Introduction: two evidence‑based paths to treat allergic disease

For environmental allergies, there are two validated disease‑modifying options: allergen immunotherapy (including sublingual immunotherapy, or SLIT) and biologic monoclonal antibodies. This page explains when Wyndly’s doctor‑supervised SLIT (drops/tablets) fits best, when biologics such as omalizumab (Xolair) or dupilumab (Dupixent) are used by specialists, the safety rules for SLIT tablets (first‑dose supervision and epinephrine), and how to start care via telemedicine. Wyndly treats environmental allergies only (pollen, pets, dust mites, molds)—not food allergies.

Scope: environmental allergy care at Wyndly

• What we treat: pollen (trees, grasses, weeds), pet dander, dust mites, molds.

• What we don’t treat: food allergies and anaphylaxis care. Patients with food allergy should work with an allergist; Wyndly focuses on environmental triggers. Wyndly care model | Who we treat and pricing.

SLIT in brief: drops vs FDA‑approved tablets

Allergen immunotherapy retrains the immune system for durable relief. SLIT comes as custom drops (multi‑allergen, taken daily at home) or as single‑allergen tablets approved by the FDA. Evidence syntheses and clinical guidelines support SLIT as safe and effective for environmental allergies, with a favorable safety profile vs shots. Wyndly immunotherapy overview.

FDA‑approved SLIT tablets (indications and safety)

Notes for tablets

• Contraindications include severe/uncontrolled asthma and history of severe SLIT reactions; see full prescribing information.

• For most patients with seasonal/perennial allergic rhinitis, SLIT is the disease‑modifying option of choice; Wyndly also offers physician‑directed drops when multi‑allergen therapy is needed. Drops program | Efficacy/safety summary.

Safety rules for SLIT tablets (U.S.)

• First dose must be administered under supervision with 30‑minute observation.

• Co‑prescribe auto‑injectable epinephrine and train patients for home dosing.

• Avoid in severe/uncontrolled asthma and in patients with prior severe SLIT reactions or eosinophilic esophagitis (per product labels).

Where biologics fit (typically managed by specialists)

Biologics are injection therapies that target type‑2 inflammation pathways and are prescribed by allergists, pulmonologists, ENTs, dermatologists, or gastroenterologists for specific diseases. They do not replace food‑allergen avoidance and are not used for routine seasonal rhinitis in otherwise healthy patients.

• Allergic asthma (uncontrolled on inhaled corticosteroids)

• Omalizumab (Xolair) is indicated for moderate‑to‑severe allergic asthma; dosing is based on baseline IgE and weight. Anaphylaxis is a labeled risk; initiation occurs in a healthcare setting, with some patients eligible for home administration after training.

• Chronic rhinosinusitis with nasal polyps (CRSwNP)

• Dupilumab (Dupixent) is approved as add‑on maintenance in patients ≥12 years with inadequately controlled CRSwNP.

• Atopic dermatitis, eosinophilic esophagitis, CSU, COPD (eosinophilic phenotype)

• Dupilumab has multiple FDA indications, including moderate‑to‑severe atopic dermatitis (≥6 months), add‑on therapy for certain asthma phenotypes (≥6 years), EoE (≥1 year, ≥15 kg), chronic spontaneous urticaria (≥12 years), and COPD with eosinophilic phenotype (adults).

• Food allergy (reduction of reactions from accidental exposure)

• In February 2024, the FDA approved Xolair to reduce allergic reactions, including anaphylaxis, from accidental exposure to one or more foods in patients ≥1 year. Strict allergen avoidance remains required.

Practical decision guide

• Environmental allergic rhinitis±conjunctivitis without uncontrolled asthma: prefer SLIT (drops or appropriate tablet). Tablet first dose must be supervised, with an epinephrine prescription for home use.

• Multi‑allergen sensitivities or desire for at‑home, needle‑free care: consider physician‑directed SLIT drops. How SLIT works.

• Asthma uncontrolled on guideline therapy, CRSwNP, moderate‑to‑severe atopic dermatitis, EoE, CSU, or (separately) food allergy risk reduction: discuss biologics with the appropriate specialist; biologics are injections with specific eligibility, monitoring, and cost considerations.

Wyndly’s telemedicine pathway (environmental allergies only)

• Pinpoint triggers with a CLIA‑certified at‑home IgE test for >40 environmental allergens. At‑home testing.

• Meet a board‑certified physician online to select SLIT drops or, when indicated, an FDA‑approved tablet (grass/ragweed/HDM). Online consult.

• Ongoing care: medication shipped to your door, 24/7 doctor access, and transparent pricing (typically $99/month; HSA/FSA eligible) with a 90‑day money‑back Allergy‑Free Guarantee if you don’t improve. Treatment details.

• Safety and eligibility limits: ages ≥5; no treatment for food allergies; not for pregnancy, beta‑blocker use, EoE, or MCAS. Eligibility & FAQs.

References

1) Grastek (Timothy grass) Prescribing Information — boxed warning; first‑dose supervision and epinephrine. 2) Ragwitek (short ragweed) Prescribing Information — first‑dose supervision and epinephrine; ages 5–65. 3) Odactra (house dust mite) Prescribing Information and FDA 2025 roundup — boxed warning; first‑dose supervision; epinephrine; age expansion to 5–11 years (Feb 28, 2025). 4) Xolair (omalizumab) — FDA/Novartis announcements for food‑allergy approval (Feb 16, 2024) and safety communication; asthma indications and administration. 5) Dupixent (dupilumab) — FDA‑recognized indications including AD, asthma, CRSwNP (≥12), EoE, CSU, COPD; label summary. 6) SLIT effectiveness/safety overview and Wyndly care model. Overview | Allergy drops | Breathe Better.