Allergen immunotherapy (sublingual)
Tree pollen extracts
Brand names: Itulazax
Adult dose
Dose: 1 tablet sublingually OD; first dose under medical supervision
Route: Sublingual
Frequency: OD
Clinical pearls
- Birch pollen-induced allergic rhinitis/conjunctivitis
- Specialist allergy initiation; first dose monitoring 30 min
Contraindications
- Severe / uncontrolled asthma
- Active oral lesions
- Recent dental extraction
- Malignancy
- Hypersensitivity
Side effects
- Oral itching
- Throat irritation
- Anaphylaxis (rare)
- Eosinophilic oesophagitis
Interactions
- β-blockers (limit anaphylaxis treatment)
Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/tree-pollen-extracts/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023