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Sublingual Immunotherapy (SLIT)

Sublingual Immunotherapy (SLIT) - What it is

How does Sublingual Immunotherapy (SLIT) work?

It works by increasing your body’s tolerance to house dust mite allergens, a process known as ‘desensitization’.
Small amounts of house dust mite (HDM) allergen extract is administered regularly over several years.

How is the medicine given?

Sublingual Immunotherapy (SLIT) is administered through the sublingual route. A small dissolvable tablet or drops of solution are placed under the tongue each day.

For sublingual spray:

Require gradual dose escalation for first few days during initial phase (Please follow the instructions as advised by your Pharmacist)

For sublingual tablets:

No dose escalation required. Take same dose throughout the treatment. After administration of the tablet/spray, keep the tablet/spray under your tongue without swallowing for 1 minute. Avoid eating/drinking, rinsing mouth or brushing teeth for at least 15 minutes. Take the treatment daily, at about the same time every day, preferably in the morning. Make it part of your daily routine (You may want to set up a reminder/alert on your phone).

How effective is the medicine?

Immunotherapy is the only treatment that aims to treat the underlying cause of an allergy, rather than just relieve symptoms (i.e. antihistamines and steroid nasal sprays). It has been shown to be effective in reducing allergy symptoms and need for medication use, prevent long term complications of your allergy, and improve quality of life.

The treatment period is between 3 to 5 years, to develop a lasting immunity.

You may expect to see an improvement in your symptoms as early as between 8 weeks to 14 weeks when your immune system becomes tolerant to HDM. It is important that you continue to take your allergy medications in the meantime.

What are the potential side effects?

Since SLIT contains the HDM that you are allergic to, some side effects may be expected in the early phase of the treatment.
These side effects are usually local and mild to moderate.
The most common side effect is itching in the mouth.

Less common side effects include:

  • Throat irritation
  • Swelling of the mouth/tongue
  • Itching of the ears/eyes
  • Sneezing, nasal itching and congestion
  • Nausea, vomiting, abdominal cramping and diarrhea

These side effects usually happen in first few days or weeks of the treatment, are tolerable, and will subside over time as your immune system become more tolerant.
However, please let your pharmacist or doctor know if you develop symptoms of asthma or urticaria (rashes over your body), have severe symptoms, or if the symptoms remain bothersome after one to two weeks of treatment.

For first dose administration, you are required to administer it under supervision of a Doctor/Pharmacist and will be monitored for 30 minutes in the clinic to ensure no serious side effects develop.

What should I do if I FORGET a dose?

Take it as soon as you remember it.
If it is more than 8 hours from your usual dosing time, you may skip the dose.
Continue taking your next day’s dose as usual. Do not double the dose to make up for the missed dose.
If you have missed more doses than the above mentioned, please contact your Doctor/Pharmacist for advice.

Can I continue/take other MEDICATIONS or SUPPLEMENTS?

You should continue taking your current antihistamines and steroid nasal sprays to help alleviate the symptoms.
You may continue your existing chronic medications as advised by your Doctor.

How do I store the medicine?

For the sublingual tablet:

  • Store at room temperature.
  • It can be carried with you when travelling.
  • Store the tablets in the original blister pack, and only remove it just before administration.
  • Wash and dry your hands before handling the tablets.

For the sublingual spray:

  • Store in a refrigerator (2-8°C). Do not freeze.
  • Keep the bottles in an upright position.
  • Carry in a portable cooler bag when travelling and avoid exposing under direct sunlight.
  • Always keep all medicines out of reach of children.
  • Please refer to the specific product information for more details.

Sublingual Immunotherapy (SLIT) - Symptoms

Sublingual Immunotherapy (SLIT) - How to prevent?

Sublingual Immunotherapy (SLIT) - Causes and Risk Factors

Sublingual Immunotherapy (SLIT) - Diagnosis

Sublingual Immunotherapy (SLIT) - Treatments

Sublingual Immunotherapy (SLIT) - Preparing for surgery

Sublingual Immunotherapy (SLIT) - Post-surgery care

Sublingual Immunotherapy (SLIT) - Other Information

​If you any further questions about your sublingual immunotherapy medication, please contact us at:

Singapore General Hospital

Department of Pharmacy & Department of Otorhinolaryngology – Head & Neck Surgery

Tel: 6321 4110
Email: [email protected]

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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