Increase Your Tolerance, Reduce Your Symptoms.

Allergy shots (also called immunotherapy) are a series of injections containing small amounts of the substances you are allergic to. They are meant to desensitize or down regulate your immune system to the specific allergens that trigger an allergic response in you. Immunotherapy is not a substitute for avoidance of allergens or for the use of allergy medications or surgery, but rather a supplement to those treatment measures. Allergy injections may permit you to tolerate exposure to the allergen with few allergy symptoms. Call Denton Combs Center for Excellence in Care in Sioux Falls, SD today!

What to Expect

Allergy symptoms will not improve overnight. It is a gradual processs that can take six months or more before you start feeling better. It may take 12-24 months for full benefits to be evident. You will most likely still need allergy medications during this time to control your symptoms. About 80% of allergy patients on immunotherapy note significant improvement of symptoms and become less dependent on medications. The goal of allergy shots is to decrease your allergy symptoms and thus your need for allergy and or asthma medications.


Allergy shots are started at a low dose and gradually increased every injection and vial until maintenance is reached. Allergy shots are given twice weekly with at least 2 days between shots until you reach "maintenance." Once you are on maintenance, shots are given once weekly for a full year going through every season. As your symptoms become controlled and you are not allergy medication dependent shots are reduced to once every 2 weeks and then every 3 weeks. After the first injection from each new vial you will need to wait in our office for 20 minutes to make sure no adverse reactions occur. This is for your safety!


It usually takes 2-6 months to reach the maintenance dose. The time may be longer depending on local reactions or if injections are not received on a regular basis. It is very important that you keep on schedule to achieve the best results. If you are unable to receive regular injections immunotherapy should not be started. Immunotherapy may be discontinued at the discretion of your physician if shots are not given on a regular basis as there is an increased risk of reactions under these circumstances. Depending on your symptom control, allergy shots may take 3-5 years to achieve maximum benefit.

Things to Know

New Medications

Please notify the allergy department if you start ANY new medication, particularly medications for high blood pressure, migraine headaches, and glaucoma. "Beta blocker" medications are contraindicated while on immunotherapy and your injections will need to be discontinued while you are taking a beta blocker. Beta blockers come in several forms such as pills or eye drops. If you are not sure if the medication is a beta blocker please ask.

Adverse Reactions

Immunotherapy is associated with some widely recognized risks. Risk is present because a substance to which you are known to be allergic is being injected into you. Some adverse reactions can be life threatening and may require immediate medical attention.

Local Reactions

These are common and are usually restricated to a small area around the injection site. These reactions are more likely to occur as you reach the maintenance dose. Redness, itching and bruising at the injection site are all normal. Tese symptoms should go away within 4-8 hours after receiving the shot. Red raised wheals larger than a 50 cent piece occurring within 30-60 minutes hould be reported to our office so we can adjust the dose accordingly. If the wheal occurs over an hour after injection you may proceed to next scheduled dose.

Systemic Reactions

In rare cases a severe allergic reaction (anaphylactic shock) can occur after an allergy shot usually within the first 20 minutes. Every patient is prescribed an EpiPen which would be used to reverse symptoms of an allergic reaction very rapidly. It is very important that you have your EpiPen at every allergy shot for this reason. Symptoms of anaphylaxis are acute shortness of breath, low blood pressure, throat tightening, wheezing, flushed skin, nausea, coughing, restlessness, heaviness in chest or chest tightness, increased secretions, rapid pulse and sense of impending doom. All allergy patients should also have antihistamines on hand particularly liquid Benadryl to counter act these reactions. If you have a sever allergic reaction you should seek medical attentiona immediately at the nearest emergency facility. Also notify us the next day so we can adjust your vial accordingly. You should not receive another allergy shot until you speak with our office. These systemic reactions can occur at any time whether building or at maintenance without previous warning.

Urticarial reactions (hives) includes various degrees of rash, swelling and/or itching of more than one part of the body. There may be mild to moderate discomfort primarily from the itching. This rare reaction may occur within minutes to hours after an injection.

If you should have an exaggeration of your allergy symptoms ( such as nasal congestion, runny nose or wheezing) in the afternoon or night of your allergy injection, take your antihistamine. Report this to the person giving you your next shot.


If you become pregnant while on immunotherapy notify our office immediately so that your doctor can determine an appropriate dosage schedule for the injections during pregnancy. Immunotherapy doses will not be advanced during pregnancy, but may be maintained at a constant level.

When you should NOT get an allergy shot:

If you have a fever greater than 100 degrees Fahrenheit please wait 48 hours after you are fever free before getting an allergy shot.

If you received an immunization or vaccination such as flu, MMR, tetanus etc. You should not do an allergy shot the same day as it would be difficult to distinguish which one caused a reaction if one were to occur.

If you are having any breathing difficulties such as asthma exacerbation or an illness such as influenza or pneumonia. If you have a cold or sinus infection you may get a shot if you don't have a fever or breathing difficulties which may be wheezing or chest tightness. If you are unsure if you can have an allergy shot please call our office.

Pateients who are in respiratory distress ( wheezing, coughing, chest tightness, or shortness of breath) should NOT receive allergy injections. If you are experiencing any problems with breathing, you should call our office for an appointment with a physician.

If swelling remains for previous injection. Postpone the next injection until the swelling has subsided.


There should be No strenuous exercise or over heating for two hours before and two hours after your allergy injection. Increased blood flow can promote faster release of allergens from the shot into the blood stream.


Asthma patients will be required to do peak flows prior to each allergy shot to increase safety while doing immunotherapy. Asthma patients will also be followed closely with pulmonary function testing if they do not have a pulmonologist they see regularly. This is to ensure safety as we increase the immunotherapy. Please notify our office of any increase in asthma symptoms such as wheezing, shortness of breath or night time coughing.

Key Points

You need to have your EpiPen with you at all allergy injections.

You mush fax, mail or bring to your appointment your COMPLETED injection log after receiving 0.50 dose from your treatment vials so we can mix your next vial.

You may start taking medications you were advised to stop such as antihistamines. Use these as a supplement until your allergy shots control your allergy symptoms.

Please let the person giving you allergy injections know of any reactions you had from the previous injection.

You may apply ice and/or hydocortisone cream to the injection site to help reduce local reactions of itching, redness and swelling. You can also take an antihistamine such as Zyrtec, Claritin, Benadryl or Allegra on the day you get your shot to prevent reactions.

Please make sure to call our office to set up your next vial appointment at least two weeks prior to needing a new vial. If you can make an appointment at least two weeks in advance you will be more likely to get the time and day you want.

You MUST reach 0.50 dose before coming in for new vials. If you do not reach 0.50 you will not be able to start your new vials.

Do not hesitate to call with any questions or concerns regarding your immunotherapy. We are more than happy to help you.