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  • Dinkar Bakshi

Sublingual immunotherapy

Updated: Oct 15, 2023

Sublingual immunotherapy (SLIT) is a form of allergen immunotherapy, also known as desensitization therapy, used to treat certain allergic conditions. SLIT involves administering small amounts of allergens (substances that trigger allergies) under the tongue to help the immune system gradually build tolerance to those allergens. This therapy is primarily used for individuals with allergic rhinitis (hay fever) and allergic asthma caused by specific allergens.

Here's how sublingual immunotherapy works:

Identification of Allergen: The specific allergen or allergens causing the allergic symptoms must be identified through allergy testing, such as skin prick tests or blood tests for specific IgE antibodies.

Allergen Extract Preparation: Allergen extracts are prepared based on the identified allergens. These extracts are purified and standardized to ensure consistent treatment.

Treatment Initiation: The patient starts the sublingual immunotherapy by taking daily doses of allergen extracts in the form of drops or tablets. The first dose is typically administered in a healthcare provider's office, and subsequent doses are taken at home.

Gradual Dosing: Over time, the patient takes gradually increasing doses of the allergen extract under the tongue. This process aims to build tolerance to the allergen, reducing the body's allergic response.

Maintenance Phase: Once a target maintenance dose is reached, the patient continues taking the daily maintenance dose to sustain the desensitization effect.

Long-Term Treatment: Sublingual immunotherapy is typically administered over several years to achieve lasting desensitization. The duration varies based on the individual's response and the specific allergen.

Benefits and considerations of sublingual immunotherapy:


Effective: SLIT has been shown to reduce allergic symptoms and the need for symptom-relief medications in individuals with allergic rhinitis or allergic asthma.

Convenience: SLIT can be self-administered at home, reducing the need for frequent office visits.

Safety: SLIT is generally considered safe, with a lower risk of severe allergic reactions compared to subcutaneous immunotherapy (allergy shots).

Well-Tolerated: Many patients find SLIT to be more comfortable and less invasive than allergy shots.


Allergen Selection: SLIT is currently approved for specific allergens, such as grass pollen, ragweed, and dust mites. It may not be suitable for all types of allergies.

Duration: The treatment duration may be several years, requiring long-term commitment.

Effectiveness: The effectiveness of SLIT can vary among individuals, and not everyone responds equally well to this therapy.

Age Considerations: SLIT is often used in older children and adults but may not be recommended for very young children.

Side Effects: Mild side effects, such as local itching or swelling in the mouth or throat, can occur during SLIT. Serious side effects are rare but can include severe allergic reactions.

Sublingual immunotherapy should be administered under the guidance of an allergist or immunologist with expertise in this form of treatment. It's essential for patients to be properly evaluated, receive personalized treatment plans, and undergo regular monitoring throughout the course of SLIT. This helps ensure the therapy is safe and effective in managing allergic conditions.

Book your appointment with Dr Bakshi one of the few formally trained top allergy cosultants in London and Birmingham, head to British Allergy Clinic, the best private allergy clinic that provides comprehensive care and treatment for all your allergies.

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