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April 17, 2014 at 8:00 AMComments: 0 Faves: 0

Oralair - The New, Great Allergy Solution?

By Jeffrey VanWingen M.D. More Blogs by This Author

Allergies are the pits - I speak this from experience - but as annoying as my allergies may be with the fatigue, sneezing, hacking, runny nose and watery eyes, I dislike the standard treatments more.

Antihistamines make me feel drugged and steroid nose sprays set fire to my nose. And there's no way I want to subject myself to weekly shots at the doctor's office even though immunotherapy is considered the most definitive treatment for allergies. This month, however, a new option was approved by the FDA which gives the benefits of immunotherapy without the shot. 

Is there a catch? 

Is it safe? 

Is it for everyone?

Introducing Oralair

Oralair is the first sublingual (under the tongue) immunotherapy treatment for allergies in the U.S.. Immunotherapy involves administering a small dose of a substance that the body's immune system is programmed to attack (allergy).  In doing so, the body "gets used to" the presence of the substance, yielding less severe reaction when exposure takes place.

Usually an allergist figures out what the body is allergic to via skin prick testing or blood tests and then prepares the immunotherapy. The approval of Oralair in the U.S. comes on the heels of its approval and use in several other countries.


The window of Oralair's use is quite limited.  It is indicated only for persons aged 10-65 with an allergy to one or more of five different grass species.  The first dose must be given in a doctors office under close supervision in the case of severe reaction.  Note that this is similar to allergy shots and that a substance is being administered for which there is a known allergy.  Oralair must be given a full four months before benefit is expected.

Other Issues

According to the FDA, the studies on Oralair demonstrated that subjects developed, "16 to 30 percent reduction in symptoms and the need for medications compared to those who received a placebo."  This was after a full four months of therapy.  Side effects noted were increased flairs of asthma.  In the study, as well with prescribing, those who take Oralair will be required to carry an epinephrine pen due to the potential for severe allergy reaction.  Beyond this, the medication can be administered at home as opposed to a doctor's office as with injected immunotherapy.  I could not find any indication as to whether other allergens will be included with this new technology or if "concoctions" will be developed for multiple allergies as with current injected immunotherapy. 

Cautious Optimism

The presence of Oralair on the scene of allergy therapy opens the door for better options in the treatment of allergies.  It is clear that presently we do not have the Holy Grail of allergy therapy but any advancement keeps hope alive.  If you have grass allergies not helped by standard therapy, talk to your doctor about Olalair. 

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