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What you need to know about

Peanut allergy drops

Food sublingual immunotherapy (SLIT)

Food sublingual immunotherapy is a process that reduces your reaction to a food allergen. Here’s how it works.

We place a dosage of food extract under your tongue – you hold it there for two minutes, then swallow. Over time, the dose is gradually increased so you can tolerate the food if accidentally exposed to it, decreasing the likelihood of a serious allergic reaction or anaphylaxis.

Food SLIT is not a cure for food allergy. Research shows that it can significantly increase the amount of food you can accept without having an allergic reaction. One study revealed that peanut allergic patients who underwent SLIT for peanut could tolerate almost seven peanuts before having a reaction, compared to less than one peanut for patients who were treated with a placebo.

While not a cure, this effect is life altering as it may mean the difference between tolerating an accidental ingestion instead of having an anaphylactic reaction. It is not known if SLIT for foods can induce long-term tolerance of the food.

Side effects from SLIT are rare. However, because we administer protein of a food that the patient is allergic to, it must be done very carefully with supervision by our allergists. In general, SLIT for foods is safe. In published studies, systemic allergic reactions were quite rare – less than 1%. In one large study:

  • 12 reactions were seen in 4,182 active doses
  • 11 were mild and needed treatment with an oral antihistamine only
  • 1 reaction required a nebulized medication for wheezing.
  • None required administration of epinephrine.

Treating your peanut allergy

We offer food SLIT for peanut allergy. It takes about 6-8 months of treatment to decrease the chance of a life-threatening allergic reaction in case of an accidental exposure. At your first visit, we start with a small amount of peanut extract, then observe you for two hours to make sure the dose is tolerated.

You’ll take this same dose daily at home for two weeks, then return for a dose escalation visit, followed by observation, then a daily dosage at home for two weeks. We increase your dose every two weeks until a maximum or maintenance dosage is achieved. You’ll need to see our allergist after two weeks, one month and three months to make sure things are going well.

Insurance companies pay for most of the food SLIT process. We anticipate that all visits with our allergist will be covered (copayments, deductibles and coinsurances will apply as per your insurance plan) and will be billed as “rapid desensitization.”

Insurers don’t pay for the actual peanut extract because this procedure is considered an off-label use of the extract. In other words, the extract is FDA approved for allergy testing but not yet for SLIT. The charge for the SLIT extract is $240 for a 6 month supply payable prior to starting food sublingual immunotherapy.

You may have also heard of oral immunotherapy (OIT), in which increasing amounts of the actual allergenic food are mixed into a safe food and fed to an allergic individual. We do not OIT at this time.