Allergy immunotherapy is a long-term treatment designed to help your immune system get less sensitive to the allergens that cause your symptoms. Depending on your treatment plan, immunotherapy may involve allergy shots or tablets taken regularly over several years.
Because immunotherapy works gradually, it’s important to follow your recommended dosing schedule. But life happens. Travel, illness, busy schedules and other unexpected events can sometimes cause you to miss a dose.
If you miss an allergy immunotherapy dose, don’t panic. An occasional missed dose usually doesn’t mean you have to restart treatment. However, you may need to make an adjustment before continuing.
What Happens After a Missed Dose?
The appropriate next step depends on the type of immunotherapy you’re receiving and how long it has been since your last dose.
Allergy Shots During the Buildup Phase
During the buildup phase of allergy shots, your allergist gradually increases the amount of the allergen you receive. This allows your body to slowly adjust to each dose. If you miss a scheduled shot, your next dose may need to be reduced rather than increased as originally planned. The longer the gap between injections, the more likely your allergist will need to modify your schedule.
We make these adjustments to reduce the risk of a reaction. We may also extend the buildup period if you’ve had a longer interruption in treatment.
Allergy Shots During the Maintenance Phase
Once you reach your maintenance dose, your injection schedule may be more flexible than it was during buildup. If you’ve missed several shots, your allergist may recommend stepping down to a lower dose before gradually returning to your maintenance schedule.
The exact adjustment depends on how long it has been since your last injection and your individual treatment plan.
Oral Immunotherapy
Oral immunotherapy, including allergy tablets or drops taken at home, follows a daily dosing schedule. Missing a single dose doesn’t usually require a change to your treatment plan. However, if you’ve missed several doses, contact your allergist before restarting.
Your allergist can let you know whether you should resume your normal dose or take another step first.
Don’t Double Up on a Missed Dose
If you realize you missed an immunotherapy dose, don’t try to increase your next dose. Immunotherapy dosing is carefully adjusted based on your treatment history and how your body has responded so far. Taking more than prescribed could increase your risk of an adverse reaction.[1] Instead, contact your allergy specialist for instructions.
Getting Back on Schedule
There’s no single rule for every missed immunotherapy dose. The appropriate adjustment depends on factors such as the type of immunotherapy you’re receiving, whether you’re in the buildup or maintenance phase and how much time has passed since your last dose.
If you’ve missed a dose, call Hampton Roads ENT ~ Allergy to get personalized advice on the safest path forward.
[1] Institute for Safe Medication Practices Canada. (2015, June 3). Missed doses of allergen extracts contribute to serious reaction. ISMP Canada Safety Bulletin, 15(5). https://ismpcanada.ca/wp-content/uploads/ISMPCSB2015-05_MissedDosesAllergen.pdf