Allergies are, frankly, The Worst. Since you settled in to read this story, you’re probably already well aware of that fact. But you might not know that, for a very specific group of people, allergy tablets may help.
Now, if you’re a frequent allergy sufferer you might be very familiar with the common treatment options out there—antihistamine pills, nasal sprays, allergy shots, stripping off all of your clothes and shoes the second you walk in from outside, etc. But allergy tablets are a lesser-known treatment that may provide long-term relief for people with certain allergies. Here’s what you should know about them if it currently seems like the itching, sneezing, headache-filled misery will never end.
Here’s how allergy tablets work.
Allergy tablets are dissolvable pills that serve as a form of sublingual (under the tongue) allergy immunotherapy.
“Allergy immunotherapy is a way to actually modify the immune system [so] that it does not react the same way to what you’re allergic to,” William Reisacher, M.D., an otolaryngologist and director of allergy services at NewYork-Presbyterian and Weill Cornell Medicine, tells SELF.
Allergies basically happen when your immune system makes a mistake and accidentally interprets pollen and other typically harmless substances as dangerous, Dr. Reisacher explains.
Your immune system responds to these allergens by producing Immunoglobulin E (IgE) antibodies that release chemicals like histamine, which prompt symptoms of an allergic reaction, according to the American Academy of Allergy, Asthma, & Immunology (AAAAI). This can manifest as persistent itching, sneezing, nasal congestion or runniness, irritated and watery eyes, and hives, to name a few symptoms. (For people who are really allergic to something like bee venom or a particular food, encountering that allergen can result in anaphylaxis, a potentially life-threatening reaction that can lead to trouble breathing, according to the Mayo Clinic.)
So, how do allergy tablets work differently from the other treatment methods you’ve probably tried? Using small amounts of allergen proteins, allergy tablets desensitize your immune system over time so it no longer overreacts when confronted with certain allergens.
Allergy immunotherapy, which also includes allergy shots, is the only form of disease-modifying treatment available for allergies, Dr. Reisacher explains. (Allergy drops are another form of allergy immunotherapy, but they’re not approved for use in the United States.) Allergy medications like antihistamines are symptom-modifying, meaning your symptoms will reappear once the drug wears off.
The Food and Drug Administration (FDA) has greenlit four types of allergy tablets for use in the United States, each for a specific allergy. There’s one for ragweed allergies (Ragwitek, recommended for adults ages 18 to 65), two different products for grass allergies (Grastek and Oralair, both recommended for people ages 5 through 65), and one for dust mite allergies (Odactra, recommended for adults ages 18 to 65). The different age ranges here come down to which populations researchers have tested for the drugs’ efficacy and safety.
How (and who) can allergy tablets help?
“If you’re the right candidate for it, [allergy tablets] can be helpful for sure,” Sandra Hong, M.D., a physician in the Department of Allergy and Clinical Immunology at the Cleveland Clinic, tells SELF.
In addition to having certain allergies and being in the right age range, you may be a candidate for allergy tablets if you’ve tried a lot of short-term allergy treatments but are still experiencing symptoms at a level you find hard to bear, according to the American Academy of Family Physicians, or if you spend so much on short-term allergy relievers that you think it may be more cost-effective to seek treatment that lasts for a longer time. (You might still need to take allergy medication depending on any other allergies you may have, but the goal is to reduce the need for as much medication overall.)
You can start taking daily allergy tablets for dust mites at any time of year, but grass and ragweed allergy tablets need to be taken daily starting three to four months ahead of the allergy season for the best possible results.
“The hope would be that by the time that [allergy] season starts, [you’re] significantly better,” Dr. Hong says. You would then continue to take the tablets until your system built up immunity.
Unfortunately, allergy tablets don’t work immediately. Taking allergy tablets as recommended can ideally provide long-lasting relief after around three to five years, according to the American College of Allergy, Asthma, and Immunology (ACAAI). (This is about the same timeline it takes allergy shots to be fully effective, at a minimum.) As with shots, allergy tablets won’t necessarily cure your allergies. But they can help reduce some people’s symptoms and need for as much medication.
As with most medications, allergy tablets have possible side effects.
Many of these side effects will be localized to the mouth area since that’s where you’re putting the allergen, Dr. Hong says. You could experience things like itching and swelling of your lips, for example.
You might be wondering why you’d take something that could give you allergy symptoms when what you want is, well, to rid yourself of allergy symptoms. But these side effects typically fade within a few days to a week, the AAAAI says. After that point, the tablets should continue to battle your allergy without causing you too much grief.
If you do experience allergy symptoms while taking sublingual immunotherapy (whether during the initial adjustment phase or just throughout the course of treatment), it’s OK to use symptom-relieving medications like nasal sprays, antihistamine tablets, and eye drops.
“Immunotherapy sort of works in the background, but whatever a person needs to take in order to feel comfortable … is perfectly fine,” Dr. Reisacher says.
More severe reactions to allergy tablets, like anaphylaxis, are rare yet possible. Doctors account for this in a few ways. “The first dose needs to be done in a monitored setting, just in case you have an allergic reaction,” Dr. Hong explains. The recommendation is typically to have a patient stick around under medical supervision for 30 minutes after taking their first allergy tablet, according to the AAAAI. It’s also recommended that doctors prescribe an epinephrine autoinjector alongside the tablets, which you could use to keep your airways open if you were having a severe allergic reaction.
Because of the possibility of an allergic reaction when starting allergy tablets, it’s not recommended that people take them for the first time when pregnant, according to the AAAAI. That also goes for allergy shots. But if you’re already taking allergy tablets or shots and become pregnant, it’s typically safe to continue your allergy immunotherapy.
How do you decide between allergy tablets and allergy shots?
These forms of allergy immunotherapy can take about the same time to work. There are a few other aspects you and your allergist can weigh when figuring out what makes the most sense for you.
One major point for allergy shots is that they can help with a wider variety of allergies than tablets. Allergy shots can be effective for ragweed, grass, and dust mites, as can tablets—but the shots can also target other allergens like mold, animal dander, and insect venom, according to the ACAAI. What’s more, allergy shots can be formulated to desensitize your body to multiple different allergens at the same time, unlike the four types of allergy tablets, which each only fight one type of allergy. If you’re “poly-sensitized,” meaning you’re allergic to a bunch of things, allergy shots might be a better option, Dr. Hong explains.
Allergy shots may also be less expensive than their tablet counterparts, given that they’re not administered every day, explains the AAAAI. Without insurance, a monthly supply of allergy tablets can cost anywhere from around $ 300 and up, which is expensive all on its own and even more so considering you’d be taking the pills for years. (Whether—or how much—allergy tablets and shots are covered by health insurance will depend on your specific carrier, so you should check directly with your insurance company for those details.)
Allergy tablets do have a few different benefits that injectable allergy immunotherapy doesn’t, though. For starters, experts say allergy tablets are typically way easier to fit into someone’s lifestyle than allergy shots. Beyond that first in-office dose, you can take allergy tablets at your discretion rather than seeing your allergist at least once a week, as you would need to for the first seven months or so of taking allergy shots, the ACAAI explains. After that, people can typically scale their shots back, like by getting them every two weeks, then once a month. Specifics here can vary, but allergy shots can still be more inconvenient than allergy tablets overall.
Overall, allergy tablets are also associated with fewer side effects compared with allergy shots, Dr. Reisacher explains, since they dissolve whereas injecting something into your body makes it enter your system more quickly.
With all of that in mind, Dr. Reisacher says the best method of immunotherapy to treat your allergies is going to be the one that you’re most likely to be consistent with. Whether administered as shots or tablets, allergy immunotherapy requires strict adherence to a drug regimen over a really long period of time.
“If it’s something that’s inconvenient for the allergic individual to do, then they’re probably not going to continue it,” Dr. Reisacher says. “No form of immunotherapy is effective if you do it inconsistently.”
An allergist can help you determine if you’re a candidate for allergy tablets.
Make an appointment with an allergist if you’re curious—or if you’re just still trying to figure out what type of treatment can finally get your symptoms under control. If you haven’t already gotten allergy testing to figure out exactly what you’re allergic to, they can start there as it will help inform what kind of allergy immunotherapy might be a fit for you.
If you don’t have insurance or aren’t a candidate for allergy immunotherapy, all hope is not lost! Talk to your doctor about which non-immunotherapy allergy medications will be best for combatting your specific symptoms, Taha Al-Shaikhly, M.D., a fellow in Allergy and Immunology at the University of Washington School of Medicine, recommends. (Even if they’re over-the-counter medications, it’s still best to have your doctor sign off on your treatment regimen since any medication can have side effects.)
Besides that, Dr. Al-Shaikhly recommends taking DIY measures to minimize your exposure to troublesome allergens. You might think you’ve done all you can, but there may be small yet mightily powerful steps you can pursue on your own to reduce your allergy symptoms. For ideas, you can check out our guides for dealing with seasonal allergies, pollen-proofing your home, handling pet allergies, and getting rid of as much dust in your home as possible.