Tree pollen extracts

How it works

Repeated controlled exposure to the relevant tree pollen allergens modifies the immune response, promoting tolerance and reducing allergic reactivity over time.

Prescribing in practice

• There is a risk of systemic allergic reactions including anaphylaxis, so treatment must be supervised by appropriately trained staff with resuscitation facilities available, particularly for the first dose.
• It is generally contraindicated in poorly controlled or severe asthma, which increases the risk of serious reactions.
• Beta-blockers may worsen and complicate the management of any anaphylactic reaction and should be reviewed before treatment.

Monitoring

Observe the patient for a period after administration for systemic and local allergic reactions, especially during initiation.

Counselling the patient

• You may be asked to wait under observation after each dose in case of a reaction.
• Tell your team if your asthma is unstable or your symptoms worsen.
• Carry any prescribed emergency treatment and know how to recognise a serious reaction.

Evidence & guidelines

Allergen immunotherapy is recommended for selected patients with troublesome allergic rhinitis inadequately controlled by standard pharmacotherapy, as reflected in UK and specialist allergy guidance.