0

Home > Drug Category > Allergy Medication > Oralair and Equivalent

Oralair Information

Oralair (a standardized sublingual allergen extract from five types of grass pollens) is a form of allergen immunotherapy designed to treat the underlying cause of grass pollen allergies. Unlike antihistamines or corticosteroids that only manage symptoms, Oralair works by desensitizing the immune system to grass allergens. It is a sublingual tablet that dissolves under the tongue, delivering a controlled dose of allergens to the body. This process gradually trains the immune system to tolerate grass pollens, reducing the body's allergic response over time. It is indicated for the treatment of moderate to severe seasonal grass pollen allergic rhinitis with or without conjunctivitis in patients whose allergy has been confirmed by a positive skin test or an in vitro test for pollen-specific IgE antibodies.

The mechanism of action for Oralair is a form of immunotherapy. By exposing the body to small, increasing amounts of the allergen, it induces a state of tolerance. While the precise immunological changes are still being studied, it is believed to induce immunological tolerance by modifying the immune system's response. This includes stimulating the production of allergen-specific blocking antibodies (e.g., IgG4) and changing the activity of T-cells and other inflammatory cells. This process effectively reduces the allergic response, leading to a long-lasting decrease in allergy symptoms.

Oralair is a prescription medication approved for use in adults and children 5 years of age and older. The treatment is a long-term therapy, typically initiated about four months before the expected onset of each grass pollen season and continued throughout the season. The first dose of Oralair must be taken in a healthcare setting under the supervision of a physician with experience in treating severe allergic reactions. Patients are typically observed for at least 30 minutes after the first dose to monitor for any signs of a severe allergic reaction. Subsequent doses are taken daily at home. The tablet is placed under the tongue, allowed to dissolve for at least one minute, and then swallowed. It is crucial not to eat or drink for five minutes after the tablet has dissolved to ensure proper absorption.

Oralair Side Effects

While Oralair can be highly effective, it also carries the risk of side effects, as it is an allergen extract. The most common side effects are often mild and localized to the oral cavity and throat due to the sublingual route of administration. These include oral itching, throat irritation, swelling of the mouth or tongue, and tingling or numbness in the mouth. Other common side effects may include itching of the ears, cough, or stomach pain. These effects are usually temporary and tend to decrease over time as the body adjusts to the treatment.

However, more serious side effects, including severe, potentially life-threatening allergic reactions, can occur. If you experience any of the following, you should stop taking the medication and seek immediate medical attention:

• Severe Allergic Reactions (Anaphylaxis): Oralair can cause systemic allergic reactions, including anaphylaxis. Symptoms may include a feeling of throat tightness or swelling, difficulty breathing or wheezing, dizziness or fainting, rapid or weak heartbeat, severe stomach cramps or pain, vomiting, diarrhea, or severe flushing or itching of the skin.

• Eosinophilic Esophagitis: This is a serious condition involving inflammation of the esophagus, which has been reported in association with sublingual immunotherapy. Symptoms may include heartburn, pain or difficulty swallowing, or persistent or worsening chest pain.

• Worsening of Asthma: For patients with pre-existing asthma, there is a risk that Oralair could worsen asthma symptoms. Any sudden or significant deterioration of asthma should be considered a profound side effect.

Oralair Precautions

Before starting Oralair, it is essential to have a thorough discussion with your healthcare provider about your medical history and any other medications you are taking. Oralair is contraindicated in patients with severe, unstable, or uncontrolled asthma, a history of a severe allergic reaction to any sublingual immunotherapy, or a history of eosinophilic esophagitis. The first dose must be taken under medical supervision, and you should be prepared to use an auto-injectable epinephrine device, which your doctor should prescribe and train you on. You should inform your doctor if you have had any recent oral surgery, dental extractions, or if you have any open sores, cuts, or infections in your mouth. Treatment should be stopped until the oral cavity has completely healed. It is also essential to use this product with caution if you have a history of cardiovascular disease, as a systemic allergic reaction could be more dangerous.

Patients taking beta-adrenergic blockers should be particularly cautious, as these medications can make epinephrine less effective in treating a severe allergic reaction. Additionally, drugs such as tricyclic antidepressants, MAOIs (monoamine oxidase inhibitors), and COMT inhibitors could potentiate the effect of epinephrine. The safety and effectiveness of Oralair have not been established in children younger than 5 years of age. For pregnant or breastfeeding individuals, it is recommended to consult a healthcare professional for guidance. It is not recommended to initiate immunotherapy during pregnancy, but if pregnancy occurs while on treatment, it may be continued under close medical supervision. Finally, this medication should be used consistently as directed and not just as needed. If you miss a dose for more than seven consecutive days, you should consult your doctor before resuming treatment.

Do I need a prescription to order Oralair?

Yes, a prescription is required from your physician to order Oralair.