For many people struggling with allergies, daily medications like antihistamines only treat symptoms, not the root cause. Allergy immunotherapy, on the other hand, works by training the immune system to become less reactive to allergens over time. While allergy shots are a common option for immunotherapy, today there are also needle-free options available. Two of the most common are sublingual allergy tablets and sublingual allergy drops.
While both treatments work under the tongue and aim to reduce long-term allergy symptoms, there are important differences between them. Understanding how each works can help you and your allergist decide which option best fits your allergy needs and lifestyle.
What Is Sublingual Immunotherapy?
“Sublingual” means “under the tongue.” Sublingual immunotherapy (SLIT) involves placing a small dose of an allergen beneath the tongue, where it is absorbed into the immune system through specialized cells in the mouth. Over time, repeated exposure helps the body build tolerance to that allergen, leading to fewer and less severe allergy symptoms.
Both sublingual allergy tablets and sublingual allergy drops rely on this same process, but they differ in how they’re formulated, prescribed, and customized.
What Are Sublingual Allergy Tablets?
Sublingual allergy tablets are FDA-approved treatments designed to target specific allergens. Currently, tablets are available for certain grass pollens, ragweed pollen, and dust mites. Each tablet contains a standardized dose of a single allergen and is taken daily by dissolving it under the tongue.
Because sublingual allergy tablets are FDA-approved, they follow strict dosing and manufacturing guidelines. This can be reassuring for patients who prefer a standardized, pre-measured treatment option. However, tablets are not customizable. If you are allergic to multiple triggers, a common situation for many Houston allergy sufferers, tablets may not fully address all of your symptoms.
Another important consideration is that the first dose of a sublingual allergy tablet must be taken in a medical office under supervision. After that initial visit, daily dosing is done at home.
What Are Sublingual Allergy Drops?
Sublingual allergy drops are liquid allergy extracts that contain small amounts of the allergens you are sensitive to, such as tree and grass pollens, mold, dust mites, or pet dander. The drops are placed under the tongue daily and can be taken at home, making them a convenient option for many patients.
One of the biggest advantages of sublingual allergy drops is personalization. Drops can be customized to include multiple allergens in a single treatment plan, which is especially beneficial for patients with complex or year-round allergies. The dosage is gradually increased over time, allowing the immune system to adjust safely and effectively.
Although sublingual allergy drops offer convenience and customization, there are currently no FDA-approved SLIT liquid (drops) formulations. The effectiveness of sublingual allergy drops is not known and is still being investigated. There is variability of reported effectiveness of the formulations in the published literature. This type of treatment is also not usually covered by insurance.
Key Differences Between Tablets and Drops
While both forms of sublingual immunotherapy are convenient, there are key differences to consider:
- FDA Approval: Sublingual allergy tablets are FDA-approved; sublingual allergy drops are not.
- Customization: Tablets target one allergen per tablet, while drops can treat multiple allergens at once.
- Allergy Coverage: Drops are often better suited for patients with multiple or overlapping allergies.
- Convenience: Both options are taken at home, but drops offer more flexibility in dosing and formulation.
Which Option Is Right for You?
The best treatment choice depends on your allergy testing results, symptom severity, lifestyle, and long-term goals. An individualized approach is key to successful allergy treatment. At McGovern, we only offer FDA-approved therapies, but we can help you navigate the treatment options that are available.
Immunotherapy at McGovern Allergy & Asthma Clinic
At McGovern Allergy and Asthma Clinic, the board-certified allergists specialize in personalized immunotherapy and allergy care for patients throughout Houston. The team takes the time to identify your specific triggers
and review all available treatment options, including sublingual allergen immunotherapy, so you can make an informed decision. If you’re ready to move beyond symptom management and address the underlying cause of your allergies, immunotherapy may be the next step.