The treatment begins with a build-up phase. Injections containing increasing amounts of the allergens are given 1 to 2 times a week until the target dose is reached. This target dose varies from person to person. The target dose may be reached in 3 to 6 months with a conventional schedule (one dose increase per visit) but may be achieved in shorter period of time with less visits with accelerated schedules such as cluster that administers 2-3 dose increases per visit.
The maintenance phase begins when the target dose is reached. Once the maintenance dose is reached, the time between the allergy injections can be increased and generally range from every 2 to every 4 weeks. Maintenance immunotherapy treatment is generally continued for 3 to 5 years.
Some people have lasting remission of their allergy symptoms but others may relapse after discontinuing immunotherapy, so the duration of allergen immunotherapy varies from person to person. Risks involved with the immunotherapy approach are rare, but may include serious life threatening anaphylaxis. For that reason, immunotherapy should only be given under the supervision of a physician or qualified physician extender (nurse practitioner or physician assistant) in a facility equipped with proper staff and equipment to identify and treat adverse reactions to allergy injections.
The decision to begin immunotherapy will be based on several factors:
- Length of allergy season and severity of symptoms
- How well medications and avoiding allergens control allergy symptoms
- Desire to avoid long-term medication use Time.