Comparison of Allergy Drops and Allergy Shots

Allergy drops, or sublingual immunotherapy, are becoming increasingly available in the United States as an alternative to allergy shots for the treatment of allergies. This therapy has been used safely and effectively in Europe for many years but has not become popular in the United States until recently.

Young woman blowing nose outdoors
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Allergy drops are not currently approved by the Food and Drug Administration (FDA) and therefore are considered an experimental therapy.

However, given the wealth of medical studies showing the safety and efficacy of allergy drops for the treatment of allergic rhinitis, allergic conjunctivitis, and allergic asthma, many allergists in the United States are offering this form of immunotherapy.

As such, people with allergies may now be given a choice between allergy drops and traditional allergy shots. Here are some comparison points that can help you choose the more appropriate treatment option.

Allergy Shots

Shots are administered in the allergy office once to twice a week for three to six months; then once to twice a month for three to five years. Allergy shots often start working within 3 to 6 months, but definitely within 12 months, depending on how often shots are given.

Allergy shots are generally safe but need to be given under physician supervision. Patients receiving allergy shots then need to be monitored for 20 to 30 minutes, given the small chance of a serious allergic reaction occurring.

Most medical insurance companies cover a significant amount of the costs of allergy shots, although co-payments and annual deductibles apply.

Allergy Drops

Drops are self-administered once daily under the tongue at home, most often for 3 to 5 years total. Some studies show that allergy drops start working within eight weeks of therapy; other studies show benefit may take one to two years to occur.

Allergy drops are extremely safe —no fatal events have ever been reported—but severe reactions have been reported in rare instances. Allergy drops can be self-administered at home without direct medical supervision. However, because there is still a risk of rare severe allergic reactions with sublingual immunotherapy, the prescribing doctor will often prescribe an epinephrine auto-injector for personal use in the event of one of these rare occurrences.

Since allergy drops are not FDA approved, they are not covered by insurance. However, the cost of allergy drops may be offset by savings in terms of not having to spend time and travel costs to a physician’s office to receive allergy shots.

Allergy Shots
  • Administered at a doctor's office

  • Initially administered once or twice a week; after at least 3 to 6 months, then administered once or twice a month

  • May be scary for some children

  • May be covered by health insurance

  • Cost varies due to unique patient, provider, and insurance variables.

Allergy Drops
  • Administered at home after an initial visit

  • Administered daily or at least three days a week

  • More acceptable to children

  • Not covered by health insurance

  • Cost varies due to unique patient, provider, and insurance variables.

The Takeaway

The type and severity of allergy you have plays a significant role in the choice of treatment. Speak with your doctor about whether drops or shots are better suited for your condition.

According to a 2012 review in the Journal of Environmental and Public Health, allergy drops were as effective as shots in treating nasal allergies.

A Word From Verywell

Allergy shots and allergy drops are not your only options for treatment. There are also four sublingual allergy tablets approved by the FDA for the treatment of allergic rhinitis and allergic conjunctivitis. These tablets, called Oralair, Grastek, Ragwitek, and Odactra are only indicated for allergies caused by grass pollen, ragweed pollen, or dust mites.

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Article Sources
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  1. Slit Treatment (Allergy Tablets) for Allergic Rhinitis Nothing to Sneeze About. American Academy of Allergy, Asthma, and Immunology.

  2. American Academy of Allergy, Asthma and Immunology. Allergen Immunotherapy A Practice Parameter Third Update. Ann Allergy Asthma Immunol. 2011 doi:10.1016/j.jaci.2010.09.034

  3. Saporta D. Sublingual Immunotherapy: A Useful Tool for the Allergist in Private Practice. Biomed Res Int. 2016;2016:9323804. doi:10.1155/2016/9323804

  4. Saporta D. Efficacy of sublingual immunotherapy versus subcutaneous injection immunotherapy in allergic patients. J Environ Public Health. 2012;2012:492405. doi:10.1155/2012/492405

  5. Saporta D. Efficacy of sublingual immunotherapy versus subcutaneous injection immunotherapy in allergic patients. Journal of environmental and public health. 2012 Feb 20;2012.

Additional Reading
  • Cox LS, Linnemann DL, Nolte H, Weldon D, Finegold I, Nelson HS. Sublingual Immunotherapy: A Comprehensive Review. J Allergy Clin Immunol. 2006;117:1021-35.

  • Potter PC. Update on Sublingual Immunotherapy. Ann Allergy Asthma Immunol. 2006;96:S22-5.