Allergy Drops versus Sublingual Tablets

A comparison of tablets versus customized drops via the La Crosse Method Protocol as you consider your treatment options.

Tablets or drops

Which is the right choice for me?

With the FDA’s recent approval sublingual immunotherapy tablets for seasonal grass, short ragweed and dust mite allergy (Oralair, Grastek, Ragwitek, Odactra), many allergy sufferers ask what that means for them. The good news is that this approval confirms what we’ve experienced for decades: that the sublingual (under the tongue) route is a safe, effective route of administration to treat allergic rhinitis and asthma. And from our experience, the benefits don’t end there.

The concept of treating through the sublingual route isn’t new — we’ve used this method for more than 50 years through customized multi-antigen liquid drops taken under the tongue. Recently approved single-antigen tablets with “standard” doses address a narrower range of patients and allergens that are not typical of the U.S. patients who typically have multiple allergies.

A boy, a young girl and an older woman each taking allergy drops under the tongue.
Customized multi-antigen liquid drops taken under the tongue — the Protocol addresses all ages.

Why one standard dose falls short

Most U.S. allergy patients are treated for multiple allergies.

Many have related conditions (moderate/severe uncontrolled asthma, need for beta blockers) or are not at an age where tablets are approved.

Through our refined approach, we have found it to be more optimal to consider the patient’s total allergic load and level of sensitivity through thorough diagnostics, followed by patient-specific sublingual immunotherapy treatment that addresses their unique allergies and sensitivity levels. That’s the concept behind the La Crosse Method Protocol.

The Protocol offers treatment options not only for seasonal sufferers as well as the broad range of patients who could benefit from tailored treatment that’s designed to maximize therapeutic benefit, minimize risk of reactions and unnecessary symptoms, and do it cost-effectively.

Side by side

Sublingual allergy tablets offer another option for patients, which is good.

But it might also be helpful to see a comparison of tablets versus customized drops via the La Crosse Method Protocol as you consider your treatment options.

  • Delivery Method

    La Crosse Method Protocol Sublingual Immunotherapy
    FDA-approved liquid antigen under the tongue. Currently considered “off label” use of FDA-approved antigens.
    Sublingual Immunotherapy Tablets
    FDA-approved antigens in tablet form delivered under the tongue. Approved for grass, ragweed and dust mite only.
  • Customized to Patient Sensitivity

    La Crosse Method Protocol Sublingual Immunotherapy
    Yes. Dose is based on individual patient sensitivity, dosed to provide therapeutic benefit and minimize risk of reactions.
    Sublingual Immunotherapy Tablets
    No. Standardized dosing for all patients.
  • Treats Multiple Sensitivities Simultaneously

    La Crosse Method Protocol Sublingual Immunotherapy
    Yes, multi-antigen treatment available to address sensitivities based on patient test results, most flexible protocol available.
    Sublingual Immunotherapy Tablets
    No, focused on individual pollens (grass, ragweed, dust mite).
  • Patient Ages Treated

    La Crosse Method Protocol Sublingual Immunotherapy
    Protocol addresses all ages.
    Sublingual Immunotherapy Tablets
    Indicated for ages starting at 5, 10 or 18, up to 65.
  • Addresses food allergy

    La Crosse Method Protocol Sublingual Immunotherapy
    Yes
    Sublingual Immunotherapy Tablets
    No, treats only specific pollens indicated.
  • Patients Treated Clinically in the U.S.

    La Crosse Method Protocol Sublingual Immunotherapy
    250,000+
    Sublingual Immunotherapy Tablets
    Patients treated since recent approval
  • Estimated Cost

    La Crosse Method Protocol Sublingual Immunotherapy
    Roughly $1.50 day for custom multi-antigen inhalant threshold treatment.
    Sublingual Immunotherapy Tablets
    Roughly $4-10/day for single antigen prescriptions.
  • Insurance Coverage

    La Crosse Method Protocol Sublingual Immunotherapy
    Not currently in most cases; check with carriers, employer coverage is growing.
    Sublingual Immunotherapy Tablets
    Subject to Tier 3 or 4 co-pays (co-pay est. $50-100 month, varies by carrier).
  • Contraindications/
    Safety

    La Crosse Method Protocol Sublingual Immunotherapy
    Extremely safe and adjustable for virtually any condition or level of severity, dose escalated based on patient tolerance. Estimated over 1 billion doses taken by patients with no life-threatening reactions reported.
    Sublingual Immunotherapy Tablets
    Variety of contraindications including uncontrolled asthma, history of severe systemic allergy reaction, eosinophilic esophagitis, those currently on beta blockers, immunotherapy, and pregnancy. Adverse event profile is high with rapid escalation.
  • Considerations

    La Crosse Method Protocol Sublingual Immunotherapy
    Developed based on clinical experience with multi-sensitized U.S. patients treated concurrently with a variety of related conditions including asthma, atopic dermatitis, food & mold allergies.
    Sublingual Immunotherapy Tablets
    Developed by European manufacturers based on European patient profiles, not treated concurrently for asthma, AD, and related conditions.
  • Require Emergency Epinephrine Device

    La Crosse Method Protocol Sublingual Immunotherapy
    Not required for general use. Required for those whose underlying allergic conditions require it (anaphylaxis history).
    Sublingual Immunotherapy Tablets
    Required with all prescriptions.
  • Long-term Efficacy

    La Crosse Method Protocol Sublingual Immunotherapy
    Majority of patients see sustained improvement after treatment conclusion.
    Sublingual Immunotherapy Tablets
    Inconclusive evidence of ongoing sustained efficacy after two seasons of treatment.

Next step

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