Initially immunotherapy requires weekly injections for about 1 year. Much of this depends on how consistent you are with your treatments. Each week a stronger dose is given until you reach your maximum dose, also called your maintenance dose. If you miss a week, the dose can’t be increased the following week. Therefore, it is important that you try your best to stick to the schedule of one allergy injection every week.
After receiving 4 weekly maintenance dose treatments, you may start having your injections every two weeks. If symptoms do not reappear, you may stay at the biweekly injections for one year. On your third year, Dr. Rubinstein may decide you are ready to get your injections once every three weeks. Some patients are able to tolerate monthly injections beginning on the 4th year of treatment.
It must be noted that in some cases allergy shots administered every 3 to 4 weeks can results in the return of your symptoms. This most commonly can happen during your peak allergy season. If this happens report your symptoms to your allergy nurse. The nurse will report this to the doctor and he may determine to return you to biweekly injections until the 3 to 4 week interval can be resumed.
The unique advantage of immunotherapy over other forms of inhalant therapy treatment is that in at least 80% of patients, treatment may be discontinued after you have been symptom free for a few years. The exact duration of therapy before this happens varies among individual patients. There may be as many as 20% of patients for whom immunotherapy will be successful but who must continue on treatment indefinitely if they are to remain symptom free.
It has been estimated that about 3 to 5 years of treatment, most of which is at a maintenance dose administered every 2, or occasionally 3, or even 4 weeks, is adequate to establish long-term relief of symptoms.
You will be required to follow up with Dr. Rubinstein every 6 months to assess your progress as well as for any potential medication refills. Immunotherapy may be discontinued if the following criteria are met:
You should have received injections for a minimum of 3 years, most of the time at stable maintenance doses that deliver an adequate level of antigens to form blocking antibodies.
You should have experienced symptom relief manifested through all four of the major seasons. If you miss an injection it should not result in a symptom flare-up. At some point between the 3 and 5 years discontinuing therapy should be considered. Injections can always be restarted as necessary.
Immunotherapy will not cure food allergies. These are treated by avoiding those foods. Some foods such as wheat, soy, corn, and dairy may create allergic symptoms which are very similar to those you may experience from pollens, dust, mold or pet dander. Following your “rotation diet” will help alleviate these symptoms. Failure to follow this diet may lead you to believe your allergy shots are not working due to your persistent allergy symptoms.
Appointment 1: Patients receive an allergy skin test for indoor, outdoor and airborne allergens.
Appointment 2: The second segment of the allergy testing may or may not be done on the first appointment. This segment includes an intradermal skin test. This testing is done by injecting, with a tiny needle, a small amount of allergen just underneath the surface of the skin.