May 31, 2018

Odactra - Under the Tongue Immunotherapy for Dust Mite Allergy

Website for Odactra
The FDA formally approved Odactra, the fourth new sublingual allergy tablet to be sold in the United States that works the same way allergy shots do... but instead is dissolved under the tongue at home instead of a shot in the arm in a medical office. Odactra is specifically used in the treatment of dust mite allergy.

The other sublingual immunotherapy tablets currently available include:

Ragwitek used to treat ragweed.
• Oralair and Grastek are two other sublingual tablets to treat grass allergies.

Odactra is a tablet made by Merck and treats patients aged 18-65 years who are allergic to only dust mite, specifically dermatophagoides farina and dermatophagoides pteronyssinus. Odactra has a simple regimen of 1 sublingual tablet daily. As with Oralair and Grastek, the first dose is given in a medical office to ensure safety with all other doses are taken at home. The tablet dissolves in less than 10 seconds.

As with Ragwitek, Oralair, and Grastek, epipen needs to be available at home due to possible risk of anaphylaxis. As with allergy shots, patients on beta-blockers for high blood pressure are not eligible to undergo this treatment.

The cost of treatment is about ~$300 a month. Insurance coverage is limited. And there are cheaper immunotherapy alternatives including allergy drops (SLIT) which cost about $100 for a 3 month supply. Allergy drops can also treat multiple different allergies rather than these sublingual tablets which each treat only ONE thing.

Sources:
FDA approves Odactra for house dust mite allergies. FDA 3/1/17

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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