SLIT

Learn how to use SLIT and manage your account.

Introduction

What is SLIT?

Sublingual Immunotherapy (SLIT) treats the underlying cause of allergic reactions and is designed to gradually desensitize the immune system to specific environmental allergens as environmental allergens share biosimilar proteins with food allergens.

In order to treat certain food allergies, environmental allergies need to be treated as well. Our unique formula is TIP driven, created with extensive research by our founder Dr. Randhawa and designed for our patients in TIP. While some patients require starting SLIT before they start the program based on lab analysis, other patients are required to undergo a Skin Prick Test (SPT) after they have started the program to determine if SLIT is necessary.

What are 5 Reasons Why You Should Start SLIT?

01

Your allergies are caused by triggers that are difficult to avoid, like pollen.

02

Allergy medications are not providing adequate relief.

03

You would like a lasting solution for your allergies.

04

You are concerned with the long-term use and side-effects of medications.

05

Allergy shots are too inconvenient and costly.

Instructional Video

Instructional Videos

Please watch this instructional Q&A video of Dr. Randhawa answering questions about SLIT.

Using SLIT

Starting with the Build Up Kit

There are 2 different kinds of build-up kits (3 months or 6 months). Each Build-up Kit has a total of 4 steps that patients must complete before proceeding to the maintenance SLIT. Each bottle in the kit corresponds to the number and color of each step.

Step 1 is Blue, Step 2 is Yellow, Step 3 is Orange, and Step 4 is Green. Some patients receive a 2-bottle per step build-up kit as some allergens can not be compounded together but can be dosed together. A SLIT dosing calendar is included for guidance.

Watch this SLIT step-by-step video breakdown.

In this series of videos, you will find the essential keys to ensuring a successful SLIT treatment for you or your child. Please have your SLIT Build/Up kit in hand while watching these videos. It is necessary to watch all of the videos before starting the medication.

Switching from the Build Up Kit to Maintenance

Once your child completes the build up stage, they will move on to the maintenance refill. Please note that a SLIT dosing calendar is not included in the maintenance refills because the number of sprays will be the same every day.

If you have a set with one bottle, spray twice under the tongue and hold the medication there for two minutes. If you have a set with two bottles (red and blue sticker), spray twice under the tongue from each bottle and hold the medication there for two minutes. Do not eat or drink for 10 minutes after administering SLIT.

Storing my SLIT

We recommend refrigerating SLIT bottles once they arrive. Please remember, once your SLIT bottle is in use you must refrigerate it by the end of the day to avoid the growth of bacteria. The bottles can be stored at room temperature prior to opening if necessary.

3 Month Build-Up Step 1 & 2

3 Month Build-Up Step 3 & 4

6 Month Build-Up Step 1 & 2

6 Month Build-Up Step 3 & 4

Troubleshooting and Potency with SLIT

What should I do if my bottle spills or breaks?

We strongly suggest to always test and prime your nozzles before administering and inspect your bottles for possible leaks. If you see any damages on the rim of the bottle and/or nozzle, hold off on dosing and contact us immediately so we can send you a nozzle or bottle replacement.

The SLIT department will only cover leaks and damages that happen during shipment. If your bottle was damaged or if there was a leak during shipment please take detailed photos and send them to SLIT@tpirc.org immediately. The medication is wrapped securely to prevent damage. However, if your medication gets damaged during transit we will replace it at no cost.

What should I do if I have an accumulation of bottles?

Each spray of SLIT represents 0.6 to 0.8ml of volume. If each spray is pumped effectively, the maintenance bottle should last for 3 months and 10 days. If your bottles accumulate, please make sure you are using the pump appropriately. You are required to switch bottles every 3 months in order to have quality allergen extracts to ensure the best potency. Your medication is not expired after 3 months, but your allergy treatment will have less satisfying results. However, if you are not ready for your next automated charge, you can request to push out the date by contacting SLIT@tpirc.org with the date you would like to adjust to.

What happens if I use a bottle that is older than 3 months?

If you are currently dosing a “low dose” or a bottle that is older than 3 months, you are dosing with a less intense potency but the antigens in this bottle are still working. It is ideal to dose SLIT within the first 3 months from the compounding date. This is when it is the strongest potency and considered “high dose”. After the 3 month period, the “high dose” starts decreasing its potency and after 9-12 months it is considered ineffective.

If my SLIT bottle still works after the “high dose” period (3 months), why do I have to switch to a new bottle?

It is best for the immune system to receive the highest dose of allergen potency during your SLIT treatment. Utilizing low dosing potency is not recommended to ensure the best outcome for your child. Receiving a new refill as soon as possible is best for treatment. Remember that some environmental allergies are linked to foods. Each bottle is made with precise quantities. If taken daily and correctly, your SLIT bottle will not last more than 100 days (including 10 extra days in case of emergencies).

What if my child is experiencing symptoms?

For oral itchiness, please have your child sip some water or take a sialagogue such as a Starburst candy. You may also consider diluting the SLIT into 2-3 oz. of water for 5-7 days before resuming regular dosing. It is also recommended to visually inspect the mouth for residual protein stuck in your child’s teeth or dental gear. Also check to see if there are any abrasions or cuts in their mouth. If their symptoms worsen or persist please reach out to TIPhelp@tpirc.org.

What if my child is having significant eczema symptoms?

During TIP some patients will develop more clinical symptoms of eczema, we highly recommend aggressive treatment and barrier care of the skin. For significant changes in your child’s skin, please take pictures and let one of our providers know at TIPhelp@tpirc.org.

Missed Dosing

What if I miss SLIT for a few days?

If SLIT is missed for one day, you do not need to double spray the following day, continue normally. If you miss more than three days consecutively, contact TIPhelp@tpirc.org for guidance from the provider on call.

What if I miss SLIT for a week or more?

If you miss more than a week of dosing please email TIPhelp@tpirc.org for further instructions.

What if my child is sick or experiencing an allergic reaction?

If your child is sick or has a fever, we recommend skipping SLIT on these days. If your child is having other allergic symptoms and you are unsure if you should continue your SLIT, skip that day and resume when they have recovered.

When should I skip SLIT?

You should skip SLIT if you are experiencing the following:

Your child has a fever of 100.4 F or greater
The first 24 hours after starting antibiotics
The first 24 hours after losing a tooth, having dental work, or if there are cuts/sores in the mouth
The day following a reaction to maintenance or treatment doses

Managing My SLIT Account

What Information Do I Need to Manage my SLIT Account?

Enrollment

Cost
Slit CC Form
Acknowledgement Forms

Shipping

SLIT orders are now shipped at no cost to you. Please follow the instructions given in your arrival notification email that is sent once your medication arrives at our office.

I am an international patient. I usually order multiple SLIT bottles at a time to avoid paying extra import and shipping costs. How will this affect my future orders?

Please contact us at SLIT@tpirc.org so we can work to get you your SLIT in the most efficient way.

Billing Schedule

Placing your account on HOLD or skipping one scheduled billing cycle

SLIT plays a vital role in the TIP process and it is important that it is being administered as instructed on a daily basis. SLIT bottles are meant to last 3-4 months before a new refill is needed. Our goal is to ensure continuity in SLIT dosing. Please reach out to the SLIT department for further instructions at SLIT@tpirc.org.

Canceling Your Account

It is the patient’s responsibility to contact the SLIT department to cancel their account. Accounts can only be canceled If:

The patient was instructed to stop SLIT by a provider or during a remission visit.
The patient was discharged from the program OR requested a program pause. However, If you are currently on a TIP™ pause, do not stop dosing SLIT unless it has been approved by a provider or if you have been notified of SLIT treatment completion.

If you are not sure if you are allowed to stop SLIT, please contact TIPhelp@tpirc.org. You must contact SLIT@tpirc.org to pause your SLIT billing schedule if instructed by a provider.