Treatment
➤ Summary Statement (SS) 1: Use only FDA-approved SLIT products for
the treatment of allergic rhinitis/rhinoconjunctivitis and not for any other
related or unrelated condition. (S-A/B)
➤ SS2: The physician should be aware that SLIT may not be suitable in
patients with certain medical conditions, particularly those that may
reduce the patient's ability to survive a systemic reaction or the resultant
treatment of the systemic reaction. (S-D)
➤ SS3: Use FDA-approved SLIT products very cautiously in the pregnant
or breastfeeding patient because there are insufficient data regarding
the safety of initiating or continuing SLIT during either pregnancy or
breastfeeding. (W-C)
➤ SS4: Do not assume dosing equivalence between SLIT tablets and extracts
of the same allergen. (W-C)
Notes: There are no direct comparisons between the same allergen extract administered as a
SLIT tablet vs. as an aqueous SLIT extract, and it is unknown whether equal efficacy and/or
safety exists when using similar doses of the 2 preparations.
Each formulation has to have its own safety profile established.
➤ SS5: Administer the patient's first dose of SLIT in a medical facility under
the supervision of a physician or other health care professional with
experience in the diagnosis and treatment of anaphylaxis. The patient
should be observed in the clinic or medical facility for 30 minutes after
the administration of the SLIT dose. (S-D)
➤ SS6: Prescribe epinephrine (either an autoinjector or other form for self-
injection) to patients receiving SLIT tablets. (S-D)
Notes: Patients should be trained how to use the device, instructed on how to recognize and
manage adverse reactions and missed doses, and advised on when to contact their physician or
other health care professional.
Recommendations for when to withhold the SLIT tablet dose to avoid potential situations
when systemic allergic reactions may be more likely should also be provided.
➤ SS7: Reduce a patient's SLIT dose if they have missed treatment for more
than 7 days. (W-D)
➤ SS8: Schedule patients receiving SLIT therapy for regular follow-up
care with a specialist trained in the evaluation of patients with allergic
conditions to monitor efficacy and safety and as a strategy for optimizing
adherence. (M-D)
