Sublingual Immunotherapy (SLIT)
Sublingual allergy drops (SLIT) treat allergies at their source. They train your immune system to stop overreacting. They work similarly to allergy shots, but without needles. The result is lasting relief without pills or sprays.
Treatment starts with careful testing. A doctor reviews your symptoms and history. Simple at-home or in-office tests identify exactly what you're allergic to — pollen, dust mites, pet dander, mold, or foods. Knowing the precise triggers lets the drops be made just for you.
The drops contain tiny amounts of your specific allergens. You place them under your tongue every day. The allergens are absorbed quickly and safely. With daily use, your immune system gradually gets used to them. It learns they are harmless. Over time, it stops launching a full attack.
This is not an overnight solution. Most people notice improvement in the first few months. Full benefits usually appear after 3 to 5 years of consistent use. Once your immune system is retrained, many people keep their results for years — even after stopping the drops.
Allergy drops work by gently and repeatedly exposing your body to those same allergens in very small doses. This slowly lowers the number and activity of IgE antibodies. Mast cells become much less reactive. Your immune system starts making protective IgG antibodies instead. The allergic "alarm" gets quieter and quieter until symptoms fade or disappear.
Sublingual immunotherapy is one of the most studied treatments in allergy medicine. Here are the findings that matter most.
A landmark Cochrane meta-analysis of 49 randomized controlled trials found sublingual immunotherapy produced significant reductions in both allergy symptom scores and medication use compared to placebo, with efficacy comparable to subcutaneous immunotherapy.
A systematic review comparing sublingual and subcutaneous immunotherapy head-to-head found no statistically significant difference in clinical efficacy for allergic rhinitis, with both forms producing durable immune tolerance when treatment is maintained for 3+ years.
A comprehensive safety review of over 1 billion SLIT doses administered worldwide found zero fatalities and an anaphylaxis rate of approximately 1 per 100 million doses — orders of magnitude safer than injection immunotherapy, which carries an estimated 1 per 1 million injection risk.
The European Academy of Allergy and Clinical Immunology (EAACI) guidelines confirm that sublingual immunotherapy can be safely self-administered at home after the first dose, due to its favorable systemic safety profile — a key advantage over injection therapy.
Clinical trials of sublingual immunotherapy for peanut allergy demonstrated that treated patients could safely tolerate significantly higher amounts of peanut protein — up to a 10-fold increase — compared to placebo, with far fewer side effects than oral immunotherapy (OIT).
A comparative review found that sublingual food immunotherapy produces significantly fewer gastrointestinal side effects and adverse events than oral immunotherapy, making it a preferred option for patients who cannot tolerate OIT — especially young children.
The landmark GAP (Grazax Asthma Prevention) trial showed that sublingual immunotherapy in children with allergic rhinitis reduced the risk of developing asthma by 40% — an effect sustained for at least two years after treatment ended. This preventive capacity is unique to immunotherapy.
A meta-analysis found that sublingual immunotherapy in patients with allergic asthma led to significant reductions in asthma symptom scores, rescue inhaler use, and steroid requirements — offering a disease-modifying approach rather than symptom control alone.
Allergists don't recommend immunotherapy lightly — they recommend it because it's the only treatment that addresses the underlying immune dysfunction driving your allergies, rather than simply suppressing symptoms.
Antihistamines, decongestants, and nasal sprays provide temporary relief. Immunotherapy retrains your immune system at the cellular level — teaching it that pollen, dust, and dander are not threats. Over time, the allergic response itself diminishes.
Immunotherapy works with your body, not against it. By introducing tiny, gradually increasing amounts of natural allergen extracts, it harnesses your immune system's own ability to build tolerance — the same process your body uses to develop immunity to infections.
Unlike medications that stop working the moment you stop taking them, the benefits of immunotherapy can persist for years — even decades — after you complete your treatment course. Studies show sustained remission in the majority of patients.
Allergies tend to worsen over time. Untreated allergic rhinitis can progress to asthma. Immunotherapy has been shown to halt this "allergic march," reducing the risk of developing asthma in children and adults with allergic rhinitis by up to 40%.
Most immunotherapy patients significantly reduce — or completely eliminate — their need for daily allergy medications. Your body learns to manage allergen exposure on its own, the way a non-allergic person's immune system naturally does.
Allergists have recommended immunotherapy for over a century. Curex makes this gold-standard treatment accessible by bringing it online — with board-certified allergists, at-home allergy testing, and custom drops delivered to your door.
Allergy drops may be a good fit if your symptoms are hard to control, you are tired of relying on allergy medications, or you want a convenient alternative to allergy shots. They are designed to treat the underlying allergy over time and support long-term relief.
Adults and children with confirmed allergic rhinitis, allergic asthma, or food allergies who want a long-term solution. Patients who've tried antihistamines or nasal sprays without lasting relief. Those who can't tolerate needles, can't make regular office visits, or want to treat at home.
If your symptoms are occasional and well managed with an antihistamine or nasal spray, immunotherapy may be more treatment than you need. Similarly, if your food allergies are mild and avoidance works for your lifestyle, drops may not be necessary. If you have uncontrolled asthma, your doctor will likely prescribe medication to stabilize it before starting allergy drops. Certain conditions — such as mast cell disease or eosinophilic esophagitis (EoE) — or the use of beta-blockers may increase risk, and your allergist may recommend against immunotherapy in those cases.
Both allergy drops and allergy shots use immunotherapy to desensitize your immune system. The difference is how — and where — treatment happens.
| Allergy Drops | Allergy Shots | |
|---|---|---|
| Where | At home — drops under the tongue | In-office injections, every 1–2 weeks |
| Needles | ✓ None | ✗ Required |
| Time commitment | ~2 minutes per day at home | 1–3 hours per visit including wait times |
| Risk of anaphylaxis | ✓ Extremely rare | ✗ Possible — requires in-office monitoring |
| Suitable for children | ✓ Yes — preferred for young patients | Yes, but needles can be distressing |
| Food allergy treatment | ✓ Available | ✗ Not applicable |
| Custom formulation | ✓ Yes — personalized to your allergy profile | ✓ Yes — personalized to your allergy profile |
| Clinical efficacy | Comparable long-term outcomes | Comparable long-term outcomes |
Both allergy drops and SLIT tablets are forms of sublingual immunotherapy — but they differ in flexibility, customization, and allergen coverage. There are currently four FDA-approved SLIT tablets: Grastek (timothy grass), Ragwitek (ragweed), Odactra (dust mite), and Palforzia (peanut, oral). Allergy drops, by contrast, are custom-compounded to address your full allergen profile in a single formulation.
| Allergy Drops | SLIT Tablets | |
|---|---|---|
| Allergen coverage | ✓ Multiple allergens in one formulation | Single allergen per tablet |
| Customization | ✓ Fully personalized to your allergy profile | ✗ Fixed, pre-manufactured formulas |
| FDA status | Off-label (compounded, personalized) | FDA-approved |
| Where | At home | In office for first dose |
| Food allergy treatment | ✓ Available | ✗ Not available |
| Dosing flexibility | ✓ Adjustable by your allergist | Fixed dose |
| Available allergens | ✓ Broad — pollen, dust, mold, pets, foods | Timothy grass, ragweed, dust mites only |
For families managing food allergies, sublingual immunotherapy offers a safer, lower-side-effect alternative to traditional oral immunotherapy (OIT) — with treatment that can be done entirely at home.
Oral immunotherapy requires patients to eat increasing doses of the food they're allergic to — often causing significant gastrointestinal distress, with up to 20% of patients discontinuing due to side effects. Sublingual food immunotherapy delivers micro-doses of allergen protein under the tongue, bypassing the gut entirely. The result: far fewer adverse reactions, better adherence, and a treatment experience that's dramatically less stressful — especially for children.
Researchers at the University of North Carolina School of Medicine conducted studies demonstrating that sublingual immunotherapy for food allergies is both safe and effective, showing significant increases in tolerated food protein doses with a favorable side-effect profile compared to oral immunotherapy.
Allergy Associates of La Crosse has been offering sublingual immunotherapy for food allergies for over 50 years, treating thousands of patients with personalized allergy drop protocols. Their long track record demonstrates strong real-world outcomes and sustained patient improvement across a wide range of food allergens.
Allergies are the most common trigger of asthma. When your immune system overreacts to airborne allergens, it can inflame and constrict the airways — leading to wheezing, coughing, and shortness of breath. Allergy drops target this root cause.
Clinical studies show sublingual immunotherapy significantly reduces asthma symptom scores, rescue inhaler use, and the need for corticosteroids in patients with allergic asthma. By calming the underlying allergic response, the airways stay more open and less reactive.
The landmark GAP trial demonstrated that sublingual immunotherapy reduced the risk of children with allergic rhinitis developing asthma by 40%. Immunotherapy is the only treatment shown to prevent this progression — known as the "allergic march."
Inhalers and steroids manage asthma symptoms. Allergy drops address the allergic inflammation that triggers asthma attacks in the first place. For patients with allergic asthma, treating the allergy can mean better long-term asthma control with fewer medications. Before starting allergy immunotherapy, your doctor may prescribe controller inhalers to get your asthma under control first — generally defined as no more than two days per week of rescue inhaler use and no nighttime awakenings due to symptoms.
Atopic dermatitis (eczema) is closely linked to allergies. In many patients — especially children — eczema is the first sign of an overactive immune system that will later develop into allergic rhinitis and asthma. Allergy drops can help address this underlying immune dysfunction.
Up to 80% of children with eczema go on to develop allergic rhinitis or asthma. Environmental allergens like dust mites and pet dander can trigger or worsen eczema flares. By desensitizing the immune system to these triggers, allergy drops may help reduce the frequency and severity of flare-ups.
Research suggests sublingual immunotherapy can improve eczema severity scores — particularly in patients whose eczema is driven by specific allergen sensitivities. While more studies are underway, many allergists are already incorporating SLIT into treatment plans for patients with allergic eczema. Allergy immunotherapy may help with long-term eczema relief, but beforehand your doctor may prescribe a variety of treatments — including topical corticosteroids and non-steroidal options like calcineurin inhibitors or JAK inhibitors — to get active flare-ups under control first.
Allergy drops are compounded medications — personalized for each patient — which are typically not covered by standard health insurance. Allergy drops normally cost about $1,000 per year, depending on the provider. However, the associated allergy testing and physician consultations are normally covered by insurance plans.
Allergy drops, along with allergy testing and allergist consultations, are eligible for reimbursement through Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA), helping offset out-of-pocket costs.
Allergy shots may be covered by insurance, but for patients on deductible plans, that often means at least $2,000 or more in out-of-pocket responsibility before coverage kicks in — plus the cost of frequent office visits, co-pays, and time off work or school.
Americans spend an average of $3,000–$5,000 per year managing allergy symptoms through medications, doctor visits, and lost productivity. Immunotherapy is an investment in a lasting solution — one that can reduce or eliminate those recurring costs over time.
You can get started with allergy drops by visiting a local allergy clinic that offers sublingual immunotherapy. Or, if you're comfortable using modern technology, try Curex — the largest online allergy clinic in the U.S., currently treating over 50,000 patients. No referrals, no waiting rooms, no weekly office visits.
A quick online assessment to see if allergy drops are right for your symptoms and health history.
We send an at-home allergy test kit to identify your exact triggers — environmental, food, or both.
A board-certified allergist reviews your results and creates a personalized treatment plan via telehealth.
Your custom-formulated allergy drops are delivered to your door. Place drops under your tongue daily — done.
Allergy drops give patients something antihistamines never can — the possibility of outgrowing their allergies. We're not managing symptoms. We're retraining the immune system.
I've seen patients who suffered for 20 years on daily medications become symptom-free within a year of starting drops. That transformation is why I practice allergy medicine.
For children with food allergies, sublingual immunotherapy is a game-changer. Parents tell me it's the first time they've felt hopeful — and the first time their child hasn't been afraid of food.
The compliance rates we see with allergy drops are remarkable. When patients can treat at home on their own schedule, they actually stick with it — and that's when real, lasting change happens.
I counsel patients every day who've tried everything — sprays, pills, avoidance. When I explain that we can actually treat the cause and potentially eliminate the problem, it changes the conversation entirely.
The safety data on sublingual immunotherapy is extraordinary. In over a billion doses administered worldwide, the serious adverse event rate is virtually zero. That's what allows us to offer this treatment at home with confidence.
Immunotherapy is the closest thing we have to a cure for allergies. Allergy drops simply make that cure accessible to everyone — not just those who can drive to an allergist's office twice a month.
Take a 2-minute eligibility quiz to see if Curex sublingual immunotherapy could help you treat the root cause of your allergies — from home.
No insurance required. FSA/HSA eligible. Cancel anytime.
Get the latest in allergy science and treatment breakthroughs delivered to your inbox.
