Allergy drops are a needle-free treatment for managing environmental allergies, such as those caused by pollen, dust mites, and pet dander. This method provides a long-term solution by gradually training the immune system to stop overreacting to these substances.
Defining Sublingual Immunotherapy
Allergy drops are a form of treatment known as Sublingual Immunotherapy (SLIT), which involves placing allergen extracts under the tongue. The drops are a liquid solution containing small, controlled amounts of the specific allergens a person reacts to.
The mechanism relies on specialized immune cells found in the oral mucosa beneath the tongue. When the drops are held in place, the allergen is absorbed directly into the immune system, bypassing the digestive tract. This controlled exposure encourages the immune system to shift its response from an allergic reaction to a state of tolerance.
Over time, this process changes the body’s immune profile by promoting the induction of regulatory T cells. These regulatory cells produce anti-inflammatory cytokines, such as Interleukin-10 (IL-10), which suppress the allergic response. The goal is to retrain the immune system so that natural exposure no longer triggers allergic symptoms.
Administration and Treatment Protocol
The application of allergy drops is designed for convenience, allowing for self-administration at home. A patient places the prescribed number of drops under the tongue using a dropper vial, typically once per day. The liquid must be held in this position for one to two minutes before being swallowed to ensure proper absorption.
The dosing schedule begins with a “build-up” phase, where the concentration or volume of the drops is gradually increased over several weeks. This phase allows the body to safely adjust before moving to a “maintenance” dose. Patients are advised to avoid eating or drinking for about fifteen minutes after taking the drops to maximize effectiveness.
To achieve lasting tolerance, treatment duration is typically long-term. Most physicians recommend continuing daily administration for three to five years. The ability to treat at home, rather than requiring frequent clinic visits, contributes significantly to the protocol’s convenience.
Comparing Drops to Allergy Injections
SLIT with drops is frequently compared to Subcutaneous Immunotherapy (SCIT), commonly known as allergy shots. A primary difference is the location of treatment; drops are self-administered daily at home, while shots must be given in a medical clinic. Shots are generally given less frequently, starting weekly and then moving to a maintenance phase every four to six weeks.
The safety profile of allergy drops is generally milder, with a much lower risk of severe systemic reactions like anaphylaxis. Allergy shots carry a higher risk of severe reactions because the allergen is injected directly into the body. For this reason, patients receiving shots must be observed in the clinic for about thirty minutes after each injection.
In terms of efficacy, allergy shots often have a more consistently high success rate and can treat a broader range of allergens. Allergy drops are also effective at reducing symptoms for many patients, particularly those with allergies to pollens, dust mites, and pet dander. The choice often involves balancing the convenience and safety of drops against the potentially broader effectiveness of shots.
Regulatory Status and Safety Considerations
In the United States, the regulatory status of allergy drops differs based on their specific formulation. Several single-allergen SLIT tablets for grass, ragweed, and dust mites have received formal Food and Drug Administration (FDA) approval. However, the compounded liquid drops are not officially FDA-approved.
Compounded allergy drops are customized mixtures of multiple allergens. They are considered an “off-label” use of FDA-approved allergen extracts, a common practice where physicians use an approved substance in a manner not specified on the label. While the use of these compounded drops is legal and widespread, they are often not covered by health insurance.
The most common side effects are mild local reactions in the mouth, such as itching, tingling, or irritation under the tongue (oral pruritus). These symptoms usually occur at the beginning of treatment or after a dose increase and typically subside quickly. Although the risk of a severe systemic reaction is much lower than with injections, it remains a rare possibility, and patients are monitored for any adverse effects.