The recommended dose is 1 tablet placed under the tongue once daily.  The first dose must be taken at the doctor’s office. The doctor will keep you at the office for 30 minutes to check for possible serious side effects. After that, the medication may be taken at home.

The immune system is the target of immunotherapy. The aim is to prevent or suppress allergic symptoms, such as allergic rhinitis, through repeated administration of the allergen. The effect of sublingual immunotherapy is thought to be mediated through local and systemic immunomodulatory mechanisms (immune deviation) including changes in allergen specific antibodies and regulatory T- cells leading to long-term tolerance development.

The most common side effects include:

• throat irritation
• itching of the ears and/or mouth
• tingling and/or burning of the mouth
• swelling of the mouth including lips and/or tongue

Stop treatment and get emergency medical treatment right away if you have any of the following side effects:

• dizziness, fainting, fast or weak heartbeat, feeling nervous or feeling of “impending doom”
• throat tightness or swelling of the tongue or throat that causes trouble speaking, breathing or swallowing
• wheezing, shortness of breath, cough, chest tightness or trouble breathing
• stomach cramps, vomiting or diarrhea
• skin rash, itching, flushing or hives

Do not use this medication if:

• you are under 12 years of age (safety has not been determined)
• you have had a previous serious allergic reaction to house dust mite allergy shots, tablets or drops;
• you have severe or unstable asthma.
• you have any swelling or sores in your mouth or have recently had any mouth injury or mouth surgery (such as a tooth removal). 
• you have eosinophilic esophagitis.

Discuss use of this medication with your physician or pharmacist if you have:

• ever had a serious allergic reaction to allergy shots, tablets or drops
• worsening asthma symptoms or breathing problems
• a respiratory infection, such as common cold, sore throat or pneumonia
• a condition affecting the immune system e.g. autoimmune diseases such as rheumatoid arthritis, multiple sclerosis
• cancer

Use in pregnancy: Therapy with this medication should not be started during pregnancy because possibility of a severe allergic reaction may be dangerous to the mother or fetus. Otherwise, no untoward effects are expected since the medication is not absorbed into the blood streatm.
Use in breastfeeding: No human studies have been performed.  It is not known whether this medication is passed on to the infant in human milk.