Treatment
Aer professional
dental cleaning
It is suggested to resume SLIT 24 hours aer a dental cleaning
procedure.
a
Aer brushing and
flossing of teeth
No caution is usually advised for brushing teeth. Because flossing
and gum hygiene can be associated with gum bleeding, it is
recommended that the patient delay the administration of SLIT for
a few hours aer the cessation of gum bleeding.
Aer dental
extraction and gum
surgery
e FDA advises waiting for complete healing. Although adequate
healing will usually occur aer 10–14 days (eg, when stiches are
oen removed), it is advised to discuss with the dentist when
adequate healing will occur.
a
Aphthous stomatitis,
herpes, oral lichen
planus
e FDA advises waiting for complete healing. Recovery can vary
from days to longer than 1 week. If longer than 2 weeks, return
to office for examination and SLIT tablet administration under
supervision.
High degree of
specific IgE allergen
sensitivity
Although there is no firm answer, some studies suggest no increased
risk. However, because increased allergen sensitivity is known to
be a risk factor for SCIT and anaphylaxis, in general, caution is
advised, especially for former SCIT patients who have experienced
anaphylaxis from SCIT.
Administration of
SLIT during active
allergen season
Although no change in schedule is advised, patients should be
advised to contact their allergist if seasonal allerg y symptoms are
significantly increased.
Use of SLIT in a
patient who has been
diagnosed to have
asthma
SLIT is currently not approved for patients with severe, unstable,
or uncontrolled asthma. Patients with controlled mild to moderate
asthma may be given SLIT when the patient and physician have
determined that the benefits of treatment outweigh the potential
risks.
Symptomatic
asthma or an asthma
exacerbation
Because of a possible increased risk of anaphylaxis, the patient
should discontinue SLIT until they have discussed their increase in
asthma symptoms with their physician.
Increased symptoms
of allergic rhinitis
(AR), allergic
conjunctivitis (AC)
or atopic dermatitis
ere are no reported increased risks associated with the
administration of SLIT when a worsening of symptoms occurs.
However, patients should contact their physicians if they are unable
to bring their symptoms under control.
Overdosing errors
with SLIT
SLIT case reports have reported an increased risk. Patients should
withhold SLIT until they have contacted their allergist for advice.
Table 3. Suggested Guidelines for the Practicing Allergist
Regarding the Use of FDA-Approved SLIT Products
(cont'd)
Question or
concern Expert suggestion and rationale
