Allergy and cold
Allergy shots and under-the-tongue immunotherapy and your FAA medical
Immunotherapy
Other names: allergy injections, SLIT, Grastek, Odactra, Ragwitek, Oralair
Wait
48 hours
after the first dose in the first season ever taken, 24 hours after the first dose in later seasons, 4 hours after each dose and the same after the final dose (the FAA's MedGuide, for allergy shots)
Two FAA documents give different waits. Both are below.
Examiner
The examiner can issue when the document's criteria are met
FAA label
ACCEPTABLE
The FAA's allergy sheet and its MedGuide give different waits for allergy shots.
Track your medicationsCompare FAA documents: Allergy shots and under-the-tongue immunotherapyWhat each of the three FAA documents says, in plain wordsOpen
The FAA's documents differ. The FAA's allergy sheet gives immunotherapy, allergy injections and under-the-tongue immunotherapy alike, a 48-hour no-fly after the first dose and a 4-hour no-fly after each subsequent dose, with no line between seasons; the FAA's MedGuide, written medicine by medicine, names only the allergy shot and gives it 48 hours after the first dose for the first season ever taken or 24 hours for subsequent seasons, 4 hours after each dose and the same after the final dose. They differ on the first dose of a later season. Both are current FAA documents and both name allergy shots, so neither is set aside.
Wait
- 48 hours after the first dose and 4 hours after each later dose (the FAA's allergy sheet, for allergy shots and under-the-tongue immunotherapy)
The FAA's allergy sheet lists allergy shots as acceptable for conditions controlled by desensitization, and under-the-tongue immunotherapy (SLIT) as acceptable for allergic rhinitis but prohibited for airmen 65 or older who have an asthma diagnosis that does not meet CACI criteria. The initial observation time is a 48-hour no-fly after the first dose and a 4-hour no-fly after each subsequent dose. The sheet also says the pilot must confirm with their treating physician that no other medication is being taken which would impair the effectiveness of epinephrine (should it be needed) or increase the risk of heart rhythm disturbances, and that airmen who are exhibiting symptoms, regardless of the treatment used, must not fly.
The FAA's Item 35 allergies table says, for hay fever controlled solely by desensitization without antihistamines or other medications, for all classes, to submit all pertinent medical information and a current status report, including duration of symptoms, name and dosage of drugs and side effects; if it responds to treatment and without side effects, the examiner issues; otherwise it requires an FAA decision. The sheet and the Item 35 table are both quoted.
The FAA's MedGuide names subcutaneous immunotherapy, the allergy shot, as allowed, for allergies, with a wait of 48 hours after the first dose for the first season ever taken or 24 hours for subsequent seasons, 4 hours after each dose and the same after the final dose, used as prescribed. The MedGuide defines allowed as acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.
- allergy shots and under-the-tongue immunotherapy (the FAA's allergy sheet); the first season of allergy shots (the FAA's MedGuide): 48 hours after the first dose: no flying
- 4 hours after each dose: no flying
- a later season of allergy shots (the FAA's MedGuide): 24 hours after the first dose: no flying
- allergy shots (the FAA's MedGuide): 4 hours after stopping: no flying
Show the FAA's words: Allergy shots and under-the-tongue immunotherapyThe official FAA wording: four passages, each with its document and dateOpen
Immunotherapy: Airman must confirm with their treating physician that no other medication is being taken which would impair the effectiveness of epinephrine (should it be needed) or increase the risk of heart rhythm disturbances.
Allergy injections: Acceptable for conditions controlled by desensitization.
Sublingual immunotherapy (SLIT): Acceptable for allergic rhinitis; however, prohibited for airmen 65 or older who have an asthma diagnosis that does not meet CACI criteria (See Lungs and Chest).
Initial observation time: 48-hour no-fly after the first dose AND 4-hour no-fly after each subsequent dose.
Generic: subcutaneous immunotherapy (SCIT); allergy shot (injection)
Brand Name: Immunotherapy injections
Drug Class: Allergen-Specific Immunotherapy
Underlying Condition: Allergies
Use: ALLOW
INITIAL Wait Time (after first dose): 48 hours (for first season ever taken); or 24 hours (for subsequent seasons)
SUBSEQUENT Dose Wait Time (after each dose): 4 hours
DISCONTINUATION Wait Time (after final dose): Same as subsequent dose wait time
Frequency Use Limit: As prescribed
Airmen who are exhibiting symptoms, regardless of the treatment used, must not fly.
Hay fever controlled solely by desensitization without antihistamines or other medications
All
Submit all pertinent medical information and current status report, include duration of symptoms, name and dosage of drugs and side effects
If responds to treatment and without side effects - Issue
Otherwise - Requires FAA Decision
ALLOWED: The medication is acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.