Environmental Medicine

Environmental Medicine -
Inhalant Allergy: Subcutaneous Immunotherapy

Subcutaneous Immunotherapy (SCIT) is the traditional “allergy shot” management of allergic rhinitis. It is usually a covered benefit by health insurance and requires weekly or biweekly injections of the antigens that have been identified by skin or serologic testing.

SCIT requires the patient come into the office for the buildup of the immunotherapy. The injection(s) consists of the same antigens which the patient has been determined to be allergic. The dose is started at a level that does not cause obvious reactions and is built up to the maintenance level that relieves the allergic symptoms. This causes the body to reduce the amount of the active biochemical causing the allergic response.

SCIT has a small but significant risk of anaphylaxis. Anaphylaxis is a systemic allergic reaction that can be life threatening. In addition, the escalation phase can be delayed by local reactions. If the patient is very allergic to certain pollens, it may be necessary to keep the same dosing level until the pollen season has passed prior to resumption of the escalation phase. Once the patient has reached the maintenance dose, the maintenance dose is continued for three years prior to stopping the immunotherapy. At this time, the patient may or may not have complete resolution of the allergic symptoms. There are some patients who require lifelong immunotherapy.

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