SLIT is a daily allergy treatment you take at home, under your tongue. A custom-mixed spray contains tiny amounts of the same allergens you're sensitive to. Over months and years, your immune system learns to tolerate them — addressing the root of your allergies, not just masking symptoms.

Adults and children with allergic rhinitis (hay fever), allergic conjunctivitis, mild-to-moderate allergic asthma, or environmental allergies to pollens, dust mites, animal dander, or molds. Especially valuable for patients who can't commit to a weekly shot schedule, have needle aversion, live far from the clinic, or simply want a more convenient option.

Both retrain your immune system. The differences:

• Delivery: Shots at the clinic. SLIT at home, under the tongue.
• Visit burden: Shots = 30–50 visits/year. SLIT = 3–4 visits/year.
• Safety: SLIT has fewer systemic reactions.
• Coverage: Shots are insurance-billed for visit and serum. SLIT compound is cash-pay; quarterly office visits are insurance-billed.

OIT is for food allergies and involves eating gradually increasing amounts of the food allergen. SLIT is for environmental allergies and goes under the tongue. CFMA currently offers SLIT for environmental allergies; food OIT is coming soon — ask to be added to the interest list.

FDA-approved SLIT tablets exist for a handful of single allergens. The custom-compounded SLIT drops we provide are off-label use of FDA-approved allergen extracts — the same extracts used in allergy shots. Supported by hundreds of clinical trials. Insurance does not typically cover compounded SLIT, which is why our program is cash-pay.

Off-label status + insurance non-coverage means it doesn't fit the insurance-billing model many allergy offices rely on. SLIT also requires investment in compounding equipment, patient education, and longer evaluation visits. SLIT has been first-line therapy in Europe for decades and is growing in U.S. cash-pay and direct-care practices like ours.

1. Real therapeutic doses. We use full concentrations supported by published SLIT research — not over-diluted formulas. Many ENT clinics dispense SLIT at concentrations too low to retrain the immune system effectively.
2. Personalized, in-house compounding. Every vial is mixed in our Clearwater office to match your specific allergy panel — not a generic mail-order blend.
3. High-risk capable. Dedicated protocol for anaphylaxis history, severe asthma, or beta-blocker therapy.

A custom-compounded mix of the specific allergens your skin test or blood test showed you're sensitive to (bermuda grass, oak, dust mites, cat dander, etc.), in a 50% glycerin solution that preserves the extracts. FDA-approved allergen extracts from licensed U.S. manufacturers — the same extracts used in allergy shots.

1. Open your mouth and lift your tongue toward the roof of your mouth so the sublingual space is exposed.
2. Press the pump fully so the metered dose sprays into that space. If technique is right, you'll notice a slightly sweet taste — that's the glycerin.
3. Lower your tongue gently and let the liquid rest under your tongue for 2 minutes without swallowing. Most absorption happens in the first 30 seconds; 2 minutes is the goal.
4. Swallow your saliva and any remaining liquid (unless your provider has told you to spit it out).

Important rules: No food or drink for 30 minutes before or after. Take at the same time each day — first thing in the morning works well, before brushing teeth.

Infants and young children may not achieve the technique perfectly. That's not a reason to skip treatment if SLIT is otherwise appropriate — we'll show parents alternative methods.

The first week or two of SLIT is a gradual build-up — you'll start with 1 spray, then increase by 1 spray each day until you reach your maintenance dose (typically 5 sprays daily). Lets your immune system adjust. Higher-risk patients use a longer 15-day three-vial build-up.

Common: tingling or itching under the tongue, mild lip/mouth swelling, mild stomach upset. Typically appear in the first week and fade.

Uncommon: hives, asthma flare, GI symptoms — call us if these occur.

Rare: severe allergic reaction. We discuss your individual risk and provide a written symptom guide at your dispensing visit.

Most patients begin noticing improvement in 3–6 months, with continued progress over the first year. SLIT is a long-term immune retraining therapy — not like antihistamines or nasal sprays that mask symptoms within hours.

Standard duration is 3–5 years. Stopping earlier often leads to symptoms returning. Completing the full course is associated with durable benefit that can persist for years after stopping.

One day — resume the next day at your usual dose. 3–7 days — drop back to a lower dose and rebuild; call us. More than a week — contact us before resuming for a safe restart.

You receive your custom vial and take your first observed dose with us. 30–45 minutes (longer for high-risk). We monitor you for 30 minutes after the first dose. You leave with vial, take-home instructions, and a clear daily routine.

Refrigerate unopened. Once you start using a vial, room temperature is fine for up to 60 days. Avoid heat, direct sunlight, freezing. For travel, carry-on (under TSA 3-1-1 limit). For longer trips in heat, use a small insulated cooler.

Most patients pay roughly $5 to $10 per day, all-in, for treatment that addresses the root cause of their allergies.

Three cash-pay tiers, billed every 3 months:

Core — $165/month equivalent ($495/quarter)
1 custom vial · ~2 months supply per dispensing · quarterly provider visit

Expanded — $225/month equivalent ($675/quarter)
2 custom vials · broader sensitivity panels · quarterly provider visit

Elite — $299/month equivalent ($897/quarter)
Up to 3 vials · BodySite educational program · direct messaging · annual outcome report · concierge refill scheduling

First invoice also includes a one-time setup fee covering initial vial compounding. After that, just the recurring quarterly amount.

It's split into two parts — and only one is cash-pay:

• The SLIT compound (your vial) — NOT typically covered. Cash-pay; HSA/FSA/HRA eligible.
• Your quarterly office visits — ARE billed to insurance like any office visit. Standard copays and deductibles apply.

Total cost = quarterly subscription + your normal visit copay every 3 months.

Yes — SLIT is an eligible medical expense for HSA, FSA, and most HRA accounts. We can provide an itemized receipt or superbill.

Quarterly — about four times per year. We review symptoms, refill your vial, make adjustments. Higher-risk patients may have an additional tolerability check 6 weeks after starting. Major advantage over allergy shots, which require 30–50 visits/year.

BodySite is a patient engagement platform we use to deliver an organized, evidence-based wellness program alongside your SLIT treatment. Elite-tier patients get a mobile app and web portal with:

• A structured 12-week onboarding curriculum covering SLIT mechanics, allergen avoidance, nutrition, sleep, exercise, and stress as they relate to allergy outcomes
• Ongoing weekly educational content rotating through 11 evidence-based pillars
• Florida-specific seasonal allergy updates (oak peaks, ragweed season, etc.)
• Periodic check-in surveys tracking symptom progress over time
• An annual outcome report summarizing how you've responded
• Direct messaging with our team between visits

Core and Expanded patients don't get BodySite access, but can upgrade to Elite at any annual visit.

Yes — at any annual visit. Switches typically happen at the end of a billing quarter so we don't pro-rate.

Yes. We require 30 days' written notice. Subscription continues billing for 30 days from notice, then automatically stops. We document the discontinuation in your chart. Re-enrollment available anytime.

Yes. We restart the build-up appropriate to the new method.

SLIT has an excellent safety profile. Most side effects are mild and local — tingling, itching, mild swelling under the tongue — and fade in the first 1–2 weeks. Serious systemic reactions are rare and far less common than with shots. Your first dose is always taken in our office under observation.

Mild-to-moderate well-controlled asthma is often fine for SLIT. Severe or uncontrolled asthma is the bigger concern — we'd want it optimized first, often coordinated with your primary care provider or pulmonologist.

Important consideration, but not an automatic disqualification. We use our High-Risk Protocol: three-vial gradual build-up, premedication, longer in-office observation.

Beta-blockers don't disqualify you, but require careful consideration since they can blunt the response to epinephrine if a severe reaction occurs. We may use the High-Risk Protocol or coordinate with your cardiologist. Always tell us about beta-blockers, ACE inhibitors, immunosuppressants, and biologics.

Patients already established on SLIT before pregnancy can typically continue under shared decision with their OB and our office. We do not initiate SLIT during pregnancy — standard of care is to defer new starts until after delivery, due to small risk of an allergic reaction during build-up.

Yes — well-studied in children as young as 5, often easier than weekly allergy shots. We'll discuss based on age, allergy profile, and ability to follow daily dosing.

Most medications are compatible. Antihistamines, nasal sprays, asthma inhalers, and most prescription medications are fine. We pay special attention to beta-blockers, ACE inhibitors, immunosuppressants, and biologic medications.