Food Sublingual Immunotherapy
(Food SLIT)
Physician reviewed by Jacqueline A. Ross, MD, board certified in Allergy and Clinical Immunology. Jan 2026.
A Gentle, Needle-Free Approach
to Food Allergy Treatment at Home
If food allergies limit your diet choices, or cause anxiety about the risks associated with accidental exposure to food allergens, you can now rest easier. There is a new and effective treatment option called Food Sublingual Immunotherapy or Food SLIT.
Food SLIT is a low dose form of oral immunotherapy (OIT) which involves the placement of a small amount of a food allergen, in liquid drop form, under the tongue. The drops work gradually, as allergen levels are increased over time, to help your immune system build tolerance.
Food SLIT is a safe, effective, and proven treatment designed to help the immune system become less sensitive to foods like peanuts, tree nuts, milk, eggs, sesame, wheat, and others.
Food SLIT treatment involves an initial visit to your allergy doctor’s office to receive the first dose, followed by a 30-minute observation period. After your initial dose in-office, the drops are then taken at home, once a day. The dose is gradually increased, about every two weeks, following your doctor’s instructions. You return to the Allergy Partners office every two months during this build-up phase to receive a higher concentration of the food allergen for the next cycle.
Just like brushing your teeth, Food SLIT will become part of your daily routine.
Why Families and Patients Choose Food SLIT
Needle-Free
No injections. Just drops under the tongue.
Customized for You
Food SLIT is tailored to your food allergies with the ability to desensitize up to three allergens at one time.
Safe and Well-Tolerated
Patients generally experience minimal side effects and much lower reaction rates with Food SLIT, when compared to Food OIT. About 1 in 10,000 patients experience a severe allergic reaction.
Convenient
Taken at home, after your first in-office dose under the supervision of your allergy doctor. Then you take the drops at home, once a day for about two months when you return to the Allergy Partners office to receive a higher concentration for your next cycle. In general, the average course of Food SLIT is two years, though in some cases, it may take as long as three to four years.
Long-Term Relief
Food SLIT decreases the risk associated with accidental exposures, and in some cases, helps your body outgrow your food allergy altogether. It works with your body, naturally.
How Food SLIT Works with Your Immune System
Food SLIT drops are custom-prepared for you, using precisely measured medical grade extracts which have been developed from actual food proteins. Most Food SLIT patients can be desensitized to two or three allergens at the same time.
The drops, when placed under the tongue, interact with immune cells that allow your body to build tolerance and become less sensitive. The gradual exposure to food allergens increases the likelihood that you could tolerate accidental exposure and perhaps even outgrow your food allergy altogether.
Think of Food SLIT as building new habits for your immune system — like brushing your teeth or daily exercise. These small steps every day lead to long-term results.
What to Expect During Food SLIT Treatment
Getting started with Food SLIT is simple and your Allergy Partners team will guide you every step of the way:
Consultation & Allergy Testing
Your journey begins with a visit to your Allergy Partners doctor. We will review your medical history, your symptoms, and perform allergy testing (often a skin test or blood test) to identify the specific food allergens causing your reactions.
Personalized Treatment Formula
Based on your results, we create a custom-prepared Food SLIT formula tailored to your unique allergies. Your personalized Food SLIT vial includes precisely measured medical extracts which have been developed from actual food proteins. This ensures that your treatment is focused on the allergens that matter most to you.
First Dose of Each Vial Safely Monitored in Office
Your Food SLIT treatment begins at your initial visit to your Allergy Partner’s office. Our team will demonstrate how to use the dropper bottle, review your dosing schedule, discuss precautions, and administer and monitor your first dose for safety.
Daily Routine at Home
Each day, you will place the prescribed drops under your tongue and hold them there for about a minute before swallowing. The dose is gradually increased, about every two weeks, following your doctor’s instructions. It is quick, painless, and becomes a simple part of your daily allergy treatment routine.
Regular Follow-Ups
You return to your doctor’s office every two months during this build-up phase to receive a higher concentration of the food allergen for your next cycle. Our team will track your progress, refill your prescription vials as needed, and answer any questions you may have.
Your allergy doctor will determine when you have reached the maintenance level as this gradual exposure to food allergens allows your body to become more tolerant, and less sensitive, over time. In general, the average course of Food SLIT is two years, though in some cases it may take as long as three to four years.
You will also carry an epinephrine injector as a precaution, just like with any allergy immunotherapy.
Safety and Effectiveness
Food SLIT has been shown in research and clinical practice to be:
- Safe
Lower rate of systemic reactions when compared to OIT, with about 1 in 10,000 experiencing a severe reaction. - Tolerable
Most individuals experience little or no discomfort, though mild symptoms such as itching or tingling in the mouth may occur. - Effective
Food SLIT builds tolerance over time and may reduce the risk of severe reaction in the event of accidental exposure. In some cases Food SLIT can help the body outgrow a food allergy altogether.
Your first dose of Food SLIT is always supervised by your provider in the Allergy Partners office. You will also carry an epinephrine injector as a precaution, for you or your child, just like with any allergy immunotherapy.
Comparison of Food SLIT, Oral
Immunotherapy, and Allergen Avoidance
Feature |
Food SLIT Allergy Drops |
Oral Immunotherapy (OIT) |
Avoidance |
Needle Needed? |
Needle-Free |
Needle-Free |
Needle-Free |
How It’s Taken |
Daily drops are taken at home with periodic supervised doses in your allergy doctor’s office. |
The patient follows a prescribed process to mix the food allergen with safe foods in the doctor’s office.
The amount of the food allergen is increased over time until the immune system can tolerate larger doses. |
The patient makes a point of avoiding the food causing the allergic reaction. |
Setting |
The first Food SLIT dose is given in the doctor’s office to monitor any possible reaction. You then take the drops at home, once a day. The dose is gradually increased, about every two weeks, following your doctor’s instructions. You return to your doctor’s office every two months during this build-up phase to receive a higher concentration of the food allergen for your next cycle. |
In office and at home, with frequent visits to the doctor’s office, generally once every two weeks.
A clinical based escalation process, which today, is not commonly offered by most allergists. |
Avoiding food allergens must be considered all the time and everywhere.
If accidental exposure occurs, then a possible visit to the Emergency Department may be required.
|
Risk of Reaction to Treatment |
Extremely low. Most individuals experience little or no discomfort, though mild symptoms such as itching or tingling in the mouth may occur. Unlike OIT, severe reactions requiring epinephrine are extremely rare at a rate of about 1 in 10,000. |
Moderate with a risk of reaction during build up phase about 60 to 90% chance. |
Moderate. |
Treatment Goal |
To build gradual tolerance to the food allergen. |
To build faster tolerance to the food allergen. |
To prevent exposure to the food allergen. |
Commonly Treated Food Allergies
Food SLIT can be formulated for many single or combined allergens, including these listed below.
Peanuts
Tree Nuts
Milk
Eggs
Sesame
Wheat
Soy
Your allergy doctor will tailor your Food SLIT treatment plan based on your test results and clinical history.
Important Considerations
Food SLIT is not yet approved by the US Food and Drug Administration (FDA), and as a result, it is not currently covered by insurance providers. Many patients are still interested in Food SLIT treatment and often utilize their FSA (Flexible Spending Account) or HSA (Health Savings Account) funds to cover the cost.
FSAs are typically sponsored by an employer. These accounts allow employees to set aside pre-tax dollars earned to pay for certain healthcare costs. HSA’s also use pre-tax money for medical expenses, but they are designed for those enrolled in a high-deductible health plan.
Your Allergy Partners team will review all costs with you in our office before starting treatment. Despite the absence of insurance coverage, individuals with food allergies often consider Food SLIT to be a worthwhile investment because it provides:
- A needle-free, at home food allergy treatment option.
- Greater peace-of-mind and less worry while avoiding accidental ingestion of an allergic food.
- Fewer dietary and social restrictions.
Food SLIT is a relatively new approach to managing food allergies and it not widely available across all Allergy Partners medical practices. We are pleased to be among the first to offer this innovative treatment.
Is Food SLIT Right for You or Your Child?
Food SLIT may be right for you if:
- You, or your child, have food allergies that cause daily anxiety or require you to live life with a limited diet.
- You prefer a needle-free and a gentle desensitization option that can be done in your home.
- You are committed to daily treatment for yourself, or your child, for long-term protection.
- You understand treatment costs are not covered by insurance.
- You are ready for a comprehensive treatment plan, supervised by a board-certified allergist, that can offer gradual increased confidence around certain food(s).
Frequently Asked Questions
Yes. Food SLIT is safe and well-tolerated for both adults and children when prescribed and monitored by an allergy doctor. Most individuals experience little or no discomfort, though mild symptoms such as itching or tingling in the mouth may occur..
Many foods, including peanuts, tree nuts, milk, eggs, sesame, and others, can be treated, depending on your allergy profile.
Gradual exposure to food allergens via Food SLIT treatment allows your body to become more tolerant and less sensitive over time. In general, the average course of Food SLIT is two years, though in some cases it may take as long as three to four years.
Yes, you can combine both Food and Environmental SLIT. In many cases your allergist can combine food and environmental drops into one coordinated treatment plan. More information on Environmental SLIT can be viewed on this web page.
Food SLIT is not yet approved by the US Food and Drug Administration, and as a result, it is not currently covered by insurance providers. Many families are still interested in Food SLIT treatment and often utilize FSA or HSA funds to cover the cost. We review all costs with you up front before starting treatment.
Despite the absence of insurance coverage, individuals with food allergies often consider Food SLIT to be a worthwhile investment.
Caring Support Every Step of the Way
At Allergy Partners, we understand that choosing an allergy treatment is a big decision. Our physicians and staff provide compassionate, expert care – from testing and diagnosis through treatment and follow-up. Our goal is to provide a safe and convenient treatment plan that works.
Food SLIT is a relatively new approach to managing food allergies and we are pleased to be among the first to offer this innovative treatment. You will have the support of a trusted medical team that provides personalized care, close follow-up, and on-going education to help you reach greater freedom from food allergy anxiety.
Before beginning Food SLIT, or any other immunotherapy, it is important to understand the benefits, risks, and costs. Your Allergy Partners physician can provide more information regarding treatment results, duration, risks of anaphylaxis, and the importance of adhering to your daily therapy schedule.
If you are interested in learning more about Food SLIT, our Allergy Partners board-certified allergists and team members would be glad to discuss details with you, including what to expect and how soon you might see relief.
Special Note
Not all Allergy Partners locations currently offer Food SLIT. Before making an appointment, check which offices near you provide this allergy treatment option.
