Allergy Drops vs. Shots: Which Would You Prefer?


There is exciting news for those of you who suffer from pollen allergies (specifically grass pollen allergies). You can now safely choose between three proven pollen allergy treatment options: sublingual grass pollen tablets, sublingual grass pollen drops or subcutaneous grass pollen injections.

The currentJournal of Allergy and Clinical Immunology: In Practice (March 2015) published a meta-analysis (which means they looked at and compared multiple published studies) and determined that each of these treatments were equally effective for treatment of pollen allergies.

Big News for Pollen Allergy Sufferers

This is big news because for years, some doctors in the allergy community said sublingual allergy treatment wasn’t effective at all, while others said even if it was effective it wasn’t as good as shots.

Now we know for sure – they all work! But what does this mean if you suffer from environmental allergies? You have to make a decision about which allergy treatment is best for you.

Which Allergy Treatment is Best?

The choice of which allergy treatment to choose seems to be obvious. Who wants to get shots on a weekly basis? But it is important to look closely at the advantages and disadvantages of each allergy treatment option.

Subcutaneous Allergy Injections (aka Allergy Shots)

Allergy injections have been around since the days of the horse and buggy. You probably think this is a joke but that is when Dr. Robert Cooke developed this treatment in the United States.

Dr. Cooke had a severe horse allergy, and in those days his ambulance was a horse and buggy. He came up with allergy shots as a way to desensitize himself to the horse, and he later developed shots for pollen and dust allergies as well.

Strangely, in the almost 100 years since this treatment was developed it has not changed at all! The process still involves going for weekly injections for the first year and trying to build up immunity.

The treatment has been proven to work, but the negative sides are clearly the inconvenience of going to your doctor’s office for the weekly shots. I also have concerns that the shots could cause a severe allergic reaction, a risk patients have to be willing to take.

The injection treatment typically lasts 3 to 5 years, and the good news for patients is that insurance companies cover this medical service.

Sublingual Allergy Tablets

Last April, the FDA approved two new products for treatment of grass pollen and one for ragweed pollen. These sublingual tablets are called Grastek, Orlair and Ragwitek.


These three products are the first allergy immunotherapy products to be approved in a century! The importance of this is that there is now proven scientific evidence that sublingual allergy immunotherapy is effective in treating pollen allergies.

One of the important points to note however, is that these products must be started at least 4 months prior to an allergy season. So it’s too late to start the Grastek or Orlair to treat grass pollen this season.

Grastek and Orlair are approved for children 5 years of age and older, while Ragwitek is approved only for those 18 years and older. I have two main concerns with these tablets:

  • Firstly, the tablets come in only one strength – the high maintenance dose. This means many patients will experience adverse reactions, such as itching in the mouth or an upset stomach.
  • It’s also likely that the cost will be expensive. They should be covered by many insurances but, like all new products, it may come with a high co-pay.

Sublingual Allergy Drops (aka Allergy Drops)

I wrote about this treatment in my book –Dr. Dean Mitchell’s Allergy andAsthmaSolution (De Capo 2006) – and I predicted that sublingual allergy treatment would become the new way to treat environmental allergies.

I had the good fortune of training with the early pioneers in this field and went on to develop custom-made treatments for my patients.

There are a number of advantages to taking allergy drops over tablets:

  • With allergy drops you can combine several different allergens in the liquid form. There are very few allergic patients who are only allergic to one allergen, so for example, we mix grass pollen with tree pollens to get full spring protection.
  • Drops can be custom made to start at low doses and gradually built up to higher doses. This is very important because many allergic patients are highly sensitive to the allergen and this technique avoids side-effects.
  • Drops are easy to take – all you have to do is place a few drops under your tongue.
  • These drops taste pretty good.
  • You can take them at home, so there’s no need to go to your doctor’s office on a regular basis.

I have treated patients with allergy drops for 16 years and have had wonderful results. These allergy drops are not currently covered by insurance companies (maybe this will change with these new findings), but we try to make them an affordable price. Currently, they cost slightly more than you would pay in copays for a weekly allergy shot.

When I first started in my allergy practice 22 years ago, my fellow doctors called me, ” The Shot Doctor.” Now I’m so thrilled that they refer to me as the “Drop Doctor.”

If you suffer from allergies contact your doctor to find out which treatment options are best for you.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Leave a Comment

Your email address will not be published. Required fields are marked *