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SLIT appears to be safer than conventional allergy shots. The most frequent report of adverse effects include oral itching or swelling, as well as gastrointestinal upset; in the great majority of cases, these are mild and short-lived.1 2 In one study, 12% of patients with allergic rhinitis and/or asthma experienced worsening of symptoms at some point in their treatment. 3 Severe allergic reactions appear to occur rarely. However, it has not been tested in high-risk asthma patients. 4 Another problem is that no allergy extracts for use in sublingual immunotherapy have been officially approved for use in the US, and therefore products available remain incompletely regulated.