor for developing anaphylaxis, questions about current asthma status (or actual peak flow measurement) are appropriate on each test or treatment day. Inhalant allergies, although rarely life threat- ening, have a major negative impact on quality of life. Symptom improve- ment or resolution with the above approaches is usually possible.

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