Oralair
Oralair (mixed pollens extract) is an allergen immunotherapy. It's approved to treat specific mixed grass pollen allergies in people ages 5 to 65 years old. You'll need to get a skin test or lab test to make sure that your allergy will respond to this medication before your provider can prescribe it. Oralair (mixed pollens extract) is dissolved under the tongue (sublingual) once a day, starting typically a few months before and during allergy season. This medication can sometimes cause itchy mouth or throat irritation as side effects.
What is Oralair (mixed pollens extract)?
What is Oralair (mixed pollens extract) used for?
- Allergic rhinitis (seasonal allergy) caused by sweet vernal, orchard, perennial rye, Kentucky bluegrass, or Timothy grass pollens
How Oralair (mixed pollens extract) works
Oralair (mixed pollens extract) is an allergen immunotherapy. It's an allergen extract that's made from five different grass pollens, including sweet vernal, orchard, perennial rye, timothy, and Kentucky bluegrass. The way it works isn't fully known, but it's thought to treat allergy symptoms to grass pollens by changing the way your immune system reacts to grass pollens.
Drug facts
Side effects of Oralair (mixed pollens extract)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults:
- Itchy mouth (25%)
- Throat irritation (22%)
- Itchy ears (8%)
- Swelling in the mouth (8%)
- Itchy tongue (8%)
- Cough (7%)
- Mouth and throat pain (5%)
Less Common Side Effects
- Swelling of the throat, lips, or tongue
- Prickly or burning sensation in the mouth
- Itchy lips
- Stomach upset and pain
- Numb mouth
- Sore mouth
- Difficulty speaking
- Rash
Oralair (mixed pollens extract) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: trouble breathing, throat swelling or tightness, chest tightness, swelling of lips or tongue, dizziness, fainting, fast heartbeat, rash, flushing or itching of the skin, stomach pain or cramps, vomiting, diarrhea
The following Oralair (mixed pollens extract) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heartburn, pain or trouble swallowing, chest pain that does not go away or gets worse
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Burning or tingling of the tongue, mouth, throat, or face
- Irritation inside the mouth or throat
- Itching of the mouth, lips, tongue, or ears
- Mild swelling of the mouth, lips, tongue, or throat
Pros and cons of Oralair (mixed pollens extract)
Pros
- Conveniently dissolves under the tongue for people who have trouble swallowing pills
- Improves eye and nose symptoms during grass pollen allergy season
- Only needs to be taken once daily
- Can be used in children as young as 5 years of age
Cons
- Need to take it daily for 4 months before and during grass pollen season
- Can cause severe life-threatening allergic reactions
- Not approved for use in adults 66 years and older
- Not recommended if you or your child isn't able or willing to use auto-injectable epinephrine (Epipen) in case of a severe allergic reaction
Pharmacist tips for Oralair (mixed pollens extract)
- After your first dose of Oralair (mixed pollens extract), you'll need to be monitored by a healthcare provider for at least 30 minutes for signs of an allergic reaction, which include trouble breathing, swelling of the throat, rash, and fast heartbeat. If you tolerate the first dose, you can continue taking this medication at home.
- If your child is continuing Oralair (mixed pollens extract) treatment at home, you'll need to supervise them when they take each dose. If your child gets an allergic reaction, be prepared to give them epinephrine (Epipen) to treat the reaction and get medical help, if needed.
- Make sure you have auto-injectable epinephrine and your provider has trained you on how to use it in case of an allergic reaction to Oralair (mixed pollens extract).
- Always remove the tablets from the foil packaging with dry hands. If your hands are wet, the tablet can start to dissolve in your hands and you might not get the full dose of medication. Wash your hands after each dose because there might be powder or residue from the tablet on your hands.
- Place one Oralair (mixed pollens extract) tablet under your or your child's tongue and keep it there for at least 1 minute, or until it's completely dissolved, before swallowing. This allows the medication to be absorbed under your tongue. This medication isn't meant to be swallowed whole.
- Avoid eating and drinking for 5 minutes after taking the tablet to make sure all of the medication is absorbed under your tongue.
- Let your provider know right away if you missed any doses of Oralair (mixed pollens extract) so they can instruct you on what to do next.
- Keep Oralair (mixed pollens extract) tablets sealed in the original packaging and only open it right before taking your dose to protect the tablets from moisture in the air, which can damage them.
- Let your provider know you're taking Oralair (mixed pollens extract) before starting any new medications or other allergen extract treatments for allergy. There are some medications that can prevent auto-injectable epinephrine (Epipen) or rescue inhalers from working well (e.g., beta blockers). Using other allergen extract treatments at the same time might raise your risk for severe allergic reactions.
Common questions about Oralair (mixed pollens extract)
Since each person responds differently to medications, it's hard to know how well Oralair (mixed pollens extract) might work for you. In clinical studies, adults who took Oralair (mixed pollens extract) during the first pollen season saw almost a 30% improvement in their allergy symptoms and need for rescue allergy medications (e.g., antihistamines) compared to those who didn't. Keep in mind that Oralair (mixed pollens extract) won't give you immediate relief for your allergy symptoms. Oralair (mixed pollens extract) a long-term treatment to prevent your allergic reaction to grass pollen. It doesn't work fast to help your symptoms go away like some other allergy medications (e.g., loratadine (Claritin)).
Your provider will likely recommend that you start taking Oralair (mixed pollens extract) daily 4 months before each grass pollen season, and to continue taking it daily throughout the entire grass pollen season. After grass pollen season is over, you can stop taking Oralair (mixed pollens extract). You'll have to take it for each grass pollen season to treat your allergy symptoms, since symptom relief won't last once you stop taking it.
Place the Oralair (mixed pollens extract) tablet under your tongue and allow it to dissolve. Don't swallow Oralair (mixed pollens extract) for at least one minute to allow the medication to get absorbed into your body through the area under your tongue. If you swallow too early, your body might not absorb the full dose of the medication. Avoid eating or drinking for 5 minutes after taking Oralair (mixed pollens extract)
Oralair (mixed pollens extract) can cause serious, life-threatening allergic reactions. You'll need an auto-injectable epinephrine (Epipen) because it can open up your airways and save your life during an allergic reaction while you wait for medical help to come. If you don't already have one, ask your provider for a prescription and pick it up at your local pharmacy. Your provider or pharmacist will teach you when and how to use your auto-injectable epinephrine syringe. Make sure you can recognize symptoms of a severe allergic reaction, which include trouble breathing, swelling of the throat, rash, and fast heartbeat. Call 911 if you ever experience these symptoms.
There isn't enough information available to know if Oralair (mixed pollens extract) is safe to take during pregnancy because it hasn't been studied in people who are pregnant. In animal studies, high doses of Oralair (mixed pollens extract) didn't cause harm to pregnant mothers and their unborn babies. If you're currently pregnant or planning to become pregnant, talk with your provider about the risks and benefits to you and your unborn baby.
Both Oralair (mixed pollens extract) and Grastek are allergen extracts that are dissolved under the tongue once daily for seasonal allergies. The main difference is that Grastek contains allergen extracts from Timothy grass (common in pastures and on the roadside), while Oralair (mixed pollens extract) contains pollen from five different grasses, including Timothy grass.
You can get Oralair (mixed pollens extract) from a participating pharmacy, or you can have it delivered to your home. Ask your provider about your options.
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Risks and warnings for Oralair (mixed pollens extract)
Oralair (mixed pollens extract) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reactions
- Risk factors: History of severe allergic reaction
Oralair (mixed pollens extract) can cause severe, life-threatening allergic reactions, such as anaphylaxis. That's why you'll take your first dose of this medication at your provider's office and be monitored for at least 30 minutes afterwards. Oralair (mixed pollens extract) might not be recommended for you if you have certain medical conditions that makes it less likely for you to survive an allergic reaction (e.g., lung problems, recent heart attack, or uncontrolled asthma) or if you're taking medications that might prevent epinephrine or rescue inhalers from working well (e.g., beta blockers). If you experience symptoms such as having trouble breathing, chest tightness, swelling of your lips or tongue, or rash, inject your epinephrine syringe into your thigh muscle and call 911 right away.
Before starting Oralair (mixed pollens extract), it's recommended that you get an auto-injectable epinephrine (Epipen) and be trained on how to use it.
Difficulty breathing
Oralair (mixed pollens extract) can cause some side effects, like swelling of the tongue or throat, that can make it harder to breathe. You should stop taking Oralair (mixed pollens extract) and let your provider know if you're experiencing any side effects that cause you to have trouble breathing.
Trouble swallowing (eosinophilic esophagitis)
In some rare cases, a condition called eosinophilic esophagitis has been reported in people taking medications similar to Oralair (mixed pollens extract). This is when your body's immune system attacks the tube connecting your mouth to your stomach, causing problems like chest pain and trouble eating or drinking. Stop taking Oralair (mixed pollens extract) and contact your provider if you experience any of these problems.
Mouth inflammation and irritation
If you have thrush (a yeast infection in your mouth), wounds in your mouth, or any recent oral surgery, contact your provider right away. You'll need to stop taking Oralair (mixed pollens extract) until your mouth completely heals. Oralair (mixed pollens extract) can cause mouth irritation as a side effect, which can make it take longer for your mouth to heal.
Oralair (mixed pollens extract) dosage
Typical dosage for Oralair (mixed pollens extract)
The first dose needs to be supervised by a healthcare provider.
Start taking Oralair (mixed pollens extract) 4 months before and throughout the grass pollen season.
Adults 18 to 65 years of age: The typical dose is 300 index of reactivity (IR) dissolved under the tongue once daily.
Children 5 to 17 years of age: The typical starting dose is 100 IR dissolved under your child's tongue on day 1. Your child's provider will raise their dose every day for 3 days until your child reaches a maintenance dose of 300 IR once daily.
- Day 1: 100 IR once daily
- Day 2: 200 IR once daily
- Day 3 and thereafter: 300 IR once daily
Oralair (mixed pollens extract) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Oralair (mixed pollens extract) will not be safe for you to take.
- Severe, unstable, or uncontrolled asthma
- History of severe allergic reaction
- History of eosinophilic esophagitis (a condition where your body's immune system attacks the tube connecting your mouth to your stomach)
What are alternatives to Oralair (mixed pollens extract)?
