Otolaryngology Book


Sublingual Immunotherapy

Aka: Sublingual Immunotherapy, Grastek, Oralair, Ragwitek
  1. Indications
    1. Allergy Immunotherapy
      1. For allergic symptoms refractory to standard allergy medications
  2. Precautions
    1. Not to be used without formal Allergy Testing first
    2. Observe in office for first sublingual dose
    3. All patients should receive Epinephrine auto-injector in case of Anaphylaxis reaction
  3. Preparations
    1. Grass allergies
      1. Grastek
      2. Oralair
    2. Ragweed allergy
      1. Ragwitek
  4. Dosing: Protocol
    1. Start medication 3-4 months prior to allergy season and continue throughout the season
    2. Have Epinephrine auto-injector readily available in case of Anaphylaxis reaction
  5. Advantages
    1. More convenient, possibly safer, and without the pain of standard allergy Immunotherapy injections
    2. Efficacy approaches that of standard allergy Immunotherapy injections
  6. Disadvantages
    1. More expensive than standard allergy Immunotherapy injections
  7. References
    1. (2014) Presc Lett 21(6):35
    2. Koberlein (2013) Immunotherapy 5(1):13-21 [PubMed]
    3. Maloney (2014) Ann Allergy Asthma Immunol 112(2):146-153 [PubMed]
    4. Nolte (2013) Ann Allergy Asthma Immunol 110(6):450-456 [PubMed]
Medication Costs
grastek (on 11/23/2016 at Medicaid.Gov Pharmacy Drug pricing)
GRASTEK 2,800 BAU SL TABLET $8.43 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

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