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Allergen immunotherapy

Grass pollen extracts

Brand names: Grazax (sublingual), Pollinex (SC)

Adult dose

Dose: Sublingual (Grazax): 1 tab daily, start 4 months before pollen season, continue for 3 years. SC: per up-titration schedule
Route: SL/SC
Frequency: OD or per regimen

Clinical pearls

  • First sublingual dose under medical supervision; anaphylaxis kit on hand for SC therapy
  • BSACI specialist referral

Contraindications

  • Severe/uncontrolled asthma
  • Active malignancy
  • Severe immune deficiency
  • Recent oral inflammation/dental procedure (sublingual)

Side effects

  • Local oral itch/oedema
  • Anaphylaxis (rare; SC route higher risk)

Interactions

  • β-blockers (worsen anaphylaxis)

Reference: BNF; BSACI immunotherapy guidelines; https://bnf.nice.org.uk/drugs/grass-pollen-extracts/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.